Legionella Risk Assessment

• Client

• Report reference

• Premises address
  Address

• Date assessment conducted on

  Date

• Assessment completed by

• Review of assessment due

  Date

• Any previous assessments

  Yes

  No

• Date of previous assessment

  Date

Introduction

• This risk assessment has been carried out to ascertain the possible risk of contracting Legionellosis, including Legionnaire’s disease, from water systems and to identify remedial works required and produce a scheme for the prevention or control of the risks. This report relates to the risk assessment and water hygiene survey completed for this facility.

Assessment of Risk

• To assess the risk of Legionella Bacteria associated with water usage at this site, each of the water services are surveyed and allocated scores. The scoring system enables necessary remedial actions to be easily prioritised. This method of assessment is designed to identify features, which contribute or combine to
  form an increased risk and to aid in the design of a scheme to control the risk from Legionella bacteria.
  A Group Susceptibility Rating relating will be applied for any type of population group that would be at risk if exposed to Legionella bacteria. This is based on the general age, gender, and health conditions of the at risk.
  In accordance with ACOP L8 (2013) – This risk assessment must be reviewed regularly and/or whenever there is reason to believe that the original assessment may no longer be valid.
  We cannot guarantee that all pipe work passing underground or through floors, walls and ceilings has been traced, and it is possible that certain system dead-ends or dead legs may not have been identified. As a result, the schematic diagram(s) contained within this report only detail the visible or assumed pipe work.

• Mains water supply

  Yes

  No

• Other water supplies to site

  Yes

  No

• Cold water storage and distribution services

  Yes

  No

Domestic Hot Water Services

• Storage calorifiers

  Yes

  No

• Instantaneous water heaters, plate exchangers, combi boilers

  Yes

  No

• Point of use water heaters

  Yes

  No

• Volume storage water heaters

  Yes

  No

Spray Humidifiers

• Air washers

  Yes

  No

• Steam humidifiers

  Yes

  No

• Wet scrubbers

  Yes

  No

Other Systems

• Showerheads

  Yes

  No

• Little used outlets

  Yes

  No

• Cooling towers and evaporative condensers

  Yes

  No

• Ventilation and air conditioning systems

  Yes

  No

• Ultrasonic humidifiers

  Yes

  No

• Foggers and water misting systems

  Yes

  No

• Humidification systems

  Yes

  No

• Water softeners

  Yes

  No

• Closed heating system

  Yes

  No

• Display fountains/indoor water features

  Yes

  No

Miscellaneous systems

• Emergency showers and eyewash stations

  Yes

  No

• Sprinkler and hose reel systems

  Yes

  No

• Lathe and Machine tool coolant systems

  Yes

  No

• Spa baths / Whirlpools

  Yes

  No

• Horticultural misting systems

  Yes

  No

• Dental equipment

  Yes

  No

• Vehicle washing systems / Spray booths / Water Curtains

  Yes

  No

• Industrial process water

  Yes

  No

• Adiabatic coolers

  Yes

  No

• Others (provide details)

  Yes

  No

• Only systems/pipework that are clearly visible have been identified. We cannot guarantee that systems/pipework has been traced in areas that are inaccessible, and pass underground through walls, floors, and ceilings.

Building Overview

• Site Description

• Water Supply Company

• Incoming water main location

Duty Holder

• Name of Statutory Duty holder

• Name of Responsible Person

• Deputy Responsible Person

Records

• Person onsite responsible for the maintenance of records

Water Heaters

• Type

  Instantaneous

  Low Volume <25ltrs

  High Volume >25ltrs

• Instantaneous or Point of Use water heaters present little risk of harbouring Legionella bacteria due to the nature of the plant. They are not required to reach any temperature criteria but should be in good condition and inspected frequently.

• Low Volume (<25 Litres) water heaters present a slight risk of Legionella and should be monitored in accordance with ACOP L8 and HSG 274.

• Where water heaters store over 25L of water they present a larger risk of Legionella and as such subject to a higher degree of inspection.

• Location

• Make/model

• Condition

What is the temperature

• The Health & Safety Executives ACOP L8 tells us that the hot water temperature at outlets should be above 50oC within one minute, and the cold below 20oC after two minutes.

• Picture

  Media
Cold Water Outlet Temperature

• Outlet location/description

What is the cold water temperature at water outlets after 2 minutes?

• The Health & Safety Executives ACOP L8 tells us that the hot water temperature at outlets should be above 50oC within one minute, and the cold below 20oC after two minutes.

• Picture

  Media
Hot Water Outlet Temperature

• Outlet location/description

What is the hot water temperature at water outlets within 1 minute?

• The Health & Safety Executives ACOP L8 tells us that the hot water temperature at outlets should be above 50oC within one minute, and the cold below 20oC after two minutes.

• Picture

  Media

Cold Water System

• Drinking water outlets labelled

  Yes

  No

  N/A

• Is a cold water storage tank present?

  Yes

  No

• Is the cold water tank accessible?

  Yes

  No

  N/A

• Does it have a tight-fitting lid?

  Yes

  No

  N/A

• Is the water in the tank clean and free from rust, debris, scale, and organic matter?

  Yes

  No

  N/A

• Is the cold water tank insulated?

  Yes

  No

  N/A
What is the temperature in the tank?

Hot Water System

• Are high temperature outlets labelled to warn of scald risk

  Yes

  No

  N/A

• Is the temperature setting on the boiler and/or hot water tank such that hot water is heated to and stored at a temperature of 60 ° celsius?

  Yes

  No

  N/A

• Are the hot water distribution pipes insulated?

  Yes

  No

  N/A

• If more than one calorifier is used, are they connected in parallel?

  Yes

  No

  N/A

• Does the calorifier have everything fitted?

  Select Drain valve Temperature gauge on the inlet and outlet An access panel N/A

  • Drain valve
  • Temperature gauge on the inlet and outlet
  • An access panel
  • N/A

• Does the calorifier have everything fitted?

  Select Drain valve Temperature gauge on the inlet and outlet An access panel N/A

  • Drain valve
  • Temperature gauge on the inlet and outlet
  • An access panel
  • N/A

Showers

• Are there any showers?

  Yes

  No

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

  Yes

  No

  N/A

• Are there arrangements to clean and disinfect the shower heads and hoses on at least a quarterly basis?

  Yes

  No

  N/A

Little Used Outlets

• Are there any water outlets that are used less than once per week e.g. guest bathrooms?

  Yes

  No

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

  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

• Where in the facility?

• Maintaining and monitoring appropriate records

  0

  10

• Are tanks and outlets free from scale

  0

  10

• Are dead-ends / blind ends evident

  0

  10

• System design - Do TMVs supply long pipe runs or multiple outlets

  0

  10

• Group susceptibility factor - high risk groups

  0

  10

Total Score

• Total score out of 50

Final Risk Rating

• 

• Rating

  Low

  Medium

  High