Water Cooling System Operation And Maintenance Inspection Checklist Template
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1
2Water Cooling System – Operation and
Maintenance Inspection Checklist
Clauses 7, 8, 9, 10 & 11, Public Health Regulation 2012,
AS/NZS 3666.2:2011 & AS/NZS 3666.3:2011
Local Council: ___________________________
Public Health Unit: ___________________
A
PREMISES DETAILS:
Premises Name: ___________________________
Address:_______________________
Suburb: _______________ Postcode: ________________
Owner Name: __________________
Occupier Name: __________________________________
WCS Identification:
Model: ______________ Serial No: _______________________________
WCS Location on Site: ____________________________________________________________
Yes No
Registration Number: ____________
Registration Details complete?
Yes No
Registration details match with above? (Section 31 & Clause 11)
Commissioning Date: ______/__________/_________
Number of other WCS on site? _____________________
B
AUDIT DETAILS
Compliance with Section 29 & 30 of the Public Health Act 2010
Yes No
•
Was O&M carried out by a duly qualified person? (S29)
•
O & M person details: _________________________________________________________
_________________________________________________________________________________
Is the duly qualified person reasonably expected to be competent? (S26) Yes No
•
Compliance with Clauses 7 & 8 Public Health Regulation 2012 - Operation
Yes No
•
Safe and easy access to the WCS? (Cl 7(3))
Yes No
•
Operation manual provided on site?
Yes No
•
Maintenance manual provided on site?
•
Manuals comply with AS/NZS 3666.2:2002? (2.6 & Reg Cl 8(b))
(Drawings, suppliers recommendations, cleaning and dismantling instructions, start up and shut down
Yes No
procedures, maintenance management program)
Yes No
•
Maintenance records up to date?
Yes No
•
Records on site?
Equipped with an automatic disinfection procedure to control microbial growth? (Cl 7) Yes No
•
Yes No
•
In operation at all times?(Cl 7)
Yes No
•
Certified by a competent person (Cl 4(2)) in the past 12 months? (Cl 10(1))
Yes No
•
Certificate satisfactory? (Cl 10)
5
•
Any sample exceed specified levels of 10
cfu HPC
Yes No NA
and 10 cfu TL in past 12 months? (Cl 10)
Yes No NA
•
Necessary action taken on sample result?
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WCS~Maintain4.docxx
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