Warm Water System – Operation and Maintenance Inspection Checklist

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Council:

  Balranald Shire

  Wentworth Shire

  Broken Hill

  Central Darling

  Unincorporated

• Public Health Unit:

  Far West

  Western

Premises Name:

• Address:
  Address

• Owner Name:

• Occupier Name:

WWS Identification

• Model:

• Serial No.:

• WWS Location on Site:

• Registration Number:

• Registration Details complete?

  Yes

  No

  N/A

• Registration details match with above? (Section 31 & Clause 11)

  Yes

  No

  N/A

• Commissioning Date:

  Date

• Number of other WWS on site?

• Type of WWS

  Tepid

  TMV

• Measured temperature of operation < 60°C?

  Yes

  No

Compliance with Section 28 of the Public Health Act 2010

• Is O&M carried out by a duly qualified person? (S28)

  Yes

  No

• Duly qualified person details :

• Is the duly qualified person reasonably expected to be competent (S26)?

  Yes

  No

Compliance with Clause 7 & 8 Public Health Regulation – Operation & Maintenance and (AS/NZS3666.2:2002)

• Safe and easy access? (Cl 7(3))

  Yes

  No

• Operation manual provided on site? (2.6.3)

  Yes

  No

• Maintenance manual provided on site? (2.6.3)

  Yes

  No

• Manuals comply with AS/NZS 3666.2:2002? (2.6.1)<br>(Drawings, suppliers recommendations, cleaning and<br>dismantling instructions, start up and shut down procedures,<br>maintenance management program)

  Yes

  No

• Maintenance records up to date? (2.6.2)

  Yes

  No

• And on site? (2.6.3)

  Yes

  No

• Equipped with a water treatment unit? (2.4.1) (optional)

  Yes

  No

• Has the water storage tank (tepid system) been cleaned? (2.4.2)

  Yes

  No

Compliance with Clause 9 Public Health Regulation 2012

• Are maintenance precautions being observed<br>when maintenance is being carried out?

  Yes

  No

  N/A

Compliance with Clause 8(7) Public Health Regulation 2012  NSW Health Document “Requirements for the Provision of Cold and Heated Water”

• Monthly temperature check?

  Yes

  No

• Temperatures and colour codes comply?

  Yes

  No

• If the WWS is a TMV has a service report in accordance<br>with the TMV Code of Practice been completed?

  Yes

  No

• Has the TMV service interval exceeded 12 months?

  Yes

  No