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A1. Hot Water Calorifiers - Monthly Temperature Check

  • 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

  • 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.

  • 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.

  • 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
  • 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

  • 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

  • Cubicle 1 Shower Head Dismantled, Cleaned and Descaled

  • Cubicle 1 Remedial Works Actioned

  • Cubicle 2 Shower Head Dismantled, Cleaned and Descaled

  • Cubicle 2 Remedial Works Actioned

First Floor Male Change

  • Cubicle 1 Shower Head Dismantled, Cleaned and Descaled

  • Cubicle 1 Remedial Works Actioned

  • Cubicle 2 Shower Head Dismantled, Cleaned and Descaled

  • Cubicle 2 Remedial Works Actioned

First Floor Accessible Change

  • Shower Head Dismantled, Cleaned and Descaled

  • Remedial Works Actioned

Lower Ground Changing Village

  • Cubicle 1 Shower Head Dismantled, Cleaned and Descaled

  • Cubicle 1 Remedial Works Actioned

  • Cubicle 2 Shower Head Dismantled, Cleaned and Descaled

  • Cubicle 2 Remedial Works Actioned

  • Cubicle 3 Shower Head Dismantled, Cleaned and Descaled

  • Cubicle 3 Remedial Works Actioned

Lower Ground Pre Swim

  • Pre Swim 1 Shower Head Dismantled, Cleaned and Descaled

  • Pre Swim 1 Remedial Works Actioned

  • Pre Swim 2 Shower Head Dismantled, Cleaned and Descaled

  • Pre Swim 2 Remedial Works Actioned

  • Pre Swim 3 Shower Head Dismantled, Cleaned and Descaled

  • Pre Swim 3 Remedial Works Actioned

Lower Ground Poolside

  • Poolside Shower Head Dismantled, Cleaned and Descaled

  • Poolside Remedial Works Actioned

Lower Ground Accessible Shower

  • Accessible Shower Head Dismantled, Cleaned and Descaled

  • Accessible Shower Remedial Works Actioned

A5. Monthly Shower Temperature Checks

  • 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

  • Shower 1 - TMV Installed?

  • Shower 1 - Hot Pipework Temperature Shower 1 - Cold Pipework Temperature Shower 1 - Outlet Flow Temperature
  • Shower 1 - Remedial Works Actioned?

  • Shower 2 - TMV Installed?

  • Shower 2 - Hot Pipework Temperature Shower 2 - Cold Pipework Temperature Shower 2 - Outlet Flow Temperature
  • Shower 2 - Remedial Works Actioned?

First Floor Male Change

  • Shower 1 - TMV Installed?

  • Shower 1 - Hot Pipework Temperature Shower 1 - Cold Pipework Temperature Shower 1 - Outlet Flow Temperature
  • Shower 1 - Remedial Works Actioned?

  • Shower 2 - TMV Installed?

  • Shower 2 - Hot Pipework Temperature Shower 2 - Cold Pipework Temperature Shower 2 - Outlet Flow Temperature
  • Shower 2 - Remedial Works Actioned?

First Floor Accessible Change

  • TMV Installed?

  • Hot Pipework Temperature Cold Pipework Temperature Outlet Flow Temperature
  • Remedial Works Actioned?

Lower Ground

  • Cubicle Shower 1 - TMV Installed?

  • Cubicle Shower 1 - Hot Pipework Temperature Cubicle Shower 1 - Cold Pipework Temperature Cubicle Shower 1 - Outlet Flow Temperature
  • Cubicle Shower 1 - Remedial Works Actioned?

  • Cubicle Shower 2 - TMV Installed?

  • Cubicle Shower 2 - Hot Pipework Temperature Cubicle Shower 2 - Cold Pipework Temperature Cubicle Shower 2 - Outlet Flow Temperature
  • Cubicle Shower 2 - Remedial Works Actioned?

  • Cubicle Shower 3 - TMV Installed?

  • Cubicle Shower 3 - Hot Pipework Temperature Cubicle Shower 3 - Cold Pipework Temperature Cubicle Shower 3 - Outlet Flow Temperature
  • Cubicle Shower 3 - Remedial Works Actioned?

  • 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
  • Pre Swim Shower 1 - Remedial Works Actioned?

  • 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
  • Pre Swim Shower 2 - Remedial Works Actioned?

  • 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
  • Pre Swim Shower 3 - Remedial Works Actioned?

  • 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
  • Pre Swim Shower 4 - Remedial Works Actioned?

  • Poolside Shower - TMV Installed?

  • Poolside Shower- Hot Pipework Temperature Poolside Shower - Cold Pipework Temperature Poolside Shower - Outlet Flow Temperature
  • Poolside Shower - Remedial Works Actioned?

  • Accessible Change Shower - TMV Installed?

  • Accessible Change Shower - Hot Pipework Temperature Accessible Change Shower - Cold Pipework Temperature Accessible Change Shower - Outlet Flow Temperature
  • Accessible Change Shower - Remedial Works Actioned?

A7. Hot and Cold Water Tap Outlets - Monthly Temperature Readings

  • 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

  • Female Change Tap 1 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Female Change Tap 1 - Cold Outlet Temperature
  • Female Change Tap 1 - Remedial Works Actioned

  • Female Change Tap 2 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Female Change Tap 2 - Cold Outlet Temperature
  • Female Change Tap 2 - Remedial Works Actioned

  • Male Change Tap 1 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Male Change Tap 1 - Cold Outlet Temperature
  • Male Change Tap 1 - Remedial Works Actioned

  • Male Change Tap 2 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Male Change Tap 2 - Cold Outlet Temperature
  • Male Change Tap 2 - Remedial Works Actioned

  • Accessible Change Tap - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Accessible Change Tap - Cold Outlet Temperature
  • Accessible Change Tap - Remedial Works Actioned

  • Corridor Water Fountain
  • Corridor Water Fountain Remedial Works Actioned

Ground Floor

  • Kitchen Tap - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Kitchen Tap - Cold Outlet Temperature
  • Kitchen Tap - Remedial Works Actioned

  • Toilet Tap - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Toilet Tap - Cold Outlet Temperature
  • Toilet Tap - Remedial Works Actioned

Lower Floor

  • Female Change Tap 1 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Female Change Tap 1 - Cold Outlet Temperature
  • Female Change Tap 1 - Remedial Works Actioned

  • Female Change Tap 2 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Female Change Tap 2 - Cold Outlet Temperature
  • Female Change Tap 2 - Remedial Works Actioned

  • Female Change Tap 3 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Female Change Tap 3 - Cold Outlet Temperature
  • Female Change Tap 3 - Remedial Works Actioned

  • Female Change Tap 4 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Female Change Tap 4 - Cold Outlet Temperature
  • Female Change Tap 4 - Remedial Works Actioned

  • Male Change Tap 1 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Male Change Tap 1 - Cold Outlet Temperature
  • Male Change Tap 1 - Remedial Works Actioned

  • Male Change Tap 2 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Male Change Tap 2 - Cold Outlet Temperature
  • Male Change Tap 2 - Remedial Works Actioned

  • Male Change Tap 3 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Male Change Tap 3 - Cold Outlet Temperature
  • Male Change Tap 3 - Remedial Works Actioned

  • Male Change Tap 4 - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Male Change Tap 4 - Cold Outlet Temperature
  • Male Change Tap 4 - Remedial Works Actioned

  • Accessible Change Tap - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Accessible Change Tap - Cold Outlet Temperature
  • Accessible Change Tap - Remedial Works Actioned

  • Cleaning Store Tap - TMV Installed?

  • Hot Outlet Temperature Hot Pipework Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Hot Outlet Temperature
  • Caution Hot Water Signage in place if over 45 degrees celsius

  • Cleaning Store Tap - Cold Outlet Temperature
  • Cleaning Store Tap - Remedial Works Actioned

A8. Tap Cleaning

  • 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

  • Female Change Tap 1 - Hot and Cold Tap Cleaned and Descaled

  • Female Change Tap 1 - Remedial Works Actioned

  • Female Change Tap 2 - Hot and Cold Tap Cleaned and Descaled

  • Female Change Tap 2 - Remedial Works Actioned

  • Male Change Tap 1 - Hot and Cold Tap Cleaned and Descaled

  • Male Change Tap 1 - Remedial Works Actioned

  • Male Change Tap 2 - Hot and Cold Tap Cleaned and Descaled

  • Male Change Tap 2 - Remedial Works Actioned

  • Accessible Change Tap - Hot and Cold Tap Cleaned and Descaled

  • Accessible Change Tap - Remedial Works Actioned

  • Corridor Water Fountain - Cleaned and Descaled

  • Corridor Water Fountain - Remedial Works Actioned

Ground Floor

  • Kitchen Tap - Hot and Cold Tap Cleaned and Descaled

  • Kitchen Tap - Remedial Works Actioned

  • Toilet Tap - Hot and Cold Tap Cleaned and Descaled

  • Toilet Tap - Remedial Works Actioned

Lower Floor

  • Female Change Tap 1 - Hot and Cold Tap Cleaned and Descaled

  • Female Change Tap 1 - Remedial Works Actioned

  • Female Change Tap 2 - Hot and Cold Tap Cleaned and Descaled

  • Female Change Tap 2 - Remedial Works Actioned

  • Female Change Tap 3 - Hot and Cold Tap Cleaned and Descaled

  • Female Change Tap 3 - Remedial Works Actioned

  • Female Change Tap 4 - Hot and Cold Tap Cleaned and Descaled

  • Female Change Tap 4 - Remedial Works Actioned

  • Male Change Tap 1 - Hot and Cold Tap Cleaned and Descaled

  • Male Change Tap 1 - Remedial Works Actioned

  • Male Change Tap 2 - Hot and Cold Tap Cleaned and Descaled

  • Male Change Tap 2 - Remedial Works Actioned

  • Male Change Tap 3 - Hot and Cold Tap Cleaned and Descaled

  • Male Change Tap 3 - Remedial Works Actioned

  • Male Change Tap 4 - Hot and Cold Tap Cleaned and Descaled

  • Male Change Tap 4 - Remedial Works Actioned

  • Cleaning Store Tap - Cleaned and Descaled

  • Cleaning Store Tap - Remedial Works Actioned

  • Accessible Change Tap - Hot and Cold Tap Cleaned and Descaled

  • Accessible Change Tap - Remedial Works Actioned

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.