Title Page

  • Client / Site

  • Location
  • Conducted on

  • Prepared by


  • Is the Safety, reliability, maintenance and technical management plan (SRMTMP) effective and functional?

  • Has the purpose of the SRMTMP changed?

  • Have the scope and objectives changed?

  • Is the responsible person for the SRMTMP still current?

  • Is the Organisational Chart up to date?

  • Have any roles and responsibilities for key position/s changed?

  • Is the communication strategy for the plan still current?

  • Are relevant legislation, codes and standards listed?

  • Are the major approvals and licenses listed?

Description of the Operation

  • Do the assets summary and the high-level descriptions including system/scheme list reflect your current infrastructure?

  • Is there additional asset design and operational information?

Operational Safety and Reliability

  • Leadership and Commitment – Has there been any changes to:

  • Person responsible for water and/or sewerage infrastructure safety

  • Employee selection, competency and training commitment

  • Contractor and end-user training commitment

  • Effective Planning– Has there been any changes to:

  • Design management approach

  • Design life of the plant in line with nominated standards or otherwise

  • Safety in design requirements adopted

  • Procurement systems and processes

  • Controlled Implementation– Has there been any changes to:

  • Construction and commissioning management systems

  • Safe operational procedures

  • Maintenance and reliability considerations

  • Decommissioning, demolition and abandonment/disposal

  • Emergency response management

  • Monitoring and Evaluation– Has there been any changes to:

  • Incident management, incl. classification, reporting and investigation

  • Document management system

  • Reporting requirements

  • Audit and Review– Has there been any changes to:

  • Auditing processes, reviews, and responsibilities, including but not limited to long-term evaluation plans

Formal Safety and Reliability Assessment

  • Has there been any changes to:

  • Hazard identification and rating system

  • Risk response mitigation and controls

  • Risk Assessment principles and guidelines

Asset Management

  • Has there been any changes to:

  • Asset management system

  • Change management system

  • Operations and maintenance strategies

  • Maintenance program

Contract Management

  • Has there been any changes to:

  • Contract management system

  • Contract assessment processes

  • Contractor Management, i.e. CMS

Customer / Public Protocols and Agreements

  • Has there been any changes to:

  • Stakeholder communication protocols

  • Public communication protocols

  • Education and notices related to recycled water

  • Supply agreements – statement and/or list of recipients

  • Register of customer contact, issues raised – identified, response

Compliance Monitoring

  • Has there been any changes to:

  • Performance monitoring and compliance structure

  • KPI measurement and reporting processes

  • Periodic operations audits/ Water quality monitoring and compliance

  • Corrective actions and continuous improvement strategies

Emergency Response and Incident Reporting

  • Were there any emergencies/incidents?

  • How many?

  • Were the incident/s reported in accordance with OTR requirements?

  • Were the incident/s investigated (internally/externally)?


  • Has the version table in the SRMTMP been updated and all changes noted?

  • Has the updated version of the SRMTMP been provided to the OTR for approval?


  • Full Name and Signature of Inspector

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.