Information
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Document No.
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Facility name :
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Client :
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Audit conducted on
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Report prepared by: (name & contact number)
LEGACY INFORMATION
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STREET ADDRESS OF FACILITY, INCLUDING SUBURB
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PARK / RESERVE NAME (if applicable)
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FACILITY ID NUMBER FROM FAR
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FACILITY ID NUMBER FROM AUTHORITY
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FACILITY NAME (if applicable)
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GIS REF (OR USE GPS IF CONNECTED TO NETWORK)
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LOT ON PLAN e.g. 12RP12345
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ASSESSMENT NUMBER
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PARCEL NUMBER
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WHAT LEVEL OF SERVICE IS REQUIRED FOR THIS FACILITY ?
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FOR THIS LOS CR EXPECTED TO BE 'EXCELLENT' WITH NO DEFECTS OR DETERIORATION
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FOR THIS LOS CR EXPECTED TO BE 'EXCELLENT' TO 'GOOD' WITH VERY MINOR DETERIORATION ONLY
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FOR THIS LOS CR EXPECTED TO BE 'AVERAGE' WITH MINOR DETERIORATION ALLOWED
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FOR THIS LOS CR EXPECTED TO BE 'AVERAGE' TENDING TO 'POOR' WITH MAJOR DETERIORATION ALLOWED
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FOR THIS LOS CR EXPECTED TO BE 'POOR' CONDITION BUT STILL SAFE. SIGNIFICANT DETERIORATION ALLOWED
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ASSET OWNER; NAME, ADDRESS AND TELEPHONE NUMBER
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IS THIS A LEASED OR LOCKED FACILITY ?
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DETAILS OF KEY HOLDER OR ACCESS REQUIREMENTS
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Date placed in service if known
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LEGACY INFORMATION
LAND & SURROUNDS
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PHOTO (S) OF FACILITY
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ARE THERE ANY TREES/VEGETATION NEARBY THAT ARE TOUCHING THE FACILITY OR ARE LIKELY TO CAUSE DAMAGE IF LEFT UNCHANGED ?
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RAISE A DEFECT
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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DOES THE FACILITY OR ACCESS TO THE FACILITY MEET CURRENT DAY ACCESS REQUIREMENTS ?
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PROVIDE DETAILS OF WHAT IS REQUIRED TO BRING UP TO CURRENT STANDARD
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TAKE PHOTO
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Is there a car park within 50m of the facility ?
BBQ SHELTER
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Is there a shelter associated with the bbq(s) ?
Structural components
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ROOF STRUCTURE (Material) - (NOT roof covering - e.g. timber)
- TIMBER
- BLOCKWORK
- STEEL
- UNKNOWN
- OTHER
- COMPOSITE
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PROVIDE DETAILS OF MATERIAL ..
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IS THERE A DEFECT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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WALLS / FRAME (Material) - (NOT FINISHES - e.g. Steel)
- TIMBER
- BLOCKWORK
- STEEL
- UNKNOWN
- OTHER
- COMPOSITE
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PROVIDE DETAILS OF MATERIAL ..
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IS THERE A DEFECT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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FLOOR (Material) - (NOT COVERINGS e.g. reinforced concrete)
- REINFORCED CONCRETE
- TIMBER - SOLID
- PLY BOARD
- COMPRESSED FIBRES
- STONE
- NATURAL SURFACE
- BRICK
- UNKNOWN
- OTHER
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PROVIDE DETAILS OF MATERIAL ..
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IS THERE A DEFECT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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CONDITION RATING of STRUCTURE as a WHOLE (NOTE: 'EXCELLENT' OR 'GOOD' assumed 10+ years RUL)
- EXCELLENT
- GOOD
- AVERAGE
- POOR
- VERY POOR
- FAILED / DORMANT
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REMAINING USEFUL LIFE OF ROOF STRUCTURE (E.G. TRUSSES) IS APPROXIMATELY
- 5-10 years
- 3-5 years
- 1-3 years
- less than 1 year
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REMAINING USEFUL LIFE OF WALL FRAME (E.G. BLOCKWORK) IS APPROXIMATELY
- 5-10 years
- 3-5 years
- 1-3 years
- less than 1 year
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REMAINING USEFUL LIFE OF FLOOR (E.G. SLAB) IS APPROXIMATELY
- 5-10 years
- 3-5 years
- 1-3 years
- less than 1 year
Roof covering and drainage
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ROOF COVERING (Material)
- ZINC ALUM
- COLOURBOND
- PVC
- CONCRETE TILES
- STAINLESS STEEL
- CHAINS
- UNKNOWN
- OTHER
- CLAY TILES
- REINFORCED CONCRETE
- COMP FIBRE WITH COVERING
- POLYCARBONATE
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PROVIDE DETAILS OF MATERIAL
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IS THERE A DEFECT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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ARE THERE GUTTERS OR DOWNPIPES ?
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DOWNPIPES (Material)
- ZINC ALUM
- COLOURBOND
- PVC
- CONCRETE TILES
- STAINLESS STEEL
- CHAINS
- UNKNOWN
- OTHER
- CLAY TILES
- REINFORCED CONCRETE
- COMP FIBRE WITH COVERING
- POLYCARBONATE
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PROVIDE DETAILS OF MATERIAL
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IS THERE A DEFECT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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GUTTERS (Material)
- ZINC ALUM
- COLOURBOND
- PVC
- CONCRETE TILES
- STAINLESS STEEL
- CHAINS
- UNKNOWN
- OTHER
- CLAY TILES
- REINFORCED CONCRETE
- COMP FIBRE WITH COVERING
- POLYCARBONATE
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PROVIDE DETAILS OF MATERIAL
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IS THERE A DEFECT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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CONDITION RATING of ROOF COVERING and DRAINAGE (NOTE:'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
- EXCELLENT
- GOOD
- AVERAGE
- POOR
- VERY POOR
- FAILED / DORMANT
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REMAINING USEFUL LIFE OF ROOF IS APPROXIMATELY
- 5-10 years
- 3-5 years
- 1-3 years
- less than 1 year
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REMAINING USEFUL LIFE OF GUTTERS IS APPROXIMATELY
- 5-10 years
- 3-5 years
- 1-3 years
- less than 1 year
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REMAINING USEFUL LIFE OF DOWN PIPES IS APPROXIMATELY
- 5-10 years
- 3-5 years
- 1-3 years
- less than 1 year
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ADDITIONAL COMMENTS
Shelter finishes
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Does the facility have walls ?
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WALL FINISHES (Material) e.g. painted render
- BLOCKS/BRICKS - UNPAINTED
- BLOCKS/BRICKS - PAINTED
- BLOCKS - RENDERED - UNPAINTED
- BLOCKS - RENDERED - PAINTED
- TIMBER CLAD - UNPAINTED
- TIMBER CLAD - PAINTED
- METAL COVERED
- COMPOSITE
- FIBRO
- UNKNOWN
- OTHER
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PROVIDE DETAILS OF MATERIAL
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IS THERE A DEFECT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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Condition rating of WALL finishes (e.g. painted surfaces etc.) (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
- EXCELLENT
- GOOD
- AVERAGE
- POOR
- VERY POOR
- FAILED / DORMANT
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REMAINING USEFUL LIFE OF WALL FINISHES IS...
- 5-10 years
- 3-5 years
- 1-3 years
- less than 1 year
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Does the shelter have a ceiling ( I.e. More than just the underside of the roof covering) ?
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CEILING FINISH (Material) e.g. painted boards
- PAINTED BOARD
- NATURAL TIMBER
- SHEET METAL
- UNKNOWN
- OTHER
- NO CEILING - JUST U/SIDE ROOF COVERING
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PROVIDE DETAILS OF MATERIAL ..
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IS THERE A DEFECT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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Condition rating of CEILING finishes (NOTE: 'EXCELLENT' or 'GOOD' assumed 10+ years RUL)
- EXCELLENT
- GOOD
- AVERAGE
- POOR
- VERY POOR
- FAILED / DORMANT
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REMAINING USEFUL LIFE OF CEILING FINISHES IS...
- 5-10 years
- 3-5 years
- 1-3 years
- less than 1 year
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ADDITIONAL COMMENTS
WATER AND ELECTRICAL SERVICES
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IS WATER SUPPLIED TO THE FACILITY ?
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IS THERE A DEFECT WITH WATER SUPPLY OR OUTLETS ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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IS THERE A SINK PRESENT ?
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ARE SINK TAPS AUTO SHUT OFF TYPE ?
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NUMBER OF TAPS THAT ARE NOT AUTO SHUT OFF TYPE AND LOCATION
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CONDITION RATING OF WATER SERVICES (NOTE: 'POOR' or worse assumed less than 5 years RUL)
- EXCELLENT
- GOOD
- AVERAGE
- POOR
- VERY POOR
- FAILED / DORMANT
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REMAINING USEFUL LIFE OF WATER SERVICES IS...
- 3-5 YEARS
- 1 - 3 YEARS
- WITHIN 1 YEAR
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IS ELECTRICITY SUPPLIED TO FACILITY ?
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IS ANY EQUIPMENT SUPPLIED BY TIME CLOCKS / PHOTOCELLS etc. ?
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ADJUST TO CORRECT TIME AND NOTE ON & OFF TIMES BELOW....
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ARE ALL CIRCUITS PROTECTED BY RCDS ETC.?
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HAS THE RCD BEEN TESTED WITHIN THE LAST 12 MONTHS ?
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REPORT AS HIGH PRIORITY WORKS:
- P2-HIGH PRIORITY
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REPORT AS HIGH PRIORITY WORKS:
- P2-HIGH PRIORITY
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IS THERE A DEFECT WITH ANY ELECTRICAL SUPPLY, EQUIPMENT, CONDUITS & CABINETS (include any RCD isues)
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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CONDITION RATING OF ELECTRICAL SERVICES e.g. lighting (NOTE: 'POOR' or worse assumed less than 5 years RUL)
- EXCELLENT
- GOOD
- AVERAGE
- POOR
- VERY POOR
- FAILED / DORMANT
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REMAINING USEFUL LIFE OF ELECTRICAL SERVICES IS...
- 3-5 YEARS
- 1 - 3 YEARS
- WITHIN 1 YEAR
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LIST ANCILLARY BENCHES / EQUIPMENT (e.g. RUBBISH BIN, WORK BENCH, PICNIC TABLE AND 2 BENCHES ETC.) - use + button to add more features.
ANCILLARY
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ANCILLARY DESCRIPTION AND MATERIAL
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IS THERE A DEFECT WITH THIS PIECE OF ANCILLARY EQUIPMENT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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ADDITIONAL COMMENTS
BBQ EQUIPMENT / HOTPLATES
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PROVIDE DETAILS OF EACH HOTPLATE (use + button to add more hotplates)
HOTPLATES
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WHAT FUEL TYPE IS USED ?
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PROVIDE DETAILS OF FUEL TYPE ...
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MAKE & MODEL
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SERIAL NUMBERS - LEFT TO RIGHT
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UNIQUE ASSET ID NUMBER FROM AUTHORITY (If provided)
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HOUSING TYPE
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PROVIDE DETAILS OF HOUSING TYPE ..
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APPROX. AGE OF THIS BBQ UNIT
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IS THERE A DEFECT WITH THIS PIECE OF BBQ EQUIPMENT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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TAKE PHOTO OR ADD FROM LIBRARY
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ENTER WORKS PRIORITY:
- P1-IMMEDIATE
- P2-HIGH - WITHIN 1 MONTH
- P3-MEDIUM - 3 - 6 MONTHS
- P4-MED/LOW - WITHIN 1 YR
- P5.3-LOW - 2 to 3 YRS
- P5.5-LOW - WITHIN 5 YRS
- P5.9-LOW - 10+ YRS
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CONDITION RATING of BBQ HOTPLATES & CONTROL EQUIPMENT (NOTE: 'POOR' or worse assumed less than 5 years RUL)
- EXCELLENT
- GOOD
- AVERAGE
- POOR
- VERY POOR
- FAILED / DORMANT
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REMAINING USEFUL LIFE OF BBQ HOTPLATES AND CONTROL EQUIPMENT
- 3-5 YEARS
- 1 - 3 YEARS
- WITHIN 1 YEAR
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ADDITIONAL COMMENTS
FACILITY SUMMARY
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General comments ...
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IF ANY ITEM HAS AN RUL OF 2 YEARS OR LESS OR NEEDS REFERRAL OR FURTHER INSPECTION, TICK BOX AND ENSURE DETAILS PROVIDED ABOVE