Water Management Worksheets - Weekly Checks

• Site conducted

  Select

• Completed on

  Date

• Completed by

• Location
  Address

• In each area listed, complete checks from left to right where there is more than one tap or shower present (i.e. start with tap or shower furthest to the left)

Level 1

• Female Change Tap 1 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Female Change Tap 1 - Remedial Work Actioned

  Yes

  No

  N/A

• Female Change Tap 2 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Female Change Tap 2 - Remedial Work Actioned

  Yes

  No

  N/A

• Female Change Shower 1 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Female Change Shower 1 - Remedial Work Actioned

  Yes

  No

  N/A

• Female Change Shower 2 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Female Change Shower 2 - Remedial Work Actioned

  Yes

  No

  N/A

• Male Change Tap 1 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Male Change Tap 1 - Remedial Work Actioned

  Yes

  No

  N/A

• Male Change Tap 2 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Male Change Tap 2 - Remedial Work Actioned

  Yes

  No

  N/A

• Male Change Shower 1 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Male Change Shower 1 - Remedial Work Actioned

  Yes

  No

  N/A

• Male Change Shower 2 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Male Change Shower 2 - Remedial Work Actioned

  Yes

  No

  N/A

• Accessible Change Tap - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Accessible Change Tap - Remedial Work Actioned

  Yes

  No

  N/A

• Accessible Change Shower - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Accessible Change Shower - Remedial Work Actioned

  Yes

  No

  N/A

• Corridor Water Fountain - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Corridor Water Fountain - Remedial Work Actioned

  Yes

  No

  N/A

Ground Floor

• Kitchen Tap - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Kitchen Tap - Remedial Work Actioned

  Yes

  No

  N/A

• Toilet Tap - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Toilet Tap - Remedial Work Actioned

  Yes

  No

  N/A

Lower Level

• Female Toilet Tap 1 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Female Toilet Tap 1 - Remedial Work Actioned

  Yes

  No

  N/A

• Female Toilet Tap 2 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Female Toilet Tap 2 - Remedial Work Actioned

  Yes

  No

  N/A

• Female Toilet Tap 3 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Female Toilet Tap 3 - Remedial Work Actioned

  Yes

  No

  N/A

• Female Toilet Tap 4 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Female Toilet Tap 4 - Remedial Work Actioned

  Yes

  No

  N/A

• Male Toilet Tap 1 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Male Toilet Tap 1 - Remedial Work Actioned

  Yes

  No

  N/A

• Male Toilet Tap 2 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Male Toilet Tap 2 - Remedial Work Actioned

  Yes

  No

  N/A

• Male Toilet Tap 3 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Male Toilet Tap 3 - Remedial Work Actioned

  Yes

  No

  N/A

• Male Toilet Tap 4 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Male Toilet Tap 4 - Remedial Work Actioned

  Yes

  No

  N/A

• Cubicle Shower 1 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Cubicle Shower 1 - Remedial Work Actioned

  Yes

  No

  N/A

• Cubicle Shower 2 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Cubicle Shower 2 - Remedial Work Actioned

  Yes

  No

  N/A

• Cubicle Shower 3 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Cubicle Shower 3 - Remedial Work Actioned

  Yes

  No

  N/A

• Pre Swim Shower 1 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Pre Swim Shower 1 - Remedial Work Actioned

  Yes

  No

  N/A

• Pre Swim Shower 2 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Pre Swim Shower 2 - Remedial Work Actioned

  Yes

  No

  N/A

• Pre Swim Shower 3 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Pre Swim Shower 3 - Remedial Work Actioned

  Yes

  No

  N/A

• Pre Swim Shower 4 - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Pre Swim Shower 4 - Remedial Work Actioned

  Yes

  No

  N/A

• Accessible Change Tap - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Accessible Change Tap - Remedial Work Actioned

  Yes

  No

  N/A

• Accessible Change Shower - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Accessible Change Shower - Remedial Work Actioned

  Yes

  No

  N/A

• Poolside Shower - Correct Operation

  Yes

  No

• Fault Notified

  Yes

  No

  N/A

• Poolside Shower - Remedial Work Actioned

  Yes

  No

  N/A

• Little used outlets should be flushed sufficiently until the temperature at the outlet stabilises and is comparable to the water supply (either hot or cold). As a guidance, run for 2 to 5 minutes and increase where necessary to ensure all control measures are maintained. Little used outlets to include: Showers, Taps, Emergency Shower, Eye Wash Stations, Hose Reels, Sprinklers, etc.

Pool Store Tap

• Length of time outlet run (mins)

• Remedial Works Actioned

  Yes

  No

  N/A

Cleaning Store Tap

• Length of time outlet run (mins)

• Remedial Works Actioned

  Yes

  No

  N/A

Plant Room 1 Tap

• Length of time outlet run (mins)

• Remedial Works Actioned

  Yes

  No

  N/A

Plant Room 2 Tap

• Length of time outlet run (mins)

• Remedial Works Actioned

  Yes

  No

  N/A

Plant Room 3 Tap

• Length of time outlet run (mins)

• Remedial Works Actioned

  Yes

  No

  N/A

Water Fountain - 1st Floor

• Length of time outlet run (mins)

• Remedial Works Actioned

  Yes

  No

  N/A