Annual Damper & Fire test Inspection

• Document No.

• HVAC Compliance inspection .

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

1. Mechanical Ventilation (AS 1851:2012- Maintenance -if system is part of Smoke control measures)

• Does site have Mechanical Ventilation system as part of Essential services? ( Can be identified via Essential & non- Essential Board ) All smoke control related components would be fed from either dedicated essential MSSB within the tenancy or it may be fed from base building MSSB.

  Yes

  No

  N/A

• Type of Equipment?

  Exhaust fans

  Make up air fans

  Not Applicable

  Stair Pressurization fans

• Mechanical Ventilation- (Non- essentials) Confirm if routine PM had been carried out?(eg. Fresh air fans, exhaust fans, Make-up air fan, toilet exhaust fans, Kitchen exhaust fans etc,)

  Yes

  No

  N/A

2. Air conditioning System -AS 3666 Maintenance and AS 1851(if system is part of Smoke control measures)

• Type of System

  AHU

  Package Units

  Split Ducted Units

• Confirm if System is part of Smoke Control measures?

  Yes

  No

  N/A

• Total No of Units on site(includes Back of house units, server room etc.) ?

• Confirm if regular PM's had been performed?

  Yes

  No

  N/A

• PICTURES of A/C system

  Media

• Does A/C part of Essential Services in Fire Mode?

  Yes

  No

  N/A

• Observe operation during fire trip and confirm PM being carried out as per AS1851:2012 if it is part of Smoke Control Measures?

  Essential MSSB within Store

  Non- Essential MSSB within Store

  Fed From Centre & can be confirmed from FFFT.

  NO Fire trip relay within Store

• General Condition of Unit is acceptable?

  Yes

  No- Repairs Required

  No- General Service Required

• Trading floor a/c is fed from which MSSB?

  Essential MSSb

  Non-Essential MSSB

• PICTURES of Switchboard

  Media

3. Fire / Smoke Dampers (AS 1668-1 & 2 & AS 1851:2012-table 13.4.1.4)

• Inspected operation of fire and smoke dampers as per attached Damper Schedule (Minimum 20% of dampers installed to be inspected)

  20%

  50%

  100%

  Not Applicable

• Total Dampers on Site? • If No schedule onsite, you must prepare new schedule.

• PICTURES

  Media

• Confirm if regular PM carried out on Fresh Air & Economy cycle dampers?

  Yes

  No

  N/A

4. Fire Trip Test- AS 1851-2012.

• Simulated fire test was carried out being:

  Yes

  No- Centre FIP

  N/A

• General Observation Report:

• Was any default identified?

  Yes- Further Works Required

  No - All non essential stopped.

  N/A

5. Smoke Spill Fan - AS-1851-2012

• Does Site have Smoke Spill Fans?

  Yes

  No

  N/A

• How many Smoke Spill Fans ?

  2

  4

  5

  6&more

  N/A

• Does Smoke Spill Fans Fed from Tenancy?

  Yes

  No- Centre FIP

  N/A

• If Smoke Spill Fans are part of Tenancy, are fans tested ?

  Manually

  Auto

  Not Applicable

• Add media

  Media

6. Electric Duct Heaters -AS1851-2012

• Does site have electric duct heaters installed?( This could be confirmed first through MSSB's)

  Yes

  No

  N/A

• How many heaters are on site?

  2

  4

  5

  6&more

  N/A

• Was heaters PM performed prior to this inspection as per AS1851 -2012 (Clause: 13.4.1.15) ( Please confirm via RFM PM scope check sheet)

  Yes

  No

  N/A

7. Kitchen Exhaust System- AS 1851-2012- Section 13

• Confirm if Monthly PM had been performed as per AS 1851 table 13.4.1.16 ? Item 15.1- Filters-Check grease-arresting filters for excessive grease, 15.2- Hood & Plenum-Check hood and its exhaust plenum for excessive grease accumulation., 15.3- Gutters- Check grease gutters for excessive grease accumulation ,15.4 Filter (Condition)-Check that grease –arresting filters secured in the correct position and undamaged. , 15.5- Filters (clean)-Clean grease-arresting filters as required (monthly)

  Yes

  No

  N/A

• Observation notes:

• Confirm if Annual PM had been performed as per AS 1851 table 13.4.1.17? 16.1- Monthly Service – Complete all monthly service activities as listed in table 13.4.1.16 ,16.2 – Hood and plenum – Clean hood and its exhaust plenum, 16.3 – Filter (replace) Check for excessive leaks or damage to grease arresting filters and replace as necessary. NOTE: Non-metallic grease filters and other special types have to be replaced at specific time intervals whether damaged or not. In these cases, follow manufactures instructions. ,16.4 – Duct – Check duct for accumulated grease and clean.

  Yes

  No

  N/A

• Observation Notes:

• How many kitchen exhaust hood system are on site?

  Chicken, Donut, Bakery, Dish washer.

  Chicken ,Donut ,Bakery

  Chicken, Bakery

  Not Applicable

  Bekery & Donut

• PICTURES

  Media

8. General Observation & Pictures of other equipment which requires attention

• PICTURES

  Media

9. Sign Off

• You are confirming that you/RFM have maintained HVAC equipment & have carried out visual inspection on Essential Components as per scope provided during HVAC Maintenance. “What you have performed during PM frequency throughout the year is what you are confirming” Based on this report, compliance administrator will take appropriate action for remedial & will upload this report on BOSS system for certification.

• Technician

  Sign