Hydrant clean out audit after completion

• Document No.

• Audit Title

• Client /

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Quality clean out audit

• Has site been left clean and tidy?<br>Maintenance agreement No C656. 10.3

  Yes

  No

  N/A

• Has the hydrant box been cleaned out satisfactory? ( at least below lug bolts)<br>Maintenance agreement No C656. 9.2 b)

  Yes

  No

  N/A

• Are the hydrant marking to QUU requirements?<br>Maintenance agreement No C 656. 9.2

  Yes

  No

  N/A

• Have the lug bolts been cleaned as required?<br>

  Yes

  No

  N/A

• Any other comments

• Completed by

  Sign