Third Space Tower Weekly Legionella PMV v2

• Conducted on

  Date

• Prepared by

• weekly HWS calorifier checks completed?

  Yes

  N/A

• calorifier one temperature recorded as

• carry out remedial action to increase stored water temperature

  add action taken

• calorifier two temperature recorded as

• carry out remedial action to increase stored water temperature

  add action taken

• calorifier three temperature recorded as

• carry our remedial action to increase stored water temperature

  add action taken

• calorifiers in good order and working as normal?

  Yes

  No

• Detail any issues that need to be taken or planned

weekly cold water storage tank checks

• cold water storage tank temperature on the inlet to the tank?

  Yes

  N/A

• cold water storage temperature recorded as

• Carry out remedial action to reduce the stored cold water temperature

  add action taken

• cold water storage tank in good order and clean with no signs of damage or contamination?

  Yes

  No

• carry out or plan in any remedial works required

  add action taken

water booster pumps in good working order?

• check water booster pumps for normal operation

  Yes

  No

• carry out or plan any remedial works required

  add action taken

water plant room in good order - clean - clear - safe?

• plant room should be kept in good order at all times

  Yes

  No

• note actions taken or planned to put right

  add action taken

• Sentinel tap hot water temperature recorded weekly

  Yes

  N/A

• temperature recorded as?

• carry out remedial action to increase temperature as sentinel tap

  add action taken

• Quarterly clean of shower heads in men's completed?

  Yes

  N/A

• add date and time completed

  Date

• Quarterly clean of the shower heads in the ladies completed?

  Yes

  N/A

• add date and time completed

  Date

Weekly Legionella checks completed?

• Yes

  N/A

• Add signature

  Sign