Title Page

  • Are all water sources identified

  • Location
  • Conducted on

  • Prepared by

Legionella Risk Assessment

Shower heads

  • Are there any showers in the property?

  • Take photo of shower location

  • Is power available for the Shower Cubicle?

  • Have you maintained your Legionella Certification Annual Refresher online?

  • Take a photo of the shower being flushed.

  • Shower must be flushed on Hot for at least 2.5minutes. Please confirm this has been done.

  • Signature :'

Little Used Outlets

  • Are there any water outlets are used less than once per week e.g. taps, toilets, sinks?

  • Are there arrangements in place to flush them through on at least a weekly basis?

Dead Legs and Redundant Pipework

  • Sections of pipework which are redundant or owing to the system design and have little/no through the flow of water (knows as 'dead legs") can allow water to stagnate in the system.

  • Are there any dead legs on the property?

  • Take photo location

Completion

  • Full Name and Signature

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