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NAME*
EMAIL*
ORGANISATION*
 COMPANY WEBSITE ADDRESS*
ADDRESS
TELEPHONE NUMBER*
 
 
What is the buildings use? i.e. healthcare, factory, office etc.
 
How many buildings  are you looking to Risk Assess? (Amount)
 

Do you have a Legionella Risk Assessment on site?
YES NO
If so when was it carried out (MM/YYYY)
Approximatly how old is the building? (YEARS)
 
How is Hot Water Supplied?
 
Centralised Hot Water Storage Calorifier
Local Water Heaters
Mix of Both
Unknown
 
Are there any Cooling Towers or Evaporative Condensers on site
YES NO  
If so how many

 

Are there any Cold Water Storage Tanks on site
YES NO 
If so how many

  

How many floors in the building   (Skip if quote is for multiple sites)
How many toilet blocks 
 
How many showers on site
 
 
Are drawings of the water systems available
 
YES NO 
 
Microbiological Sampling is offered as an optional extra  
 
Do you want any Legionella Water Samples to be taken?
 
YES NO 
If so how many

 

 All quotes will be delivered via email.
 
 
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