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Audit
BACKGROUND INFORMATION
Fixed Asset Register number
Authority number
GIS location
Photo of facility (at date of audit)
Asset owner
Tenure type
Tenant type
Lease commencement date
Lease expiry date
Revenue account number
Key holder details..
Legacy documents ...
Date placed in service
Is it Heritage listed ?
Required level of service
1 High
2
3
4
5 Low
EXTERNAL ELEMENTS -
Are external elements shared by other facilities on the site e.g. Communal car parking etc?
If data has not already been collected for the site, collect it now, taking into account the whole site, not just the area around the audited building itself
- External Access
Access Road (Material)
Concrete
Ashphalt
Chip/spray seal
Blocks / pavers
Gravel
Grass / earth / natural surface
OTHER
PROVIDE DETAILS OF MATERIAL ..
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 ($)
Access road area (m2)
CONDITION RATING OF ROADS (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF ROADS IS APPROXIMATELY (years)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Car park (Material)
Concrete
Ashphalt
Chip/spray seal
Blocks / pavers
Gravel
Grass / earth / natural surface
OTHER
PROVIDE DETAILS OF MATERIAL ..
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
Car parking area (m2)
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
Footpath (Material)
Concrete
Ashphalt
Chip/spray seal
Blocks / pavers
Gravel
Grass / earth / natural surface
OTHER
PROVIDE DETAILS OF MATERIAL ..
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 ($)
Footpath length (m)
CONDITION RATING OF FOOTPATHS (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF FOOTPATHS IS APPROXIMATELY (years)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Is there any decking ?
Decking (Material)
Concrete
Ashphalt
Chip/spray seal
Blocks / pavers
Gravel
Grass / earth / natural surface
OTHER
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
Decking area (m2)
CONDITION RATING OF DECKING (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF DECKING IS APPROXIMATELY (years)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
General comments on external access arrangements
- External Drainage
Kerb & channel length (m)
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 ($)
CONDITION RATING OF K&C (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF K&C IS APPROXIMATELY (years)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Number of drainage pits
If drainage pits exist, are they clear of debris ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
Immediate
within 1week
TAKE PHOTO
Are there any storm water gross pollutant traps on site ?
Are they free of debris ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
Immediate
within 1week
TAKE PHOTO
CONDITION RATING OF EXTERNAL DRAINAGE (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF DRAINAGE IS APPROXIMATELY (years)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
General comments on external drainage
- External Structures and Fencing
Stand alone structures or memorials - describe
Does facility have fencing or gates ?
Fencing / gate (Material)
Timber
Solid Steel Panel
Wire Mesh
Anti- Vandal
Other
Not applicable
PROVIDE DETAILS OF MATERIAL ..
Length of fencing
Height of fencing (0 if not applicable)
No. of lockable gates (0 if not applicable)
Is there a defect with the fencing, gates ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF FENCES & 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 (years)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Are there any retaining structures on the site ?
Length of retaining structures
Provide details of height and material
Is there a defect with the retaining structure ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
within 1 week
within 1 month
within 1 year
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF RETAINING STRUCTURES (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF RETAINING STRUCTURES IS APPROXIMATELY (years)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Provide details of any seating or amenity features
Is there a defect with any amenity features ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
within 1 week
within 1 month
within 1 year
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF AMENITY FEATURES (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF AMENITY FEATURES IS APPROXIMATELY (years)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
General comments on external structures and fences
- Landscaping
Provide brief details of landscaping ... E.g. Mainly grass - we'll maintained etc.
Soft landscape area (m2)
Condition of landscaped area
GOOD
AVERAGE
POOR - NEEDS WORK
Is there an irrigation system ?
Are there any trees / shrubs that are impacting on the structure ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
within 1 week
within 1 month
within 1 year
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
General comments on landscaping
- External Lighting & Power
Are there any external lights attached to the building ?
NUMBER OF EXTERNAL LIGHTS
Identify type
Is there a defect with external lighting ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
Number of solar panels ( if any)
Does it have stand alone lighting towers to illuminate the land and building ?
- Lighting towers
Number of towers at location
What is the tower lighting ? E.g. Car park etc.
Main supporting structure (Material) - (NOT FINISHES - e.g. Steel Frame)
CLAY BRICK
TIMBER
COMPOSITE
POLYCARBONATE
OTHER
UNKNOWN
CONCRETE BLOCK
METAL
CONCRETE PANEL
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 ($)
Required lux
Actual lux
Approx height of tower (m)
Description of any special access requirements
Footing details if known
Tower construction material
metal
timber
concrete
composite
Location of control gear
Main power board - last test date
ARE ALL CIRCUITS PROTECTED BY RCDS ETC.?
HAS THE RCD BEEN TESTED WITHIN THE LAST 12 MONTHS ?
REPORT AS HIGH PRIORITY WORKS:
HIGH PRIORITY DEFECT
REPORT AS HIGH PRIORITY WORKS:
HIGH PRIORITY DEFECT
APPROX COST TO RECTIFY DEFECT ($)
Number of luminaries on each tower
Lamp type
LED
Halogen
Metal Halide
high pressure sodium
unknown
other
PROVIDE DETAILS OF LAMP ...
Lamp wattage or lumens output is ... (Identify unit of measure)
Lamp fitting type
Edison screw
Bayonet
led plug in
halogen double ended
florescent
unknown
other
Colour range or Kelvin
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 ($)
CONDITION RATING OF TOWER (NOTE: 'EXCELLENT' or 'GOOD' assumed 20+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF STRUCTURE IS APPROXIMATELY
RUL bulding structure if ave or less
10 - 20+ YEARS
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
CONDITION RATING OF clipped cables and conduits (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF Cables and conduits is APPROXIMATELY
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
CONDITION RATING of luminaries and lamps (NOTE: 'EXCELLENT' oassumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF Luminaire's and lamps is APPROXIMATELY
CONDITION RATING OF BUILDING WALLS / FRAME (NOTE: 'EXCELLENT' or 'GOOD' assumed 20+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF WALL FRAME (E.G. BLOCKWORK) IS APPROXIMATELY
RUL bulding structure if ave or less
10 - 20+ YEARS
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
FLOOR (Material) - (NOT COVERINGS e.g. reinforced concrete)
REINFORCED CONCRETE
TIMBER - SOLID
PLY BOARD
COMPRESSED FIBRES
STONE
NATURAL SURFACE
BRICK
UNKNOWN
OTHER
PROVIDE DETAILS OF MATERIAL ..
IS THERE A VISIBLE DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF FLOOR - 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 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 ($)
ARE THERE ANY STRUCTURALLY SIGNIFICANT CRACKS, DEFORMATIONS IN THE FLOOR THAT WOULD INDICATE A FAILURE IN THE FLOOR / FOUNDATIONS ?
PROVIDE DETAILS OF THE DEFECT TO ASSIST IN FOLLOW UP INSPECTION ...
Is there any evidence of current/active pest infestation e.g. Termites ?
Provide details and extent of infestation
CONDITION RATING OF BUILDING FOUNDATION (NOTE: 'EXCELLENT' or 'GOOD' assumed 20+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF FOUNDATION (E.G. STUMPS / PILES) IF VISIBLE
RUL bulding structure if ave or less
10 - 20+ YEARS
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Structural Elements - General comments
ROOF COVERING, GUTTERS & DOWNPIPES
ROOF AREA (approx. m2)
ROOF COVERING (Material)
ZINC ALUM
COLOURBOND
PVC
CONCRETE TILES
STAINLESS STEEL
CHAINS
UNKNOWN
OTHER
CLAY TILES
REINFORCED CONCRETE
COMP FIBRE WITH COVERING
POLYCARBONATE
Not applicable
PROVIDE DETAILS OF MATERIAL
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF ROOF COVERING (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF ROOF COVERING IS APPROXIMATELY
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Is a safety access system in place ?
NUMBER OF SKY LIGHTS
NUMBER OF ROOF VENTS (Whirlybirds etc.)
ARE THERE GUTTERS ?
GUTTERS (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
TOTAL LENGTH OF GUTTER
Is there 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 ($)
CONDITION RATING OF GUTTERS (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF GUTTERS IS APPROXIMATELY
5 years MAX
2 - 5 years
less than 2 years
facility is potentially dangerous
ARE THERE DOWNPIPES ?
DOWNPIPES (Material)
ZINC ALUM
COLOURBOND
PVC
CONCRETE TILES
STAINLESS STEEL
CHAINS
UNKNOWN
OTHER
CLAY TILES
REINFORCED CONCRETE
COMP FIBRE WITH COVERING
POLYCARBONATE
Not applicable
PROVIDE DETAILS OF MATERIAL
TOTAL LENGTH OF DOWNPIPES
NUMBER OF DOWN-PIPE DROPS
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
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 COVERING & DRAINAGE - GENERAL COMMENTS - also include any info on roof screw condition if applicable
FINISHES (External)
EXTERNAL Wall Finishes (Material) e.g. painted render
EXTERNAL finishes lookups
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 external wall finishes are painted, the condition of the paintwork in general is ...
Total Length of walls (m)
Height of wall (m)
Approx cost to repaint
Remaining useful life of existing paintwork
less than 2 years
2 to 4 years
Is there a defect with the material of the wall (not paint finish)
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 ($)
Condition rating of EXTERNAL WALL Finishes excluding painting: (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of External WALL finishes (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
FIXTURES & FITTINGS (External)
NUMBER OF EXTERNAL DOORS
NUMBER OF LOUVRES (DO NOT INCLUDE LOUVRED BLOCKS)
NUMBER OF GLAZED WINDOWS
IS THERE A DEFECT WITH WINDOWS , EXTERNAL DOORS OR LOUVRES ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
ARE THERE WINDOW or DOOR SECURITY SCREENS, SHUTTERS OR BARS ?
IS THERE A DEFECT WITH 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 ($)
Condition rating of EXTERNAL FITTINGS: (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of Windows, doors, screens and Louvres (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
INTERIOR SPACES
Use the 'add room' button to add rooms (exclude toilets and showers which need to be identified below)
Room
Provide details of current use
Draw outline of room if necessary and add details of any important features, include NORTH arrow
INTERNAL Wall Finishes (Material) e.g. painted blockwork
PAINTED BLOCK/BRICK
NATURAL TIMBER
STONE
COMPOSITE
EXPOSED BRICK / BLOCK
GLASS
OTHER
UNKNOWN
PAINTED FIBRO SHEETS
ASBESTOS SHEETS UNPAINTED
ASBESTOS SHEETS PAINTED
GYPROCK PAINTED
GYPROCK UNPAINTED
PROVIDE DETAILS OF MATERIAL
If internal wall finishes are painted, the condition is of the paintwork is ..
Length of room (m)
Width of room (m)
Height of room (m)
Approx cost to repaint
Remaining useful life of existing paintwork
less than 2 years
2 to 4 years
IS THERE A DEFECT WITH INTERNAL WALL FINISHES (exclude paintwork) ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
Condition rating of INTERNAL WALL Finishes excluding painting: (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of INTERNAL WALL finishes : (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
CEILING FINISH (Material) e.g. painted boards
PAINTED BOARD/GYPROCK
NATURAL TIMBER
SHEET METAL
UNPAINTED BOARDS
VJ BOARDS - PAINTED
ACOUSTIC TILES
PAINTED CONCRETE
UNPAINTED CONCRETE
UNKNOWN
OTHER
Underside of roof covering
PROVIDE DETAILS OF MATERIAL ..
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 ($)
Condition rating of Ceilings (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of Ceilings (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
FLOOR COVERING (Material) e.g. finished concrete
FINISHED CONCRETE
TILED
CARPET
LINO
FLOATING TIMBER
RUBBER
PAINTED CONCRETE
STONES
NONE - NATURAL
UNKNOWN
OTHER
PROVIDE DETAILS OF MATERIAL ..
IS THERE A DEFECT WITH FLOOR COVERING ?
ENTER DEFECT DETAILS AND WORKS REQ:
If the defect requires relaying an area of floor covering e.g. A carpet, identify the approx area that needs replacement (m2)
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
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
NUMBER OF INTERNAL DOORS
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 ($)
Condition rating of Internal doors (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of Internal doors (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
- Fire & Safety Systems
Check this box if you are unsure about the requirement for exit signs, evac plans and emergency exit lighting and need further advice
Are fire exit signs in place and clearly visible ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
HIGH PRIORITY DEFECT
APPROX COST TO RECTIFY DEFECT ($)
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 ($)
Are there any heat / smoke detectors present ?
If possible, test detectors to ensure operating as designed
Are they working properly ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
HIGH PRIORITY DEFECT
APPROX COST TO RECTIFY DEFECT ($)
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
NUMBER OF INTERNAL LIGHTS
Are any lamps the incandescent type ?
Number of lamps
Is there a distribution board in this room ?
CONDITION OF THE DISTRIBUTION BOARD CABINET AND CONDUITS
GOOD
AVERAGE
POOR - NEEDS WORK
ENTER DEFECT DETAILS AND WORKS REQ:
TAKE PHOTO OR ADD FROM LIBRARY
APPROX COST TO RECTIFY DEFECT ($)
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
ARE ALL CIRCUITS PROTECTED BY RCDS ETC.?
HAS THE RCD BEEN TESTED WITHIN THE LAST 12 MONTHS ?
REPORT AS HIGH PRIORITY WORKS:
HIGH PRIORITY DEFECT
REPORT AS HIGH PRIORITY WORKS:
HIGH PRIORITY DEFECT
APPROX COST TO RECTIFY DEFECT ($)
IS THERE A DEFECT WITH ANY ELECTRICAL SUPPLY OR EQUIPMENT -ignore Major plant items ?
ENTER DEFECT DETAILS AND WORKS REQ:
TAKE PHOTO OR ADD FROM LIBRARY
APPROX COST TO RECTIFY DEFECT ($)
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
CONDITION RATING OF ELECTRICAL SERVICES - exclude Major plant items (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
PROVIDE DETAILS OF THE ASSET
REMAINING USEFUL LIFE OF ASSET
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Are there any items of ELECTRICAL MAJOR PLANT such as generator sets etc.?
Provide details of plant: serial numbers, size etc.
IS THERE AN OBVIOUS DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
Condition rating of ELECTRICAL MAJOR PLANT: (NOTE: 'EXCELLENT' or 'AVERAGE' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Identify major plant item (s)
REMAINING USEFUL LIFE OF EQUIMENT IS...
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Electrical Services - GENERAL COMMENTS
- Mechanical Services
NUMBER OF CEILING 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 ($)
ENTER WORKS PRIORITY:
within 1 week
within 1 month
within 1 year
CONDITION RATING OF MECHANICAL SERVICES (NOTE: 'EXCELLENT' , 'GOOD' or 'AVERAGE' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF EQUIMENT IS...
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Are there any items of MECHANICAL Major plant such as very large fans, compressors etc.
Provide details of plant: serial numbers, size etc.
IS THERE AN OBVIOUS DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQUIRED:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
CONDITION RATING OF Major plant (NOTE: 'EXCELLENT' 'GOOD' or 'AVERAGE' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Identify major plant item (s)
REMAINING USEFUL LIFE OF EQUIMENT IS...
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Mechanical services - General comments
Are there kitchen facilities ?
- Kitchen Facilities
Provide details of fixed appliances, sinks, benches etc.
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
Condition rating of Kitchen (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Remaining Useful Life of Kitchen (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
Are there toilet or shower facilities ?
- Toilets & Showers
ARE DISABLED TOILETS PRESENT ?
NUMBER OF DISABLED TOILETS
MATERIAL OF PAN AND CISTERN
STAINLESS STEEL
PORCELAIN/CERAMIC
PLASTIC/PVC
OTHER
UNKNOWN
n/a
mixed materials
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
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 ($)
IS THERE A DEFECT WITH EXISTING DISABLED FACILITIES ? (EXCLUDE ANY UPGRADES REQ.)
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
ARE THERE FEMALE TOILET FACILITIES ?
NUMBER OF FEMALE CUBICLES
MATERIAL OF PAN AND CISTERN
STAINLESS STEEL
PORCELAIN/CERAMIC
PLASTIC/PVC
OTHER
UNKNOWN
n/a
mixed materials
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 ($)
ARE THERE MALE TOILETS FACILITIES ?
NUMBER OF MALE CUBICLES
MATERIAL OF PAN AND CISTERN
STAINLESS STEEL
PORCELAIN/CERAMIC
PLASTIC/PVC
OTHER
UNKNOWN
n/a
mixed materials
PROVIDE DETAILS OF MATERIAL ..
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
ARE THERE URINALS PRESENT ?
NO. OF URINALS
IS THERE AN AUTOMATIC FLUSH SYSTEM IN PLACE ?
MATERIAL OF URINAL
STAINLESS STEEL
PORCELAIN/CERAMIC
PLASTIC/PVC
OTHER
UNKNOWN
n/a
mixed materials
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 ($)
IS THERE A TROUGH PRESENT ?
NO. OF PEOPLE IT CAN ACCOMMODATE
IS THERE AN AUTOMATIC FLUSH SYSTEM IN PLACE ?
MATERIAL OF TROUGH
STAINLESS STEEL
PORCELAIN/CERAMIC
PLASTIC/PVC
OTHER
UNKNOWN
n/a
mixed materials
PROVIDE DETAILS OF MATERIAL ..
IS THERE A DEFECT ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
ARE THERE UNISEX FACILITIES ?
NUMBER OF UNISEX CUBICLES
MATERIAL OF PAN AND CISTERN
STAINLESS STEEL
PORCELAIN/CERAMIC
PLASTIC/PVC
OTHER
UNKNOWN
n/a
mixed materials
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 ($)
CONDITION RATING OF SANITARY WARE (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Provide details of poor condition asset ...
REMAINING USEFUL LIFE (YEARS)
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
IS THERE A SEPTIC TANK ?
IS IT A BIO SYSTEM?
IS THERE HOT WATER AVAILABLE ?
PROVIDE DETAILS OF HEATING SOURCE ...
WHAT IS THE GENERAL CONDITION OF THE HEATER ?
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
Provide details of poor condition asset ...
TAKE PHOTO
APPROX COST TO PROVIDE REPLACEMENT HEATER or UNDERTAKE REPAIRS
IS THERE A DEFECT IN THE HOT WATER SYSTEM ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
ARE SHOWERS PRESENT ?
NUMBER OF SHOWERS
FINISH MATERIAL OF SHOWER CUBICLES
TILES
PAINTED BLOCK/RENDER
PLASTIC SHEET
METAL SHEET
OTHER
UNKNOWN
DETAILS OF MATERIAL ....
ARE ALL SHOWER TAPS AUTO SHUT OFF ?
NUMBER OF TAPS THAT ARE NOT AUTO SHUT OFF
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 ($)
ARE HAND BASINS PRESENT ?
NUMBER OF HAND BASINS
BASINS (MATERIAL)
STAINLESS STEEL
PORCELAIN/CERAMIC
PLASTIC/PVC
OTHER
UNKNOWN
n/a
mixed materials
PROVIDE DETAILS OF MATERIAL ..
IS THERE A DEFECT WITH THE BASINS ?
ENTER DEFECT DETAILS AND WORKS REQ:
ENTER WORKS PRIORITY:
IMMEDIATE
HIGH - WITHIN 1 MONTH
MEDIUM - 3 - 6 MONTHS
MED/LOW - WITHIN 1 YR
LOW - 2 -3 YRS
LOW - WITHIN 5 YEARS
LOW - 10+ YRS
Follow up insp. required
TAKE PHOTO
APPROX COST TO RECTIFY DEFECT ($)
IS THERE AN OUTSIDE TAP ?
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 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
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
unknown
Is there an open space large enough to land a helicopter nearby ( e.g. 40m diameter )
Does the facility have its own emergency generator ?
Does the facility have the ability to directly plug in portable generators ?
FACILITY SERVICES OVERVIEW
Gross floor area of facility (m2)
Electricity supply ?
Is gas supplied to facility ?
Is it bottled or reticulated ?
Cold water supply ?
Hot water supply ?
Toilet facilities ?
Air conditioning ?
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
Ability to be accessed by disabled
None
Partial access
Full access
unknown
FACILITY SUMMARY
Actual Level of Service at date of inspection
1 High
2
3
4
5 Low
CONDITION RATING OF FACILITY AS A WHOLE
Not applicable
EXCELLENT
GOOD
AVERAGE
POOR
VERY POOR
FAILED / DORMANT
REMAINING USEFUL LIFE OF FACILITY AS A WHOLE, AS CONDITION IS POOR OR WORSE ....
5 years MAX
2 - 5 years
less than 2 years
facility is potentially dangerous
Provide details to support this conclusion and ensure appropriate photos and defects have been identified previously in this audit
TAKE PHOTO OR ADD FROM LIBRARY
REMAINING USEFUL LIFE OF THE FACILITY AS A. WHOLE (YEARS)
RUL = 20+ YEARS
10 - 20 YEARS
5 - 10 YEARS
3 - 5 YEARS
1 - 3 YEARS
LESS THAN 1 YEAR
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.
