Legionella Control - Weekly Shower and Water Flush - TEMPLATE

• Are all water sources identified

  Yes

  No

  N/A
• Location
  Address

• Document No.

• Conducted on

  Date

• Prepared by

Legionella Risk Assessment

Shower heads

• Are there any showers in the property?

  Yes

  None

• Take photo of shower location

  Media

• Is power available for the Shower Cubicle?

  Yes

  No

  N/A

• Have you maintained your Legionella Certification Annual Refresher online?

  Yes

  No

  N/A

• Take a photo of the shower being flushed.

  Media

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

  Yes

  No

  N/A

Little Used Outlets

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

  Yes

  None

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

  Yes

  No

  N/A

• Have all water outlets within the property been flushed for 2.5mins?

  Yes

  No

  N/A

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?

  Yes

  No

  N/A

• Take photo location

  Media

Completion

• Full Name and Signature

  Sign