Mater Health Services - FSSO - QRTLY External Hydrant Inspection FSSO-005

• Mater Health Services - FSSO - QRTLY External Hydrant Inspection FSSO-005

• Building Name
  Address

• Address (include hospital name, floor, ward etc.)

• Prepared by

• Conducted on

  Date

Previous Inspection

• 1.1 - Has the last inspection been reviewed and are all outstanding actions completed?

  Yes

  No

  N/A

2.0 Water Supply Stop Valves & Isolating Valves

• 2.1 - Are isolating valves, including underground key valves for wear & tear fully functional?

  Yes

  No

  N/A

• 2.2 - Are all above ground valves secured?

  Yes

  No

  N/A

3.0 Hydrant valves (above ground)

• 3.1 - Are all hydrant valves accessible?

  Yes

  No

  N/A

• 3.2 - Are all duress alarms (fixed and portable) fully operational?

  Yes

  No

  N/A

• 3.3 - Are staff aware of Code Black procedures? (sample minimum 1 staff member in work area)

  Yes

  No

  N/A

4.0 Hydrant valves (above ground)

• 4.1 - are all hydrant valves accessible?

  Yes

  No

  N/A

• 4.2 - Are blanking caps, where fitted, in good condition?

  Yes

  No

  N/A

• 4.3 - Is check cover plate easy to open?

  Yes

  No

  N/A

5.0 All valves

• 5.1 - Are any valves leaking?

  Yes

  No

  N/A

6.0 Cabinets - hydrant and booster

• 6.1 - Are all cabinets accessible and clear of extraneous materials?

  Yes

  No

  N/A

• 6.2 - Are all cabinets clearly and correctly marked?

  Yes

  No

  N/A

• 6.3 - Are all cabinets in good working order?

  Yes

  No

  N/A

7.0 Signage

• 7.1 - Does hydrant have appropriate signage that is clear? e.g. FH (fire hydrant), HR (hydrant riser), BP/H (booster pump/hydrant).

  Yes

  No

  N/A

• 7.2 - Is standpipe, riser or hydrant cover painted yellow?

  Yes

  No

  N/A

8.0 Maintenance Record Tag & Label

• 8.1 - Is maintenance tag visible in each hydrant clearly showing the last level of inspection and test performed?

  Yes

  No

  N/A

5.0 Other notes or issues identified

• 5.1 - Have you identified any other safety issues during inspection? Please details location and include picture if possible.

  Yes

  No

  N/A