Title Page

  • Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Site Information

  • Store Name

  • Store Number

  • Asbestos Category

  • The purpose of this exercise it to establish if the store you are auditing falls in the category for high risk pipework corrosion. The questions below will help establish if there is a chance of any corrosion and help us identify and rectify any faults. We do not require any lagging to be removed for the purpose of this audit and all assessments should be made visual only. If the store you are auditing does not have any steel closed loop heating circuits then please email your line manager advising this and discontinue this audit.

Pipework

  • Is steel pipework used on any closed circuit heating systems? (If the answer is no then please stop this audit and inform your line manager of the result)

  • How many steel pipework closed loop heating circuits are there?

  • What is the estimated age of all pipework?

  • Are there drain sample points on each steel pipework closed heating circuit? If yes please list locations for each closed heating circuit.

  • Is visible pipework condition acceptable? (Looking for leaks, evidence of oxidisation, evidence of historic leaks)

  • Is visible lagging acceptable? If no please add photos and locations. (Looking for signs of water damage, external rust would be an indicator the lagging of pipwork is damaged. Also any areas where lagging has been removed or otherwise damaged)

  • Opportunity for photos

History

  • Are you aware of any alternations of maintenance to the system that could have resulted in a loss of water to the heating loop. If so please provide detail

  • Are any results from previous water sampling available? If so what were the results and when was the sample taken?

  • Opportunity for photos

Dosing

  • Is there an appropriate dosing pot available to add inhibitor on each loop? Please provide photos and locations.

  • Opportunity for photos

  • Sign off

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.