Flushing record sheet (low-use outlets)
A flushing record for infrequently used outlets, capturing flush duration and post-flush temperatures so stagnant water is kept under control.
Print-ready PDF with the columns laid out, or the CSV to fill in on a computer.
| Date | Outlet ID / location | Outlet type | Flushed (Y/N) | Flush duration (min) | Hot after flush °C | Cold after flush °C | Comments | Initials |
|---|---|---|---|---|---|---|---|---|
| 2026-06-08 | RM 1.12 hand basin (little-used) | Mixer tap | Y | 2 | 55 | 18 | Ran hot then cold until temperatures stabilised | AB |
| 2026-06-08 | Cleaner's sink, B basement | Sink tap | Y | 2 | 48 | 19 | Hot slow to reach temperature - reported for investigation | CD |
Sample rows are illustrative. Download the PDF for a clean print-ready form, or the CSV to fill in digitally.
How to use it
- Use for the infrequently used (little-used) outlets identified in your risk assessment that are not in regular use.
- Flush each outlet on the planned schedule (commonly weekly), running it until the temperature stabilises while keeping aerosol release to a minimum.
- Record the flush duration and post-flush hot and cold temperatures so you can spot outlets that are slow to reach temperature.
- Note any faults in the comments, raise them for investigation, and initial each entry.
Background: Legionella flushing record sheet: free template for little-used outlets