Legionella Monthly Temperature Checks

• Audit Title

• Site

• Conducted on

  Date

• Prepared by

• Personnel

• The temperature of blended water outlets must be distributed in the range of 41 and 43 Degrees Celsius
  The temperature of cold water outlets must be distributed at or below 20 Degrees Celsius
  The temperature of hot water outlets must be distributed at or above 50 Degrees Celsius
  
  1. Run the outlet for 1 minute on hot and blended water outlets, cold water outlets run water for 2 minutes
  2. Test the temperature with a thermometer
  3. Record the temperature in the following audit by stating Safe/At Risk and add the reading into the text box

Showers- Mill

• 1

  Safe

  At Risk

  N/A

• 2

  Safe

  At Risk

  N/A

• 3

  Safe

  At Risk

  N/A

• 4

  Safe

  At Risk

  N/A

• 5

  Safe

  At Risk

  N/A

• 6

  Safe

  At Risk

  N/A

• 7

  Safe

  At Risk

  N/A

• 8

  Safe

  At Risk

  N/A

Toilets- Mill

• Cold Tap

  Safe

  At Risk

  N/A

• Hot Tap

  Safe

  At Risk

  N/A

Canteen- Mill

• Hot Tap

  Safe

  At Risk

  N/A

• Cold Tap

  Safe

  At Risk

  N/A

Supplements Sink

• Hot Tap

  Safe

  At Risk

  N/A

• Cold Tap

  Safe

  At Risk

  N/A

Unit 1 Toilet

• Hot Tap

  Safe

  At Risk

  N/A

• Cold tap

  Safe

  At Risk

  N/A

• Mixer Tap

  Safe

  At Risk

  N/A

Unit 2 Toilet

• Hot Tap

  Safe

  At Risk

  N/A

• Cold Tap

  Safe

  At Risk

  N/A

• Mixer Tap

  Safe

  At Risk

  N/A

Unit 3 Toilet

• Hot Tap

  Safe

  At Risk

  N/A

• Cold Tap

  Safe

  At Risk

  N/A

• Mixer Tap

  Safe

  At Risk

  N/A

Powerwash Tap- Boiler Room

• Cold tap

  Safe

  At Risk

  N/A

Kitchen- House

• Hot Tap

  Safe

  At Risk

  N/A

• Cold Tap

  Safe

  At Risk

  N/A

Male Toilet _ House

• Hot Tap

  Yes

  No

  N/A

• Cold Tap

  Yes

  No

  N/A

Female Toilet- House

• Hot Tap

  Yes

  No

  N/A

• Cold Tap

  Yes

  No

  N/A

Signature

• Competent Person

  Sign