SPC Water Hygiene Testing Report

• Document No.

• Location
  Address

SPECTRUM PROPERTY CARE LTD Signpost House, Sunrise Business Park, Higher Shaftesbury Road, Blandford Forum, Dorset, DT11 8SA

WATER HYGIENE TESTING REPORT

• Property Address
  Address

• Job Number

• Stored Hot Water Flow Temp °C

• Stored Hot Water Return Temp °C

Outlet Temperatures

• Test frequency

  Monthly

  Quarterly

• Location

• NEAR - Hot Water

• NEAR - Cold Water

• Location

• FAR - Hot Water

• FAR - Cold Water

• Location

• OTHER - Hot Water

• OTHER - Cold Water

Water Heaters

• Does the site have water heaters?

  Yes

  No

• Location of water heater

• Point of test

• Hot water outlet temperature

• Cold water outlet temperature

• Location of water heater

• Point of test

• Hot water outlet temperature

• Cold water outlet temperature

• Location of water heater

• Point of test

• Hot water outlet temperature

• Cold water outlet temperature

• Location of water heater

• Point of test

• Hot water outlet temperature

• Cold water outlet temperature

Cylinders

• Does the site have multiple communal cylinders?

  Yes

  No

• Location of cylinder

• Point of test

• Hot water outlet temperature

• Cold water outlet temperature

• Stored hot water flow temperature

• Location of cylinder

• Point of test

• Hot water outlet temperature

• Cold water outlet temperature

• Stored hot water flow temperature

• Location of cylinder

• Point of test

• Hot water outlet temperature

• Cold water outlet temperature

• Stored hot water flow temperature

Check, descale and disinfect communal shower heads and hoses

• Number of showers

Legionella sample (one outlet)

• Location

• Add media

  Media

• Additional notes

• Engineer's Name & Signature

  Sign

IA-04-12