Part I. Basic Audits Sample Worksheet 6: Toilets
Building Name __ Building 2A____
Location
User Group
Valve Flush Rate
China Flush Rate
Manual, or Sensor
Tank or Valve
(in gpf)
(in gpf)
Timed Flush Num. Secs.
Rm 403B 1
Male Staff
Sensor
Val
1.6
3.5
7
Rm 403B 2
Male Staff
Sensor
Val
?
3.5
8
Calc. Rate (gpm)
NA=No Action R=Replace M=Mainten.
Closest to door Farthest from door
Sample Worksheet 7: Urinals
Building Name ___ Building 2A _______
Location
User Group
Valve Flush Rate
China Flush Rate
Manual, or Sensor
(in gpf)
(in gpf)
Timed Flush Num. Secs.
Calc. Rate (gpm)
NA=No Action R=Replace M=Mainten.
Leaks? Other Comments
Rm 403B 1
Male Staff
Manual
1.0
1.0
3
Closest to door
Rm 403B 2
Male Staff
Manual
1.0
1.0
5
Handle leak
Rm 403B 3
Male Staff
Manual
1.0
1.0
8
Farthest from door
57
Leaks? Other Comments