Title Page

  • Document No.

  • Name of risk assessment

  • Client

  • Location
  • Conducted on

  • Prepared by

Site photo

  • Photo of site externally

Description of the water services installation

  • Building description

  • Incoming main and cold water distribution

  • Hot water description

  • Stored cold water description

  • Stored hot water description

  • Showers in property

  • Other systems in property - sprinklers etc.

  • Dead legs and little used outlets

Scematic drawing

  • Draw a schematic drawing of the property

Temperature regime

  • Is an inspection or sampling of water taken from the base of the hws vessel taken annually to verify if debris is present?

  • Is hws being stored at between 50&60 degrees Celsius?

  • Is the hws vessel large enough to cope with demand?

  • Are operational procedures in place to heat the total contents to 60 degrees Celsius daily?

  • Are operational procedures in place to address when a hws vessel is in standby or out of use?

  • Have hot taps that are no longer in use been removed together with dead legs?

  • Do any infrequently used showers or taps exist?

  • If infrequently used showers or taps exist can these be removed, together with dead legs?

  • Where outlets are not regularly used are procedures in place for weekly flushing of these devices?

  • Are records being maintained for the flushing procedure?

  • Is water reaching 50 degrees Celsius after one minute at all outlets?

  • Are records of both hot water storage and outlet temperatures being maintained?<br>

  • Are stand by pump incorporated into the hws re circulation loop?

  • If stand by pumps are installed are procedures in place to incorporate the stand by unit into routine use?

  • Is the hot water pipe work pipe work thermal insulation complete and in good condition?

  • Is the water temperature at cold water storage outlet below 20 degrees Celsius after running water for 2 minutes?

  • Are records of cws outlet temps being maintained?

  • Are taps free from scale?

  • Are shower heads free from scale?

  • Are there any other points/notes to make towards scale/temperatures?

Water storage

  • Is the water storage clean?

  • Is there a bylaw 30 kit fitted to all tanks?

  • Are connected tanks connected in such a way to prevent stagnant water?

Other associated risks

  • Are there any spas, whirlpools, spray type air washers or other high risk items in the property?

Records held

  • Is a simple description of the water services available?

  • Is a plan/schematic drawing available and if so is it relevant?

  • Are complete and up to date details available describing and giving details of the responsible person?

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.