Weekly - Flushing of Infrequently used Outlets

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

• All Infrequently used outlets to be flushed weekly. Record kept for All Shower Hoses & Heads replacement dates.

• Were All Internal Outlets Flushed where applicable

  Yes

  No

  N/A

• Were All External Outlets Flushed where applicable

  Yes

  No

  N/A

• Were All Showers Flushed

  Yes

  No

  N/A

• What Date was the Shower Hose & Shower Head last changed or descaled

  Yes

  No

  N/A

Signed Off

• * Signature

  Sign