St Mungo's Water Risk Monitoring

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Water Risk Log Book Review.

Water Risk Log Book

• Have you undertaken an inspection of the building Water Risk Log Book

  Yes

  No

  N/A

• Can you evidence a program of monthly temperature reading detailed in Log book

  Yes

  No

  N/A

• Can you evidence program of shower head cleaning recorded in Risk Log book

  Yes

  No

  N/A

• Can you evidence that a regular regime of flushing of little use outlets are being undertaken

  Yes

  No

  N/A

• Photocopy a sample of the latest water temperature readings record in Log Book and record of shower head cleaning and either email to compliance@mungos.org or deliver to Head of for assessment and collation.

• Please provide addition comment / observations

Tank inspection

Tank inspection

• Water Tank Title

• External Photograph

  Media

• Internal temperature Reading of cold Water in tank at time of inspection

• Does the temperature reading record fall outside Legal Tolerance, cold water less than 20 degrees

  Safe

  At Risk

  N/A
Internal tank chamber assessment

• Is there evidence of Algae within the tank, caused by an unsecured or missing tank lid, that has resulted in sunlight exposure to internal parts.

  Yes

  No

  N/A

• Is there evidence of Scale, calcium carbonate deposits from the mains created by evaporation at the water line

  Yes

  No

  N/A

• Is there evidence of sediment within the tank chamber.

  Yes

  No

  N/A

• Is there evidence of rust or corrosion within the tank?

  Yes

  No

  N/A

• Is there evidence of organic matter and or biofilm, within the tank chamber and water?

  Yes

  No

  N/A

• Is there any evidence of water stagnation evidence during inspection?

  Yes

  No

  N/A

• Is there evidence of Flora Growth within tank chamber?

  Yes

  No

  N/A

• Is there any presence of pest/insects ingress within tank chamber

  Yes

  No

  N/A

• Is there evidence of any other debris within tank chamber?

  Yes

  No

  N/A
External Condition of Cold Water Storage Tank

• Is the evidence of structural deterioration to the tank base?

  Yes

  No

  N/A

• Is the evidence of physical defect to the water tank structure, that is a risk? Like warped or split tank frame

  Yes

  No

  N/A

• Is the tank cover fitted in a good structural condition?

  Yes

  No

  N/A

• Is the cold water tank adequately lagged?

  Yes

  No

  N/A

• Is the tank fitted with insect screened protection?

  Yes

  No

  N/A

• Is the water tank suitably ventilated?

  Yes

  No

  N/A

• Are all isolation valves are functioning correctly?

  Yes

  No

  N/A

Hot water Cylinder / Calorifier Inspection.

Hot water Calorifier / cylinder inspection

• Name & Location of Calorifier / Cylinder

• General Images of Calorifier / cylinder

  Media

• Hot water temperature reading at Calorifier / cylinder

• Overall condition of cylinder / Calorifier

  New

  Good

  Satisfactory

  Poor

  N/A

• Overall condition of cylinder insulation any type

  New

  Good

  Satisfactory

  Poor

  N/A

• Overall condition of isolation valves

  New

  Good

  Satisfactory

  Poor

  N/A

• Overall condition of safety valves and pressure release valves

  New

  Good

  Satisfactory

  Poor

  N/A

• Overall condition of drain sample from cylinder / calorifier

  Clear visual sample

  Contaminated visual sample

Mains water temperature reading

Mains water Annual temperature test

• Name & Location of Cold water mains temperature tap

• Image of cold water tap test point.

  Media

• Cold water temperature reading recorded during inspection

• Does the temperature reading record fall outside Legal Tolerance, greater than 20 degrees

  Safe

  At Risk

  N/A

Expansion vessel drain

Expansion Vessel Drain

• Name & Location of Expansion vessel

• Image cold vessel drain.

  Media

• Have you completed a full drain of all water contained with expansion vessel and associated pipe work

  Yes

  No

  N/A