Checklist template

Plumbing and restroom fixture maintenance inspection

A ready-to-use checklist with 118 items in 6 sections, covering Fixtures, Leaks, Drains, Water heaters, Backflow devices, Records. Use it as-is in Bindy, or adapt it to your own standards in minutes.

  • 6 Sections
  • 118 Items
  • 96 Yes / No checks
  • 6 Scored ratings
  • 126 Points

Use this template How audits work

1. Fixtures 19 items

  1. Number of restrooms inspected Number
  2. Each toilet clears the bowl in one flush Yes / No 1 pt
  3. No toilet keeps running after it refills Yes / No 1 pt
  4. Flush valves do not leak at the handle or the vacuum breaker Yes / No 1 pt
  5. Sensor flush valves trigger when the user steps away Yes / No 1 pt
  6. Toilets are firmly anchored and do not rock Yes / No 1 pt
  7. Urinals rinse the full back wall when flushed Yes / No 1 pt
  8. Faucets shut off fully, with no drip from the spout Yes / No 1 pt
  9. Sensor faucets start when hands are presented and stop when they are removed Yes / No 1 pt
  10. Metering faucets run for about 10 seconds per push Yes / No 1 pt
  11. Faucet aerators are in place and give an even stream Yes / No 1 pt
  12. Hot water reaches the restroom faucets within about 30 seconds Yes / No 1 pt
  13. Hot water temperature at a restroom hand sink (°F or °C) Number
  14. Hot water at hand sinks is within the range set by company policy Yes / No 1 pt
  15. Sinks are firmly attached to the wall or counter Yes / No 1 pt
  16. Exposed pipes under accessible sinks are insulated or covered Yes / No 1 pt
  17. Drinking fountains and bottle fillers deliver a steady stream Yes / No 1 pt
  18. Stop valves under the fixtures are present and turn Yes / No 1 pt
  19. Condition of restroom fixtures Rating
    • All working, tight and leak-free 5 pts
    • Minor adjustments needed 4 pts
    • A fixture out of service or leaking 2 pts
    • Several fixtures out of service 1 pt

2. Leaks 18 items

  1. The floor around each toilet is dry Yes / No 1 pt
  2. Supply lines and stop valves under the sinks do not drip Yes / No 1 pt
  3. Sink trap joints do not drip Yes / No 1 pt
  4. The cabinet floor under break room and kitchen sinks is dry, with no swelling or stains Yes / No 1 pt
  5. Ceiling tiles below restrooms and pipe runs are free of stains and sagging Yes / No 1 pt
  6. Exposed piping in the back room and mechanical room does not drip at joints or valves Yes / No 1 pt
  7. No leak is held by tape or a clamp as a permanent repair Yes / No 1 pt
  8. The leak indicator on the water meter stays still when every fixture is off Yes / No 1 pt
  9. Water use on the last bill is in line with the same month last year Yes / No 1 pt
  10. The main water shut-off valve is tagged and accessible Yes / No 1 pt
  11. The staff member on duty can point to the main water shut-off valve Yes / No 1 pt
  12. The main shut-off valve was exercised within the last year Yes / No 1 pt
  13. Building water pressure (psi or kPa) Number
  14. Building water pressure is within the range set by the maintenance program Yes / No 1 pt
  15. Supply connections to the ice machine and beverage equipment do not leak Yes / No 1 pt
  16. Leak sensors or the automatic shut-off valve were tested, where installed Yes / No 1 pt
  17. Pipes in vestibules, exterior walls and dock areas are insulated or heat-traced against freezing Yes / No 1 pt
  18. Leaks found during the inspection Rating
    • None 5 pts
    • Minor drip at a fitting 3 pts
    • Active leak or water damage 1 pt

3. Drains 20 items

  1. A sink filled and then released drains without standing water Yes / No 1 pt
  2. Nearby fixtures do not gurgle when a toilet is flushed Yes / No 1 pt
  3. Floor drain grates are in place and fastened Yes / No 1 pt
  4. Floor drains are free of debris Yes / No 1 pt
  5. Floor drain traps hold water Yes / No 1 pt
  6. Trap primers work, or water is poured into little-used drains on a schedule Yes / No 1 pt
  7. There is no sewer odor in the restrooms, back room or mop closet Yes / No 1 pt
  8. The mop sink drains freely and its strainer is in place Yes / No 1 pt
  9. Cleanout plugs are in place and not covered by fixtures or stock Yes / No 1 pt
  10. Floors around the floor drains show no residue lines from a recent backup Yes / No 1 pt
  11. The grease interceptor is pumped on the schedule set by local regulation or company policy, where one is fitted Yes / No 1 pt
  12. Date of the last grease interceptor pumping Date
  13. The grease interceptor lid is sealed Yes / No 1 pt
  14. Preventive jetting of the main drain line is done on the schedule in the maintenance program Yes / No 1 pt
  15. Date of the last main drain line cleaning Date
  16. The sump pump runs when its float is lifted Yes / No 1 pt
  17. The high-water alarm on the sump or sewage ejector sounds when tested Yes / No 1 pt
  18. Equipment drain lines end above the floor drain with an air gap Yes / No 1 pt
  19. Number of drain blockage service calls in the last 90 days Number
  20. Drain performance Rating
    • All drains run freely with no odor 5 pts
    • One slow drain 3 pts
    • Blockage, backup or sewer odor 1 pt

4. Water heaters 23 items

  1. Type of water heater Choice
    • Gas storage tank
    • Electric storage tank
    • Tankless
    • Boiler with storage tank
  2. Installation date shown on the water heater Date
  3. Water temperature at the heater outlet (°F or °C) Number
  4. The storage temperature is at the setting in the company water management policy Yes / No 1 pt
  5. The mixing valve at the heater delivers water at the temperature set by company policy Yes / No 1 pt
  6. The floor and the drain pan under the heater are dry Yes / No 1 pt
  7. The tank shows no rust at its base, seams or fittings Yes / No 1 pt
  8. A temperature and pressure relief valve is fitted Yes / No 1 pt
  9. The relief valve discharge pipe runs full size to within 6 in (15 cm) of the floor or a drain Yes / No 1 pt
  10. The end of the relief valve discharge pipe is not capped, plugged or threaded Yes / No 1 pt
  11. The relief valve does not drip Yes / No 1 pt
  12. The cold water shut-off valve at the heater is accessible and turns Yes / No 1 pt
  13. The expansion tank sounds hollow when tapped, showing it is not waterlogged Yes / No 1 pt
  14. The flue pipe on a gas heater is connected and slopes upward, with no gaps or corrosion holes Yes / No 1 pt
  15. There are no scorch or soot marks at the draft hood or burner access Yes / No 1 pt
  16. The gas shut-off valve at the heater is accessible Yes / No 1 pt
  17. There is no gas odor at the heater Yes / No 1 pt
  18. Combustion air openings are unobstructed Yes / No 1 pt
  19. Nothing combustible is stored within 18 in (45 cm) of the heater Yes / No 1 pt
  20. Seismic straps secure the tank where required by local regulation Yes / No 1 pt
  21. The tank was flushed of sediment within the last 12 months Yes / No 1 pt
  22. The tankless heater was descaled on schedule, where fitted Yes / No 1 pt
  23. Condition of the water heater Rating
    • Sound, safe and maintained 5 pts
    • Maintenance overdue 3 pts
    • Leak, corrosion or safety device defect 1 pt

5. Backflow devices 20 items

  1. Number of testable backflow assemblies at the site Number
  2. Each assembly carries a test tag dated within the interval required by local regulation Yes / No 1 pt
  3. Date of the last backflow test Date
  4. A test report for each assembly is on file at the site Yes / No 1 pt
  5. Each report shows a pass, or a repair followed by a retest Yes / No 1 pt
  6. The tester's certification number appears on each report Yes / No 1 pt
  7. Reports were submitted to the water utility where required Yes / No 1 pt
  8. Each assembly is listed in the site inventory with its location, size and serial number Yes / No 1 pt
  9. Assemblies are accessible and not boxed in by stock Yes / No 1 pt
  10. The relief port of each reduced-pressure assembly is not discharging Yes / No 1 pt
  11. Each relief port has an air gap above a drain able to take the discharge Yes / No 1 pt
  12. Test cocks do not leak and have their caps Yes / No 1 pt
  13. Shut-off valves on both sides of each assembly have handles and are fully open Yes / No 1 pt
  14. Outdoor assemblies are protected from freezing by an insulated enclosure Yes / No 1 pt
  15. The supply to the beverage carbonator has a backflow device, where present Yes / No 1 pt
  16. Hose bibs and threaded faucets are fitted with vacuum breakers Yes / No 1 pt
  17. Chemical dispensers at the mop sink are fed through a backflow device or an air gap Yes / No 1 pt
  18. The backflow assembly on the fire sprinkler supply carries a current test tag Yes / No 1 pt
  19. No hose is left attached with its end submerged in a sink or bucket Yes / No 1 pt
  20. Backflow protection Rating
    • Every assembly tested and in good condition 5 pts
    • Tests current, with minor defects 3 pts
    • Test overdue, assembly discharging or protection missing 1 pt

6. Records 18 items

  1. Plumbing work orders from the last 90 days were closed within the time set by company policy Yes / No 1 pt
  2. Number of open plumbing work orders Number
  3. Number of emergency plumbing calls in the last 12 months Number
  4. Repeat calls for the same fixture or drain are flagged for a permanent repair Yes / No 1 pt
  5. The plumbing contractor's service tickets on file describe the work done Yes / No 1 pt
  6. The after-hours emergency plumber's number is posted in the manager's office Yes / No 1 pt
  7. A chart of shut-off valve locations is posted Yes / No 1 pt
  8. Water heater maintenance (flush, relief valve test) is logged with dates Yes / No 1 pt
  9. Grease interceptor pumping manifests are kept, where one is fitted Yes / No 1 pt
  10. Hot water temperature checks are logged on the schedule in the water management program Yes / No 1 pt
  11. Flushing of little-used outlets is logged where the water management program requires it Yes / No 1 pt
  12. Spare flush valve kits, faucet cartridges and sensor batteries are stocked as the company list states Yes / No 1 pt
  13. Fixtures out of service are signed and reported the same day Yes / No 1 pt
  14. Shut-off and draining of exterior hose bibs before the first freeze is recorded Yes / No 1 pt
  15. Name of the plumbing contractor Short text
  16. Name of the site manager Short text
  17. Overall state of plumbing maintenance Rating
    • No defects found and records current 5 pts
    • Minor defects or open work orders 3 pts
    • Active leaks, fixtures out of service or tests overdue 1 pt
  18. Defects found and work orders to raise Comments

About this template

This checklist is part of the Bindy template library. Yes / No checks score 1 point when met; ratings score the points shown for each option. The overall score is the percentage of points earned, with N/A answers excluded. In Bindy you can add photos, assign corrective actions, require sign-off and compare results across sites.

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