Template Information
Landlords should conduct legionella risk assessments to prevent occupants from acquiring legionnaires’ disease from contaminated water. landlords can use this legionella risk assessment template to record water heating and storage equipment (boiler, hot water cylinder, cold water storage tank) installed and check each work condition and temperature. assess if occupants or tenants were given information about the control of legionella. lastly, detail other risks identified. validate the audit by providing a digital signature.
Category: general
Template Questions
- Schematics (optional - might be useful for complex system)
- Water Supply
- Add any boilers heating the hot water (including if heats a cylinder)
- Where is the boiler located?
- Record the temperature of the hot water setting (If temp. not shown, enter dial setting e.g. Max)
- Water heating and storage
- Add any hot water cylinders here (whether heated by a boiler or electric)
- Where is the hot water cylinder located?
- What is the temperature setting on the cylinder?
- Are there any cold water tanks supplying a hot water cylinder?
- List of outlets and temperatures.If there are thermostatic mixer valves, the temperatures recorded ar
- Outlet name / location
- Record of temperatures
- Add any showers
- Showers
- Shower head should be disinfected, dismantled and cleaned by the occupier quarterly or as indicated b
- Add any whirlpool baths, spa baths, hot tubs, jacuzzis
- Spa pools
- It is recommended that spa pools which include whirlpool baths, spa baths, hot tubs etc. should be re
- Add any deadlegs
- Location
- Add media
- Deadlegs
- Information
- Void periods
- Details of risk identified
- Detail of risk identified
- Take photos (optional)
- The risk score is defined as follows:0% to 40% - High risk - there is a high risk to the identified pe
- A review of this risk assessment should be carried out regularly (at least every two years) and whene
- Full Name and Signature of Assessor