BFM Audit For Complex Facilities

FACILITY LOCATION

• Street address

• Name of facility

• SUBURB

  Select AEROGLEN ALOOMBA BABINDA BARRON BARRON GORGE BARTLE FRERE BAYVIEW HEIGHTS BELLENDEN KER BENTLEY PARK BRAMSTON BEACH BRINSMEAD BUNGALOW CAIRNS CITY CAIRNS NORTH CARAVONICA CLIFTON BEACH DEERAL EAST RUSSELL EDGE HILL EDMONTON ELLIS BEACH EUBENANGEE FISHERY FALLS FITZROY ISLAND FRESHWATER GLEN BOUGHTON GOLDSBOROUGH GORDONVALE GREEN HILL HOLLOWAYS BEACH KAMERUNGA KANIMBLA KEWARRA BEACH LAMBS RANGE LITTLE MULGRAVE MACALISTER RANGE MACHANS BEACH MANOORA MANUNDA MIRRIWINNI MOOROOBOOL MOUNT PETER MOUNT SHERIDAN NGATJAN PACKERS CAMP PALM COVE PARRAMATTA PARK PORTSMITH REDLYNCH SMITHFIELD STRATFORD TRINITY BEACH TRINITY PARK WAUGH POCKET WESTCOURT WHITEROCK WHITFIELD WOOPEN CREEK WOOROONOORAN WOREE WRIGHTS CREEK YORKEYS KNOB

  • AEROGLEN
  • ALOOMBA
  • BABINDA
  • BARRON
  • BARRON GORGE
  • BARTLE FRERE
  • BAYVIEW HEIGHTS
  • BELLENDEN KER
  • BENTLEY PARK
  • BRAMSTON BEACH
  • BRINSMEAD
  • BUNGALOW
  • CAIRNS CITY
  • CAIRNS NORTH
  • CARAVONICA
  • CLIFTON BEACH
  • DEERAL
  • EAST RUSSELL
  • EDGE HILL
  • EDMONTON
  • ELLIS BEACH
  • EUBENANGEE
  • FISHERY FALLS
  • FITZROY ISLAND
  • FRESHWATER
  • GLEN BOUGHTON
  • GOLDSBOROUGH
  • GORDONVALE
  • GREEN HILL
  • HOLLOWAYS BEACH
  • KAMERUNGA
  • KANIMBLA
  • KEWARRA BEACH
  • LAMBS RANGE
  • LITTLE MULGRAVE
  • MACALISTER RANGE
  • MACHANS BEACH
  • MANOORA
  • MANUNDA
  • MIRRIWINNI
  • MOOROOBOOL
  • MOUNT PETER
  • MOUNT SHERIDAN
  • NGATJAN
  • PACKERS CAMP
  • PALM COVE
  • PARRAMATTA PARK
  • PORTSMITH
  • REDLYNCH
  • SMITHFIELD
  • STRATFORD
  • TRINITY BEACH
  • TRINITY PARK
  • WAUGH POCKET
  • WESTCOURT
  • WHITEROCK
  • WHITFIELD
  • WOOPEN CREEK
  • WOOROONOORAN
  • WOREE
  • WRIGHTS CREEK
  • YORKEYS KNOB

• Lot on plan number

• Parcel number

• Assessment number

• FAR number

• Authority Asset ID Number

• Location GIS ref.
  Address

• COUNCIL DIVISION

• Photo of facility

  Media

• DATE OF AUDIT

  Date

• Weather at time of audit:

• Report prepared by:

FACILITY OWNER, HISTORY, USE

• Asset owner

• Tenure type

• Tenant type

• Lease commencement date

  Date

• Lease expiry date

  Date

• Revenue account number

• KEY HOLDER DETAILS :

• LEGACY INFORMATION / COMMENTS

• Date placed in service

  Date

• Is it Heritage listed ?

• Required level of service

  Select 1 High 2 3 4 5 Low

  • 1 High
  • 2
  • 3
  • 4
  • 5 Low

DISASTER MANAGEMENT

• Storm surge colour for this facility

  Select RED ORANGE YELLOW Not applicable Unknown

  • RED
  • ORANGE
  • YELLOW
  • Not applicable
  • Unknown

• Cylone rating of facility if known

  1 or Unknown

  2

  3

  4

  5

• Disaster Facility Designation

  Select Major SES facility Minor SES facility Evacuation Centre Disaster Coord Centre

  • Major SES facility
  • Minor SES facility
  • Evacuation Centre
  • Disaster Coord Centre

• Is there space to land a helicopter nearby ? i.e. greater than 40m radius clear space

  YES

  NO

• Does the facility have its own emergency generator ?

• Does the facility have ability to plug in portable generators ?

  YES

  NO

EXTERNAL ELEMENTS -

- Access & Drainage

• Access Road (Material)

  Select Concrete Ashphalt Chip/spray seal Blocks / pavers Gravel Grass / earth / natural surface OTHER

  • Concrete
  • Ashphalt
  • Chip/spray seal
  • Blocks / pavers
  • Gravel
  • Grass / earth / natural surface
  • OTHER

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Access road area (m2)

• CONDITION RATING OF ROADS (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF ROADS IS APPROXIMATELY (years)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• Car park (Material)

  Select Concrete Ashphalt Chip/spray seal Blocks / pavers Gravel Grass / earth / natural surface OTHER

  • Concrete
  • Ashphalt
  • Chip/spray seal
  • Blocks / pavers
  • Gravel
  • Grass / earth / natural surface
  • OTHER

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Car parking area (m2)

• CONDITION RATING OF CAR PARK (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF CAR PARKING AREA IS APPROXIMATELY (years)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• Footpath (Material)

  Select Concrete Ashphalt Chip/spray seal Blocks / pavers Gravel Grass / earth / natural surface OTHER

  • Concrete
  • Ashphalt
  • Chip/spray seal
  • Blocks / pavers
  • Gravel
  • Grass / earth / natural surface
  • OTHER

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Footpath area (m2)

• CONDITION RATING OF FOOTPATHS (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF FOOTPATHS IS APPROXIMATELY (years)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• Kerb & channel length (m)

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF K&C (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF K&C IS APPROXIMATELY (years)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• Is there any decking ?

  YES

  NO

• Decking (Material)

  Select Concrete Ashphalt Chip/spray seal Blocks / pavers Gravel Grass / earth / natural surface OTHER

  • Concrete
  • Ashphalt
  • Chip/spray seal
  • Blocks / pavers
  • Gravel
  • Grass / earth / natural surface
  • OTHER

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Decking area (m2)

• CONDITION RATING OF DECKING (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF DECKING IS APPROXIMATELY (years)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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 ?

  Yes

  No

  N/A

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select Immediate within 1week

  • Immediate
  • within 1week

• TAKE PHOTO

  Media

• Are there any storm water gross pollutant traps on site ?

  YES

  NO

• Are they free of debris ?

  YES

  NO

  UNKNOWN

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select Immediate within 1week

  • Immediate
  • within 1week

• TAKE PHOTO

  Media

• CONDITION RATING OF EXTERNAL DRAINAGE (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF DRAINAGE IS APPROXIMATELY (years)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

- Landscaping

• Soft landscape area (m2)

• Provide brief details of landscaping ... E.g. Mainly grass - we'll maintained etc.

• Is there an irrigation system ?

• Are there any trees / shrubs that are impacting on the structure ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select within 1 week within 1 month within 1 year

  • within 1 week
  • within 1 month
  • within 1 year

• TAKE PHOTO

  Media

• APPROX COST TO RECTIFY DEFECT ($)

- Structures and Fencing

• Stand alone structures or memorials - describe

• Does facility have fencing or gates ?

  YES

  NO

• Fencing / gate (Material)

  Select Timber Solid Steel Panel Wire Mesh Anti- Vandal Other Not applicable

  • 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 ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF FENCES & GATES (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF FENCES & GATES IS APPROXIMATELY (years)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• Are there any retaining structures on the site ?

  YES

  NO

• Length of retaining structures

• Provide details of height and material

• Is there a defect with the retaining structure ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select within 1 week within 1 month within 1 year

  • within 1 week
  • within 1 month
  • within 1 year

• TAKE PHOTO

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF RETAINING STRUCTURES (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF RETAINING STRUCTURES IS APPROXIMATELY (years)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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 ?

  YES

  NO

  Not Aplicable

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select within 1 week within 1 month within 1 year

  • within 1 week
  • within 1 month
  • within 1 year

• TAKE PHOTO

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF AMENITY FEATURES (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF AMENITY FEATURES IS APPROXIMATELY (years)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

- External Lighting & Power

• Are there any external lights attached to the building ?

  YES

  NO

• NUMBER OF EXTERNAL LIGHTS

• Identify type

• Is there a defect with external lighting ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Number of solar panels ( if any)

• Does it have stand alone lighting towers to illuminate the land and building ?

  YES

  NO

- 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)

  Select CLAY BRICK TIMBER COMPOSITE POLYCARBONATE OTHER UNKNOWN CONCRETE BLOCK METAL CONCRETE PANEL

  • CLAY BRICK
  • TIMBER
  • COMPOSITE
  • POLYCARBONATE
  • OTHER
  • UNKNOWN
  • CONCRETE BLOCK
  • METAL
  • CONCRETE PANEL

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A VISIBLE DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• 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

  Select metal timber concrete composite

  • metal
  • timber
  • concrete
  • composite

• Location of control gear

• Main power board - last test date

  Date

• ARE ALL CIRCUITS PROTECTED BY RCDS ETC.?

  Yes

  No

  Not applicable

• HAS THE RCD BEEN TESTED WITHIN THE LAST 12 MONTHS ?

  Yes

  No

  Not applicable

• REPORT AS HIGH PRIORITY WORKS:

  Select HIGH PRIORITY DEFECT

  • HIGH PRIORITY DEFECT

• REPORT AS HIGH PRIORITY WORKS:

  Select HIGH PRIORITY DEFECT

  • HIGH PRIORITY DEFECT

• APPROX COST TO RECTIFY DEFECT ($)

• Number of luminaries on each tower

• Lamp type

  Select LED Halogen Metal Halide high pressure sodium unknown other

  • 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

  Select Edison screw Bayonet led plug in halogen double ended florescent unknown other

  • Edison screw
  • Bayonet
  • led plug in
  • halogen double ended
  • florescent
  • unknown
  • other

• Colour range or Kelvin

• Is there a defect with lighting towers ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF TOWER (NOTE: 'EXCELLENT' or 'GOOD' assumed 20+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF STRUCTURE IS APPROXIMATELY

  Select RUL bulding structure if ave or less 10 - 20+ YEARS 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF Cables and conduits is APPROXIMATELY

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF Luminaire's and lamps is APPROXIMATELY

  Select 5 years MAX 2 - 5 years less than 2 years facility is potentially dangerous

  • 5 years MAX
  • 2 - 5 years
  • less than 2 years
  • facility is potentially dangerous

• Recommended date for replacement of lamps

  Date

• Recommended lamp replacement frequency (years)

• Comments on EXTERNAL elements ...

STRUCTURE / ENVELOPE

• ROOF STRUCTURE (Material) - (NOT roof covering - e.g. timber trusses)

  Select TIMBER TRUSSES CONCRETE BEAMS COMPOSITE METAL MASONARY OTHER UNKNOWN

  • TIMBER TRUSSES
  • CONCRETE BEAMS
  • COMPOSITE
  • METAL
  • MASONARY
  • OTHER
  • UNKNOWN

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A VISIBLE DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF ROOF STRUCTURE - not coverings (NOTE: 'EXCELLENT' or 'GOOD' assumed 20+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF ROOF STRUCTURE (E.G. TRUSSES) IS APPROXIMATELY

  Select RUL bulding structure if ave or less 10 - 20+ YEARS 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • RUL bulding structure if ave or less
  • 10 - 20+ YEARS
  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• WALLS / FRAME (Material) - (NOT FINISHES - e.g. Steel Frame)

  Select CLAY BRICK TIMBER COMPOSITE POLYCARBONATE OTHER UNKNOWN CONCRETE BLOCK METAL CONCRETE PANEL

  • CLAY BRICK
  • TIMBER
  • COMPOSITE
  • POLYCARBONATE
  • OTHER
  • UNKNOWN
  • CONCRETE BLOCK
  • METAL
  • CONCRETE PANEL

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A VISIBLE DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF BUILDING WALLS / FRAME (NOTE: 'EXCELLENT' or 'GOOD' assumed 20+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF WALL FRAME (E.G. BLOCKWORK) IS APPROXIMATELY

  Select RUL bulding structure if ave or less 10 - 20+ YEARS 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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)

  Select REINFORCED CONCRETE TIMBER - SOLID PLY BOARD COMPRESSED FIBRES STONE NATURAL SURFACE BRICK UNKNOWN OTHER

  • REINFORCED CONCRETE
  • TIMBER - SOLID
  • PLY BOARD
  • COMPRESSED FIBRES
  • STONE
  • NATURAL SURFACE
  • BRICK
  • UNKNOWN
  • OTHER

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A VISIBLE DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF FLOOR - Not coverings (NOTE: 'EXCELLENT' or 'GOOD' assumed 20+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF FLOOR (E.G. SLAB) IS APPROXIMATELY

  Select RUL bulding structure if ave or less 10 - 20+ YEARS 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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 ?

  YES

  NO

  Not Aplicable

• FOUNDATION (Material) - (NOT COVERINGS e.g. timber stumps)

  Select CONC SLAB ON GROUND CONCRETE PILES/FOOTINGS WOODEN PILES/SUPPORTS OTHER UNKNOWN

  • CONC SLAB ON GROUND
  • CONCRETE PILES/FOOTINGS
  • WOODEN PILES/SUPPORTS
  • OTHER
  • UNKNOWN

• PROVIDE DETAILS OF MATERIAL

• IS THERE A VISIBLE DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ARE THERE ANY STRUCTURALLY SIGNIFICANT CRACKS, DEFORMATIONS IN THE FLOOR THAT WOULD INDICATE A FAILURE IN THE FLOOR / FOUNDATIONS ?

  YES

  NO

  Not Aplicable

• PROVIDE DETAILS OF THE DEFECT TO ASSIST IN FOLLOW UP INSPECTION ...

• Is there any evidence of current/active pest infestation e.g. Termites ?

  No activity

  Minor activity

  Major activity

• Provide details and extent of infestation

• CONDITION RATING OF BUILDING FOUNDATION (NOTE: 'EXCELLENT' or 'GOOD' assumed 20+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF FOUNDATION (E.G. STUMPS / PILES) IF VISIBLE

  Select RUL bulding structure if ave or less 10 - 20+ YEARS 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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)

  Select ZINC ALUM COLOURBOND PVC CONCRETE TILES STAINLESS STEEL CHAINS UNKNOWN OTHER CLAY TILES REINFORCED CONCRETE COMP FIBRE WITH COVERING POLYCARBONATE Not applicable

  • 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 ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF ROOF COVERING (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF ROOF COVERING IS APPROXIMATELY

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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 ?

  YES

  NO

• GUTTERS (Material)

  Select ZINC ALUM COLOURBOND PVC CONCRETE TILES STAINLESS STEEL CHAINS UNKNOWN OTHER CLAY TILES REINFORCED CONCRETE COMP FIBRE WITH COVERING POLYCARBONATE Not applicable

  • 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 ?

  Yes

  No

  Not applicable

• IS THERE A DEFECT WITH GUTTER or GUTTER GAURD ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF GUTTERS (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF GUTTERS IS APPROXIMATELY

  Select 5 years MAX 2 - 5 years less than 2 years facility is potentially dangerous

  • 5 years MAX
  • 2 - 5 years
  • less than 2 years
  • facility is potentially dangerous

• ARE THERE DOWNPIPES ?

  YES

  NO

• DOWNPIPES (Material)

  Select ZINC ALUM COLOURBOND PVC CONCRETE TILES STAINLESS STEEL CHAINS UNKNOWN OTHER CLAY TILES REINFORCED CONCRETE COMP FIBRE WITH COVERING POLYCARBONATE Not applicable

  • 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 ?

  YES

  NO

  Not Aplicable

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF DOWNPIPES (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF DOWN PIPES IS APPROXIMATELY

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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

  Select 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

  • 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

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Condition rating of EXTERNAL WALL Finishes: (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Remaining Useful Life of External WALL finishes (YEARS)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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 ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ARE THERE WINDOW or DOOR SECURITY SCREENS, SHUTTERS OR BARS ?

  YES

  NO

• IS THERE A DEFECT WITH SCREENS, SHUTTERS OR BARS ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Condition rating of EXTERNAL FITTINGS: (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Remaining Useful Life of Windows, doors, screens and Louvres (YEARS)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

INTERIOR SPACES

• Use + button to add rooms (exclude toilets and showers which need to be identified below)

Room number

• Provide details of current use

• Location using compass points

  Select North South East West North East North West South East South West

  • North
  • South
  • East
  • West
  • North East
  • North West
  • South East
  • South West

• Draw outline of room if necessary and add details of any important features

  Drawing

• INTERNAL Wall Finishes (Material) e.g. painted blockwork

  Select 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

  • 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

• IS THERE A DEFECT WITH INTERNAL WALL FINISHES ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Condition rating of INTERNAL WALL Finishes: (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Remaining Useful Life of INTERNAL WALL finishes : (YEARS)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• CEILING FINISH (Material) e.g. painted boards

  Select PAINTED BOARD/GYPROCK NATURAL TIMBER SHEET METAL UNPAINTED BOARDS VJ BOARDS - PAINTED ACOUSTIC TILES PAINTED CONCRETE UNPAINTED CONCRETE UNKNOWN OTHER Underside of roof covering

  • 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 ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Condition rating of Ceilings (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Remaining Useful Life of Ceilings (YEARS)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• FLOOR COVERING (Material) e.g. finished concrete

  Select FINISHED CONCRETE TILED CARPET LINO FLOATING TIMBER RUBBER PAINTED CONCRETE STONES NONE - NATURAL UNKNOWN OTHER

  • 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 ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Condition rating of Floor coverings (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Remaining Useful Life of Floor coverings (YEARS)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• NUMBER OF INTERNAL DOORS

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Condition rating of Internal doors (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Remaining Useful Life of Internal doors (YEARS)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

- Fire & Safety Systems

• Are fire exit signs in place and clearly visible ?

  Yes

  No

  Not applicable

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select HIGH PRIORITY DEFECT

  • 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 ?

  YES

  NO

  Not Aplicable

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select HIGH PRIORITY DEFECT

  • HIGH PRIORITY DEFECT

• APPROX COST TO RECTIFY DEFECT ($)

• Are there any heat / smoke detectors present ?

  YES

  NO

• If possible, test detectors to ensure operating as designed

• Are they working properly ?

  Yes

  No

  Not applicable

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select HIGH PRIORITY DEFECT

  • HIGH PRIORITY DEFECT

• APPROX COST TO RECTIFY DEFECT ($)

• Condition rating of Fire appliances and systems (NOTE: 'EXCELLENT' or 'GOOD' assumed 5+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Remaining Useful Life of Fire services equipment (YEARS)

  Select 5 years MAX 2 - 5 years less than 2 years facility is potentially dangerous

  • 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

• Is there a distribution board in this room ?

  YES

  NO

• CONDITION OF THE DISTRIBUTION BOARD CABINET AND CONDUITS

  Select GOOD AVERAGE POOR - NEEDS WORK

  • GOOD
  • AVERAGE
  • POOR - NEEDS WORK

• ENTER DEFECT DETAILS AND WORKS REQ:

• TAKE PHOTO OR ADD FROM LIBRARY

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ENTER WORKS PRIORITY:

  Select 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

  • 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.?

  YES

  NO

• HAS THE RCD BEEN TESTED WITHIN THE LAST 12 MONTHS ?

  YES

  NO

• REPORT AS HIGH PRIORITY WORKS:

  Select HIGH PRIORITY DEFECT

  • HIGH PRIORITY DEFECT

• REPORT AS HIGH PRIORITY WORKS:

  Select HIGH PRIORITY DEFECT

  • HIGH PRIORITY DEFECT

• APPROX COST TO RECTIFY DEFECT ($)

• IS THERE A DEFECT WITH ANY ELECTRICAL SUPPLY OR EQUIPMENT -ignore Major plant items ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• TAKE PHOTO OR ADD FROM LIBRARY

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• PROVIDE DETAILS OF THE ASSET

• REMAINING USEFUL LIFE OF ASSET

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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.?

  YES

  NO

• Provide details of plant: serial numbers, size etc.

• IS THERE AN OBVIOUS DEFECT ?

  YES

  NO

  UNKNOWN

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• Condition rating of ELECTRICAL MAJOR PLANT: (NOTE: 'EXCELLENT' or 'AVERAGE' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Identify major plant item (s)

• REMAINING USEFUL LIFE OF EQUIMENT IS...

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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..)

  YES

  NO

  Not Aplicable

• ENTER DEFECT DETAILS AND WORKS REQ:

• TAKE PHOTO OR ADD FROM LIBRARY

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ENTER WORKS PRIORITY:

  Select within 1 week within 1 month within 1 year

  • within 1 week
  • within 1 month
  • within 1 year

• CONDITION RATING OF MECHANICAL SERVICES (NOTE: 'EXCELLENT' or 'AVERAGE' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF EQUIMENT IS...

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 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.

  YES

  NO

• Provide details of plant: serial numbers, size etc.

• IS THERE AN OBVIOUS DEFECT ?

  YES

  NO

  UNKNOWN

• ENTER DEFECT DETAILS AND WORKS REQUIRED:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• CONDITION RATING OF Major plant (NOTE: 'EXCELLENT' or 'AVERAGE' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Identify major plant item (s)

• REMAINING USEFUL LIFE OF EQUIMENT IS...

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• Mechanical services - General comments

• Are there kitchen facilities ?

  YES

  NO

- Kitchen Facilities

• Provide details of fixed appliances, sinks, benches etc.

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• TAKE PHOTO

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ENTER WORKS PRIORITY:

  Select 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

  • 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)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Remaining Useful Life of Kitchen (YEARS)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• Are there toilet or shower facilities ?

  YES

  NO

- Toilets & Showers

• ARE DISABLED TOILETS PRESENT ?

  YES

  NO

• NUMBER OF DISABLED TOILETS

• MATERIAL OF PAN AND CISTERN

  Select STAINLESS STEEL PORCELAIN/CERAMIC PLASTIC/PVC OTHER UNKNOWN n/a mixed materials

  • STAINLESS STEEL
  • PORCELAIN/CERAMIC
  • PLASTIC/PVC
  • OTHER
  • UNKNOWN
  • n/a
  • mixed materials

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• DOES THE FACILITY MEET CURRENT DAY ACCESS REQUIREMENTS ?

  YES

  NO

• PROVIDE DETAILS OF WHAT IS REQUIRED TO BRING UP TO CURRENT STANDARD INCLUDING EXTERNAL ACCESS

• TAKE PHOTO

  Media

• APPROX COST TO MAKE UP TO TODAYS STANDARDS ($)

• IS THERE A DEFECT WITH EXISTING DISABLED FACILITIES ? (EXCLUDE ANY UPGRADES REQ.)

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ARE THERE FEMALE TOILET FACILITIES ?

  YES

  NO

• NUMBER OF FEMALE CUBICLES

• MATERIAL OF PAN AND CISTERN

  Select STAINLESS STEEL PORCELAIN/CERAMIC PLASTIC/PVC OTHER UNKNOWN n/a mixed materials

  • STAINLESS STEEL
  • PORCELAIN/CERAMIC
  • PLASTIC/PVC
  • OTHER
  • UNKNOWN
  • n/a
  • mixed materials

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ARE THERE MALE TOILETS FACILITIES ?

  YES

  NO

• NUMBER OF MALE CUBICLES

• MATERIAL OF PAN AND CISTERN

  Select STAINLESS STEEL PORCELAIN/CERAMIC PLASTIC/PVC OTHER UNKNOWN n/a mixed materials

  • STAINLESS STEEL
  • PORCELAIN/CERAMIC
  • PLASTIC/PVC
  • OTHER
  • UNKNOWN
  • n/a
  • mixed materials

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ARE THERE URINALS PRESENT ?

  YES

  NO

• NO. OF URINALS

• IS THERE AN AUTOMATIC FLUSH SYSTEM IN PLACE ?

  YES

  NO

• MATERIAL OF URINAL

  Select STAINLESS STEEL PORCELAIN/CERAMIC PLASTIC/PVC OTHER UNKNOWN n/a mixed materials

  • STAINLESS STEEL
  • PORCELAIN/CERAMIC
  • PLASTIC/PVC
  • OTHER
  • UNKNOWN
  • n/a
  • mixed materials

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• IS THERE A TROUGH PRESENT ?

  YES

  NO

• NO. OF PEOPLE IT CAN ACCOMMODATE

• IS THERE AN AUTOMATIC FLUSH SYSTEM IN PLACE ?

  YES

  NO

  Not Aplicable

• MATERIAL OF TROUGH

  Select STAINLESS STEEL PORCELAIN/CERAMIC PLASTIC/PVC OTHER UNKNOWN n/a mixed materials

  • STAINLESS STEEL
  • PORCELAIN/CERAMIC
  • PLASTIC/PVC
  • OTHER
  • UNKNOWN
  • n/a
  • mixed materials

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ARE THERE UNISEX FACILITIES ?

  YES

  NO

• NUMBER OF UNISEX CUBICLES

• MATERIAL OF PAN AND CISTERN

  Select STAINLESS STEEL PORCELAIN/CERAMIC PLASTIC/PVC OTHER UNKNOWN n/a mixed materials

  • STAINLESS STEEL
  • PORCELAIN/CERAMIC
  • PLASTIC/PVC
  • OTHER
  • UNKNOWN
  • n/a
  • mixed materials

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• IS THERE A SEPTIC TANK ?

  YES

  NO

  UNKNOWN

• IS IT A BIO SYSTEM?

  YES

  NO

  UNKNOWN

• CONDITION RATING OF SANITARY WARE (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Provide details of poor condition asset ...

• REMAINING USEFUL LIFE (YEARS)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• IS THERE HOT WATER AVAILABLE ?

  YES

  NO

• PROVIDE DETAILS OF HEATING SOURCE ...

• WHAT IS THE GENERAL CONDITION OF THE HEATER ?

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Provide details of poor condition asset ...

• TAKE PHOTO

  Media

• APPROX COST TO PROVIDE REPLACEMENT HEATER or UNDERTAKE REPAIRS

• IS THERE A DEFECT IN THE HOT WATER SYSTEM ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ARE SHOWERS PRESENT ?

  YES

  NO

• NUMBER OF SHOWERS

• FINISH MATERIAL OF SHOWER CUBICLES

  Select TILES PAINTED BLOCK/RENDER PLASTIC SHEET METAL SHEET OTHER UNKNOWN

  • TILES
  • PAINTED BLOCK/RENDER
  • PLASTIC SHEET
  • METAL SHEET
  • OTHER
  • UNKNOWN

• DETAILS OF MATERIAL ....

• ARE ALL SHOWER TAPS AUTO SHUT OFF ?

  YES

  NO

• NUMBER OF TAPS THAT ARE NOT AUTO SHUT OFF

• IS THERE A DEFECT WITH THE SHOWERS ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ARE HAND BASINS PRESENT ?

  YES

  NO

• NUMBER OF HAND BASINS

• BASINS (MATERIAL)

  Select STAINLESS STEEL PORCELAIN/CERAMIC PLASTIC/PVC OTHER UNKNOWN n/a mixed materials

  • STAINLESS STEEL
  • PORCELAIN/CERAMIC
  • PLASTIC/PVC
  • OTHER
  • UNKNOWN
  • n/a
  • mixed materials

• PROVIDE DETAILS OF MATERIAL ..

• IS THERE A DEFECT WITH THE BASINS ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• ENTER WORKS PRIORITY:

  Select 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

  • 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

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• IS THERE AN OUTSIDE TAP ?

  YES

  NO

• IS THERE A DEFECT ?

  YES

  NO

• ENTER DEFECT DETAILS AND WORKS REQ:

• TAKE PHOTO OR ADD FROM LIBRARY

  Media

• APPROX COST TO RECTIFY DEFECT ($)

• ENTER WORKS PRIORITY:

  Select 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

  • 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)

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• Enter details of the defective asset

• REMAINING USEFUL LIFE (YEARS)

  Select 5 - 10 YEARS 3 - 5 YEARS 1 - 3 YEARS LESS THAN 1 YEAR

  • 5 - 10 YEARS
  • 3 - 5 YEARS
  • 1 - 3 YEARS
  • LESS THAN 1 YEAR

• TOILETS and SHOWERS - GENERAL COMMENTS

FACILITY SERVICES OVERVIEW

• Gross floor area of facility (m2)

• Electricity supply ?

• Is gas supplied to facility ?

  YES

  NO

• Is it bottled or reticulated ?

  Bottled

  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

  YES

  NO

  UNKNOWN

• Input ID number in Council's asbestos register dm5#3608856

• Ability to be accessed by disabled

  Select None Partial access Full access unknown

  • None
  • Partial access
  • Full access
  • unknown

FACILITY SUMMARY

• Actual Level of Service at date of inspection

  Select 1 High 2 3 4 5 Low

  • 1 High
  • 2
  • 3
  • 4
  • 5 Low

• CONDITION RATING OF FACILITY AS A WHOLE

  Select Not applicable EXCELLENT GOOD AVERAGE POOR VERY POOR FAILED / DORMANT

  • Not applicable
  • EXCELLENT
  • GOOD
  • AVERAGE
  • POOR
  • VERY POOR
  • FAILED / DORMANT

• REMAINING USEFUL LIFE OF FACILITY AS A WHOLE, AS CONDITION IS POOR OR WORSE ....

  Select 5 years MAX 2 - 5 years less than 2 years facility is potentially dangerous

  • 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

  Media

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