Thank you for choosing GES Water to provide a quotation for your Legionella Compliance requirements. Before we can send you a quotation we need some information about your specific requirements and the premises. Please complete the below form so we can provide you with an accurate cost to complete the necessary works.

Type of Works Required:

Other/Specific details:

Company Name:

Site Name & Address:

Contact Email Address:

To ensure that we supply the correct Risk assessment(s) and Method statements, please confirm if we require any specific Personal Protective Equipment:-:

Please advise of any onsite risks where we may need to make provisions prior to GES attending site:-:

Do you have a current or existing Legionella Risk Assessment that we could review? (This will give us details regarding you current control programme and help with the quotation) If so, please upload a copy.

Please advise on whether there is any site induction training specifically for health and safety risks on site and the time required for this training:

Please advise if there are vulnerable people onsite: -:

Yes

Please advise on whether any areas we may need to survey have restricted access e.g. Cold Water storage tank in a loft space requiring long ladders, areas that can only be accessed at certain times during the day and, specialist access keys or codes etc.: -:

Please state any planned maintenance or treatment works that will affect the water systems: -:

Please complete the below with as much information as possible including the quanity of any plant in order for us to be able to give you an accurate quotation.

No. of Cooling Towers & Relevant details:

No. Water Softeners:

No. of Cold Water Storage Tanks:

No. of Calorifiers (Hot Water Cylinders):

No. of Point of use Water Heaters (Under-sink or Wall-mounted):

No. of Sprinklers & Fire House Reel System:

No. of Emergency Showers & Eye Wash Stations:

No. of Lathe & Machine Coding Systems:

Approx No. of Hot & Cold Domestic Outlets (Taps):

No. of Spa Baths:

No. of Ultrasonic Humidifiers/Foggers & Water Misting Systems:

No. of Spray Humidifiers, Air Washers & Hot Scrubbers:

No. of Water Misting Systems:

Any Dental Equipment:

No. of Heating & Chilled Water Systems:

No. of Air Handling Units:

No. of Grey Water System:

No. of Rain Water Harvesting:

Any Other Information:

Thank you for providing the above information. We will send a quotation to you shortly. If you have any questions, please do not hesitate to

All works completed by GES Water comply with the following legislation and guidance:

Health & Safety at Work Act 1974

The Management of Health & Safety at Work Regulations 1999

The Control of Substance Hazardous to Health Regulations 2002

AcoP L8 (4th Edition) 2013

It is important to note that you, as the client, are responsible to keep all documents for at least 5 years for Legionella Control Compliance.

The links below will take you to the following documents: Legionella Control Association (LCA) Certificate & Code of Conduct | UKAS: 17020 | Insurances | ROSPA | HSG274 Legionella Leaflet.

LCA Certificate

LCA Code of Conduct

UKAS: ISO 17020

Insurances

ROSPA Silver Award Certificate

HSG274 Leaflet

Information for Quotation

Please complete the below with as much information as possible including the quanity of any plant in order for us to be able to give you an accurate quotation.

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