Wall Post Indicating Valve Inspection

• Document No.

• Conducted on

  Date
• Add location
  Address

Tools

• 8ft Ladder

Riser Inspection

• Riser #5

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #6

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #4

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #7

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #3

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #8

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #11

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #2

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #9

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #10

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #1

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #12

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

• Riser #13

• Is the valve free from physical obstructions?

  Yes

  No

  N/A

• Is the valve wheel free of physical damage or signs of tampering?

  Yes

  No

  N/A

• Is the chain and lock free of physical damage or signs of tampering?

  Yes

  No

  N/A

• What position is the valve in? (Locate the display beneath the valve)

  Open

  Close

Inspection Completion

• Place the building back online.

• Please sign to verify that the inspection has been completed to the best of your knowledge.

  Sign