11-71-T21

Cool Water System Registration Form - 2025/2026

Information to Applicant

About this Application Form

The South Australian Public Health (Legionella) Regulations 2013 require the owner of premises on which a cooling water system is installed to ensure the system is registered with the Local Council for the area in which the premises are situated. This form is designed for the mandatory registration of cooling water system(s) under the South Australian Public Health (Legionella) Regulations 2013 and must be completed in its entirety.

Registration / Registration Renewal Fees

Registration / registration renewal fees payable to the Local Council are prescribed in Schedule 1 of the South Australian Public Health (Legionella) (Fees) Variation Regulations 2020, as follows:

For registration of 1 water system - $46.75

For registration of each additional water system installed on the same premise - $31.25

On application to an authority for renewal of registration of a high risk manufactured water system (per system) - $23.90

Please note: These fees do not include inspection fees; testing fees and applications to the minister.

Changes requiring notification to the Local Council

There are a number of mandatory requirements related to the registration of cooling water system(s), including the following:

- Registration remains in force for a period of 12 months after which the applicant must renew the registration to Council.

- The owner of premises on which a high risk manufactured water system registered with the Local Council is installed, must within 1 month after any change in the particulars registered in relation to the system, notify Council of the change.

- If a high risk manufactured water system registered with the authority is decommissioned, the owner of the premise on which the system is installed must notify the authority of the decommissioning within 1 month after the event.

Where to find more information

Local Council

Should you require assistance with registration or have any questions please contact your Council Environmental Health Officer on 8621 2300.

Registration Type

Please specify your application type: *

New Registration of Cooling Water System(s)Renew Registration of Cooling Water System(s) Modify business ownership details and/or maintenance and operation contact details of existing Registration(s) of Cooling Water System(s)

Please indicate the total number of systems for registration *

Site Details

Name of Primary Business at Site *

Business Name

Site address *

Street address

City *

State *

Postcode *

Site phone *

Description of Business Activities

Business Operating Hours

Business Contact Details (Licensee)

The Regulations stipulate that a "building owner" (i.e. the ratepayer) is ultimately responsible for the effective operation and maintenance of HRMWS on the premises. However, under the Public Health Act 2011, the following definitions apply:

Owner: in relation to premises, including an "occupier" of premises.
Occupier: in relation to premises, means a person who has, or is entitled to, posession or control of the premises and includes a person who is in charge of the premises.

NOTE: Licensee, in relation to an HRMWS, is who is deemed responsible for the systems. Generally, this will be either to owner, or the occupier when the owner is a different entity.

Registered Business Name of Licensee *

ABN *

ACN

Postal Address (all correspondence will be sent to this address) *

Address *

City *

State *

Postcode *

Contact Person and Position Title *

Residential Address *

Street address

City *

State *

Postcode *

Email *

Mobile Number *

Additional after hours contact

Name

Phone

Operation and Maintenance Details

Person/company responsible for operation & maintenance *

In-houseContractor

Name of business

Contact Person Name *

Position/Title *

Address *

Street address

City *

State *

Postcode *

Contact Phone *

Email Address

Is the postal address the same as above? *

YesNo

Postal Address *

Address Line 1

City *

State *

Postcode *

Plant Identification Form - System 1

1. Plant Idenfication

Make/Brand of system *

Model No. *

System common name / identification No. (Eg System 1; Cooling Tower 1)

2. Type of Cooling Water System

Please Choose One *

Cooling TowerEvaporative CondenserOther

If you selected 'other' please specify

3. Application of Cooling Water System

Application of cooling tower/evaporative condenser *

Air handlingProcess CoolingOther

If you selected 'other' please specify

4. Location of Cooling Water System

What is the location of the system *

RoofGroundPlant RoomOther

If you selected 'other' please specify

5. Frequency of Operation

What is the frequency of operation? *

Annual Seasonal

Please Specify Months

6. Maintenance of cooling water system

Please indicate the maintenance regime utilised for the cooling water system *

Section 2.5 of AS/NZS 3666.2; or Section 3 of AS/NZS 3666.3; or A program approved by the Minister (attach the approval as an appendix to this registration)

7. Drift Eliminators

Is a drift eliminator fitted to the system? *

YesNo

8. Automatic Biocide Dosing Devices

Is the cooling water system fitted with an automatic biocide dosing device? *

YesNo

9. Decontamination Procedure

Please indicate the decontamination procedure utilised for the cooling water system *

Prescribed decontamination procedure set out in Schedule 3 Part 1 of the Guidelines for the Control of Legionella in Manufactured Water Systems in South Australia; or A decontamination procedure approved by the Minister (attach the approval as an appendix to this registration)

Plant Identification Form - System 2

ONLY TO BE COMPLETED FOR SITES WITH MORE THAN TWO SYSTEMS

1. Plant Idenfication

Make / Brand of system

Model No,

System common name / identification No. (eg. System 1; Cooling Tower 1)

2. Type of Cooling Water System

Please choose one

Cooling TowerEvaporative CondenserOther

If you selected 'other' please specify

3. Application of Cooling Water System

Application of cooling tower / evaporative condenser

Air handlingProcess CoolingOther

If you selected 'other' please specify

4. Location of Cooling Water System

What is the location of the system?

RoofGroundPlant RoomOther

5. Frequency of Operation

What is the frequency of operation?

Annual Seasonal

Please specify months

6. Maintenance of cooling water system

Please indicate the maintenance regime utilised for the cooling water system

Section 2.5 of AS/NZS 3666.2; or Section 3 of AS/NZS 3666.3; or A program approved by the Minister (attach the approval as an appendix to this registration)

7. Drift Eliminators

Is a drift eliminator fitted to the system?

YesNo

8. Automatic Biocide Dosing Devices

Is the cooling water system fitted with an automatic biocide dosing device?

YesNo

9. Decontamination Procedure

Please indicate the decontamination procedure utilised for the cooling water system

Prescribed decontamination procedure set out in Schedule 3 Part 1 of the Guidelines for the Control of Legionella in Manufactured Water Systems in South Australia; or A decontamination procedure approved by the Minister (attach the approval as an appendix to this registration)

Plant Identification Form - System 3

ONLY TO BE COMPLETED FOR SITES WITH MORE THAN TWO SYSTEMS

1. Plant Identification

Make / Brand of system

Model No.

System common name / identification No.(Eg. System 1; Cooling Tower 1)

2. Type of Cooling Water System

Please choose one

Cooling TowerEvaporative CondenserOther

If you selected 'other' please specify

3. Application of Cooling Water System

Application of cooling tower / evaporative condenser

Air handlingProcess CoolingOther

If you selected 'other' please specify

4. Location of Cooling Water System

What is the location of the system?

RoofGroundPlant RoomOther

5. Frequency of Operation

What is the frequency of operation?

Annual Seasonal

Please specify months

6. Maintenance of cooling water system

Please indicate the maintenance regime utilised for the cooling water system

Section 2.5 of AS/NZS 3666.2; or Section 3 of AS/NZS 3666.3; or A program approved by the Minister (attach the approval as an appendix to this registration)

7. Drift Eliminators

Is a drift eliminator fitted to the system?

YesNo

8. Automatic Biocide Dosing Devices

Is the cooling water system fitted with an automatic biocide dosing device?

YesNo

9. Decontamination Procedure

Please indicate the decontamination procedure utilised for the cooling water system

Prescribed decontamination procedure set out in Schedule 3 Part 1 of the Guidelines for the Control of Legionella in Manufactured Water Systems in South Australia; or A decontamination procedure approved by the Minister (attach the approval as an appendix to this registration)

Plant Identification Form - System 4

ONLY TO BE COMPLETED FOR SITES WITH MORE THAN THREE SYSTEMS

1. Plant Identification

Make / Brand of system

Model No.

System common name / identification No.(Eg. System 1; Cooling Tower 1)

2. Type of Cooling Water System

Please Choose One

Cooling TowerEvaporative CondenserOther

If you selected 'other' please specify

3. Application of Cooling Water System

Application of cooling tower / evaporative condenser

Air handlingProcess CoolingOther

If you selected 'other' please specify

4. Location of Cooling Water System

What is the location of the system?

RoofGroundPlant RoomOther

5. Frequency of Operation

What is the frequency of operation?

Annual Seasonal

Please specify months

6. Maintenance of cooling water system

Please indicate the maintenance regime utilised for the cooling water system

Section 2.5 of AS/NZS 3666.2; or Section 3 of AS/NZS 3666.3; or A program approved by the Minister (attach the approval as an appendix to this registration)

7. Drift Eliminators

Is a drift eliminator fitted to the system?

YesNo

8. Automatic Biocide Dosing Devices

Is the cooling water system fitted with an automatic biocide dosing device?

YesNo

9. Decontamination Procedure

Please indicate the decontamination procedure utilised for the cooling water system

Prescribed decontamination procedure set out in Schedule 3 Part 1 of the Guidelines for the Control of Legionella in Manufactured Water Systems in South Australia; or A decontamination procedure approved by the Minister (attach the approval as an appendix to this registration)