PFP Leisure Legionella Inspections 2018 -Lido

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Each month complete audit and send copy to you and to contract tech manager, save in the Legionella online folder as the month and year for easy view if needed, you need to make sure on the first page you input the date ie day/month/year along with your name and the site. any remedials need putting on the site helpdesk this includes risk assessment remedials and annual external site checks by WCS Group.

Site Duty Holder...Darren Baker..Site Responsible Person..Fin Higgs..Deputy Responsible Person...Barry Wright..

Shower Daily Flushing-See Duty Manager Opening/Daily Building Checks

Calorifer Temperature Inspections-Every Month (Flow greater than 60oC return greater than 50oC)

• Monthly Calorifer Inspections Completed?

  Yes

  No

  N/A

• Calorifier 1 Mens Flow Temp

• Calorifer 1 Mens Return Temp

• Calorifer 2 Female Flow Temp

• Calorifier 2 Female Return Temp

• Calorifer 1 Pavilion Flow Temp

• Calorifier 1 Pavilion Return Temp

• Calorifer 2 Pavilion Flow Temp

• Calorifier 2 Pavilion Return Temp

Monthly Hot Tap Temp Inspections (Greater than 50oC) Sentinal Outlets (nearest outlet, furthest outlet and along branches to outlets)

• Monthly Hot Water Inspections Completed?-Sentinal Outlets (greater than 50cO) (nearest outlet, furthest outlet and along branches to outlets)

  Yes

  No

  N/A

• Hot Tap 1 Temp Ladies Change Sinks

• Hot Tap 2 Temp Ladies Disabled Change Sinks

• Hot Tap 3 Temp Male Change Sinks

• Hot Tap 4 Temp Cafe Sinks

• Hot Tap 5 Temp Pavilion Disabled Change sink

• Hot Tap 6 Temp Pavilion Office Sink

Monthly Cold Tap Temp Inspections (Less than 20oC) Sentinal Outlet (nearest outlet, furthest outlet and along branches to outlets)

• Monthly cold water Inspections Completed?

  Yes

  No

  N/A

• Cold Tap 1 Temp Ladies Change Sinks

• Cold Tap 2 Temp Ladies Change Drinking Water Tap

• Cold Tap 3 Temp Ladies Change Disabled Sink

• Cold Tap 4 Temp Male Change Sinks

• Cold Tap 5 Temp Male Change Drinking Water Tap

• Cold Tap 6 Temp Cafe Sinks

• Cold Tap 7 Temp Cafe/Plant Hose Point

• Cold Tap 8 Temp Outside Shower/Tap

• Cold Tap 9 Temp Pavilion Disabled Sink

• Cold Tap 10 Temp Pavilion Office Sink

Week 1 low Use Outlet Flush (3 Min)

• Is Week 1 Tap Flushing Completed?

  Yes

  No

  N/A

• Outlet 1 Flushed Ladies Drinking Tap

  Yes

  No

  N/A

• Outlet 2 Flushed Ladies Disabled Change Sink

  Yes

  No

  N/A

• Outlet 3 Flushed Mens Drinking Tap

  Yes

  No

  N/A

• Outlet 4 Flushed Cafe/Plant Outside Hose Tap

  Yes

  No

  N/A

• Outlet 5 Flushed Outisde Shower/Tap

  Yes

  No

  N/A

• Outlet 6 Flushed Swimming Club West-side Terrace Tea Room

  Yes

  No

  N/A

• Outlet 7 Flushed Plant-Room Hose Tap By Entrance

  Yes

  No

  N/A

• Outlet 8 Flushed Plant-Room Emergency Shower

  Yes

  No

  N/A

• Outlet 9 Flushed Plant-Room House Point Under Shower

  Yes

  No

  N/A

• Outlet 10 Flushed Plant-Room Back Hose Point

  Yes

  No

  N/A

• Week 1 Sign-Off

  Sign

Week 2 low Use Outlet Flush (3Min)

• Is Week 2 Flushing Completed?

  Yes

  No

  N/A

• Outlet 1 Flushed Ladies Drinking Tap

  Yes

  No

  N/A

• Outlet 2 Flushed Ladies Disabled Change Sink

  Yes

  No

  N/A

• Outlet 3 Flushed Mens Drinking Tap

  Yes

  No

  N/A

• Outlet 4 Flushed Cafe/Plant Outside Hose Tap

  Yes

  No

  N/A

• Outlet 5 Flushed Outisde Shower/Tap

  Yes

  No

  N/A

• Outlet 6 Flushed Swimming Club West-side Terrace Tea Room

  Yes

  No

  N/A

• Outlet 7 Flushed Plant-Room Hose Tap By Entrance

  Yes

  No

  N/A

• Outlet 8 Flushed Plant-Room Emergency Shower

  Yes

  No

  N/A

• Outlet 9 Flushed Plant-Room House Point Under Shower

  Yes

  No

  N/A

• Outlet 10 Flushed Plant-Room Back Hose Point

  Yes

  No

  N/A

• Week 2 Sign-Off

  Sign

Week 3 low Use Outlet Flush (3 Min)

• Is Week 3 Flushing Completed?

  Yes

  No

  N/A

• Outlet 1 Flushed Ladies Drinking Tap

  Yes

  No

  N/A

• Outlet 2 Flushed Ladies Disabled Change Sink

  Yes

  No

  N/A

• Outlet 3 Flushed Mens Drinking Tap

  Yes

  No

  N/A

• Outlet 4 Flushed Cafe/Plant Outside Hose Tap

  Yes

  No

  N/A

• Outlet 5 Flushed Outisde Shower/Tap

  Yes

  No

  N/A

• Outlet 6 Flushed Swimming Club West-side Terrace Tea Room

  Yes

  No

  N/A

• Outlet 7 Flushed Plant-Room Hose Tap By Entrance

  Yes

  No

  N/A

• Outlet 8 Flushed Plant-Room Emergency Shower

  Yes

  No

  N/A

• Outlet 9 Flushed Plant-Room House Point Under Shower

  Yes

  No

  N/A

• Outlet 10 Flushed Plant-Room Back Hose Point

  Yes

  No

  N/A

• Week 3 Sign-Off

  Sign

Week 4 low Use Outlet Flush (3 Min)

• Is Week 4 Flushing Completed?

  Yes

  No

  N/A

• Outlet 1 Flushed Ladies Drinking Tap

  Yes

  No

  N/A

• Outlet 2 Flushed Ladies Disabled Change Sink

  Yes

  No

  N/A

• Outlet 3 Flushed Mens Drinking Tap

  Yes

  No

  N/A

• Outlet 4 Flushed Cafe/Plant Outside Hose Tap

  Yes

  No

  N/A

• Outlet 5 Flushed Outisde Shower/Tap

  Yes

  No

  N/A

• Outlet 6 Flushed Swimming Club West-side Terrace Tea Room

  Yes

  No

  N/A

• Outlet 7 Flushed Plant-Room Hose Tap By Entrance

  Yes

  No

  N/A

• Outlet 8 Flushed Plant-Room Emergency Shower

  Yes

  No

  N/A

• Outlet 9 Flushed Plant-Room House Point Under Shower

  Yes

  No

  N/A

• Outlet 10 Flushed Plant-Room Back Hose Point

  Yes

  No

  N/A

• Week 4 Sign-Off

  Sign

Week 5 low Use Outlet Flush (3 Min)

• Is Week 5 Flushing completed?

  Yes

  No

  N/A

• Outlet 1 Flushed Ladies Drinking Tap

  Yes

  No

  N/A

• Outlet 2 Flushed Ladies Disabled Change Sink

  Yes

  No

  N/A

• Outlet 3 Flushed Mens Drinking Tap

  Yes

  No

  N/A

• Outlet 4 Flushed Cafe/Plant Outside Hose Tap

  Yes

  No

  N/A

• Outlet 5 Flushed Outisde Shower/Tap

  Yes

  No

  N/A

• Outlet 6 Flushed Swimming Club West-side Terrace Tea Room

  Yes

  No

  N/A

• Outlet 7 Flushed Plant-Room Hose Tap By Entrance

  Yes

  No

  N/A

• Outlet 8 Flushed Plant-Room Emergency Shower

  Yes

  No

  N/A

• Outlet 9 Flushed Plant-Room House Point Under Shower

  Yes

  No

  N/A

• Outlet 10 Flushed Plant-Room Back Hose Point

  Yes

  No

  N/A

• Week 5 Sign-Off

  Sign

Quarterly Shower Mixer Inspections-Mar/Jun/Sep/Dec (hot inlet greater than 50oC cold inlet less than 20oC mixed water 41oC)

• Quarterly Shower Mixer Inspections Completed?

  Yes

  No

  N/A

• Mixer 1 Male Change x 8 Showers Does the water shut off when the cold is isolated (Mixer With Plantroom)

  Yes

  No

  N/A

• Mixer 1 Male Change x 8 Showers hot inlet pipe temp

• Mixer 1 Male Change x 8 Showers cold inlet pipe temp

• Mixer 1 Male Change x 8 Showers mixed water temp

• Mixer 2 Female Change 4x showers Does the water shut off when the cold is isolated (Mixer Within Plantroom Large One)

  Yes

  No

  N/A

• Mixer 2 hot inlet pipe temp

• Mixer 2 cold inlet pipe temp

• Mixer 2 mixed water temp

• Mixer 3 Female Change 1x shower Does Shower the water shut off when the cold is isolated (mixer With disabled change behind panel)

  Yes

  No

  N/A

• Mixer 3 hot inlet pipe temp

• Mixer 3 cold inlet pipe temp

• Mixer 3 mixed water temp

• Mixer 4 Female Change 4 x Does the water shut off when the cold is isolated (Mixer behind panel first toilet cubical)

  Yes

  No

  N/A

• Mixer 4 hot inlet pipe temp

• Mixer 4 cold inlet pipe temp

• Mixer 4 mixed water temp

• Mixer 5 Pavilion RH Shower Room x 1 Shower Does the water shut off when the cold is isolated (Mixer in access panel in RH shower room)

  Yes

  No

  N/A

• Mixer 5 hot inlet pipe temp

• Mixer 5 cold inlet pipe temp

• Mixer 5 mixed water temp

• Mixer 6 Pavilion LH Shower Room x 1 Shower Does the water shut off when the cold is isolated (Mixer in access panel in LH shower room)

  Yes

  No

  N/A

• Mixer 6 hot inlet pipe temp

• Mixer 6 cold inlet pipe temp

• Mixer 6 mixed water temp

• Mixer 7 Pavilion Disabled shower Does the water shut off when the cold is isolated

  Yes

  No

  N/A

• Mixer 7 hot inlet pipe temp

• Mixer 7 cold inlet pipe temp

• Mixer 7 mixed water temp

Quarterly Shower Descale-Mar/Jun/Sep/Dec

• Shower Head Descale Completed

  Yes

  No

  N/A

• Area 1 Male Change x 8 heads descaled?

  Yes

  No

  N/A

• Area 2 Female Change x 9 heads descaled?

  Yes

  No

  N/A

• Area 3 Female Change Disabled Change heads descaled?

  Yes

  No

  N/A

• Area 4 Pavilion Change 1 (Left) heads descaled?

  Yes

  No

  N/A

• Area 5 Pavilion Change 2 (Right) heads descaled?

  Yes

  No

  N/A

• Area 6 Pavilion Disabled Change heads descaled?

  Yes

  No

  N/A

• Area 7 External Shower head descaled?

  Yes

  No

  N/A

Half Yearly Tap Mixer-Apr/Oct (Hot inlet greater than 50oC Cold inlet less than 20oC Mixed water 41oC)

• Tap mixer inspections completed?

  Yes

  No

  N/A

• Mixer 1 Male Change x 5 basins Does the water shut off when the cold is isolated (behind panel under sink)

  Yes

  No

  N/A

• Mixer 1 hot inlet pipe temp

• Mixer 1 cold inlet pipe temp

• Mixer 1 mixed water temp

• Mixer 2 Female Change x 5 basins Does the water shut off when the cold is isolated (behind panel under sink)

  Yes

  No

  N/A

• Mixer 2 hot inlet pipe temp

• Mixer 2 cold inlet pipe temp

• Mixer 2 mixed water temp

• Mixer 3 Female Change Disabled Change basin Does the water shut off when the cold is isolated

  Yes

  No

  N/A

• Mixer 3 hot inlet pipe temp

• Mixer 3 cold inlet pipe temp

• Mixer 3 mixed water temp

• Mixer 4 Female Change Baby Change Room Basin Does the water shut off when the cold is isolated

  Yes

  No

  N/A

• Mixer 4 hot inlet pipe temp

• Mixer 4 cold inlet pipe temp

• Mixer 4 mixed water temp

• Mixer 5 Pavilion Toilets x 2 basins Does the water shut off when the cold is isolated (in void above lh shower room)

  Yes

  No

  N/A

• Mixer 5 hot inlet pipe temp

• Mixer 5 cold inlet pipe temp

• Mixer 5 mixed water temp

• Mixer 6 Pavilion Disabled Change basin Does the water shut off when the cold is isolated (located under sink)

  Yes

  No

  N/A

• Mixer 6 hot inlet pipe temp

• Mixer 6 cold inlet pipe temp

• Mixer 6 mixed water temp

• Mixer 7 Pavilion Office basin Does the water shut off when the cold is isolated (located in cupboard under sink)

  Yes

  No

  N/A

• Mixer 7 hot inlet pipe temp

• Mixer 7 cold inlet pipe temp

• Mixer 7 mixed water temp

Annual Tap Temp Inspections-Nov (Hot greater than 50oC Cold less than 20oC)

• Annual tap temp inspections completed?

  Yes

  No

  N/A

• Tap 1 Hot - Male change Left To Right

• Tap 1 Cold - Male change left To Right

• Tap 2 Hot - Male change left to right

• Tap 2 Cold - Male change left to right

• Tap 3 Hot - Male change left to right

• Tap 3 Cold - Male change left to right

• Tap 4 Hot - Male change left to right

• Tap 4 Cold - Male change left to right

• Tap 5 Hot - Male change left to right

• Tap 5 Cold - Male change left to right

• Tap 5a Cold - Male change drinking water Single Tap

• Tap 6 Hot - Female change left to right

• Tap 6 Cold - Female change left to right

• Tap 7 Hot - Female change left to right

• Tap 7 Cold - Female change left to right

• Tap 8 Hot - Female change left to right

• Tap 8 Cold - Female change left to right

• Tap 9 Hot - Female change left to right

• Tap 9 Cold - Female change left to right

• Tap 10 Hot - Female change left to right

• Tap 10 Cold - Female change left to right

• Tap 10a Cold - Female change drinking water single tap

• Tap 11 Hot Female/Baby change

• Tap 11 Cold Female/Baby change

• Tap 12 Hot Cafe left to right

• Tap 12 Cold Cafe left to right

• Tap 13 Hot - Cafe left to right

• Tap 13 Cold - Cafe left to right

• Tap 14 Hot - Cafe left to right

• Tap 14 Cold - Cafe left to right

• Tap 15 Hot - Pavilion left toilet

• Tap 15 Cold - Pavilion left toilet

• Tap 16 Hot - Pavilion right toilet

• Tap 16 Cold - Pavilion right toilet

• Tap 17 Hot - Pavilion disabled toilet

• Tap 17 Cold - Pavilion disabled toilet

• Tap 18 Hot - Pavilion staff room

• Tap 18 Cold - Pavilion staff room

• Tap 19 Hot - Pavilion kitchen

• Tap 19 Cold - Pavilion Kitchen

• Tap 20 Hot - Pavilion Office

• Tap 20 Cold - Pavilion Office

• Tap 21 Cold - West terrace club tea room tap

• Tap 22 Cold - Cafe/Paddling pool hose point tap

• Tap 23 Cold - Outside shower water tap

• Tap 24 Cold - Plantoom Hose point on entry

• Tap 25 Cold - Plantoom Hose point under emergency shower

• Tap 26 Cold - Plantoom Hose point back plant area

Annual Mixer Service/Filter Clean/Replacement-Either Attach Here worksheet with photo evidence or take pic on mixer quaterly/half yearly temp checks

• Annual Mixer Service-Filter Clean/Replacement In Date?

  Yes

  No

  N/A

• Due service 20.4.19

  

Annual Thermometer Calibration -April-Advance -If yes take a picture of the worksheet or certificate when sent via email

• Thermometer calibration In Date? Advance

  Yes

  No

  N/A

• calibration due 03/2019

  

Annual Calorifer Inspection External-Advance April If yes take a picture of the worksheet or Certificate when sent via email.

• Annual external calorifier inspection In date?-Advance

  Yes

  No

  N/A

• Inspection Due 17th April 19

  

LPHW-Bi-Annual/Annual-April/October-Advance If yes take a picture of the worksheet or Certificate when sent via email.

• Are Bi-Annual/Annual LPHW Inspection In date? Advance

  Yes

  No

  N/A

• Inspection due 17th Oct 18

  

Training

• Has any additional Legionella awareness training been complete this month either via Mylearning or External training? If yes make log of name and date on note.

  Yes

  N,A

• Monthly Inspections Sign-Off

  Sign