Title Page

1.0 Property Details

  • Property ID

  • Property Address

  • Take image of front elevation showing house number

  • Prepared by

  • Conducted on

2.0 Take 5

  • Personal protective equipment {PPE} is appropriate ,in good condition and fitted correctly

  • If No, stop and ensure PPE is appropriate ,in good condition and fitted correctly

  • Is there access to inside the property?

  • Conduct external components of the audit and refer to the Project Manager to reschedule time

Question Set and results

3.0 Water Meter Assembly

  • Location of water meter

  • Is there clearance around the meter

  • If NO refer section 12

  • Is a pressure limiting valve installed at the outlet side of the meter?

  • Take image of water meter from approx.1 m away

4.0 Front Tap

  • Connect pressure guage to front tap outlet and provide image of the reading on the pressure guage

  • Is water supply pressure sound?

  • If NO refer section 12

  • Is tap in working order?

  • If NO refer section 12

5.0 Bathroom 1

  • Shower -provide the flow rating from the outlet using a flow cup {Litres/min}

  • Take images of tapware and shower rose

  • Basin- provide the flow rating from the outlet using a flow cup {Litres/min}

  • Provide images tapware and outlet

  • Bath -provide the flow rating from the outlet using a flow cup {Litres/min}

  • Provide images tapware and outlet

6.0 Ensuite

  • Does the property have an Ensuite

  • Shower -provide the flow rating from the outlet using a flow cup {Litres/min}

  • Take images of tapware and shower rose

  • Basin- provide the flow rating from the outlet using a flow cup {Litres/min}

  • Provide images tapware and outlet

  • Water Closet

  • Cistern type

  • Pan type

  • Seat type- disabled or non std

  • Provide image at the pan outlet and floor junction

  • Provide image of pan and cistern showing isolation valve

  • Will remedial works be required?

  • What remedial works are required?

  • Provide image

7.0 Kitchen

  • Kitchen Sink -provide the flow rating from the outlet using a flow cup {Litres/min}

  • Provide images tapware and outlet

8.0 Laundry

  • Wash trough -provide the flow rating from the outlet using a flow cup {Litres/min}

  • Provide images tapware and outlet

9.0 Water Closet

  • Cistern type

  • Pan type

  • Seat type - disabled or non std

  • Provide image at the pan outlet and floor junction

  • Provide image of pan and cistern showing isolation valve

  • Will remedial works be required?

  • Describe potential works

  • Room size

  • Provide image of surrounding internal and external ground structure- to identify paving or concrete

10.0 Hot water System

  • Water heater type

  • Capacity {Litres}

  • Provide images of water heater and valves

  • Is the PDRV 01 {Hot) relief valve in working order

  • If NO refer section 12

  • Is the PDRV 02 {Cold) relief valve in working order

  • If NO refer section 12

11.0 Rear hose cock

  • Is tap in working order?

  • If NO refer section 12

12.0 Miscellaneous

  • Are P1 Works required?

  • List issue and SOR/s if known

  • Action taken

  • Provide image of issue

  • Are P2 Works required?

  • List issue and SOR/s if known

  • Notify region

  • Provide Image of issue

13.0 Signature

  • Full name

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.