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/td>
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/td>
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/td>
| RAI CARE CENTER=
1 |
|
Month: 2 |
|
Year: 3 |
|
|
|
| <=
/td>
| |
Daily Water Quality Monitoring Log |
|
| NOTE:<=
span
style=3D'mso-spacerun:yes'> Most items are completed daily before
treatment initiation. Other items are completed mid-day each treatment day
unless otherwise indicated. |
|
| NOTE:<=
span
style=3D'mso-spacerun:yes'> Total chlorine testing is documented =
on a
separate log sheet. If any item is not applicable, write N/A in the
appropriate space. |
|
| <=
/td>
| Da=
te |
4 |
|
|
|
|
|
|
|
|
| Type of Test/Monitoring/Limits |
Locations |
Sun |
Mon |
Tue |
Wed |
Thu |
Fri |
Sat |
|
| Temperature (post blending valve) |
|
| *See
exception at end of form. |
|
|
|
|
|
|
|
|
|
|
|
| 5 |
|
6 |
|
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|
| Pre-Treatment Timer Checks |
|
| Correct Time of Day |
Yes/ No |
|
|
7 |
|
|
|
|
|
|
|
|
| Brine Tank |
|
| Salt G=
reater than
Water Level |
Yes / No |
|
|
8 |
|
|
|
|
|
|
|
|
| Hardness (post-softener or per BEST). Run system at least=
15
minutes. |
|
| AM Sta=
rt up: |
|
<1 g=
rain/gal |
|
|
9 |
|
|
|
|
|
|
|
|
| RO Prefilter D
Pressure =3D (Pre-filter Pressure - Post-filter Pressure) |
|
| 10 |
|
psi |
|
|
|
11 |
|
|
|
|
|
|
|
|
| RO On Line? |
|
| NOTE: =
Check if
On-Line |
Yes/ No |
|
|
12 |
|
|
|
|
|
|
|
|
| RO Bypass Closed? |
|
| =
|
|
Yes/ No |
|
&nb=
sp; |
13 |
|
|
|
|
|
|
|
|
| DI
Tanks in Use as Polish? |
|
|
Note: DI Monito=
ring Log
must be used whenever DI Tanks are in use |
|
|
|
| |
|
|
|
Yes/No |
|
&nb=
sp; |
14 |
|
|
|
|
|
|
|
|
| DI =
Tanks in Use as Primary? |
|
|
|
|
|
Note: DI Monito=
ring Log
must be used whenever DI Tanks are in use |
|
|
|
| &nb=
sp; |
|
|
|
Yes/No |
|
|
15 |
|
|
|
|
|
|
|
|
| Most recent DI exchange date |
|
| NOTE: DI tanks must be changed at least ev=
ery
three months |
|
16 |
|
|
|
|
|
|
|
|
| Deionization
Quality Meter Alarm Check |
|
|
|
|
|
|
|
|
|
|
|
| Audible/Visible
alarm when test button depressed? |
Yes/No |
|
17 |
|
|
|
|
|
|
|
|
| UV Light On? (if applicable) |
|
| |
|
|
Yes/No |
|
|
18 |
|
|
|
|
|
|
|
|
| Endotoxin Filter D Pressure =3D (Pre-filter Pressure - Post-filter Pressure=
) D Pressure between 2 and 15=
psi |
|
| D<=
span
style=3D'mso-spacerun:yes'> Pressure Calculation |
|
|
|
|
|
|
19 |
|
|
|
|
|
|
|
|
| <=
/td>
| |
|
This document i=
s the
proprietary property of Renal Advantage, Inc. and may not be reproduced
without written permission. |
|
| <=
/td>
| |
|
|
|
|
|
| <=
/td>
| |
|
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|
| <=
/td>
| |
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| <=
/td>
| |
|
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/td>
| |
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| <=
/td>
| |
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| <=
/td>
| |
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|
|
| <=
/td>
| |
|
|
|
|
| NOTE:
Numbers 20-39 apply to Non-CWP RO systems (mark
section N/A if not applicable) |
|
|
|
|
|
|
|
|
|
|
|
|
| Da=
te |
|
|
|
|
|
|
|
|
| Type of Test/Monitoring/Limits |
Locations |
Sun |
Mon |
Tue |
Wed |
Thu |
Fri |
Sat |
|
| RO Product/Permeate Flow R=
ate |
|
| 20 |
|
gpm or |
|
|
|
21 |
|
|
|
|
|
|
|
|
| |
|
|
Liters/Min
(Per Manuf. Spec) |
&nb=
sp; |
|
|
|
|
|
|
|
|
|
| RO Reject/Concentrate Flow Rate |
|
| 22 |
|
gpm or |
|
|
|
23 |
|
|
|
|
|
|
|
|
| &nb=
sp; |
|
|
Liters/Min
(Per Manuf. Spec) |
|
|
|
|
|
|
|
|
|
|
| RO Feed Meter Reading (TDS or Conductivity) |
|
| 24 |
|
normal range
| |
|
25 |
|
|
|
|
|
|
|
|
| RO Product/Permeate Meter Reading (TDS or Conductivity)
| |
| 26 |
|
normal range
| |
|
27 |
|
|
|
|
|
|
|
|
| %
Rejection =3D RO Feed - RO Product
| |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| |
|
|
RO Feed |
|
|
|
|
|
|
|
|
|
|
|
|
| %
Rejection |
|
If not >90%=
contact
BEST |
|
|
28 |
|
|
|
|
|
|
|
|
| Return Loop Flow/Pressure Rate |
|
| 29 |
|
|
|
|
30 |
|
|
|
|
|
|
|
|
| Water Quality Meter (Allow system to operate at least 2 h=
ours
before performing this test) |
|
| <60 |
mS
(microSiemens) |
|
|
|
|
31 |
|
|
|
|
|
|
|
|
| Water Quality Meter Alarm Check (Allow system to operate =
at
least 2 hours before performing this test) |
|
| Audibl=
e/Visible
alarm when test button depressed. |
|
|
|
|
|
|
|
|
|
|
| |
|
|
|
Yes/No |
|
32 |
|
|
|
|
|
|
|
|
| =
System
Disinfection Data <=
/td>
| DO=
NOT WRITE
BELOW THIS LINE (For BEST Biomed Technician only) |
|
| Type of
disinfectant: |
33: |
&nb=
sp; |
|
|
|
|
|
|
|
|
|
|
| RO (Dwell Time and Initials) |
|
34 |
|
|
|
|
|
|
|
|
| Holdin=
g Tank
(Dwell Time and Initials) |
|
|
35 |
|
|
|
|
|
|
|
|
| Distri=
bution Loop
(Dwell Time and Initials) |
|
|
36 |
|
|
|
|
|
|
|
|
| Residu=
al
Disinfection Level Acceptable (Initials) |
|
|
37 |
|
|
|
|
|
|
|
|
| RO Membrane Clean 38___________________________ |
|
| Initia=
l on Date
Done |
|
|
39 |
|
|
|
|
|
|
|
|
| <=
/td>
| This document i=
s the
proprietary property of Renal Advantage, Inc. and may not be reproduced
without written permission. |
|
| <=
/td>
| |
|
|
|
|
|
| <=
/td>
| |
|
|
|
|
|
| <=
/td>
| |
|
|
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|
| <=
/td>
| |
|
|
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|
| <=
/td>
| |
|
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| <=
/td>
| |
|
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|
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| <=
/td>
| |
|
|
|
| <=
/td>
| |
|
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|
| <=
/td>
| |
|
|
|
| <=
/td>
| |
|
|
|
|
| NOTE:
Numbers 40-53 apply to CWP RO systems (mark section
N/A if not applicable) |
|
|
|
|
|
|
|
|
|
|
|
|
| Da=
te |
|
|
|
|
|
|
|
|
|
| Type of
Test/Monitoring/Limits |
|
|
|
Locations |
Sun |
Mon |
Tue |
Wed |
Thu |
Fri |
Sat |
|
| Press CWP RO MAIN MENU + ENTER. Then record the following values:
| |
| Inlet watere flow rate, L/min |
|
40 |
|
|
|
|
|
|
|
|
| Pure water flow rate, L/min |
|
41 |
|
|
|
|
|
|
|
|
| RO reject flow rate, L/min |
|
42 |
|
|
|
|
|
|
|
|
| Return flow rate from clinic, L/min |
|
43 |
|
|
|
|
|
|
|
|
| Consumption, L/min |
|
44 |
|
|
|
|
|
|
|
|
| Feed water conductivity (in), mS/cm |
|
45 |
|
|
|
|
|
|
|
|
| Pure water conductivity (out), mS/cm |
|
46 |
|
|
|
|
|
|
|
|
| Recovery rate, % |
|
47 |
|
|
|
|
|
|
|
|
| Rejection rate, % |
|
|
|
|
|
|
|
|
|
|
| Contact BEST Techinician if less than 90% |
48 |
|
|
|
|
|
|
|
|
| CWP Hot Water Recirculation |
|
| Start of hot water circulation (time) |
|
49 |
|
|
|
|
|
|
|
|
| Low disinfection temperature alarm (Yes/No) |
|
50 |
|
|
|
|
|
|
|
|
| CWP RP Unit Chemical Disinfection |
|
| Chemical Disinfection Initiated (time) |
|
51 |
|
|
|
|
|
|
|
|
| Test for Chemical Residual After Disinfection |
|
52 |
|
|
|
|
|
|
|
|
| Check of Chemical Consumption |
|
53 |
|
|
|
|
|
|
|
|
| <=
/td>
| This document i=
s the
proprietary property of Renal Advantage, Inc. and may not be reproduced
without written permission. |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
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|
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|
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|
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|
| <=
/td>
| |
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| <=
/td>
| |
|
|
|
| <=
/td>
| |
|
|
|
| <=
/td>
| |
|
|
|
|
| NOTE:
Items on this page apply to both CWP and non-CWP RO systems |
|
|
|
|
|
| Da=
te |
|
|
|
|
|
|
|
|
|
| Type of Test/Monitoring/Limits |
Locations |
Sun |
Mon |
Tue |
Wed |
Thu |
Fri |
Sat |
|
| Hardness (post-softener or per BEST) |
|
| PM Reading: |
|
< 1 grain/gal |
|
|
54 |
|
|
|
|
|
|
|
|
| Initials of staff member completing checks |
|
| Complete signature required below |
55 |
|
|
|
|
|
|
|
|
| Complete signature required below |
56 |
|
|
|
|
|
|
|
|
| Complete signature required below |
57 |
|
|
|
|
|
|
|
|
|
*Temperature parameters - Municipal water
temperatures, particularly in southern climates or during summer months, =
may
exceed 85°F (non-CWP) or 75°F (CWP). |
|
|
The BEST Technician responsible for the fac=
ility
will determine acceptable limits in these instances. |
|
| <=
/td>
| |
|
|
Signature:
58_________________________________ |
Signature: _________________________________<=
/td>
| Signature: _________________________________<=
/td>
| |
|
Signature: _________________________________<=
/td>
| Signature: _________________________________<=
/td>
| Signature: _________________________________<=
/td>
| |
|
Signature: _________________________________<=
/td>
| Signature: _________________________________<=
/td>
| |
|
|
|
59 |
|
|
|
|
|
|
60_____________=
________
(Weekly) |
|
| <=
/td>
| Signature of Nu=
rse
Responsible for Clinical Care or designee |
|
Review Date |
|
| <=
/td>
| |
|
|
Additional Comm=
ents: 61 |
|
|
|
| <=
/td>
| |
|
| <=
/td>
| |
|
| <=
/td>
| |
|
| <=
/td>
| |
|
| <=
/td>
| |
|
| <=
/td>
| |
|
| <=
/td>
| |
|
| <=
/td>
| |
|
| <=
/td>
| |
|
| <=
/td>
| This document i=
s the
proprietary property of Renal Advantage, Inc. and may not be reproduced
without written permission. |
|
| <=
/td>
| |
|
| <=
/td>
| |
|
| <=
/td>
| |
|
| <=
/td>
| |
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| |
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|
------=_NextPart_01C780D7.F4B0F430
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