Date Certificate Serial No/Ref: LEGIONELLA RISK ASSESSMENT · The risk being assessed This assessment is designed to determine the risk to tenants and visitors of exposure to legionella
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A. DETAILS OF THE CLIENT OR PERSON ORDERING THE WORK
B. REASON FOR PRODUCING THIS REPORT
C. DETAILS OF THE INSTALLATION WHICH IS THE SUBJECT OF THIS REPORT
D. EXTENT AND LIMITATIONS OF INSPECTION AND TESTING
E. SUMMARY OF THE CONDITION OF THE INSTALLATION
Date Certificate Serial No/Ref:
Name:
Address:
Date(s) inspection and testing carried out:
C
Address:
Occupier:
Description of premises:
Estimated age of system: Years Evidence of additions of alterations No Yes Not apparent
Installation records available: Date of last
inspection No Yes
Alternative source of supply
(as described in attached
schedule if applicable)
Extent of the water system covered by this report
Agreed limitations, including reasons
Limitations agreed with Position (if applicable)
Operational limitations
including the reasons
General condition of the installation (in terms of legionella safety)
Overall assessment of the installation in terms of its suitability for continued use:
An unsatisfactory indicates that dangerous (code C1) and/or potentially dangerous (code C2) conditions have been identified
LEGIONELLA RISK
ASSESSMENT (Requirements for HSG274 Part 2: Legionella bacteria in
H. SCHEDULES The attached schedule(s) are part of this document and this report is valid only when they are attached to it
I. ADVICE FOR DUTY HOLDER
What is Legionnaires' disease?
Legionellosis is a collective term for respiratory illnesses caused by inhalation of vapourised legionella bacteria including the most serious; Legionnaires’ disease. Legionnaires’ disease is a potentially fatal form of pneumonia and everyone is susceptib le to infection. Some people are at higher risk including:
people over 45 years of age
smokers and heavy drinkers
people suffering from chronic respiratory or kidney disease
people with diabetes, lung and/or heart disease
anyone with an impaired immune system
Outbreaks of the disease stem from people inhaling water vapour containing legionella bacteria. This bacteria is found in domestic hot and cold water systems where water is stored within a hospitable temperature range which promotes formation, i.e. 20-50°C.
How do people contract it?
People contract Legionnaires’ disease by inhaling water vapour containing the bacteria. Certain factors increase the risk of legionella bacteria formation in a domestic system, including:
if the water temperature in all or some parts of a system is between 20-50 °C the abundance of vapour producing water outlets e.g. shower heads if stored water is present the availability of contaminants which act as a source of nutrients for the bacteria, promoting formation i.e. rust, sludge,
limescale, organic matter and biofilm
Where the overall assessment of the suitability of the installation for continued use on page 1 is stated as
UNSATISFACTORY, I/we recommend that any observations classified as 'Danger present• (Code C1) or 'Potentially
dangerous• (Code C2) are acted upon as a matter of urgency. Investigation without delay is recommended for
observations identified as 'Further investigation required' (Fl) Observations classified as 'improvement
recommended' (Code C3) should be given due consideration.
Subject to the necessary remedial action being taken, I/we recommend that the installation is further inspected and tested by
I (the assessor) have completed this form in accordance with ‘The Approved Code of Practice: Legionnaires’
disease: The control of Legionella bacteria in water systems (L8)’ and accompanying technical guidance notes
‘HSG274 (Part 2)’.
INSPECTED AND TESTED BY:
Name
(CAPITALS)
Signature
Position
Contact
Date
REPORT AUTHORISED FOR ISSUE BY:
Contractor
Address
Name
Signature
Schedule of inspection attached Schedule(s) of test results attached
The symptoms of Legionnaires' disease are similar to the symptoms of influenza, namely:
high temperature, feverishness and chills
cough
muscle pains
headache
pneumonia
diarrhoea and signs of mental confusion
Legionnaires’ disease is not considered contagious.
How is it treated?
The illness is treatable with an antibiotics in certain cases. Unfortunately however, it can prove fatal.
If your tenant(s) develop one or more of the above symptoms and you are concerned that they may have contracted Legionnaires' disease, urge them to seek medical attention immediately.
Legal requirement
‘It is a legal duty to carry out an assessment [on a domestic property] to identify and assess whether there is a risk posed by exposure to legionella from the hot and cold water system …’ HSG274 - Part 2 (Section 2.6); technical guidance accompaniment to ‘The Approved Code of Practice: Legionnaires’ disease: The control of Legionella bacteria in water systems (L8)’
The risk being assessed
This assessment is designed to determine the risk to tenants and visitors of exposure to legionella bacteria from activities utilising the hot and cold water system on the premises.
The hazard
The hazard is the inhalation of water droplets containing legionella bacteria.
The people at risk
The following parties have been identified as being at risk:
tenants visitors
Of particular risk are:
those with a long term illness, especially if the respiratory system is affected smokers heavy drinkers the elderly
Active parties in this assessment
Duty holder – (person in control of the property i.e. Landlord/letting agent) Assessor – Mr. P Cookson Service Provider – P Cookson Maintenance Ltd
Duty Holder Responsibilities
The duty holder must:
inform tenants of the potential risk of Legionella advise tenants on any actions arising from the findings of this risk assessment flush through all hot/cold outlets for 2 minutes prior to letting the property following a period of no occupancy
The duty holder must instruct tenants they should:
inform duty holder if they believe the hot water temperature is below 50°C orthe hot water cylinder/boiler is defective not adjust the temperature of the hot water advise the duty holder if they believe the cold water temperature is above 20°C clean, disinfect and descale shower heads on a quarterly basis notify the duty holder if they notice any debris or discolouration in the hot/cold water flush through all hot/cold outlets for 2 minutes upon returning from any extended period of absence e.g. holiday
1. Whilst we make every effort to ensure that the information provided on this form is accurate and up to date, we will notbe held responsible for any errors, omissions, misleading statements, the use of any information, method or equipmentherein presented, or provided to you, and you must make your own determination as to its accuracy and suitability foryour own use, for the protection of the environment and for health and safety purposes.
2. You assume the entire risk of relying on this information. In no event shall we be liable for damages of any naturewhatsoever resulting from the use of or reliance upon this information.
3. By providing this service, we neither can nor intend to control the method or manner by which you use, handle or storeany services sold by ourselves.
4. Materials generated due to remedial works undertaken which are rendered surplus to the requirements of the watersystem will be left in situ. The disposal of such materials is the responsibility of the duty holder. Materials may include:decommissioned steel cold water storage cisterns, cistern lids, insulating jackets and associated elements.
We pride ourselves on a policy of continual improvement in all aspects of our business. As such, our assessments and associated paperwork evolve over time to accommodate improvements in understanding of the risks associated with legionella.
(This form contains public sector information licensed under the Open Government License v3.0).