Water Quality Compliance · Log Form

ASHRAE 188 Legionella Testing Template

Standardized log for recording water quality parameters – temperature, disinfectant residual, pH – and corrective actions in accordance with ASHRAE Standard 188: Legionellosis: Risk Management for Building Water Systems.

Frequency
Weekly / Monthly
per plan
Department
Facilities / EHS
Asset Type
Domestic Hot Water
Version
1.0
Free download — no sign‑up, no email.Take this log to your shop floor and mount it on a clipboard.
Overview & Purpose

This template documents routine testing of water quality parameters as part of a facility’s Legionella Water Management Plan (WMP) per ASHRAE Standard 188-2021. Regular logging ensures that temperatures remain outside the Legionella growth range (20–50 °C), disinfectant residuals stay within target levels, and corrective actions are tracked. Use this form in conjunction with your facility’s WMP and any applicable local health authority regulations.

Equipment & Safety Prerequisites
  • LOTOLockout/Tagout water heaters, circulation pumps, and any chemical feed systems before performing maintenance or accessing ports.
  • PPEWear nitrile gloves, safety glasses, and heat‑resistant gloves when sampling hot water (≥60 °C). Use a face shield if splash risk exists.
  • CHEMVerify chemical feed (if any) is properly isolated before sampling. Never mix disinfectant samples with other chemicals.

Inspection / Log Matrix

Status (P/F) Inspection Item / Task Tolerance / Threshold Actual Reading
[ ] Pass [ ] Fail Hot water temperature at distal outlet (furthest fixture) ≥ 60 °C (140 °F) after 1 minute flow _________ °C
[ ] Pass [ ] Fail Hot water return temperature at recirculation loop ≥ 55 °C (131 °F) _________ °C
[ ] Pass [ ] Fail Cold water temperature at distal outlet ≤ 25 °C (77 °F) _________ °C
[ ] Pass [ ] Fail Free chlorine residual (if chlorinated system) 0.5 – 2.0 mg/L (ppm) _________ ppm
[ ] Pass [ ] Fail pH of water 6.5 – 8.5 _________ pH
[ ] Pass [ ] Fail Visual inspection: sediment / biofilm at designated sampling point No visible discoloration or slime □ Clear □ Turbid □ Slime

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Defect / Corrective Action Log

Date / Time Item # Issue Identified Corrective Action Taken WO #
___/___/_____ _______ _______________________________ _______________________________ _______
___/___/_____ _______ _______________________________ _______________________________ _______
Sign-Off & Verification

By signing below, the inspector verifies that all water quality tests have been performed according to the facility’s Water Management Plan and that any out-of-specification conditions have been recorded with a corresponding corrective action.

Inspector Name / Signature
Date & Time

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