• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Please enter date and time of audit commencing.

Identification of hazardous systems

  • Hot water systems

  • Cold water systems

  • Water softeners

  • Sprinkler Systems

  • Hose reels

  • Spa baths

  • Indoor fountains

Risk Assessments

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

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

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

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

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

  • Does the assessment consider the systems physical condition?

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

System Schematics

  • Do they show all system control valves?

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

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

  • Do they show any associated storage tanks?

  • Do they show system bleed valves?

  • Do they show chemical dosing pumps and injection points?

  • Do they show system drain valves?

  • Do they show the origin of the water supply?

Programme Management

  • Is there a responsible person nominated in writing?

  • Is there an appointed deputy?

  • Are the duties of all persons involved clearly defined?

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

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

Hot and Cold Water Systems

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

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

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

  • Is trace heating required?

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

  • Is the temperature of incoming water monitored?

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

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

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

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

  • Is this logged and recorded?

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

  • Is this logged and recorded?

  • Do calorifiers have drain valves at the lowest point?

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

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

  • Has consideration been given to removing infrequently used outlets?

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

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

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

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

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

  • Are a representative number of all outlets checked annually?

  • Are all the above logged and recorded?

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

  • Please sign this audit to complete.

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