Template

Legionella Survey and Risk Assessment Template

by Abdul Muflahi, from the Community

10+

This sample Legionella survey and risk assessment template helps landlords and facility managers evaluate building water systems and control risks. Sections cover cold and hot water temperatures, storage tanks, little used outlets, shower heads, and dead legs, plus tenant guidance and corrective actions. Capture outlet locations and conditions, document findings and notes, then conclude overall risk and schedule regular reviews at least annually. Use this template to assign actions, maintain records, and support compliance across properties.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

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Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Legionella Risk Assessment
Use this Legionella Risk Assessment template to evaluate water systems across your site. Check cold and hot water temperatures, inspect storage tanks, distribution pipes, showers, and little-used outlets, and identify dead legs and stagnation risks. Capture photos, add notes, log temperatures, and verify flushing routines for unoccupied properties. Create on-site reports to document findings, track corrective actions, and maintain compliance with legionella control guidelines.
by Caroline Paton, from the Community
Downloads: 10+
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Template
Legionella Risk Assessment for Domestic Properties
This sample Legionella risk assessment for domestic properties helps landlords, property managers, and homeowners evaluate hot and cold water systems. It covers outlet temperature checks, cold water storage tanks, hot water settings at 60 degrees centigrade, little-used outlets, shower heads, dead legs, and unoccupied periods. Use it to identify hazards, record risks and recommendations, assign responsible persons, and plan remedial actions in line with HSE L8 guidance. Includes prompts for evidence, notes, and annual review.
by Ivelisse Figueroa, from the Community
Downloads: 20+
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Template
Legionella Risk Assessment Template
This sample Legionella risk assessment helps duty holders evaluate domestic hot and cold water systems to minimize Legionnaires disease risk. It covers outlet temperature checks, cold water tank condition and lids, hot water stored at 60 degrees C, flushing of little used outlets, shower head cleaning and descaling, removal of dead legs, and controls for unoccupied properties. The checklist prompts defects, risks, recommendations, and responsible persons, and advises regular review at least annually or when conditions change. Use as a starting point and seek professional guidance to ensure compliance in your jurisdiction.
by machine guading, from the Community
Downloads: 10+
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Template
Domestic Legionella Risk Assessment
Use this domestic Legionella risk assessment to evaluate water systems in homes and small properties. Document property details, water supply, boiler type, and any hot water storage. Record outlet temperatures for taps and showers, inspect header tanks, thermostatic mixing valves, and shower heads, and note any dead legs or external outlets. Assign risk bands, capture photos and signatures, and create recommended actions with target timeframes to control bacteria growth. Ideal for landlords, letting agents, and facility managers to stay compliant and keep occupants safe.
by Greig Nicholls, from the Community
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Legionella Survey and Risk Assessment Template

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