Legionella sampling record
A record for legionella water sampling, capturing sample details, laboratory results and the action taken in response.
Print-ready PDF with the columns laid out, or the CSV to fill in on a computer.
| Date sampled | Sample ID / ref | Outlet / location | Type (pre/post-flush) | Sample temp °C | Laboratory (UKAS) | Result received | Result (CFU/L) | Action taken |
|---|---|---|---|---|---|---|---|---|
| 2026-06-08 | S-2026-014 | 2/F shower 204 | Pre-flush | 42 | Example UKAS lab | 2026-06-18 | <100 | Within expected range; continue routine monitoring |
| 2026-06-08 | S-2026-015 | G/F kitchen tap | Post-flush | 54 | Example UKAS lab | 2026-06-18 | Not detected | No action required |
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 when legionella sampling forms part of your monitoring regime, planning samples in line with BS 7592.
- Record the sample reference, location, whether it is pre- or post-flush, and the water temperature at the time of sampling.
- Use a UKAS-accredited laboratory and record the date results are received and the reported count.
- Note the action taken in response to each result and review your control measures against HSG274 guidance.
Background: Keeping records of flushing and sampling activities