LCA Reg.

No: 7095

Signed: Print Name Peter Range

Date: 13/03/2024 Mobile No: 07368242453
Please tick all categories which your organisation offers, and also the appropriate sub-categories relevant to your
organisation. (PLEASE SEE OVERLEAF FOR NOTES ON COMPLETING THIS FORM*)
ALL SERVICES THAT YOU OFFER MUST BE LISTED ON YOUR AREAS OF INTEREST FORM. OFFERING, ADVERTISING OR
IMPLEMENTING LEGIONELLA CONTROL SERVICES, AS DEFINED IN THE LCA SERVICE STANDARDS, THAT FALL OUTSIDE THE
SCOPE OF YOUR REGISTRATION MAY JEOPARDISE YOUR LCA MEMBERSHIP.

1. Legionella Risk Assessment Services 5. Independent Consultancy Services

1.1 Hot and Cold Water Systems Risk Assessment In-house Sub-contracted / LCA reg.
In-house Sub-contracted / LCA reg.
1.2 Evaporative Cooling Systems Risk Assessment 6. Training Services
In-house Sub-contracted / LCA reg. In-house Sub-contracted / LCA reg.
1.3 Process and Other Systems Risk Assessment
7. Legionella Monitoring Services
In-house Sub-contracted / LCA reg.
7.1 Sampling
1.4 Healthcare Risk Assessment
In-house Sub-contracted / LCA reg.
In-house Sub-contracted / LCA reg.
7.2 In Field Analysis
In-house External / LCA reg.
2. Water Treatment Services
2.1 Hot and Cold Water Systems Water Treatment 7.3 Laboratory Analysis
In-house Sub-contracted / LCA reg. In-house

2.2 Evaporative Cooling Systems Water Treatment 7.4 Interpretation of Analysis

In-house Sub-contracted / LCA reg. In-house External / LCA reg.

2.3 Process and Other Systems Water Treatment

8. Plant and Equipment Services
In-house Sub-contracted / LCA reg.
8.1 Design and Supply
In-house Sub-contracted / LCA reg.
3. Hot and Cold Water Monitoring and Inspection Services
8.2 Installation
In-house Sub-contracted / LCA reg.
In-house Sub-contracted / LCA reg.
8.3 Servicing/maintenance
4. Cleaning and Disinfection Services
In-house Sub-contracted / LCA reg.
4.1 Hot and Cold Water Systems Disinfection
In-house Sub-contracted / LCA reg. 8.4 Refurbishment
In-house Sub-contracted / LCA reg.
4.2 Evaporative Cooling Systems Cleaning and Disinfection
In-house Sub-contracted / LCA reg.
4.3 Process and Other Systems Cleaning and Disinfection
In-house Sub-contracted / LCA reg.

All categories selected will be shown on your Certificate of Registration and the website.
Categories will be charged at the rate on the Registration Form.
Are you currently assessed or accredited to any other quality management systems relevant to
legionella control?

203.20 07-23
www.legionellacontrol.org.uk
*Notes on completing this form

All services that you offer, advertise or implement must be listed on your Areas of Interest Form.
All categories selected will be shown on your Certificate of Registration and the LCA website suppliers directory and will be
visible to service users.

The green boxes indicate the major categories that your organisation offers; you will be charged for each of these main
categories that you tick.

The white boxes indicate sub-categories within your main area of expertise and it is important that you complete these
boxes appropriately as we will cross reference these to your advertised services and your actual services at our audit.

Categories and sub-categories are shown on the LCA website suppliers directory to give more information on the services
you offer. You will not be charged for these sub-categories.

Your registration will be delayed if any information is not completed correctly and needs further clarification.

If the services are undertaken by a sub-contractor please tick the white box.

If this sub-contractor is LCA registered please tick the blue box.

Please make sure that you sign and date this form, keep a copy of this sheet for your records and return the original to us with the
re-registration form. You are required to complete a form each year even if the details have not changed.

The legal duty to comply with relevant health and safety legislation (including avoidance or control of risk to exposure to Legionella bacteria) rests solely with
the statutory dutyholder, being either the employer or the person in control of the premises or systems where any relevant risk is present, and this cannot be
delegated. Specific functions (e.g. carrying out risk assessment) can be delegated and the Legionella Control Association (LCA) Code of Conduct is designed to
help service providers, who also have duties under health and safety legislation, to establish appropriate management systems for the prevention or control of
risk from Legionella bacteria. The LCA assesses the management systems of LCA members upon initial registration, reviews annually upon re-registration, and
re-assesses by annual company audits. The LCA cannot and does not carry out other regular supervision of its members’ commitments to the Code of Conduct
nor their compliance with other LCA guidelines. A valid LCA certificate of registration (which is only valid if the Company named is listed on the LCA website www.
legionellacontrol.org.uk/directory.php ) confirms only that a service provider has satisfied LCA requirements at registration, re-registration and its most recent
company audit. It does not confirm the service provider’s actual or continuing compliance with their commitments to the LCA Code of Conduct and/or other LCA
guidelines. The LCA does not approve specific products or services as being effective in controlling Legionella or verify the competence of service providers’ staff
and sub-contractors, which is the duty of the service provider and the statutory dutyholder. The LCA accepts no liability for any omission or any act carried out in
reliance on the LCA Code of Conduct or other LCA guidelines, or any loss or damage resulting from non-compliance with such documents.
203.20 07-23