Legionella Testing Quotation Form

Your Details

email address: Leave this field email-address blank:
Homepage: Leave this field homepage blank:
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Comment: Leave this field comment blank:

Company Name*:
Contact Name*:
Contact Telephone Number*:
Contact Email:
Website*:
Property Address*:
Postcode*:
Number of Floors*:
Number of Blocks:
Number of Flats*:
Approximate Sq Meterage*:
Has a Asbestos report been carried out ? *:	YesNo
When was the fixed wiring last inspected? *:
As landlord are you responsible for –
whole installation *:	YesNo
common areas only*:	YesNo
How are the windows cleaned?
Cradle *:	YesNo
Anchor Points*:	YesNo
Cherry Picker *:	YesNo
Do you have any Boilers that work at over 100 degrees Centigrade *:	YesNo
Verification:	10 multiply 3 =  Fill in the result

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