Pfp Leisure Legionella Inspections 2020 - Putney

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Site Duty Holder Tracy Mcneela Site Responsible Person Adriano Pitorri Deputy Responsible Person Barry Wright

Shower Daily Flushing-See Duty Manager Opening 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 boiler house Flow Temp

• Calorifer 1 boiler house Return Temp

• Calorifer 2 boiler house Flow Temp

• Calorifier 2 boiler house Return Temp

• Calorifier 3 back of boiler house Flow Temp

• Calorifier 3 back of boiler house 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 Changing village gents toilet temp

• Hot Tap 2 First aid room tap temp

• Hot Tap 3 Dryburgh kitchen temp

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 Village Change gents toilet temp

• Cold Tap 2 First aid room temp

• Cold Tap 3 Dryburgh kitchen temp

Week 1 low Use Outlet Flush (3 Min)

• Is Week 1 Tap Flushing Completed?

  Yes

  No

  N/A

• Outlet 1 Flushed drybugh Kitchen

  Yes

  No

  N/A

• Outlet 2 Flushed cleaning cupboards village and drybugh

  Yes

  No

  N/A

• Outlet 3 Flushed Fire hoses main and teaching pool, head in bucket of water to avoid spray

  Yes

  No

  N/A

• Outlet 4 Flushed car wash taps

  Yes

  No

  N/A

• Outlet 5 Flushed lower plant sink

  Yes

  No

  N/A

• Outlet 6 Flushed Emergency shower

  Yes

  No

  N/A

• Outlet 7 Flushed dryburgh toilets

  Yes

  No

  N/A

• Outlet 8 Flushed staff area, changes and kitchen.

  Yes

  No

  N/A

• Outlet 9 Flushed Treatment room lower

  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 drybugh Kitchen

  Yes

  No

  N/A

• Outlet 2 Flushed cleaning cupboards village and drybugh

  Yes

  No

  N/A

• Outlet 3 Flushed Fire hoses main and teaching pool, head in bucket of water to avoid spray

  Yes

  No

  N/A

• Outlet 4 Flushed car wash taps

  Yes

  No

  N/A

• Outlet 5 Flushed lower plant sink

  Yes

  No

  N/A

• Outlet 6 Flushed Emergency shower

  Yes

  No

  N/A

• Outlet 7 Flushed dryburgh toilets

  Yes

  No

  N/A

• Outlet 8 Flushed staff area, changes and kitchen.

  Yes

  No

  N/A

• Outlet 9 Flushed Treatment room lower

  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 drybugh Kitchen

  Yes

  No

  N/A

• Outlet 2 Flushed cleaning cupboards village and drybugh

  Yes

  No

  N/A

• Outlet 3 Flushed Fire hoses main and teaching pool, head in bucket of water to avoid spray

  Yes

  No

  N/A

• Outlet 4 Flushed car wash taps

  Yes

  No

  N/A

• Outlet 5 Flushed lower plant sink

  Yes

  No

  N/A

• Outlet 6 Flushed Emergency shower

  Yes

  No

  N/A

• Outlet 7 Flushed dryburgh toilets

  Yes

  No

  N/A

• Outlet 8 Flushed staff area, changes and kitchen.

  Yes

  No

  N/A

• Outlet 9 Flushed Treatment room lower

  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 drybugh Kitchen

  Yes

  No

  N/A

• Outlet 2 Flushed cleaning cupboards village and drybugh

  Yes

  No

  N/A

• Outlet 3 Flushed Fire hoses main and teaching pool, head in bucket of water to avoid spray

  Yes

  No

  N/A

• Outlet 4 Flushed car wash taps

  Yes

  No

  N/A

• Outlet 5 Flushed lower plant sink

  Yes

  No

  N/A

• Outlet 6 Flushed Emergency shower

  Yes

  No

  N/A

• Outlet 7 Flushed dryburgh toilets

  Yes

  No

  N/A

• Outlet 8 Flushed staff area, changes and kitchen.

  Yes

  No

  N/A

• Outlet 9 Flushed Treatment room lower

  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 drybugh Kitchen

  Yes

  No

  N/A

• Outlet 2 Flushed cleaning cupboards village and drybugh

  Yes

  No

  N/A

• Outlet 3 Flushed Fire hoses main and teaching pool, head in bucket of water to avoid spray

  Yes

  No

  N/A

• Outlet 4 Flushed car wash taps

  Yes

  No

  N/A

• Outlet 5 Flushed lower plant sink

  Yes

  No

  N/A

• Outlet 6 Flushed Emergency shower

  Yes

  No

  N/A

• Outlet 7 Flushed dryburgh toilets

  Yes

  No

  N/A

• Outlet 8 Flushed staff area, changes and kitchen.

  Yes

  No

  N/A

• Outlet 9 Flushed Treatment room lower

  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 wet change Does the water shut off when the cold is isolated (in cubby hole in wall by door) x3 showers

  Yes

  No

  N/A

• Mixer 1 hot inlet pipe temp (in cubby hole in wall by door)

• Mixer 1 cold inlet pipe temp (in cubby hole in wall by door)

• Mixer 1 mixed water temp (in cubby hole in wall by door)

• Mixer 2 Female wet change Does the water shut off when the cold is isolated (behind toilet panel) x3 showers

  Yes

  No

  N/A

• Mixer 2 hot inlet pipe temp (behind toilet panel)

• Mixer 2 cold inlet pipe temp (behind toilet panel)

• Mixer 2 mixed water temp (behind toilet panel)

• Mixer 3 Village Change Left Does the water shut off when the cold is isolated (communal showers left as looking at them from poolside) x5 showers

  Yes

  No

  N/A

• Mixer 3 hot inlet pipe temp

• Mixer 3 cold inlet pipe temp

• Mixer 3 mixed water temp

• Mixer 4 Village Change right Does the water shut off when the cold is isolated (communal showers right as looking at them from poolside female side) x5 shower plus 3 poolside ones that come off this

  Yes

  No

  N/A

• Mixer 4 hot inlet pipe temp

• Mixer 4 cold inlet pipe temp

• Mixer 4 mixed water temp

• Mixer 5 Disabled Change Drysid Does the water shut off when the cold is isolated (disabled change shower by female in corridor) x1

  Yes

  No

  N/A

• Mixer 5 hot inlet pipe temp

• Mixer 5 cold inlet pipe temp

• Mixer 5 mixed water temp

• Mixer 6 Disabled Change wetside Does the water shut off when the cold is isolated (disabled change shower by poolside) x1

  Yes

  No

  N/A

• Mixer 6 hot inlet pipe temp

• Mixer 6 cold inlet pipe temp

• Mixer 6 mixed water temp

• Mixer 7 Male Members 1 left 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

• Mixer 8 Male Members 2 middle Does the water shut off when the cold is isolated

  Yes

  No

  N/A

• Mixer 8 hot inlet pipe temp

• Mixer 8 cold inlet pipe temp

• Mixer 8 mixed water temp

• Mixer 9 Male Members 3 right Does the water shut off when the cold is isolated

  Yes

  No

  N/A

• Mixer 9 hot inlet pipe temp

• Mixer 9 cold inlet pipe temp

• Mixer 9 mixed water temp

• Mixer 10 Female Members 1 Left Does the water shut off when the cold is isolated

  Yes

  No

  N/A

• Mixer 10 hot inlet pipe temp

• Mixer 10 cold inlet pipe temp

• Mixer 10 mixed water temp

• Mixer 11 Female Members 2 Middle Does the water shut off when the cold is isolated

  Yes

  No

  N/A

• Mixer 11 hot inlet pipe temp

• Mixer 11 cold inlet pipe temp

• Mixer 11 mixed water temp

• Mixer 12 Female Members 3 right does the water shut off when cold is isolated?

  Yes

  No

  N/A

• Mixer 12 hot inlet pipe temp

• Mixer 12 cold inlet pipe temp

• Mixer 12 mixed water temp

Quarterly Shower Descale-Mar/Jun/Sep/Dec

• Shower Head Descale Completed

  Yes

  No

  N/A

• Area 1 Male wetside x 3 heads descaled?

  Yes

  No

  N/A

• Area 2 Female wetside x3 heads descaled?

  Yes

  No

  N/A

• Area 3 Village change left x5 heads descaled?

  Yes

  No

  N/A

• Area 4 Village Change right x 8 heads descaled?

  Yes

  No

  N/A

• Area 5 Disabled change in dry corridor x heads descaled?

  Yes

  No

  N/A

• Area 6 Disabled change poolside x1 heads descaled?

  Yes

  No

  N/A

• Area 7 Male Dryside heads descaled? x3 heads descaled

  Yes

  No

  N/A

• Area 8 Female Dryside heads descaled? x3 heads 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 dryburgh Does the water shut off when the cold is isolated x2 Sinks

  Yes

  No

  N/A

• Mixer 1 hot inlet pipe temp

• Mixer 1 cold inlet pipe temp

• Mixer 1 mixed water temp

• Mixer 2 male drybugh disabled Does the water shut off when the cold is isolated x1 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 drybugh Does the water shut off when the cold is isolated x2 Sinks

  Yes

  No

  N/A

• Mixer 3 hot inlet pipe temp

• Mixer 3 cold inlet pipe temp

• Mixer 3 mixed water temp

• Mixer 4 Female drybugh disabled Does the water shut off when the cold is isolated 1x Sink

  Yes

  No

  N/A

• Mixer 4 hot inlet pipe temp

• Mixer 4 cold inlet pipe temp

• Mixer 4 mixed water temp

• Mixer 5 Dance studio male Does the water shut off when the cold is isolated x2 sinks

  Yes

  No

  N/A

• Mixer 5 hot inlet pipe temp

• Mixer 5 cold inlet pipe temp

• Mixer 5 mixed water temp

• Mixer 6 Dance studio female Does the water shut off when the cold is isolated x3 sinks

  Yes

  No

  N/A

• Mixer 6 hot inlet pipe temp

• Mixer 6 cold inlet pipe temp

• Mixer 6 mixed water temp

• Mixer 7 Creche Does the water shut off when the cold is isolated x2 sinks

  Yes

  No

  N/A

• Mixer 7 hot inlet pipe temp

• Mixer 7 cold inlet pipe temp

• Mixer 7 mixed water temp

• Mixer 8 Male members Does the water shut off when the cold is isolated x2 sinks

  Yes

  No

  N/A

• Mixer 8 hot inlet pipe temp

• Mixer 8 cold inlet pipe temp

• Mixer 8 mixed water temp

• Mixer 9 Female Does the water shut off when the cold is isolated x2 sinks

  Yes

  No

  N/A

• Mixer 9 hot inlet pipe temp

• Mixer 9 cold inlet pipe temp

• Mixer 9 mixed water temp

• Mixer 10 village change left mens Does the water shut off when the cold is isolated x2 sinks

  Yes

  No

  N/A

• Mixer 10 hot inlet pipe temp

• Mixer 10 cold inlet pipe temp

• Mixer 10 mixed water temp

• Mixer 11 village change right mens Does the water shut off when the cold is isolated x2 sinks

  Yes

  No

  N/A

• Mixer 11 hot inlet pipe temp

• Mixer 11 cold inlet pipe temp

• Mixer 11 mixed water temp

• Mixer 12 Female village change left Does the water shut off when the cold is isolated x2 sinks

  Yes

  No

  N/A

• Mixer 12 hot inlet pipe temp

• Mixer 12 cold inlet pipe temp

• Mixer 12 mixed water temp

• Mixer 13 Female village change right does the water shut off when cold is isolated x 2 sinks

  Yes

  No

  N/A

• Mixer 13 hot inlet pipe temp

• Mixer 13 cold inlet pipe temp

• Mixer 13 Mixed water temp

Annual Tap Temp Inspections-Nov (taps not inspected under sentinel Inspections) (Hot greater than 50oC Cold less than 20oC)

• Annual tap temp inspections completed?

  Yes

  No

  N/A

• Tap 1 Hot - Area staff kitchen

• Tap 1 Cold - Area staff kitchen

• Tap 2 Hot - Area mens staff change

• Tap 2 Cold - Area mens staff change

• Tap 3 Hot - Area womens staff change

• Tap 3 Cold - Area womens staff change

• Tap 4 Hot - Area mens wet change toilet tap 1 left

• Tap 4 Cold - Area mens wet change toilet tap 1 left

• Tap 5 Hot - Area mens wet change toilet tap 2 middle left

• Tap 5 Cold - Area mens wet change toilet tap 2 middle left

• Tap 6 Hot - Area mens wet change toilet tap 3 middle right

• Tap 6 Cold - Area mens wet change toilet tap 3 middle right

• Tap 7 Hot - Area mens wet change toilet tap 4 right

• Tap 7 Cold - Area mens wet change toilet tap 4 right

• Tap 8 Hot - Area womens wet change toilet tap 1 left

• Tap 8 Cold - Area womens wet change toilet tap 1 left

• Tap 9 Hot - Area womens wet change toilet tap 2 middle

• Tap 10 Cold - Area womens wet change toilet tap 2 middle

• Tap 11 Hot - Area womens wet change toilet tap 3 right

• Tap 11 Cold - Area womens wet change toilet tap 3 right

• Tap 12 Hot - Area cleaners cupboard downstairs

• Tap 12 Cold - Area cleaners cupboard downstairs

• Tap 12A Cold - Area cleaners cupboard downstairs HOSE TAP

• Tap 12B Cold - Members only tap

• Tap 12C Cold - Poolside tap spa

• Tap 12d Cold - Poolside tap

• Tap 13 Hot - Area Disabled toilet poolside

• Tap 13 Cold - Area Disabled toilet poolside

• Tap 14 Hot - Area Disabled toilet dryside corridor

• Tap 14 Cold - Area Disabled toilet dryside corridor

• Tap 15 Hot - Area Teaching Pool Toilet

• Tap 15 Cold - Area Teaching Pool Toilet

• Tap 16 Hot - Area First aid room

• Tap 16 Cold - Area First aid room

• Tap 16A Cold- Area GM Kitchen

• Tap 16B-Cold-Area Treatment Room

• Tap 17 Hot - Area Mens studio toilet tap 1 left

• Tap 17 Cold - Area Mens studio toilet tap 1 left

• Tap 18 Hot - Area Mens studio toilet tap 2 right

• Tap 18 Cold - Area Mens studio toilet tap 2 right

• Tap 19 Hot - Area womens studio toilet tap 1 left

• Tap 19 Cold - Area womens studio toilet tap 1 left

• Tap 20 Hot - Area womens studio toilet tap 2 middle

• Tap 20 Cold - Area womens studio toilet tap 2 middle

• Tap 21 Hot - Area womens studio toilet tap 3 right

• Tap 21 Cold - Area womens studio toilet tap 3 right

• Tap 22 Hot - Area Creche Kitchen

• Tap 22 Cold - Area Creche Kitchen

• Tap 23 Hot - Area creche toilet tap 1 left

• Tap 23 Cold - Area creche toilet tap 1 left

• Tap 24 Hot - Area creche toilet tap 2 right

• Tap 24 Cold - Area creche toilet tap 2 right

• Tap 25 Hot - Area cafe main sink

• Tap 25 Cold - Area cafe main sink

• Tap 26 Hot- Area Cafe hand wash sink

• Tap 26 Cold- Area Cafe hand wash sink

• Tap 27 Hot- Area Cleaning cupboard drybugh

• Tap 27 Cold- Area Cleaning cupboard drybugh

• Tap 28 Hot- Area Male dryburgh tap 1 left

• Tap 28 Cold- Area Male dryburgh tap 1 left

• Tap 29 Hot- Area Male dryburgh tap 2 Right

• Tap 29 Cold- Area Male dryburgh tap 2 Right

• Tap 30 Hot- Area Female dryburgh tap 1 Left

• Tap 30 Cold- Area Female dryburgh tap 1 Left

• Tap 31 Hot- Area Female dryburgh tap 2 Right

• Tap 31 Cold- Area Female dryburgh tap 2 Right

• Tap 32 Hot- Area dryburgh kitchen tap 1 Left

• Tap 32 Cold- Area dryburgh kitchen tap 1 Left

• Tap 33 Hot- Area dryburgh kitchen tap 2 Right

• Tap 33 Cold- Area dryburgh kitchen tap 2 Right

• Tap 34 Hot- Area dryburgh kitchen hand wash sink

• Tap 34 Cold- Area dryburgh kitchen hand wash sink

• Tap 35 Hot- Area Car wash sink

• Tap 35 Cold- Area Car wash sink

• Tap 35A Cold- Area Car wash external Hose tap

• Tap 36 Hot- Area Male Members tap 1 left

• Tap 36 Cold- Area Male Members tap 1 left

• Tap 37 Hot- Area Male Members tap 2 right

• Tap 37 cold- Area Male Members tap 2 right

• Tap 38 Hot- Area Male Members tap 1 left

• Tap 38 Cold- Area Male Members tap 1 left

• Tap 39 Hot- Area Male Members tap 2 right

• Tap 39 Cold- Area Male Members tap 2 left

• Tap 40 Hot- Area Plant room kitchen

• Tap 40 Cold- Area Plant room kitchen

• Tap 41 Cold- Area Workshop

• Tap 42 Cold- Area Lower plant room sink

• Tap 43 Hot- Area Tap by Boiler

Annual Thermometer Calibration-April-WCS will do when on site

• Is the Annual thermometer calibration In date? wcs

  Yes

  No

  N/A

• In date to 17.9.2020

  

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

• Is Annual external calorifier inspection In Date?- WCS

  Yes

  No

  N/A

• In Date to 17.9.2020

  

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

• Annual external tank inspection In Date?-WCS

  Yes

  No

  N/A

• In date to 17.9.2020

  

LPHW-Bi-Annual/Annual-April/October

• Is Bi-Annual/Annual LPHW Inspection In Date? If yes take a picture of the worksheet or Certificate when sent via email.

  Yes

  No

  N/A

• In Date to 2.1.2020

  

Annual tank Inspection Site-July

• Annual tank Inspection-Site

  Yes

  No

  N/A

• Tank 1 Left mains Incoming Water Temp

• Tank 1 Left Water Temp Away From Incoming?

• Tank 2 Right mains Incoming Water Temp

• Tank 2 Right Water Temp Away From Incoming?

Legionella Risk Assessment

• Is Risk Legionella Risk Assessment in date?

  Yes

  No

  N/A

• in Date to Sep 2021

  

• Are All Remedials From the last risk assessment signed off on the signoff sheet with all addtional worksheets saved as evidence?

  Yes

  No

  N/A

• Only tick yes once you have signed them all off with evidence of worksheets

  

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