Water Distribution System Operation and Maintenance Checklist Form
Use this form to document routine water distribution system operation and maintenance tasks. Title: Water Distribution System Operation and Maintenance Checklist.
Date of Inspection
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
System/Site Identification
*
Inspector Name
*
First Name
Last Name
Weather/Conditions
*
Please Select
Clear
Cloudy
Rainy
Windy
Other
Valve Inspection Completed
*
Yes
No
N/A
Leak Detection Performed
*
Yes
No
N/A
Pressure Monitoring Completed
*
Yes
No
N/A
System Flushing Performed
*
Yes
No
N/A
Chlorine Residual Checked
*
Yes
No
N/A
Additional Comments or Notes
Submit Checklist
Should be Empty: