Title Page
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Site conducted
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Completed on
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Completed by
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Location
A1. Hot Water Calorifiers - Monthly Temperature Check
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NOTE: Where multiple calorifiers are in use, individual calorifier stored flow & return temperatures should be recorded where possible
Atlas Basement - Stored Hot Water Temperature (Minimum 60 degrees)
Atlas Basement - Flow Hot Water Temperature (Minimum 60 degrees)
Atlas Basement - Return Hot Water Temperature (Minimum 50 degrees)
A2. Sentinel Taps - Monthly Temperature Check
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Definition of sentinel taps: Hot water services. The first and last taps on a recirculating system. Cold water systems (or non-recirculating hot water systems). The nearest and furthest taps from the storage tank. the choice of sentinel taps may also include other taps which are considered to represent a particular risk.
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Where a TMV is installed on a sentinel location, the pipework supplying the TMV should be monitored to ensure the hot pipe is >50 degrees celcius & the cold pipework is < 20 degrees celcius.
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Hot water > 50 degrees celsius at the outlet within 1 minute
Closest Hot Water Outlet Temperature - Pool Plant Room Tap
Furthest Hot Water Outlet Temperature - 1st Floor Accessible Change
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Cold water < 20 degrees celsius at outlet within 2 minutes
Closest Cold water Outlet Temperature - 1st Floor Male Tap
Furthest Cold water Outlet Temperature - Pool Store Room Tap
A3. Cold Water Tanks (CWS) - Monthly Temperature Check
- CWS Incoming Water Mains Temperature - First Floor Plant Room
CWS Stored Water Temperature - First Floor Plant Room
A4. Shower Head Cleaning
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In each area listed, complete checks from left to right where there is more than one shower present (i.e. start with shower furthest to the left)
First Floor Female Change
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Cubicle 1 Shower Head Dismantled, Cleaned and Descaled
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Cubicle 1 Remedial Works Actioned
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Cubicle 2 Shower Head Dismantled, Cleaned and Descaled
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Cubicle 2 Remedial Works Actioned
First Floor Male Change
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Cubicle 1 Shower Head Dismantled, Cleaned and Descaled
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Cubicle 1 Remedial Works Actioned
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Cubicle 2 Shower Head Dismantled, Cleaned and Descaled
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Cubicle 2 Remedial Works Actioned
First Floor Accessible Change
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Shower Head Dismantled, Cleaned and Descaled
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Remedial Works Actioned
Lower Ground Changing Village
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Cubicle 1 Shower Head Dismantled, Cleaned and Descaled
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Cubicle 1 Remedial Works Actioned
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Cubicle 2 Shower Head Dismantled, Cleaned and Descaled
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Cubicle 2 Remedial Works Actioned
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Cubicle 3 Shower Head Dismantled, Cleaned and Descaled
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Cubicle 3 Remedial Works Actioned
Lower Ground Pre Swim
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Pre Swim 1 Shower Head Dismantled, Cleaned and Descaled
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Pre Swim 1 Remedial Works Actioned
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Pre Swim 2 Shower Head Dismantled, Cleaned and Descaled
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Pre Swim 2 Remedial Works Actioned
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Pre Swim 3 Shower Head Dismantled, Cleaned and Descaled
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Pre Swim 3 Remedial Works Actioned
Lower Ground Poolside
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Poolside Shower Head Dismantled, Cleaned and Descaled
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Poolside Remedial Works Actioned
Lower Ground Accessible Shower
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Accessible Shower Head Dismantled, Cleaned and Descaled
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Accessible Shower Remedial Works Actioned
A5. Monthly Shower Temperature Checks
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Select approximately 25% of showers in block for temperature checks. In each area listed, complete checks from left to right where there is more than one shower present (i.e. start with shower furthest to the left). Where a TMV is installed and the pipework is accessible, take the temperature on the pipework.
First Floor Female Change
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Shower 1 - TMV Installed?
Shower 1 - Hot Pipework Temperature
Shower 1 - Cold Pipework Temperature
Shower 1 - Outlet Flow Temperature
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Shower 1 - Remedial Works Actioned?
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Shower 2 - TMV Installed?
Shower 2 - Hot Pipework Temperature
Shower 2 - Cold Pipework Temperature
Shower 2 - Outlet Flow Temperature
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Shower 2 - Remedial Works Actioned?
First Floor Male Change
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Shower 1 - TMV Installed?
Shower 1 - Hot Pipework Temperature
Shower 1 - Cold Pipework Temperature
Shower 1 - Outlet Flow Temperature
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Shower 1 - Remedial Works Actioned?
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Shower 2 - TMV Installed?
Shower 2 - Hot Pipework Temperature
Shower 2 - Cold Pipework Temperature
Shower 2 - Outlet Flow Temperature
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Shower 2 - Remedial Works Actioned?
First Floor Accessible Change
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TMV Installed?
Hot Pipework Temperature
Cold Pipework Temperature
Outlet Flow Temperature
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Remedial Works Actioned?
Lower Ground
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Cubicle Shower 1 - TMV Installed?
Cubicle Shower 1 - Hot Pipework Temperature
Cubicle Shower 1 - Cold Pipework Temperature
Cubicle Shower 1 - Outlet Flow Temperature
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Cubicle Shower 1 - Remedial Works Actioned?
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Cubicle Shower 2 - TMV Installed?
Cubicle Shower 2 - Hot Pipework Temperature
Cubicle Shower 2 - Cold Pipework Temperature
Cubicle Shower 2 - Outlet Flow Temperature
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Cubicle Shower 2 - Remedial Works Actioned?
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Cubicle Shower 3 - TMV Installed?
Cubicle Shower 3 - Hot Pipework Temperature
Cubicle Shower 3 - Cold Pipework Temperature
Cubicle Shower 3 - Outlet Flow Temperature
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Cubicle Shower 3 - Remedial Works Actioned?
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Pre Swim Shower 1 - TMV Installed?
Pre Swim Shower 1 - Hot Pipework Temperature
Pre Swim Shower 1 - Cold Pipework Temperature
Pre Swim Shower 1 - Outlet Flow Temperature
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Pre Swim Shower 1 - Remedial Works Actioned?
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Pre Swim Shower 2 - TMV Installed?
Pre Swim Shower 2 - Hot Pipework Temperature
Pre Swim Shower 2 - Cold Pipework Temperature
Pre Swim Shower 2 - Outlet Flow Temperature
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Pre Swim Shower 2 - Remedial Works Actioned?
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Pre Swim Shower 3 - TMV Installed?
Pre Swim Shower 3 - Hot Pipework Temperature
Pre Swim Shower 3 - Cold Pipework Temperature
Pre Swim Shower 3 - Outlet Flow Temperature
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Pre Swim Shower 3 - Remedial Works Actioned?
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Pre Swim Shower 4 - TMV Installed?
Pre Swim Shower 4 - Hot Pipework Temperature
Pre Swim Shower 4 - Cold Pipework Temperature
Pre Swim Shower 4 - Outlet Flow Temperature
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Pre Swim Shower 4 - Remedial Works Actioned?
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Poolside Shower - TMV Installed?
Poolside Shower- Hot Pipework Temperature
Poolside Shower - Cold Pipework Temperature
Poolside Shower - Outlet Flow Temperature
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Poolside Shower - Remedial Works Actioned?
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Accessible Change Shower - TMV Installed?
Accessible Change Shower - Hot Pipework Temperature
Accessible Change Shower - Cold Pipework Temperature
Accessible Change Shower - Outlet Flow Temperature
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Accessible Change Shower - Remedial Works Actioned?
A7. Hot and Cold Water Tap Outlets - Monthly Temperature Readings
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In each area listed, complete checks from left to right where there is more than one tap present (i.e. start with shower furthest to the left). Where a TMV is installed and the pipework is accessible, take the temperature on the pipework. Where a TMV is in place, hot outlet temperature should by 39-43 degrees celsius within 1 minute of tap running. Without a TMV, hot outlet temperature should be >50 degrees celsius within 1 minute of tap running. Cold outlet temperature should be below 20 degrees celsius within 2 minutes of tap running.
Level 1
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Female Change Tap 1 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Female Change Tap 1 - Cold Outlet Temperature
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Female Change Tap 1 - Remedial Works Actioned
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Female Change Tap 2 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Female Change Tap 2 - Cold Outlet Temperature
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Female Change Tap 2 - Remedial Works Actioned
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Male Change Tap 1 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Male Change Tap 1 - Cold Outlet Temperature
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Male Change Tap 1 - Remedial Works Actioned
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Male Change Tap 2 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Male Change Tap 2 - Cold Outlet Temperature
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Male Change Tap 2 - Remedial Works Actioned
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Accessible Change Tap - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Accessible Change Tap - Cold Outlet Temperature
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Accessible Change Tap - Remedial Works Actioned
Corridor Water Fountain
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Corridor Water Fountain Remedial Works Actioned
Ground Floor
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Kitchen Tap - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Kitchen Tap - Cold Outlet Temperature
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Kitchen Tap - Remedial Works Actioned
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Toilet Tap - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Toilet Tap - Cold Outlet Temperature
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Toilet Tap - Remedial Works Actioned
Lower Floor
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Female Change Tap 1 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Female Change Tap 1 - Cold Outlet Temperature
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Female Change Tap 1 - Remedial Works Actioned
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Female Change Tap 2 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Female Change Tap 2 - Cold Outlet Temperature
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Female Change Tap 2 - Remedial Works Actioned
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Female Change Tap 3 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Female Change Tap 3 - Cold Outlet Temperature
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Female Change Tap 3 - Remedial Works Actioned
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Female Change Tap 4 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Female Change Tap 4 - Cold Outlet Temperature
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Female Change Tap 4 - Remedial Works Actioned
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Male Change Tap 1 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Male Change Tap 1 - Cold Outlet Temperature
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Male Change Tap 1 - Remedial Works Actioned
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Male Change Tap 2 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Male Change Tap 2 - Cold Outlet Temperature
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Male Change Tap 2 - Remedial Works Actioned
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Male Change Tap 3 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Male Change Tap 3 - Cold Outlet Temperature
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Male Change Tap 3 - Remedial Works Actioned
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Male Change Tap 4 - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Male Change Tap 4 - Cold Outlet Temperature
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Male Change Tap 4 - Remedial Works Actioned
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Accessible Change Tap - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Accessible Change Tap - Cold Outlet Temperature
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Accessible Change Tap - Remedial Works Actioned
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Cleaning Store Tap - TMV Installed?
Hot Outlet Temperature
Hot Pipework Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Hot Outlet Temperature
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Caution Hot Water Signage in place if over 45 degrees celsius
Cleaning Store Tap - Cold Outlet Temperature
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Cleaning Store Tap - Remedial Works Actioned
A8. Tap Cleaning
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In each area listed, complete checks from left to right where there is more than one tap present (i.e. start with tap furthest to the left)
Level 1
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Female Change Tap 1 - Hot and Cold Tap Cleaned and Descaled
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Female Change Tap 1 - Remedial Works Actioned
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Female Change Tap 2 - Hot and Cold Tap Cleaned and Descaled
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Female Change Tap 2 - Remedial Works Actioned
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Male Change Tap 1 - Hot and Cold Tap Cleaned and Descaled
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Male Change Tap 1 - Remedial Works Actioned
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Male Change Tap 2 - Hot and Cold Tap Cleaned and Descaled
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Male Change Tap 2 - Remedial Works Actioned
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Accessible Change Tap - Hot and Cold Tap Cleaned and Descaled
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Accessible Change Tap - Remedial Works Actioned
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Corridor Water Fountain - Cleaned and Descaled
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Corridor Water Fountain - Remedial Works Actioned
Ground Floor
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Kitchen Tap - Hot and Cold Tap Cleaned and Descaled
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Kitchen Tap - Remedial Works Actioned
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Toilet Tap - Hot and Cold Tap Cleaned and Descaled
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Toilet Tap - Remedial Works Actioned
Lower Floor
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Female Change Tap 1 - Hot and Cold Tap Cleaned and Descaled
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Female Change Tap 1 - Remedial Works Actioned
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Female Change Tap 2 - Hot and Cold Tap Cleaned and Descaled
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Female Change Tap 2 - Remedial Works Actioned
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Female Change Tap 3 - Hot and Cold Tap Cleaned and Descaled
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Female Change Tap 3 - Remedial Works Actioned
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Female Change Tap 4 - Hot and Cold Tap Cleaned and Descaled
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Female Change Tap 4 - Remedial Works Actioned
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Male Change Tap 1 - Hot and Cold Tap Cleaned and Descaled
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Male Change Tap 1 - Remedial Works Actioned
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Male Change Tap 2 - Hot and Cold Tap Cleaned and Descaled
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Male Change Tap 2 - Remedial Works Actioned
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Male Change Tap 3 - Hot and Cold Tap Cleaned and Descaled
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Male Change Tap 3 - Remedial Works Actioned
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Male Change Tap 4 - Hot and Cold Tap Cleaned and Descaled
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Male Change Tap 4 - Remedial Works Actioned
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Cleaning Store Tap - Cleaned and Descaled
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Cleaning Store Tap - Remedial Works Actioned
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Accessible Change Tap - Hot and Cold Tap Cleaned and Descaled
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Accessible Change Tap - Remedial Works Actioned