Dental waterline testing log
Log template
Check this template against your local regulations and your own policies before you use it.
- Business
- Location
- Date
- Record each chair’s morning flush and line treatment every day.
- Test the water from each chair as often as your guidelines and the maker say, and write the result.
- If a test fails, take the chair’s water out of use for treatment, shock-treat the lines as the maker says and retest before using it.
| Date | Chair | Flushed | Treatment | Test result | Pass / fail | Action | Initials |
|---|---|---|---|---|---|---|---|
