Templates
Effective Legionella Prevention: Monthly Temperature Inspections

Effective Legionella Prevention: Monthly Temperature Inspections

With this template, maintenance personnel can record the temperature of the water outlets on a monthly basis, making it easy to track fluctuations.

Use this template
or download pdf
Effective Legionella Prevention: Monthly Temperature Inspections

With this template, maintenance personnel can record the temperature of the water outlets on a monthly basis, making it easy to track fluctuations.

Use this template
or download pdf

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Preview of the template
Audit
The temperature of blended water outlets must be distributed in the range of 41 and 43 Degrees Celsius The temperature of cold water outlets must be distributed at or below 20 Degrees Celsius The temperature of hot water outlets must be distributed at or above 50 Degrees Celsius 1. Run the outlet for 1 minute on hot and blended water outlets, cold water outlets run water for 2 minutes 2. Test the temperature with a thermometer 3. Record the temperature in the following audit by stating Safe/At Risk and add the reading into the text box
Blended Water Outlets - Showers
Female 1
Female 2
Female 3
Female 4
Female 5
Female 6
Female 7
Female 8
Male 1
Male 2
Male 3
Male 4
Male 5
Male 6
Male 7
Male 8
Pool Hall
Poolside - Cold
First Aid Room - Hot
First Aid Room - Cold
Wetside Cold Water Outlets - Taps
Female 1
Female 2
Female 3
Male 1
Male 2
Male 3
Cleaners Cupboard
Staff Room
Staff Change
Wetside Hot Water Outlets - Taps
Disabled
Staff Room
Staff Change
Wetside Blended Water Outlets - Taps
Female Disable
Female 1
Female 2
Female 3
Male Disabled
Male 1
Male 2
Male 3
Dryside Cold Water Outlets - Taps
Female 4
Male 4
Male 5
Laundry
Cleaners Cupboard
Dryside Hot Water Outlets - Taps
Laundry
Cleaners Cupboard
Dryside Blended Water Outlets - Taps
Female 4
Male 4
Male 5
Utility Rooms Cold Water Outlets - Taps
Plant Room
Boiler Room
Chemical Room
Signature
Competent Person
Leisure Supervisor/Facility Manager
This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.