SiteCaddy BG50 — Closed System Sampling

1 · Site & System Information

Client Site Building / Area System Reference System Description Sample Location Sample Point Engineer Date Time

System Type

Select System Type

Specify System Type

2 · System Status

System Operational?

Reason Not Operational

3 · Visual Assessment

Sample Appearance

Visual Observation Photograph

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Evidence of Corrosion Products?

Severity

Details Photograph

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Evidence of Biological Fouling?

Description Photograph

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4 · Physical Parameters

Target ranges pre-populated from system type. Override if your supplier specifies different values.

Temperature (°C) — Record Only pH

Result

Target Min

Target Max

Conductivity (μS/cm)

Result

Target Min

Target Max

TDS (mg/L)

Result

Target Min

Target Max

Total Hardness (mg/L CaCO₃)

Fixed thresholds: <50 ✓ · 50–150 ⚠ · >150 ✗

5 · Glycol Assessment

Not applicable for selected system type.

6 · Chemical Testing

Molybdate Analysis

Reagents: Molybdate HR No.1 & No.2

Result (mg/L)

Supplier Min

Supplier Max

Re-dose Required?

Nitrite Analysis

Reagents: Nitriphot 1 & 2

Result (mg/L)

Supplier Min

Supplier Max

Inhibitor Review Required?

Iron Analysis

Reagents: Iron MR 1 & 2 · <1 mg/L ✓ · 1–5 mg/L ⚠ · >5 mg/L ✗

Iron Result (mg/L)

Copper Analysis

Reagents: Coppercol 1 & 2 · <0.1 mg/L ✓ · 0.1–0.5 mg/L ⚠ · >0.5 mg/L ✗

Copper Result (mg/L)

Alkalinity Analysis

Reagent: Alkaphot

Result (mg/L)

Target Min

Target Max

7 · Historical Trend Review

Historical Sample Available?

Previous Iron (mg/L) Previous Conductivity (μS/cm) Previous Inhibitor Level Trend Assessment

8 · Laboratory Sample

Laboratory Sample Taken?

Bottle Reference Laboratory Sample Reference Parameters Requested

9 · Recommendations

10 · Engineer Comments

Summary of Findings & Observations Supporting Photographs

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11 · Sign-Off

Engineer Name Date