Date Found Date Found By Location Reason for Negative Response Resolved Resolved Resolution YES / NO YES / NO YES / NO YES / NO YES / NO B) CLEANING TREATMENT CHECKS Questions (See details below) % 1) 2) 3) 4) 5) 6) 7) 8) 9) Date Description of Work Performed Complete Initials YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES NO NO NO NO NO NO NO NO NO CHECKLIST GROUP COMPLETE INITIALS: DATE: Question Details All chemicals added to system according to manufacturer recommendations. Water filter elements removed from the system before starting circulation. Neutralizer agents used on recommendation of system cleaner supplier and approval of Architect/Engineer. Cleaning treatment procedures, metrics and circulation durations follow specification requirements for system type. Open systems flushed for a minimum of one hour before being drained and re-filled. Strainer screens removed, cleaned and replaced after cleaning treatment. Startup screen removed from strainers in suction diffusers.
Date Found Found By Location Reason for Negative Response Resolved Date Resolved Resolution YES / NO YES / NO YES / NO YES / NO YES / NO B) CLEANING TREATMENT CHECKS Date Description of Work Performed % Complete Initials Questions (See details below) 1) 2) 3) 4) 5) 6) 7) 8) 9) YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO YES NO CHECKLIST GROUP COMPLETE INITIALS: DATE: Question Details All chemicals added to system according to manufacturer recommendations. Water filter elements removed from the system before starting circulation. Neutralizer agents used on recommendation of system cleaner supplier and approval of Architect/Engineer. Cleaning treatment procedures, metrics and circulation durations follow specification requirements for system type. Open systems flushed for a minimum of one hour before being drained and re-filled. Strainer screens removed, cleaned and replaced after cleaning treatment. Startup screen removed from strainers in suction diffusers.
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