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Inspection & Certification of Water Storage Tank by Licensed Plumber
To : Director, Water Supply (Network) Department                                                                         Date :

Details of Registered Customer and Location/ Nature of Work
Name of Registered Customer                                                                                   PUB Account No:
Name of company (if any)                                                                                                   Tel No:

                                                                                                                              Postal Code:
Nature of Work                                  Inspection & Certification                                       Cleaning & Sterilisation
Name of Laboratory (if any)
Total number of Tanks                        Low Level Tanks :              Intermediate Level Tanks:                   High Level Tanks :

Any unlined galvanised iron                     No                     Yes.
(GI) water pipes/fittings in the

Name & Signature of
Registered Customer / Date

Particulars of Licensed Plumber
Name                                                                                                              Licence No: WS/                  /

                                                                                                                             Postal Code:
Tel No (Home/Office*)                                           Handphone/Pager*                                       Fax No

Water Tanks Certified
   Level/ Storey ‡              Number of                  Size of Compartment                       Material                   Type of Coating/ Lining
                            Tanks/Compartments                 (LxWxH) m                                                          (State Brand Name)
          /                              /
          /                              /
          /                              /
          /                              /
          /                              /
          /                              /

Report on Leak Inspection in Water Service Pipes (Under Mains Pressure)
Any leak in service pipe detected†                   No                       Yes. Leak was repaired on:
                            Meter No             Initial Reading after Shut-off              Time          Final Reading Before Turn-on                Time
Bulk Meter

                            Meter No             Initial Reading after Shut-off              Time          Final Reading Before Turn-on                Time
By-pass Meter

Note – This form is to be submitted with the Certificate of Satisfactory Completion of Water Service Work for the cleaning and sterilisation of water storage
tank. The Licensed Water Service Plumber shall submit these forms to Director, Water Supply (Network) Department within seven days of completion of the
          I, the undersigned, hereby certify that all the above water storage tanks are in a condition fit and safe for the storage of potable
water in accordance with the Public Utilities (Water Supply) Regulations and the Singapore Standard CP48 - Code of Practice for Water
Services. I also certify that all downfeed and distributing pipes from the tanks had been thoroughly flushed until clean before water from the
tanks was put into use and there are no leaks in the pipes and fittings at the above premises.

2        The attached reports from a SAC-SINGLAS accredited laboratory show that the water samples taken from every tank passed the
chemical and bacteriological examinations.

Signature of Licensed Water Service Plumber/ Date

                                                                                                                                            RELEASE 0
* Delete where applicable
  Tick where applicable

Checklist for Inspection & Certification of Water Storage Tank

                     Defects Description                                Defects Description

Physical Condition of Tank:                           Condition of Ancillary Fittings/ Equipment & Others :

       Internal walls rusty                               No ventilation
       Internal walls dirty                               Ventilation openings not covered with fine netting
       Internal walls covered with moss                   Other openings not covered with netting
       External walls rusty                               Faulty electrical float switch
       External walls dirty                               Faulty ball valve
       External walls badly corroded                      Faulty ball float
       External walls found with cracked lines            No access ladder for inspection
       External walls others                              No safety measures provided for access
       Roof cover rusty                                   Safety measures provided for access is inadequate
       Roof cover dirty                                   Space around tank less than 600 mm width
       Part of roof cover missing                         Diameter of overflow pipe the same as inlet pipe
       Whole of roof cover not provided                   Diameter of overflow pipe smaller than inlet pipe
                                                           Overflow pipe higher than inlet pipe
                                                           Overflow pipe not covered with fine netting
                                                           Overflow pipe not provided
Condition of Water:                                        Drain-off pipe not provided
                                                           Warning pipe not provided
       Water dirty with sediment                          Warning pipe higher than overflow pipe
       Water dirty with oil film                          Warning pipe not covered with fine netting
       Water dirty with colour                            Sanitary pipe, floor trap, sewer pipe, reclaimed
       Water dirty with smell                              water pipe or waste pipe located above water tank
       Water contaminated                                 Tank positioned such that water contained therein is
       Water samples fail to comply with chemical/         contaminated/ likely to be contaminated
        bacteriological analysis                           Service pipe and distributing pipe are connected
                                                           Service pipe and pump are connected
                                                           Orifice of outlet is not 75 - 100 mm above bottom
                                                           Outlet is not opposite inlet
Security of Tank:                                          Water leaking from stopcocks, valves, etc
                                                           Water leaking from water pump
       Room/enclosure housing water tanks not             Water leaking from water tank
                                                           Water leaking from service pipes
       Access to high level tanks not locked
                                                           Failed meter test
       Inspection manhole cover not locked
                                                           Unsuitable nettings at vents and overflow/warning
       Inspection manhole not properly covered             pipes
       Inspection manhole cover not hinged or             Nettings at vents and overflow/warning pipes not in
        chained to tank                                     good condition
       Cover for inspection manhole not provided          Nettings at vents and overflow/warning pipes
                                                            tampered with
                                                           No inspection manhole
                                                           Size of inspection manhole is less than 450 mm

Note: The checklist given above is meant only as a guide to assist in the inspection and certification of the
     water storage tank. It is by no means an exhaustive list.

                                                                                                    RELEASE 0

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