7/26/2019 Clean Water Auditing Checklist
1/1
Clean Water Audit Checklist
Campus:
Audit Date:
Auditor:
yes no n/a comments
Drinking Water System1 Does the facility own or operate a
public
drinking water system?
2 Does the facility own or operate a public
drinking water well system?
3 Is the facility required to perform drinkingwater
monitoring?
4 Does the facility respond to water quality
complaints?
!hen responding to water quality complaints"
does the facility perform drinking water
sampling and analysis?
# $re all drinking water samples analy%ed by acertified
laboratory?
& $re analysis results reported to complainants?
' $re analysis results maintained onsite for 1(
years?
Backflow Prevention Devices
) $re backflow pre*ention de*ices installed to
protect the public water system when
irrigation systems" drinking water systems"
fire protection systems" and other water
systems that may contain possible
contaminants are connected to public water?
1( !hen installed are backflow pre*entionde*ices tested" prior
to water ser*ice being
acti*ated" by an +, D-., certified tester and
results submitted to the ,olumbia ,ross
,onnection ,ontrol rogram within 1( days
after installation?
11 $re all backflow pre*ention de*ices tested by
an +, D-., certified tester at least one time
per year?
12 Is a copy of the annual test results for eachbackflow
pre*ention de*ice forwarded to
,olumbia ,ross ,onnection ,ontrol
rogram" as required?
USC EHS Ofce o Environmental Management Destroy Previous
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