| Inspecting Officer: |
| Name of Establishment: |
| Date: |
| Time: |
| Type of Plant: |
| Design Flow: |
| Operator: |
| Address: |
| Phone: |
| | YES | NO | REMARKS |
| 1 | GENERAL CONDITIONS | | | |
| 1 | Condition of landscaping | | | |
| 1 | Condition of roads | | | |
| 1 | Condition of fencing | | | |
| 1 | Condition of drying beds | | | |
| Cleanliness of site | | | |
| II | HYDRAULIC STRUCTURES | | | |
| 2 | Significant leakage from structure or pond | | | |
| 2 | Overall condition of structure | | | |
| 2 | Overall condition of lagoons | | | |
| 2 | Overall condition of the wet well | | | |
| 2 | Condition of disinfection chamber | | | |
| | YES | NO | REMARKS |
| 2 | Condition of discharge structure | | | |
| III | CONDITION MECHANICAL ITEMS | | | |
| 2 | Piping | | | |
| 2 | Valves | | | |
| 2 | Weirs | | | |
| 2 | Gates | | | |
| 2 | Bar Screens | | | |
| 2 | Clarifier equipment | | | |
| 2 | Aeration equipment | | | |
| 2 | Disinfection equipment | | | |
| IV | CONDITION OF ELECTRICAL ITEMS | | | |
| 1 | Emergency generators | | | |
| 2 | Control Panels | | | |
| 2 | Instrumentation | | | |
| 2 | Meters | | | |
| V | EFFLUENT QUALITY | | | |
| 4* | BOD Compliance | | | |
| 4* | TSS Compliance | | | |
| 4* | Faecal Coliform compliance | | | |
| 2 | Phosphate compliance | | | |
| 4* | Chlorine residual | | | |
| 3 | Nitrate compliance | | | |
| 2 | Absence of noticeable foul odour | | | |
| 2 | Absence of solids, scum, grease, floating oils or suspended materials or weed growth in treatment units | | | |
| | YES | NO | REMARKS |
| VI | HEALTH AND SAFETY | | | |
| 2 | First aids and safety equipment | | | |
| 2 | Emergency plan | | | |
| 2 | Facility secure | | | |
| 2 | Adequate supply of potable water | | | |
| 2 | Adequate sanitation facilities | | | |
| 2 | Functional communication system | | | |
| VII | STAFF | | | |
| 2 | Adequately staffed | | | |
| 3 | Staff trained | | | |
| VIII | DOCUMENTATION | | | |
| 2 | Operation and maintenance manual | | | |
| 2 | Current maintenance records | | | |
| 1 | Current design plans of facility | | | |
| IX | OPERATION AND MAINTENANCE ITEMS | | | |
| 5* | Operation of wastewater treatment processes | | | |
| 2 | Maintenance proper and current | | | |
| 1 | Spare parts and supplies available | | | |
| 1 | Required tools available | | | |
| | YES | NO | REMARKS |
| X | QUALITY ASSURANCE | | | |
| 4* | Third party effluent testing results available | | | |
| *Critical items requiring immediate action rating score | (“100”) less weight of items violated | |
| | |
| Environmental Health Officer | |