• Audit Title

  • Document No.

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

Part A Identification

  • Flood Protection Feature or ID

  • Description or Procedure Title


  • Building

  • Elevation

  • Room

  • Column

  • Indicate below the type of the feature (check all that are applicable)

  • Enter the flood height at the location of the feature

  • References

  • Add signature

  • Select date


Part B1 : Visual Inspection

  • Is a Visual Inspection Required ?

  • If No, Explain why not If Yes:  annotate (below) that Part C must be completed, and  list any Licensing Basis / Acceptance Criteria that require verification during visual inspection (identify any critical characteristics / parameters applicable to the flood protection feature that are verifiable by inspection such as flood height or elevation, expected operation (e.g., door must close), and equipment name plate data (for example, pump capacity, seal rating, etc.)):

  • Add signature

  • Select date

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.