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Audit
BACKGROUND INFORMATION
FAR number
AUTHORITY number
Date placed in service
KEY HOLDER DETAILS :
Is asbestos known to be present ? Note: Do not rely on warning stickers to be present. If in doubt, DO NOT go into ceiling cavities or remove cladding. Check councils asbestos register dm5#3608856
Input ID number in Council's asbestos register dm5#3608856
Are there warning stickers in place ?
Raise as high priority defect
High priority defect
HIGH PRIORITY DEFECT
LEGACY INFORMATION / COMMENTS
LAND & SURROUNDS - External elements
Date and time of audit
Weather conditions at time of audit
EXTERNAL PHOTO (S) OF FACILITY - taken at time of audit
Note : External elements that are shared with other facilities on the site need to be captured separately and must not be associated with individual assets e.g. Communal car parking areas etc.
Are external elements shared with other facilities on the site ?
Is there a formed access road ?
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF ROADS (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF ROADS IS APPROXIMATELY (years)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Is there a formed car parking area ?
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF CAR PARK (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF CAR PARKING AREA IS APPROXIMATELY (years)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Is there a formed footpath ?
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF FOOTPATHS (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF FOOTPATHS IS APPROXIMATELY (years)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Does facility have fencing or gates ?
Is there a defect with the fencing, gates ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF FENCES or GATES ? (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF FENCES & GATES IS APPROXIMATELY
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Are there any retaining structures on the site which relate to protecting this building ?
Is there a defect with the retaining structure ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF RETAINING STRUCTURES ? (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF RETAINING STRUCTURES IS APPROXIMATELY
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Does it have stand alone lighting towers to illuminate the land and building ?
Is there a defect with lighting towers ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF LIGHTING TOWERS ? (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF LIGHTING TOWERS IS APPROXIMATELY
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Are there any external lights attached to the building ?
Is there a defect with external lighting ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF EXTERNAL LIGHTS ? (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF EXTERNAL LIGHTING IS APPROXIMATELY
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Are there any trees nearby that are touching the facility or are likely to cause damage if left unchanged ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
Is there any bridging of the d.p.c. Or is the exterior surface level above vulnerable exterior finishes or slab level ?
CONDITION RATING OF WALLS / FRAME (NOTE: 'EXCELLENT' or 'GOOD' assumed 20+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF WALL FRAME (E.G. BLOCKWORK) IS APPROXIMATELY
RUL bulding structure if ave or less
10 - 20+ YEARS
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
FLOOR (Material) - (NOT COVERINGS e.g. reinforced concrete)
REINFORCED CONCRETE
TIMBER - SOLID
PLY BOARD
COMPRESSED FIBRES
STONE
NATURAL SURFACE
BRICK
UNKNOWN
OTHER
PROVIDE DETAILS OF MATERIAL ..
IS THERE A VISIBLE DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF FLOORS - not coverings (NOTE: 'EXCELLENT' or 'GOOD' assumed 20+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF FLOOR (E.G. SLAB) IS APPROXIMATELY
RUL bulding structure if ave or less
10 - 20+ YEARS
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
IS IT POSSIBLE TO SEE THE FOOTINGS / STUMPS THAT FORM PART OF THE FOUNDATION ?
FOUNDATION (Material) - (NOT COVERINGS e.g. timber stumps)
CONC SLAB ON GROUND
CONCRETE PILES/FOOTINGS
WOODEN PILES/SUPPORTS
OTHER
UNKNOWN
PROVIDE DETAILS OF MATERIAL
IS THERE A VISIBLE DEFECT ?
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
ARE THERE ANY STRUCTURALLY SIGNIFICANT CRACKS, DEFORMATIONS IN THE FLOOR THAT WOULD INDICATE A FAILURE IN THE FLOOR / FOUNDATIONS ?
PROVIDE DETAILS OF THE DEFECT TO ASSIST IN FOLLOW UP INSPECTION ...
CONDITION RATING OF FOUNDATION (NOTE: 'EXCELLENT' or 'GOOD' assumed 20+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF FOUNDATION (E.G. STUMPS / PILES) IF VISIBLE
RUL bulding structure if ave or less
10 - 20+ YEARS
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Is there any evidence of current/active pest infestation e.g. Termites ?
Provide details of the infestation and potential works required
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
STRUCTURAL COMPONENTS - GENERAL COMMENTS
ROOF COVERING & DRAINAGE FOR WHOLE FACILITY
Roof length (m)
Roof width (m)
ROOF COVERING (Material)
ZINC ALUM
COLOURBOND
PVC
CONCRETE TILES
STAINLESS STEEL
CHAINS
UNKNOWN
OTHER
CLAY TILES
REINFORCED CONCRETE
COMP FIBRE WITH COVERING
POLYCARBONATE
Not applicable
PROVIDE DETAILS OF MATERIAL
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
ARE THERE GUTTERS ?
Is gutter guard installed ?
IS THERE A DEFECT WITH GUTTER or GUTTER GAURD ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF GUTTERS (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF GUTTERS IS APPROXIMATELY
5 years MAX
2 - 5 years
less than 2 years
facility is potentially dangerous
ARE THERE DOWNPIPES ?
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF DOWNPIPES (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF DOWN PIPES IS APPROXIMATELY
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
ROOF AND DRAINAGE - GENERAL COMMENTS - also include any info on roof screw condition
EXTERNAL FIXTURES, FITTINGS & FINISHES FOR WHOLE FACILITY
BUILDING EXTERNAL Wall Finishes (Material) e.g. painted render
BLOCKS/BRICKS - UNPAINTED
BLOCKS/BRICKS - PAINTED
BLOCKS - RENDERED - UNPAINTED
BLOCKS - RENDERED - PAINTED
TIMBER CLAD - UNPAINTED
TIMBER CLAD - PAINTED
METAL COVERED
COMPOSITE
FIBRO
UNKNOWN
OTHER
PROVIDE DETAILS OF MATERIAL
If the exterior walls have a painted finish, condition is ...
Total Length of walls
Height of wall
APPROX COST TO REPAINT ($)
Remaining Useful Life of Painted surfaces (YEARS)
1-2 Years
2-4 Years
Is there a defect with the fabric of the wall (not paint condition) ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
Condition rating of External Wall finishes: (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of External finishes (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Are doors or windows security screened ?
IS THERE A DEFECT WITH EXTERNAL DOORS, LOUVRES, WINDOWS, SCREENS, SHUTTERS OR BARS ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
Condition rating of Windows, doors, screens & Louvres (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of doors, windows, louvres and screens (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Comments on external finishes, doors, windows etc.
- INTERIOR ELEMENTS - Room by room
Rooms (press 'add room' button to add more rooms)
Room
Provide details on room location and current use
Draw a sketch of the room in relation to the facility
Optional photo of room
Fittings and finishes
If the interior walls have a painted finish, condition is ...
Length of room
Width of room
Height of ceiling
APPROX COST TO REPAINT ($)
Remaining Useful Life of Painted surfaces (YEARS)
1-2 Years
2-4 Years
Is there a defect with the wall finishes ( excluding painting ) ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
IS THERE A DEFECT WITH CEILING ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
FLOOR COVERING (Material) e.g. finished concrete
FINISHED CONCRETE
TILED
CARPET
LINO
FLOATING TIMBER
RUBBER
PAINTED CONCRETE
STONES
NONE - NATURAL
UNKNOWN
OTHER
PROVIDE DETAILS OF MATERIAL ..
IS THERE A DEFECT WITH FLOOR COVERING ?
ENTER DEFECT DETAILS AND WORKS REQ:
If defect requires the replacement of the floor covering e.g. Carpet, identify approximate area that is require (m2)
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
Remaining Useful Life of Floor covering (YEARS)
1-2 Years
2-4 Years
IS THERE A DEFECT WITH INTERNAL DOORS ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
Condition rating of INTERNAL finishes : Walls, Ceilings, Floors, internal doors (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Condition rating of Walls (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of Walls (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Condition rating of Ceilings (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of Ceilings (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Condition rating of Floor coverings (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of Floor coverings (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Condition rating of Internal doors (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of Internal doors (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Are there kitchen facilities present ?
Provide details of fixed appliances, sinks, benches etc.
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
TAKE PHOTO OR ADD FROM LIBRARY
APPROX COST TO RECTIFY DEFECT ($)
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
Condition rating of Kitchen (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of Kitchen (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
- MECHANICAL SERVICES - room by room
NUMBER OF CEILING FANS
NUMBER OF EXHAUST FANS
NUMBER OF SPLIT AIRCONS
NUMBER OF BOX / WINDOW AIRCONS
NUMBER OF EXTRACT FANS
IS THERE A DEFECT WITH ANY MECHANICAL EQUIPMENT (exclude any major plant items which follow below..)
ENTER DEFECT DETAILS AND WORKS REQ:
TAKE PHOTO OR ADD FROM LIBRARY
APPROX COST TO RECTIFY DEFECT ($)
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
Are there any items of MECHANICAL Major plant such as very large fans, compressors etc.
Provide details of plant: serial numbers, size etc.
IS THERE AN OBVIOUS DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF MECHANICAL SERVICES and Major plant (NOTE: 'EXCELLENT' or 'AVERAGE' assumed 10+ years RUL)
GOOD
AVERAGE
POOR - NEEDS WORK
Needs further investigation
REMAINING USEFUL LIFE OF EQUIMENT IS...
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
- FIRE & SAFETY SYSTEMS - room by room
Are fire exit signs in place and clearly visible ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
HIGH PRIORITY DEFECT
APPROX COST TO RECTIFY DEFECT ($)
Fire extinguishers (No.)
Fire blankets (No.)
Fire hose reels (No.)
Are there any defects with extinguishers , blankets or hoses ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
HIGH PRIORITY DEFECT
APPROX COST TO RECTIFY DEFECT ($)
Are there any heat / smoke detectors present ?
If possible, test detectors to ensure operating as designed
Are they working properly ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
HIGH PRIORITY DEFECT
APPROX COST TO RECTIFY DEFECT ($)
Provide details
Condition rating of Fire appliances and systems (NOTE: 'EXCELLENT' or 'GOOD' assumed 5+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of Fire services equipment (YEARS)
5 years MAX
2 - 5 years
less than 2 years
facility is potentially dangerous
General comments on fire services equipment
- ELECTRICAL SERVICES - room by room
NUMBER OF INTERNAL LIGHTS
Is there a distribution board in this room ?
CONDITION OF THE DISTRIBUTION BOARD CABINET AND CONDUITS
GOOD
AVERAGE
POOR - NEEDS WORK
Needs further investigation
ENTER DEFECT DETAILS AND WORKS REQ:
TAKE PHOTO OR ADD FROM LIBRARY
APPROX COST TO RECTIFY DEFECT ($)
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
ARE ALL CIRCUITS PROTECTED BY RCDS ETC.?
HAS THE RCD BEEN TESTED WITHIN THE LAST 12 MONTHS ?
REPORT AS HIGH PRIORITY WORKS:
HIGH PRIORITY DEFECT
REPORT AS HIGH PRIORITY WORKS:
HIGH PRIORITY DEFECT
APPROX COST TO RECTIFY DEFECT ($)
Has facility got emergency power (generators or UPS) or large items of electrical Major plant ?
Provide details of plant: location within facility, if it is under cover, serial numbers, output etc.
IS THERE AN OBVIOUS DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
General comments on Major Plant item ..
IS THERE A DEFECT WITH ANY ELECTRICAL SUPPLY OR EQUIPMENT ?
ENTER DEFECT DETAILS AND WORKS REQ:
TAKE PHOTO OR ADD FROM LIBRARY
APPROX COST TO RECTIFY DEFECT ($)
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
CONDITION RATING OF ELECTRICAL SERVICES (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL
GOOD
AVERAGE
POOR - NEEDS WORK
Needs further investigation
PROVIDE DETAILS OF THE ASSET
REMAINING USEFUL LIFE OF ASSET
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Electrical Services - GENERAL COMMENTS
- TOILETS & SHOWERS
Is the room a toilet or shower ?
ARE DISABLED TOILETS PRESENT ?
NUMBER OF DISABLED TOILETS
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
DOES THE FACILITY MEET CURRENT DAY ACCESS REQUIREMENTS ?
PROVIDE DETAILS OF WHAT IS REQUIRED TO BRING UP TO CURRENT STANDARD INCLUDING EXTERNAL ACCESS
TAKE PHOTO
APPROX COST TO MAKE UP TO TODAYS STANDARDS ($)
IS THERE A DEFECT WITH EXISTING DISABLED FACILITIES ? (EXCLUDE ANY UPGRADES REQ.)
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
NUMBER OF FEMALE CUBICLES
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
NUMBER OF MALE CUBICLES
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
ARE THERE URINALS PRESENT ?
NO. OF URINALS
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
IS THERE A TROUGH PRESENT ?
NO. OF PEOPLE IT CAN ACCOMMODATE
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
NUMBER OF UNISEX CUBICLES
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
IS THERE A SEPTIC TANK ?
IS IT A BIO SYSTEM?
CONDITION RATING OF SANITARY WARE (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Provide details of poor condition asset ...
REMAINING USEFUL LIFE (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
IS THERE HOT WATER AVAILABLE ?
PROVIDE DETAILS OF HEATING SOURCE ...
WHAT IS THE GENERAL CONDITION OF THE HEATER ?
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Provide details of poor condition asset ...
TAKE PHOTO
APPROX COST TO PROVIDE REPLACEMENT HEATER or UNDERTAKE REPAIRS
IS THERE A DEFECT IN THE HOT WATER SYSTEM ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
ARE SHOWERS PRESENT ?
NUMBER OF SHOWERS
IS THERE A DEFECT WITH THE SHOWERS ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
NUMBER OF HAND BASINS
IS THERE A DEFECT WITH THE BASINS or TAPS ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING SHOWERS, BASINS, PLUMBING & TAPS - (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Enter details of the defective asset
REMAINING USEFUL LIFE (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
TOILETS and SHOWERS - GENERAL COMMENTS
DISASTER MANAGEMENT OVERVIEW
Storm surge colour for this facility
RED
ORANGE
YELLOW
Not applicable
Unknown
Cylone rating of facility if known
1
2
3
4
5
unknown
Disaster Facility Designation
Major SES facility
Minor SES facility
Evacuation Centre
Disaster Coord Centre
Not classified
unknown
Is there space to land a helicopter nearby ? i.e. greater than 40m radius clear space
Facility to directly plug in portable generators ?
FACILITY OVERVIEW
Electricity supply ?
Gas supplied to facility ?
Is it bottled or reticulated ?
Cold water supply ?
Hot water supply ?
Toilet Facilities ?
Shower facilities ?
Air conditioning ?
Ability to be accessed by disabled
None
Partial access
Full access
CONDITION RATING OF FACILITY AS A WHOLE
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
RUL OF FACILITY AS A WHOLE
RUL = 20+ YEARS
10 - 20 YEARS
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
GENERAL COMMENTS AS A WHOLE
IF ANY COMPONENT OF THIS FACILITY HAS AN R.U.L. OF 2 YEARS OR LESS, OR REQUIRES REFERRAL OR FURTHER INSPECTION, IDENTIFY BY CHECKING THIS BOX AND ENSURE DETAILS PROVIDED SOMEWHERE IN THIS AUDIT
Please note that this checklist is a hypothetical example and provides basic information only. It is not intended
to
take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or
treatment;
or other applicable laws. You should also seek your own professional advice to determine if the use of such
checklist is
permissible in your workplace or jurisdiction.
