Legionella Risk Assessment

Important: A Legionella Risk Assessment should be carried out by a competent person. This log is for recording the findings and actions. Retain the original signed assessment.

1. Assessment & Property Details

Date of Assessment

Property Address

2. Assessor & Client Details

Assessor's Name

Assessor's Company (if applicable)

Assessor's Competency/Qualifications

Client Name (Landlord/Agent)

3. Scope & Water System Description

Scope of Assessment (Areas/Systems Covered):

Description of Water System:

4. Identified Risk Factors & Control Measures Plan

List all identified risk factors. For each, specify location, risk level, recommended controls, responsibility, and action dates.

Risk Factor / Observation 1

Description of Risk Factor/Observation

Location/Appliance

Assessed Risk

Recommended Control Measures/Action

Responsibility

Target Date

Date Completed

5. Existing Control Measures

Summary of Existing Legionella Control Measures:

6. Overall Risk Assessment Summary & Review

Overall Risk Assessment Summary & Conclusion:

Recommended LRA Review Date

Assessor's Signature (Confirm on physical LRA)