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O. Reg. 243/07 - Flushing Record

Instructions:
- use this template (or one like it) to record the required flushing of your facility's plumbing (examples shown below)
- a water inspector from the Ministry of the Environment and Climate Change (MOECC) can ask for a record of your flushing activities at any time to confirm your
facility is meeting compliance with O. Reg. 243/07
- a best practice to help staff who are conducting flushing activities is to label each drinking water tap and fountain with a unique fixture number from your drinking
water fixture inventory
- your drinking water fixture inventory can be used as an easy reference tool to document the frequency and duration of flushing required for each individual fixture

GENERAL INFORMATION School Private School Child Care Centre

Facility Type:
Drinking Water System Number (provided by MOECC):

School Board/Organization (if applicable):

Facility Name:

5-minute Flushing 10-second Flushing

(Required for end of branch taps only; (Required for all
should be completed before 10-second drinking water taps
flushing) and fountains that
are not exempt from
flushing)

Fixture Number Location Date Time Flushing Time Flushing Time Completed Name of Person Flushing
(Unique identifier (Physical location of the (DD/MM/YYYY) Started Ended (hh:mm)
from your drinking fixture, e.g., kitchen, (hh:mm) (hh:mm)
water fixture hallway, or lunch room)
inventory assigned
to this individual
drinking water tap
or fountain)

T001-1 Kitchen 1/5/2017 6:00 AM 6:05 AM 6:05 AM John Doe

F001-1 1st fl hallway 1/5/2017 N/A N/A 6:08 AM John Doe
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5-minute Flushing 10-second Flushing

(Required for end of branch taps only; (Required for all
should be completed before 10-second drinking water taps
flushing) and fountains that
are not exempt from
flushing)

Fixture Number Location Date Time Flushing Time Flushing Time Completed Name of Person Flushing
(Unique identifier (Physical location of the (DD/MM/YYYY) Started Ended (hh:mm)
from your drinking fixture, e.g., kitchen, (hh:mm) (hh:mm)
water fixture hallway, or lunch room)
inventory assigned
to this individual
drinking water tap
or fountain)
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5-minute Flushing 10-second Flushing

(Required for end of branch taps only; (Required for all
should be completed before 10-second drinking water taps
flushing) and fountains that
are not exempt from
flushing)

Fixture Number Location Date Time Flushing Time Flushing Time Completed Name of Person Flushing
(Unique identifier (Physical location of the (DD/MM/YYYY) Started Ended (hh:mm)
from your drinking fixture, e.g., kitchen, (hh:mm) (hh:mm)
water fixture hallway, or lunch room)
inventory assigned
to this individual
drinking water tap
or fountain)