Legionella Certificate Template UK

The Legionella Certificate Template UK is available in multiple formats, including PDF, Word, and Google Docs, featuring customizable and printable samples to meet your needs.

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Legionella Certificate Template UK

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PDF – 1 PDF – 2

Legionella Certificate Template UK

1. Client Information


2. Certificate Issuer Information


3. Property Details

4. Assessment Date

5. Assessment Findings

6. Control Measures Implemented

7. Recommendations

8. Responsible Persons

9. Certificate Validity

10. Signatures and Declaration



PDF

WORD

Examples

Legionella Certificate Template UK (1)
Issued To:
[Name of the Client]
[Address of the Client]
[Client’s Contact Information]
Certificate Number:
[Unique Certificate Number]
Date of Issue:
[Date]
Service Provider:
[Name of the Service Provider]
[Provider’s Address]
[Provider’s Contact Information]
Introduction:
This certificate verifies that the Legionella risk assessment and management plan has been successfully implemented in accordance with the Health and Safety Executive (HSE) guidelines.
Assessment Date:
The assessment was conducted on [Assessment Date].
Scope of Work:
The following activities were performed:
1. Identification of water systems at risk
2. Assessment of Legionella bacteria levels
3. Recommendations for testing and monitoring
4. Implementation of control measures
Findings:
The water systems have been assessed, and the following findings were noted:
– [Summary of Findings, e.g., levels of bacteria, areas of concern].
Control Measures Implemented:
The following control measures were recommended and implemented:
– [List of control measures, e.g., temperature management, cleaning protocols].
Next Steps:
It is recommended to conduct follow-up assessments every [Recommended Follow-up Frequency] to ensure ongoing compliance and safety.
Signed by:
[Signature of the Service Provider]
[Name of the Service Provider]
[Position]
[Date]
Legionella Certificate Template UK (2)
Issued To:
[Name of the Client]
[Address of the Client]
[Client’s Contact Information]
Certificate Number:
[Unique Certificate Number]
Date of Issue:
[Date]
Service Provider:
[Name of the Service Provider]
[Provider’s Address]
[Provider’s Contact Information]
Introduction:
This certificate attests that the client has conducted a thorough Legionella risk assessment and has taken proactive measures to mitigate risks as recommended by HSE.
Assessment Date:
The assessment was conducted on [Assessment Date].
Scope of Work:
The following activities were performed during the assessment:
1. Comprehensive review of water systems
2. Testing for Legionella bacteria
3. Recommendations for maintenance
4. Training for staff on Legionella management
Findings:
The following results were obtained:
– [Detailed Findings, e.g., detection of bacteria, areas needing attention].
Control Measures Implemented:
Implemented measures include:
– [List of control measures, e.g., regular maintenance schedules, staff training programs].
Next Steps:
A follow-up assessment should be conducted every [Recommended Follow-up Frequency] to ensure continued compliance with safety standards.
Signed by:
[Signature of the Service Provider]
[Name of the Service Provider]
[Position]
[Date]

Printable

PDF – 1 PDF – 2

Legionella Certificate Template UK