Anonymous

Pump house monthly report

Pump house structure maintenance check.

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Title Page

Audit Title
Document No.
Conducted on
Prepared by
Location
Personnel

Mandatory Information

Is all Risk Management paperwork in place?

Pumps

Add Pump
Serial Number
Hours Run
Pump Greased
Meter Reading
Panel Lights
Comments

Structure

Pump Discharge Flaps
Pump Discharge Reflux Valves
Penstock
Weed Screen
Building Condition

Safety Equipment and Signage

Add Safety Equipment
Type
In Service Date
All signage visible and defect free
Reports of any faults

Access and Ground Conditions

Ladders and Walkways
Perimeter Fencing and Gates
Ground Conditions
Person carrying out inspection
Signature

Anonymous

Pump house monthly report

Pump house structure maintenance check.

Use this Template

Print as PDF

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.