Low Use Outlets Weekly Flushing - Hadleigh

• Document No.

• Conducted on

  Date

• Prepared by

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

  Date

• Completed by

  Sign

• 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

  Date

• Completed by

  Sign

• 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

  Date

• Flushed for 5 mins. (check box)

• Completed by

  Sign

• 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

  Date

• Completed by

  Sign

• Comments