Template No: 11-71-T22

Warm 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 warm 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 warm 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 warm water system $46.75

For registration of each additional warm 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) $23.60

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 warm water system(s), including the following:

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

· 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 the Coucil of the change.

· If a high risk manufactured water system registered with Council is decommissioned, the owner of the premise on which the system is installed must notify Council 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 Warm Water System(s)Renew Registration of Warm Water System(s) Modify business ownership details and/or maintenance and operation contact details of existing Registration(s) of Warm 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 of Contact Person *

Street address *

City *

State *

Postcode *

Email *

Mobile Number *

Additional after hours contact

Name

Phone

Plant Identification Form - System 1

1. Type of water heating device

Make / Brand of system *

Model No. *

System Common name/Identification No.(e.g. floor 1; warm water system 1)

2. Features of System

Source of water heating

Gas ElectricOther

If you selected 'other' please specify

Water storage or instantaneous?

StorageInstant

Are there any temperature control devices installed with this system?

YesNo

Frequency of operation *

OngoingIntermittentSeasonal - Specify Months

Please specify months of operation

3. Location

Location of areas serviced by the warm water system *

4. Decontamination Procedure

Please indicate the decontamination procedure utilised for the warm water system

Prescribed decontamination procedure set out in Schedule 3 Part 2 of the Guidelines for the Control of Legionella in Manufactured Water Systems in South Australia, namely: Alternative decontamination procedure approved by the Minister for Health

Pasteurisation method; or Chlorination method; or

Plant Identification Form - System 2

ONLY COMPLETE THIS PAGE IF MORE THAN ONE WARM WATER SYSTEM

1. Type of water heating device

Make / Brand of system

Model No.

System Common name / identification No. (e.g floor 1; warm water system 1)

2. Features of System

Source of water heating

Gas ElectricOther

If you selected 'other' please specify

Water storage or instantaneous?

StorageInstant

Are there any temperature control devices installed with this system?

YesNo

Frequency of operation

OngoingIntermittentSeasonal - Specify Months

Please specify months

3. Location

Location of areas serviced by the warm water system

4. Decontamination Procedure

Please indicate the decontamination procedure utilised for the warm water system

Prescribed decontamination procedure set out in Schedule 3 Part 2 of the Guidelines for the Control of Legionella in Manufactured Water Systems in South Australia, namely: Alternative decontamination procedure approved by the Minister for Health

Pasteurisation method; or Chlorination method; or

Upload Site / System Plan *

Browse

Applicant Details

Name of person submitting registration form

First Name *

Surname *

Positon Title

Signature *

Draw signature|Type signatureClear

Date of Signature *

I declare that all the information I have supplied is true and correct. I acknowledge that personal information provided may be used by the City of Port Lincoln for the purpose of Council business, as specified in Council's Privacy Policy.

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