3M Operations L8 Audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Please enter date and time of audit commencing.

  Date

Identification of hazardous systems

• Hot water systems

  Yes

  No

  N/A

• Cold water systems

  Yes

  No

  N/A

• Water softeners

  Yes

  No

  N/A

• Sprinkler Systems

  Yes

  No

  N/A

• Hose reels

  Yes

  No

  N/A

• Spa baths

  Yes

  No

  N/A

• Indoor fountains

  Yes

  No

  N/A

Risk Assessments

• Is there a written risk assessment for all water systems?

  Yes

  No

  N/A

• <br>Does it contain up to date schematic plans of the system?<br>

  Yes

  No

  N/A

• Does it contain details of the precautions to be taken?

  Yes

  No

  N/A

• Does it contain instruction for the operation of the systems?

  Yes

  No

  N/A

• Does the assessment conclude that there is a significant risk?

  Yes

  No

  N/A

• Does the assessment consider the systems physical condition?

  Yes

  No

  N/A

• Does it consider any “at risk” groups of persons?

  Yes

  No

  N/A

System Schematics

• Do they show all system control valves?

  Yes

  No

  N/A

• Do they show standby plant (spare pumps etc)?

  Yes

  No

  N/A

• <br>Do they show all system outlets?<br>

  Yes

  No

  N/A

• Do they show any associated storage tanks?

  Yes

  No

  N/A

• Do they show system bleed valves?

  Yes

  No

  N/A

• Do they show chemical dosing pumps and injection points?

  Yes

  No

  N/A

• Do they show system drain valves?

  Yes

  No

  N/A

• Do they show the origin of the water supply?

  Yes

  No

  N/A

Programme Management

• Is there a responsible person nominated in writing?

  Yes

  No

  N/A

• Is there an appointed deputy?

  Yes

  No

  N/A

• Are the duties of all persons involved clearly defined?

  Yes

  No

  N/A

• Are the responsibilities of the occupier and consultant(s) clearly defined?

  Yes

  No

  N/A

• Have the other relevant health and safety issues – COSHH assessments for chemicals, safe access etc been addressed?

  Yes

  No

  N/A

Hot and Cold Water Systems

• Is water temperature used as a means of controlling legionella?

  Yes

  No

  N/A

• <br>Does recirculation water return to the calorifier at 50oC?<br>

  Yes

  No

  N/A

• Does temperature at the hot taps reach 50oC within 1 minute?

  Yes

  No

  N/A

• Is trace heating required?

  Yes

  No

  N/A

• Are thermometer pockets fitted on flow and return to the calorifier?

  Yes

  No

  N/A

• Is the temperature of incoming water monitored?

  Yes

  No

  N/A

• Does the temperature of the top and base of the calorifier reach 60oC for at least one hour per week?

  Yes

  No

  N/A

• Have thermostatic mixing valves (TVM’s) been considered for high-risk groups?

  Yes

  No

  N/A

• Are these placed as close as possible to recirculation water supply?

  Yes

  No

  N/A

• <br>Does weekly flushing take place of outlets not regularly used?<br>

  Yes

  No

  N/A

• Is this logged and recorded?

  Yes

  No

  N/A

• Are shower-heads dismantled and cleaned at least quarterly?

  Yes

  No

  N/A

• Is this logged and recorded?

  Yes

  No

  N/A

• Do calorifiers have drain valves at the lowest point?

  Yes

  No

  N/A

• Is the cold water stored not more than one days use?

  Yes

  No

  N/A

• On an annual basis is there a check to ascertain the correct temperature across the storage tank?

  Yes

  No

  N/A

• Has consideration been given to removing infrequently used outlets?

  Yes

  No

  N/A

• Is there an annual check, with clear indication of the areas and items to be covered?

  Yes

  No

  N/A

• Are all systems also checked regularly at an interval determined by the assessment?

  Yes

  No

  N/A

• Are these checks recorded with date and signature of the inspector?

  Yes

  No

  N/A

• Are monthly checks made on hot and water temperatures at sentinel outlets?

  Yes

  No

  N/A

• Is the incoming water temperature checked at least 6 monthly?

  Yes

  No

  N/A

• Are a representative number of all outlets checked annually?

  Yes

  No

  N/A

• Are all the above logged and recorded?

  Yes

  No

  N/A

• Please add any additional images which relate to this audit.

  Media

• Please sign this audit to complete.

  Sign