Title Page

  • Site Name (Treatment Plant)

  • Conducted on

  • Prepared by

  • Task Number

1.0 General Information

  • NOTIFY CONTROL ROOM PRIOR TO MAINTENANCE ACTIVITY

  • Minor Repairs to be rectified during service

  • Major repairs to be documented on checklist and form forwarded to Water Infrastructure Services.

  • Site Overview

2.0 Valve House

  • Is there a Valve House at this Site?

  • Check 4-20mA loops

  • 1.

  • 2.

  • 3.

  • 4.

  • 24V Battery Condition(V)

  • Check power lead insulation

  • Check if the Actuator battery needs replacing

  • Has the Actuator battery been replaced?

  • Check Continuity of main earth (Ohms)

  • Check fuses

  • Check cabinet cleanliness

3.0 Flash Mixer

  • Is there a Flash Mixer at this Site?

Motor Test

  • Run Time (Hours)

Winding Continuity (Ω)

  • A

  • B

  • C

Tong Test Running Load

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

  • Check Fuses

  • Check power lead condition

4.0 Flocculator's

Motor Test

  • Total Motors on Site?

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

No Load

  • A-B

  • B-C

  • A-C

Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 3

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 3

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 4

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 3

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 4

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 5

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

5.0 Sludge Rake

  • Is there a Sludge Rake onsite?

Motor Test

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check power lead condition

6.0 Filter Inlet Valves

Check valve position indicators

  • Total number of filter inlet valves on site?

Filter 1

  • Open

  • Closed

Filter 1

  • Open

  • Closed

Filter 2

  • Open

  • Closed

Filter 1

  • Open

  • Closed

Filter 2

  • Open

  • Closed

Filter 3

  • Open

  • Closed

Filter 1

  • Open

  • Closed

Filter 2

  • Open

  • Closed

Filter 3

  • Open

  • Closed

Filter 4

  • Open

  • Closed

Filter 1

  • Open

  • Closed

Filter 2

  • Open

  • Closed

Filter 3

  • Open

  • Closed

Filter 4

  • Open

  • Closed

Filter 5

  • Open

  • Closed

Filter 1

  • Open

  • Closed

Filter 2

  • Open

  • Closed

Filter 3

  • Open

  • Closed

Filter 4

  • Open

  • Closed

Filter 5

  • Open

  • Closed

Filter 6

  • Open

  • Closed

Filter 1

  • Open

  • Closed

Filter 2

  • Open

  • Closed

Filter 3

  • Open

  • Closed

Filter 4

  • Open

  • Closed

Filter 5

  • Open

  • Closed

Filter 6

  • Open

  • Closed

Filter 7

  • Open

  • Closed

Filter 1

  • Open

  • Closed

Filter 2

  • Open

  • Closed

Filter 3

  • Open

  • Closed

Filter 4

  • Open

  • Closed

Filter 5

  • Open

  • Closed

Filter 6

  • Open

  • Closed

Filter 7

  • Open

  • Closed

Filter 8

  • Open

  • Closed

7.0 Dolphin Pumps

  • Total number of motors on site?

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

8.0 Clearwater Pumps

  • Total number of motors on site?

Motor 1

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 3

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

9.0 Backwash Pumps

  • Total number of motors on site?

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 3

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

10.0 Domestic and Service Water Pumps

  • Total number of domestic motors on site?

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

  • Total number of service motors on site?

Motor 1

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

11.0 Blowers

  • Total number of motors on site?

Motor 1

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 3

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

12.0 Chlorine Booster Pumps

  • Discharge Pressure

Motor Test

  • Total number of motors on site?

Motor 1

Winding Continuity (Ω)

  • A

  • B

  • C

Insulation Resistance (MΩ)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 1

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 2

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

Motor 3

Winding Continuity (Ohms)

  • A

  • B

  • C

Insulation Resistance (MegaOhms)

  • A

  • B

  • C

Tong Test Running Load (A)

  • A

  • B

  • C

Phase Check (V)

  • No Load

  • A-B

  • B-C

  • A-C

  • Load

  • A-B

  • B-C

  • A-C

Checklist

  • Check Fuses

  • Check Power lead condition

13.0 Switchboards Control Room

  • Check Labelling

  • Check Lighting

  • Check Fuses and RCD's

  • Check Alarm Faults to SCADA

  • Check / Calibrate 4-20mA Loops

  • Cabinet Cleanliness

14.0 PLC Electrical

  • Check Labelling

  • Check Lighting

  • Check Alarm Faults to SCADA

  • Check and Tighten all Connections

  • Check 4-20mA Loops

  • Cabinet Cleanliness

15.0 Telemetry Cabinet

  • Check Batteries

  • Check Labels

  • Check Connections

  • Check 4-20mA Loops

  • Check all Physical I/0

  • Cabinet Cleanliness

16.0 Chemical Room Switchboard

  • Is there a Chemical Room Switchboard on site?

  • Check Labelling

  • Check Lighting

  • Check Fuses and RCD's

  • Check Alarm Faults to SCADA

  • Check and Tighten all Connections

  • Check 4-20mA Loops

  • Cabinet Cleanliness

17.0 Filter Gallery Switchboard

  • Is there a Filter Gallery Switchboard on site?

  • Check Labelling

  • Check Lighting

  • Check Fuses and RCD's

  • Check Alarm Faults to SCADA

  • Check and Tighten all Connections

  • Check 4-20mA Loops

  • Cabinet Cleanliness

18.0 Completed and Future Work

  • Completed Work

  • Work to be Completed

Signature

  • Tradesman and Signature

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.