Form template for completion of a documented Legionella Management Plan.

This form can be used to prepare a documented Legionella Management Plan detailing an overview of the water system, the associated Legionella risk and details of all actions required and scheduled as part of this plan. This form can be used to log completion of scheduled actions as well as detailing what is due and when.

This form includes the following sections;

• Overview of completed Legionella Risk Reviews / Risk Assessment(s)
• Overview of Infrequently used Outlet Flushing - details of what outlets and frequency to be detailed
• Listing of other scheduled actions to note details of any scheduled testing, safety checks, water tank Inspection, draining, cleaning, flushing after a period of inoccupation or any other planned or completed actions related to the water system
• Responsibilities - overview of responsible person(s) and their responsibilities
• Monthly Checklist  / Planner - yearly planner using the same format as F-Q26 Premises Monthly Checklist
• Section to include overview of the water system 

This form can be used if a documented Legionella Management Plan is required.