Document name: Maintenance & Operational Procedures for the control of Legionella, water hygiene, ‘safe’ hot water, cold water, drinking water and non-drinking water. Document type


RECORD SHEET C – LEG07 MUST BE FILLED IN AND RETURNED TO THE AUTHORISED PERSON [WATER]



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RECORD SHEET C – LEG07 MUST BE FILLED IN AND RETURNED TO THE AUTHORISED PERSON [WATER]





Procedure:

DOMESTIC COLD WATER TANK MAINTENANCE RECORD SHEET

Frequency:

As necessary

Acceptance date:

Oct’12

File Ref:

C - LEG07 [page 1 of 6]

Next review date:

Oct’14


Property:




Location:





System Reference:





Tank Id. No.:






Date:




Time:




Permit issued by:




Permits issued to:




Company carrying out work:





PRE MAINTENANCE AUTHORISATION RECORD


QUESTION

NAME

DATE

TIME


Site manager notified of works?











Tank taken out of service and isolated by:











Contractor’s isolation locks fitted?











Warning labels displayed?











Chlorination periods?

DURATION:









Details of cleaning materials used:



Tank put back into service:











Permit cancelled by:










I, the undersigned, have completed the works outlined above:

Competent Person


Name:

Signature:


Date:

Authorised Person [Water]


Name:

Signature:

Date:

Additional docket numbers issued:






Procedure:

DOMESTIC COLD WATER TANK MAINTENANCE RECORD SHEET

Frequency:

As necessary

Acceptance date:

Oct’12

File & Form Ref:

C - LEG07 [page 2 of 6]

Next review date:

Oct’14


Property:




Location:





System Reference:





Tank Id. No.:






Date:




Time:




Incoming MCW TOC at point of entry to building:




Cold tank incoming MCW TOC:




Cold tank storage TOC:




Cold tank outflow TOC:




Ambient air TOC in tank room:




Ambient air TOC outside:




QUESTION

COMPLY

[YES or NO]

Tank room access locked? [if applicable]

Yes / No

Adequate cover / inspection hatch fitted to tank?

Yes / No

Cover / inspection hatch secure?

Yes / No

Insect screens & filters fitted? (if not record details)

Yes / No

Insulation material for tank and pipe is adequate and in place? (if not record details)

Yes / No

External condition ok? Area free from debris / clutter & top of tank to be clear (if not record details).

Yes / No

Internal condition ok? Free from vermin / insects. Note the degree of sediment at % cover (if not record details).

Yes / No

Condition of water? Stagnant or turning over. Is there evidence of sufficient turnover? (if not record details)

Yes / No

Water level ok? Single and multiple linked tanks (if not record details).

Yes / No

Operation of ball valve ok? (if not record details)

Yes / No

Operation of isolation valves ok? (if not record details)

Yes / No

Pipework configuration correct (inlet and outlet at opposite ends)? (if not record details)

Yes / No

DHW vent not over drinking water tank? (if not record details)

Yes / No

Pre chlorination to 50 PPM?

Yes / No

Post chlorination @ 50 PPM? 1 hour minimum contact time.

Yes / No

Post chlorination mains water TVC sample taken?* (See sampling procedure on page 2).

Yes / No

Post chlorination tank water TVC sample taken?* (See sampling procedure on page 2).

Yes / No

* The Authorised Person [Water] has responsibility for reviewing sample results. These should be reviewed against the parameters detailed on pages 4 & 5 of this form, the results should then attached to this form and filed in C. Any action necessary needs to be recorded on an Incident Report and filed in A.

Details of cleaning /painting materials used:



I, the undersigned, have completed the works outlined above:

Competent Person


Name:

Signature:


Date:




Procedure:

DOMESTIC COLD WATER TANK MAINTENANCE RECORD SHEET

Frequency:

Annually

Acceptance date:

Oct’12

File & Form Ref:

C - LEG07 [page 3 of 6]

Next review date:

Oct’14

Sampling Procedure

SAMPLING PROCEDURE



  • Samples only to be taken using an un-tampered sterile bottle.

  • Single use disposable gloves are to be worn. A new pair will be worn for each sample taken and disposed of immediately after the sample has been taken. The disposable gloves shall be kept in their original supplied packaging until the time when they are required [ensure the user is not sensitive to the disposable gloves supplied].

  • Pre flush sample shall be taken (regardless of sampling for Legionella or bacteriological). The outlet will not be disinfected prior to taking the sample. The sample of water will be taken without letting any water run to waste. (This type of sample is most representative of the risk to individuals and is the only sample that should need to be taken from systems where there is evidence of adequate, sustained control and low risk).

  • Post flush samples shall be taken (regardless of sampling for Legionella or bacteriological).

    • Sample taps are disinfected before being sampled. Disinfection methods by using a 1 in 10 dilution of a commercial grade sodium hypochlorite solution (containing in the range 12% to 14% available chlorine Sodium hypochlorite solution.

    • The outlet shall be disinfected in accordance with BS7592:2008.

    • Flaming method is not to be used.

  • When taking samples the bottle is held in one hand and the bottle cap removed with the other hand, ensuring the top or the neck of the bottle doesn’t come in contact with hands or the outlet.

  • Do not rinse out the bottle or the cap.

  • Do not place the cap on any surface, it should remain in your fingers.

  • Turn on the water so a gentle stream is flow, fill the bottle leaving a small air gap at the top, do not allow to over flow.

  • Replace bottle cap immediately taking care not to touch the top or the neck of the bottle.

  • The bottle should then be placed into a cool, dark, insulated container for transporting to the laboratory (see below for more detail).

  • Sample delivery times to the laboratory:

    • Legionella samples within 24 hours but no more than 48 hours.

    • Bacteriological samples should be as soon as possible, not exceeding 24 hours if stored correctly (see below).

  • Transportation of sample:

    • Legionella samples should be protected from heat and sunlight, kept at ambient temperature not exceeding 20OC. Hot and cold samples to be packaged separately.

    • Bacteriological should be kept in dark, insulated storage containers which are regularly disinfected. The temperature of the sample should be kept at 2-8OC.

  • If during sampling accidental contamination is suspect the sample should be discarded and a fresh sterile bottle used to take a new sample.





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