Preventive Maintenance Tasks for 

Tribal Drinking Water Systems 

Log Cards

United States EPA 816-F-01-017

Environmental Protection Office of Water (4604)

Agency June 2001
1

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2

Tools For Preventative Maintenance

These log cards, along with the accompanying guidance notes booklet, provide a schedule of

routine operation and maintenance tasks for small groundwater systems. They will help you

develop a preventative maintenance program for your system.

The cards are divided into sections that list daily, weekly, and monthly tasks, with individual

sections that outline specific tasks for each month of the year. They correspond to the guidance

notes in the booklet. Each section of cards contains a list of suggested tasks to be carried out for

that time period and log cards to record information. We have not included log cards for every task

because some tasks can be completed without recording anything. Tasks that do not have log

cards are in italicized print.

You should copy all of the blank log cards for future use. Each log card has space for additional

comments. A follow-up log card, included at the end of this card set, can be used to record any

problems you encounter and to help you keep a schedule for any needed repairs or replacements. 

Please review the guidance notes in the accompanying booklet, which provide additional

information on some tasks. Note that we have not defined all tasks because some are self

explanatory. A contact list is provided in the accompanying guidance notes booklet if you need

additional information. 
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Daily Daily

4

Recommended Daily Operational Duties

‘ Check water meter readings and record water production.

‘ Check chemical solution tanks and record amounts used. 

‘ Check and record water levels in storage tanks. 

‘ Check and record chlorine residual at the point of application.

‘ Check and record chlorine residual in the distribution system. 

‘ Inspect chemical feed pumps.

‘ Inspect booster pump stations.

‘ Check and record fluoride concentration in the distribution system.

(Continued on other side of card.) 
Daily Daily

5

Recommended Daily Operational Duties

(Cont.)

‘ Record well pump running times and pump cycle starts.

‘ Investigate customer complaints.

‘ Inspect heater operation during winter months 

‘ Inspect well pumps, motors, and controls.

(Reminder: italicized tasks do not have log cards)
Daily Daily

6

Daily Water Production Log Card*

Month of _______________

Date Meter Reading Amount of Water Used Notes or Comments

31st

30th

29th

28th

27th

26th

25th

24th

23rd

22nd

21st

20th

19th

18th

17th
Daily Daily

Date Meter Reading Amount of Water Used Notes or Comments

7

16th

15th

14th

13th

12th

11th

10th

9

th

8

th

7

th

6

th

5

th

4

th

3

rd

2

nd

1

st

*Remember to photocopy the log card for future use before filling it out.
Daily Daily

8

Daily Chemical Solution Usage Log Card* Month of _________

Date Water

Prod.

Chlorine

Solution Used

Chlorine Used per ______

gal water produced 

Fluoride

Solution Used

Fluoride Used per ______

gal water produced 

31st

30th

29th

28th

27th

26th

25th

24th

23rd

22nd

21st

20th

19th

18th

17th
Daily Daily

Date Water

Prod.

Chlorine

Solution Used

Chlorine Used per ______

gal water produced 

Fluoride

Solution Used

Fluoride Used per ______

gal water produced 

9

16th

15th

14th

13th

12th

11th

10th

9

th

8

th

7

th

6

th

5

th

4

th

3

rd

2

nd

1

st

*Remember to photocopy the log card for future use before filling it out.
Daily Daily

10

Daily Storage Tank Water Level Log Card

Month of _______________Tank No. _______________

Date Water Level (check one) Action Taken 

(if not within normal operating range) Normal Overflow Too Low

1

st

2

nd

3

rd

4

th

5

th

6

th

7

th

8

th

9

th

10th

11th

12th

13th

14th

15th
Daily Daily

Date Water Level (check one) Action Taken 

(if not within normal operating range) Normal Overflow Too Low

11

16th

17th

18th

19th

20th

21st

22nd

23rd

24th

25th

26th

27th

28th

29th

30th

31st
Daily Daily

12

Daily Chlorine Residual Log Card*

Month of _______________

Day Chlorine Residual (in mg/L) at

Point of Application

Chlorine Residual (in mg/L) in

Distribution System Notes or Comments

1

st

2

nd

3

rd

4

th

5

th

6

th

7

th

8

th

9

th

10th

11th

12th

13th

14th

15th
Daily Daily

Day Chlorine Residual (in mg/L) at

Point of Application

Chlorine Residual (in mg/L) in

Distribution System Notes or Comments

13

16th

17th

18th

19th

20th

21st

22nd

23rd

24th

25th

26th

27th

28th

29th

30th

31st

*Remember to photocopy the log card for future use before filling it out.
Daily Daily

14

Daily Chemical Feed Pump Log Card*

Month of _______________

Day Concentration of

Chemical Solution 

Volume of Solution

Pumped

Volume of Water

Treated Calculated Dosage (mg/L)

31st

30th

29th

28th

27th

26th

25th

24th

23rd

22nd

21st

20th

19th

18th

17th
Daily Daily

Day Concentration of

Chemical Solution 

Volume of Solution

Pumped

Volume of Water

Treated Calculated Dosage (mg/L)

15

16th

15th

14th

13th

12th

11th

10th

9

th

8

th

7

th

6

th

5

th

4

th

3

rd

2

nd

1

st

*Remember to photocopy the log card for future use before filling it out.
Daily Daily

16

Daily Booster Pump Log Card*

Month of _______________

Day Are Pump Operating Times

Equalized? Meter Readings

Pressure Gauge Readings

Suction Side Discharge Side

1

st Yes/No

2

nd Yes/No

3

rd Yes/No

4

th Yes/No

5

th Yes/No

6

th Yes/No

7

th Yes/No

8

th Yes/No

9

th Yes/No

10th Yes/No

11th Yes/No

12th Yes/No

13th Yes/No

14th Yes/No

15th Yes/No
Daily Daily

Day Are Pump Operating Times

Equalized? Meter Readings

Pressure Gauge Readings

Suction Side Discharge Side

17

16th Yes/No

17th Yes/No

18th Yes/No

19th Yes/No

20th Yes/No

21st Yes/No

22nd Yes/No

23rd Yes/No

24th Yes/No

25th Yes/No

26th Yes/No

27th Yes/No

28th Yes/No

29th Yes/No

30th Yes/No

31st Yes/No

*Remember to photocopy the log card for future use before filling it out.
Daily Daily

18

Daily Fluoride Concentration Log Card*

Month of ____________

Predetermined Concentration ________

Day Fluoride Concentration in

Distribution System Adjustment Needed +/- Notes or Comments

1

st

2

nd

3

rd

4

th

5

th

6

th

7

th

8

th

9

th

10th

11th

12th

13th

14th

15th
Daily Daily

Day Fluoride Concentration in

Distribution System Adjustment Needed +/- Notes or Comments

19

16th

17th

18th

19th

20th

21st

22nd

23rd

24th

25th

26th

27th

28th

29th

30th

31st

*Remember to photocopy the log card for future use before filling it out.
Daily Daily

20

Daily Well Pump Log Card*

Month of _______________

Date Running Time

(in Hrs.)

Number of Cycle

Starts Notes or Comments

1

st

2

nd

3

rd

4

th

5

th

6

th

7

th

8

th

9

th

10th

11th

12th

13th

14th

15th
Daily Daily

Date Running Time

(in Hrs.)

Number of Cycle

Starts Notes or Comments

21

16th

17th

18th

19th

20th

21st

22nd

23rd

24th

25th

26th

27th

28th

29th

30th

31st

*Remember to photocopy the log card for future use before filling it out.
Daily Daily

22

Customer Complaint Log Card*

Date Questions, Concerns, or Potential

Problems

Customer Name

and Information Action Taken

1.

2.
Daily Daily

23

Date Questions, Concerns, or Potential

Problems

Customer Name

and Information Action Taken

3.

4.

*Remember to photocopy the log card for future use before filling it out.
Daily Daily

24

Other Notes and Comments
Daily Daily

25

Other Notes and Comments
Weekly Weekly

26

Recommended Weekly Operational Duties

‘ Inspect chlorine and fluoride testing equipment. 

‘ Clean pump house and grounds. 

‘ Make sure fire hydrants are accessible. 

‘ Record pumping rate for each well or source water pump.

‘ Inspect all pump house plumbing for leaks.
Weekly Weekly

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Weekly Weekly

28

Weekly Chemical Equipment Testing Log Card

Month of ____________

Week

(Date)

Is Equipment

Calibrated

Properly?

Are Reagents

Clearly Marked and

Safely Stored?

Are

Reagents

Expired?

Notes or Comments

1

st Yes/No Yes/No Yes/No

2

nd Yes/No Yes/No Yes/No

3

rd Yes/No Yes/No Yes/No

4

th Yes/No Yes/No Yes/No

5

th Yes/No Yes/No Yes/No
Weekly Weekly

29

Weekly Chemical Equipment Testing Log Card*

Month of ____________

Week

(Date)

Is Equipment

Calibrated

Properly?

Are Reagents

Clearly Marked and

Safely Stored?

Are

Reagents

Expired?

Notes or Comments

1

st Yes/No Yes/No Yes/No

2

nd Yes/No Yes/No Yes/No

3

rd Yes/No Yes/No Yes/No

4

th Yes/No Yes/No Yes/No

5

th Yes/No Yes/No Yes/No

*Remember to photocopy the log card for future use before filling it out.
Weekly Weekly

30

Weekly Cleanliness Log Card

Month ____________

Week

(Date)

Are Pump house and

Grounds Clean?

Are Fire Hydrants

Accessible? Notes or Comments

1

st

 

Yes/No Yes/No

2

nd Yes/No Yes/No

3

rd Yes/No Yes/No

4

th Yes/No Yes/No

5

th Yes/No Yes/No
Weekly Weekly

31

Weekly Cleanliness Log Card*

Month ____________

Week

(Date)

Are Pump house and

Grounds Clean?

Are Fire Hydrants

Accessible?

1

st

 

Yes/No Yes/No

2

nd Yes/No Yes/No

3

rd Yes/No Yes/No

4

th Yes/No Yes/No

5

th Yes/No Yes/No

*Remember to photocopy the log card for future use before filling it out.
Weekly Weekly

32

Weekly Pumping Rate Log Card

Month ____________

Week

(Date) Pumping Rate/Flow Notes or Comments

1

st

 

2

nd

3

rd

4

th

5

th
Weekly Weekly

33

Weekly Pumping Rate Log Card*

Month ____________

Week

(Date) Pumping Rate/Flow Notes or Comments

1

st

 

2

nd

3

rd

4

th

5

th

*Remember to photocopy the log card for future use before filling it out.
Weekly Weekly

34

Other Notes and Comments
Weekly Weekly

35

Other Notes and Comments
Monthly Monthly

36

Recommended Monthly Operational Duties

‘ Read electric meter at pump house and record. 

‘ Take appropriate monthly water quality samples.

‘ Check and record static and pumping levels of each well. 

‘ Inspect well heads. 

‘ Inspect and lubricate locks.

‘ Check on-site readings against lab results. 
Monthly Monthly

37

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Monthly Monthly

38

Monthly Electric Meter Log Card*

Month

(Date)

Electric Meter

Reading

Monthly Water Production

(if pumping is major use of energy) Notes or Comments

Jan.

 

Feb.

 

March

 

April

 

May

 

June

 
Monthly Monthly

39

Month

(Date)

Electric Meter

Reading

Monthly Water Production

(if pumping is major use of energy) Notes or Comments

July

 

Aug.

 

Sept.

 

Oct.

 

Nov.

 

Dec. 

 

*Remember to photocopy the log card for future use before filling it out.
Monthly Monthly

40

Monthly Sampling Log Card*

Month Take Coliform

Sample (U)

Take Other

Samples (U)

Notes or Comments

Jan.

Feb.

March

April

May

June

July

Aug.

Sept.

Oct.

Nov.

Dec.

*Remember to photocopy the log card for future use before filling it out.
Monthly Monthly

41

Month Take Coliform

Sample (U)

Take Other

Samples (U)

Notes or Comments

Jan.

Feb.

March

April

May

June

July

Aug.

Sept.

Oct.

Nov.

Dec.
Monthly Monthly

42

Monthly Static (S) and Pumping (P) Level Log Card*

Month

(Date)

S & P Level 

(in ft)

Well #____

S & P Level 

(in ft)

Well #____

Notes or Comments

Jan.

 

S: S:

Feb.

 

P: P:

March

 

S: S:

April

 

P: P:

May

 

S: S:

June

 

P: P:
Monthly Monthly

43

Month

(Date)

S & P Level 

(in ft)

Well #____

S & P Level 

(in ft)

Well #____

Notes or Comments

July

 

S: S:

Aug.

 

P: P:

Sept.

 

S: S:

Oct.

 

P: P:

Nov.

 

S: S:

Dec. 

 

P: P:

*Remember to photocopy the log card for future use, and if you have more than two wells,

before filling it out.
Monthly Monthly

44

Other Notes and Comments
Monthly Monthly

45

Other Notes and Comments
46

Recommended January Operational Duties

‘ Overhaul chemical feed pumps (O rings, check valves, and

diaphragm).

‘ Inspect and clean chemical feed lines and solution tanks.

‘ Calibrate chemical feed pumps after overhaul.
47

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48

January Task Log Card*

Task Date Completed Notes or Comments

Overhaul chemical feed pumps:

Feeder head cleaned.

O rings and valves checked

for wear. 

Worn out parts replaced.

Inspect and clean:

Chemical feed lines.

Solution tanks.

Calibrate chemical feed pumps

after overhaul.

*Remember to photocopy the log card for future use before filling it out.
49

Other Notes or Comments
50

Recommended February Operational Duties

‘ Inspect chemical safety equipment and repair or replace as needed.

‘ Operate all gate valves inside the treatment plant and pump house.
51

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52

February Task Log Card*

Task Date Completed Number & Direction

of Turns

Notes or Comments

Check chemical safety equipment

and repair or replace as needed.

Not Applicable

Operate all gate valves inside the

treatment plant and pump house.

*Remember to photocopy the log card for future use before filling it out.
53

Other Notes or Comments
54

Recommended March Operational Duties

‘ Inspect, clean, and repair control panel in pump house and

treatment plant.

‘ Exercise half of all mainline gate valves.
55

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56

March Task Log Card*

Task Date

Completed

Valves

Exercised

Number of

Failures

Date

Scheduled

for Repair

Number and Direction of

Turns to Close

Inspect, clean,

and repair

control panel in

pump house

and treatment

plant.

Not

Applicable

Not

Applicable

Not Applicable

Exercise half of

all mainline

gate valves.

*Remember to photocopy the log card for future use before filling it out.
57

Other Notes or Comments
58

Recommended April Operational Duties

‘ Flush the distribution systemand exercise/check allfire hydrantgate

valves.

‘ Inspect and clean chemical feed lines and solution tanks.

‘ Calibrate chemical feed pumps.

‘ Inspect fencing and gates.
59

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60

April Task Log Card*

Task Date Completed Notes or Comments

Flush the distribution system. 

Exercise/check all fire hydrant

gate valves.

Inspect and clean:

Chemical feed lines. 

Solution tanks.

Calibrate chemical feed pumps.

Inspect fencing and gates.

*Remember to photocopy the log card for future use before filling it out.
61

Other Notes or Comments
62

Recommended May Operational Duties

‘ Inspect storage tanks for defects and sanitary deficiencies. 

‘ Clean storage tanks if necessary.
63

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64

May Task Log*

Task Date Completed Notes or Comments

Inspect Storage Tank #_____

Check vents and screens.

Check for overflows.

Check water level measuring

devices.

Check hatch seals/locks.

Check for deterioration.

Inspect Storage Tank #______

Check vents and screens.

Check for overflows.

Check water level measuring 

devices.

Check hatch seals/locks.

Check for deterioration.

Clean Storage Tanks.
65

*Remember to photocopy the log card for future use, and if you have more than two tanks, before filling

it out.

Other Notes or Comments
66

Recommended June Operational Duties

‘ Perform preventative maintenance on treatment plant and pump

house buildings.
67

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68

June Task Log Card*

Task Date Completed Notes or Comments

Paint the:

Plant piping.

Buildings.

Tanks.

Safely store the:

Pipes.

Plumbing fittings.

Chemicals.

Tools.

Unblock pump house ventilation.

Check fan operation. 

*Remember to photocopy the log card for future use before filling it out.
69

Other Notes or Comments
70

Recommended July Operational Duties

‘ Inspect and clean chemical feed lines and solution tanks.

‘ Calibrate chemical feed pumps.
71

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72

July Task Log Card*

Task Date Completed Notes or Comments

Inspect and clean:

Chemical feed lines. 

Solution tanks.

Calibrate chemical feed pumps.

*Remember to photocopy the log card for future use before filling it out.
73

Other Notes or Comments
74

Recommended August Operational Duties

‘ Operate all gate valves inside the treatment plant and pump house.
75

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76

August Task Log Card*

Task Date Completed Number & Direction

of Turns

Notes or Comments

Operate all gate valves

inside the treatment plant

and pump house.

*Remember to photocopy the log card for future use before filling it out.
77

Other Notes or Comments
78

Recommended September Operational Tasks

‘ Exercise mainline gate valves that were not exercised in March. 

‘ Prepare system for winter operation. 

This task may be postponed until October or November, based on local conditions.
79

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80

September Task Log Card*

Task Date

Completed

Valves

Exercised

Number of

Failures

Date

Scheduled

for Repair

Direction and Number of

Turns to Close

Exercise

mainline gate

valves that were

not exercised in

March.

Prepare System for Winter Operation

Task Date Completed Notes or Comments

Check that all exposed facilities

are properly insulated.

Check that all heaters are

operable.

Check that all vents are closed.

*Remember to photocopy the log card for future use before filling it out.
81

Other Notes or Comments
82

Recommended October Operational Tasks

‘ Inspect and clean chemical feed lines and solution tanks.

‘ Calibrate chemical feed pumps.

‘ Inspect fencing and gates.
83

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84

October Task Log Card*

Task Date Completed Notes or Comments

Inspect and clean:

Chemical feed lines. 

Solution tanks.

Calibrate chemical feed pumps.

Inspect fencing and gates.

*Remember to photocopy the log card for future use before filling it out.
85

Other Notes or Comments
86

Recommended November Operational Tasks

‘ Prepare system for winter operation if not completed in September

or October. 
87

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88

November Task Log Card*

Prepare System for Winter Operation

Task Date Completed Notes or Comments

Check that all exposed facilities

are properly insulated.

Check that all heaters are

operable.

Check that all vents are closed.

*Remember to photocopy the log card for future use before filling it out.
89

Other Notes or Comments
90

Recommended December Operational Tasks 

‘ Contact an electrician to check running amps on well pumps.
91

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92

December Task Log Card*

Task Date Completed Notes or Comments

Contact an electrician to check

running amps on well pumps.

*Remember to photocopy the log card for future use before filling it out.
93

Other Notes or Comments
94

Follow-Up Log Card*

Questions,

Concerns, or

Potential Problems

Date Action Plan
Questions,

Concerns, or

Potential Problems

Date Action Plan

95

*Remember to photocopy the log card for future use before filling it out.