Title Page
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Conducted on
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Prepared by
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Location
Site Overview
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Where are the manuals kept
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Are the books in a tidy and legible format?
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Is the site manager happy with the service?
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Is there evidence of the water treatment company using Verisae?
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Are there any other H&S Concerns relating to water treatment?
Plant Room / Water Treatment Area
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What chemicals are used including Bromine?
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Are there copies of risk assessment and method statements for decanting chemicals?
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Are there any faults with dosing pumps?
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Any leaks from chemicals?
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Is the area clean and tidy?
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Are the chemicals closed and bunded?
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Are COHSHH and MSDS present only for chemicals in use?
Towers
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Any evidence of leaks?
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Are louvers in good condition?
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Is water pump and associated pipework free form leak?
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Is tower free from leaks?
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Are drift eliminators clean?
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Are spray nozzle in working order?
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Is access to gantry safe and secure?
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Is condenser area free from rubbish?
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If access is restricted to ladders are keys available?
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Is brominator and pipework in good working order?
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Are condenser drains capped?
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Are drift eliminators able to be accessed safely
Site Details
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Are the site contacts up to date?
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Is the RMC introduction available?
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Is the registration available for all towers?
Legionella Risk Assessment
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When was the risk assessment created?
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Is the risk assessment out of date?
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Have latest remedial action been updated recently?
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Does risk assessment reflect the amount of towers, make and model on site?
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Are the nominated authorities in risk assessment up to date?
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Is management procedure and reporting chart up to date?
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Does the survey information contain the correct information?
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Does the risk assessment show all nursing homes, hospital and areas of dense population in 1000m radius?
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Are all check points in the risk assessment correct?
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Is condition of condenser components correct?
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Is recirculating systems document correct?
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Is there a summary of risk in risk assessment?
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Has the risk assessment been signed by the water treatment company and responsible person?
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Do photos show current conditions of towers?
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Is there an up to date schematic of each tower?
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Does the drawings show sample points with pictures?
Written Scheme
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Does the written scheme show the correct number of towers and towers details?
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Does the written scheme show procedure for shutting down towers in an emergency?
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Is the recommended maintenance schedule correct?
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Does the water treatment program state any risk in the make-up of supply in composition?
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Does current chemical treatment match what is in use?
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Is there any action chart showing what action needs to be taken if microbial has a high count?
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Does the written scheme show clean and disinfection schedule?
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Does the written scheme review periods?
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Does the written scheme show action to be taken if suspected or actual break in the area occurs?
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Does the written scheme show detailed overview of risk assessment?
Management Structure
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Is the nominated person list up to date?
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Have all the nominated person signed the acceptance?
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Does the nominated person list show who is trained?
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Is there a site responsibility chart in place?
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Does responsibility chart detail what people are responsible for?
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Has the responsibility chart been updated in the last 6 months?
Lines of Communication
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Is there an up to date escalation procedure?
M.S.D.S/COSHH Assessments
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Does all the MSDS and COSHH match what is on site in risk assessment and written scheme?
Review Meetings
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Has a code of conduct been done in the last 12 months?
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Have all review action from the last code of conduct been actioned?
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Does the condition report show any outstanding issues?
Code of Conduct
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Is the LCA certificate in date?
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Until when is the LCA certificate valid?
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Is there a recommended code of conduct providers’ sheet?
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Are sub-contractors certificates available? (Please note what they are)
HSG274 Part 1 Technical Guidance Document
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Is a copy available?
Operator Reports (Weekly Reports)
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Is there an emergency shut down available?
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Are all weekly service reports available?
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Do any abnormal headings show action taken/required on service sheet?
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Are all weekly visits available in colour?
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Are there any concerns with weekly reports?
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Are all sheets signed by Site and RMC as being accepted?
Service Reports (Monthly Reports)
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Are all reports present in the last 2 years?
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Any issues identified?
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Are there any trends that show concern?
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Are all sheets signed by Site and RMC as being accepted?
Visit Reports
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Is there an updated to date remedial action list?
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Are all remedial done?
Inventory Reports
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Is there an up to date inventory for this month?
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Does stock show good level?
Dipslide Chart(s) & Component Trend Analysis
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Have Dipslide been recorded weekly?
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Are there any abnormalities or inconsistent reading?
Legionella Screening
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Has a legionella sample been taken in the past 3 months?
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Please provide the latest date of legionella sample taken in the past 3 months
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Are the latest lab results available?
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Are all legionella sampling records available?
Cleaning and Disinfection Records
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Have the towers had clean and disinfection in the last 6 months?
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Is the last clean and disinfection report available?
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Does the report show a coloured picture, before and after?
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Are all previous clean and disinfection reports available for the last 2 years?
Method statements and Risk Assessments
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Is there a method statement and risk assessment available for the clean and disinfection of the towers?
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Has the method statement and risk assessment been reviewed in the past 2 years?
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Are the risk assessment and method statement available for weekly and monthly visits?
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Has the method statement and risk assessment for weekly and monthly visits been reviewed in the past 2 years?
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Is there a method statement and risk assess for chemical decanting?
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Has the method statement and risk assessment been reviewed for chemical decanting in the past 2 years?
Maintenance Schedule
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Is the schedule available?
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Is there a procedure for shutting down and starting towers?
Water Treatment Application
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Is there a copy of the service agreement for towers?
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Is there an up to date annual planner for current year?
Other Information
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Is the certificate available for everyone on responsible person list?
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Are there any technical documents to support towers and water treatment system?