172 Daily Daily Daily Daily Once per Week Twice per Week Once per Week if used Monthly Monthly As Indicated As Indicated As Indicated Pump Safety* Check(s) Completed (check box) Safety Equipment** Check Completed (check box) Backwashing completed when pressure indicates (check box) Fecal incidents recorded; Death, Illness, Injury Reported as required (check box when completed) Corrective Actions Taken or Commentsbrief (use back of sheet if needed)
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