43
Backflow stops and Cleaning pipes Triplex
Maintenance log
English
Prior to servicing
General condition
Evaluation
Level of soiling
low medium high
Level of wear
low medium high
Servicing checklist
Backflow stop
Servicing work
Performed
Type
0
Type
1
Type
2
–
X
X
Emergency flap closed/opened,
Section 4.1
yes no
X
X
X
Backflow flap(s) tested for functional reliability
yes no
X
X
X
Backflow unit and all parts inspected and
cleaned,
Section 5.2
yes no
–
–
X
Tightness test,
Section 4.2
yes no
–
X
X
After servicing: Emergency flap opened
yes no
X
X
X
Backflow stop in good operating condition
yes no
Parts replaced:
Remarks:
Signature (work performed by):
Signature (work accepted by):