Flushing Checks

Monday
First Aid Room

Type of Outlet: Kitchen Sink (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Pool Side

Type of Outlet: Wash down BIB tap Deep End
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Type of Outlet: Non - Concussive Tap
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Disabled Wet Side Toilet

Type of Outlet: Basin (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Type of Outlet: Shower (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Date and Time completed
Completed by

Comments

Tuesday
Kitchen

Type of Outlet: Washing Up Sink (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Type of Outlet: Wash Down Sink (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Type of Outlet: Hand Wash Sink (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Social Room

Type of Outlet: SINK (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Type of Outlet: Boiler
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Reception Cleaners Cupboard

Type of Outlet: Sink (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Disabled Reception Toilet

Type of Outlet: Basin (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Date and Time completed
Completed by

Comments

Wednesday
Pool Plant Room

Type of Outlet: Mains water pool fill hose
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Type of Outlet: Pool Water Wash Down BIB Tap.
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Type of Outlet: Emergency Drench Shower with eye bath.
Frequency of Use: Emergency

Flushed for 5 mins. (check box)

Acid Store

Type of Outlet: Emergency Drench Shower
Frequency of Use: Emergency

Flushed for 5 mins. (check box)

Hypo Store

Type of Outlet: Emergency Drench Shower
Frequency of Use: Emergency.

Date and Time completed

Flushed for 5 mins. (check box)

Completed by

Comments

Friday
First Floor Cleaner Store

Type of Outlet: Sink (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Disabled Gym Toilet

Type of Outlet: Basin. (hot and cold
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Type of Outlet: Shower (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Osteopaths Room

Type of Outlet: HAND BASIN (hot and cold)
Frequency of Use: Low.

Flushed for 5 mins. (check box)

Date and Time completed
Completed by

Comments

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.