Title Page

  • Site conducted

  • Location
  • Date

  • Inspector

  • Shift Controller

  • Time of radio/phone IN

Conditions on Arrival

  • I am wearing steel toe caps, long pants & sleeves, ear & eye protection and a hi-viz top.

  • I am an inducted CCC key holder.

  • What is your CCL Type 1 permit to enter number?

  • I have read the site hazard board.

  • I am aware of the specific risks of rotating shafts, water/oil on the floor, sodium hypochlorite and potential electrocution.

  • If I observe sodium hypochlorite leaks in/around the pump station I will call the CCL call-out phone (027 647 0931) immediately.

  • Do you consider the site safe to enter?

  • I will complete all inspection questions and photograph all variances (and record date and time of photo in the comments column).

Gate/Boundary

  • Is there a gate?

  • Is the gate secure and daisy chained?

  • Are the padlocks as per most recent photo?

  • Is the CCC master padlock present?

  • Is the CCC parks padlock present?

  • Comments

  • Is there a boundary?

  • Is the fence line secured?

  • Is the boundary free of signs of vandalism or forced entry

  • Are all sections above 1.8 m?

  • Comments

Pump Station Building

  • Is the building free of signs of vandalism or forced entry?

  • Comments

Doors

Ensure to only add the amount of doors present to avoid creating blank sections.

    External Door
  • Which door is this?

  • Is the door locked on arrival?

  • Does the primary alarm activate when the door is opened?

  • Is the alarm ID tag correct?

  • Comments

  • Internal Door
  • Which door is this?

  • Is the door locked on arrival?

  • Does the primary alarm activate when the door is opened?

  • Is the alarm ID tag correct?

  • Comments

Above Ground Wells

    Above Ground Well
  • Is the well labelled with the correct number?

  • What is the well number?

  • Is the cage locked on arrival?

  • Is the well free of signs of vandalism or forced entry?

  • Is the sampling point locked on arrival?

  • Comments

Below Ground Wells

Please ignore this page in the case that there are no operation below ground wells.

    Below Ground Well
  • Are the wells labelled with the correct number?

  • Are the hatches locked on arrival?

  • Are the wells free of signs of vandalism or forced entry?

  • Does the secondary alarm activate when the hatches are opened?

  • Can the pit flooded alarms be triggered?

  • Are the chambers free of flooding?

  • Are the sample points secure and above ground?

  • Comments

Flow Meter Chamber

  • Is there a flow meter chamber?

  • Is the hatch locked on arrival?

  • Is the chamber free of signs of vandalism or forced entry?

  • Can the sump pump be triggered and is it working?

  • Is the chamber free of flooding?

  • Comments

Valve Chamber

  • Is there a valve chamber?

  • Is the hatch locked on arrival?

  • Is the chamber free of signs of vandalism or forced entry?

  • Can the sump pump be triggered and is it working?

  • Is the chamber free of flooding?

  • Comments

Temporary Chlorination Unit

  • Is there a temporary chlorination unit?

  • Is the TCU and associated pipework free of signs of vandalism or damage?

  • Is the lid secured?

  • Does the hypochlorite in the tank appear colourless?

  • Is the TCU protected by an alarm?

  • Does the primary alarm activate when the door is opened?

  • Is the alarm ID tag correct?

  • Comments

Generator

  • Is there a generator?

  • Is the generator free of signs of vandalism or forced entry?

  • Is the area free of fuel or cooling system leaks?

  • Is there a fire extinguisher?

  • Comments

Diesel Tank

  • Is there a diesel tank?

  • Is the tank free of signs of vandalism or forced entry?

  • Is the area free of fuel leaks?

  • Comments

Suction Tank

  • Is there a suction tank?

  • Is the suction tank free of signs of vandalism or forced entry?

  • Is the ladder access secure?

  • Is the suction tank hatch locked on arrival?

  • Comments

Sand Filters

  • Is there a sand filter?

  • Is the sand filter perimeter secure?

  • Is the sand filter perimeter free of signs of vandalism or forced entry?

  • Comments

Conditions on Departure

  • The site is fully secured on leaving.

  • All the doors are locked and primary alarms are acknowledged.

  • All hatches are locked and secondary alarms are acknowledged.

  • All well cages and sample points are locked.

  • Time of radio/phone OUT

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