Legionella risk assessment checklist
This general legionella risk assessment form can be used by the legionella responsible person to assess the premises. record cold and hot water temperatures and check if maintained properly. evaluate if air conditioning and water systems are clean and disinfected. you may not need take any further action at this stage but you can use the gathered data to review the assessment regularly in case anything changes in your system. maximize iauditor’s features by capturing photos of risks present in the workplace. annotate photos to emphasize underlying factors and report risks to safety managers and officials. use iauditor’s temperature field to enter the current temperature readings. generate reports while on-site for better reporting process.
What does this form include?
This form contains 16 sections:
Legionella Risk Assessment
- Is there any tenant, resident or regular visitor particularly suscetible to legionella due to age, health or lifestyle?
Take a photo of the cold water system
Provide a short description
Take a photo of the hot water system
Water Outlet Temperature
- Is the cold water temperature at water outlets below 20° Celsius?
- Is the hot water temperature at water outlets above 50° Celsius?
Cold water storage tank location (photo)
Cold Water System
- Is a cold water storage tank present?
- Is the cold water tank accessible?
- Does it have a tight-fitting lid?
- Is the water in the tank clean and free from rust, debris, scale, and organic matter?
- Is the temperature of the water in the tank below 20 ° celsius?
- Is the cold water tank insulated?
Hot Water System
- Is the temperature setting on the boiler and/or hot water tank such that hot water is heated to and stored at a temperature of 60 ° celsius?
- Are the hot water distribution pipes insulated?
- If more than one calorifier is used, are they connected in parallel?
Does the calorifier have the following fitted?
Little Used Outlets
- Are there any water outlets are used less than once per week e.g. guest bathrooms?
Shower heads
- Are there any showers in the property?
Sections of pipework which are redundant or owing to the system design and have little/no through the
Dead Legs and Redundant Pipework
- Are there any dead legs on the property?
Unoccupied Properties
- Is the property left unoccupied for periods of time?
Full Name and Signature of Landlord
Full Name and Signature of Legionella Responsible Person
Use this template