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Free template

Landlord Legionella Risk Assessment Template

A simple printable form for landlords who are competent to assess their own straightforward rental property.

How to use this sheet

  1. Use it only if you understand the risks and the property is straightforward
  2. Walk round the whole property, including the loft and any cylinder cupboard
  3. Take hot and cold temperatures at the kitchen tap and bathroom
  4. Write down anything that needs doing and by when
  5. Review it when something changes, such as a new boiler or a long void

Landlord Legionella Risk Assessment TemplateAquastead Water · aquasteadwater.co.uk
Property address
Date
Assessed by
Next review
QuestionYesNoNotes
Hot water from a combi boiler or instantaneous heater only
Hot water cylinder present (stored temperature set to 60°C)
Cold water storage tank present
Tank has a close-fitting lid and insect screens
Tank is clean with no debris
Hot water reaches 50°C or more within one minute
Cold water is below 20°C within two minutes
Showers present and shower heads clean
Any outlets used less than once a week
Any dead legs or redundant pipework
Anyone living there at higher risk (over 45, smoker, health conditions)
Property empty for more than a week recently
Tenants given water safety information
Actions needed and target dates
Signed

Keep completed records for at least five years. General guidance only: follow your own risk assessment where it sets different checks or frequencies.

Frequently asked questions

Can landlords do their own legionella risk assessment?

Yes, if they are competent. HSE allows landlords to assess their own properties if they understand the risks and how to control them.

Is this template a legal certificate?

No. There is no legal legionella certificate. A completed and dated assessment is evidence that you have assessed the risk.

More free templates

Legionella Flushing Record SheetWater Temperature LogTMV Service Record SheetCold Water Tank Inspection Record

Rather we kept the records for you?

Our monitoring contracts carry out the checks and keep a digital log book for every building.