Information
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Site conducted
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Facility name :
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Address
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SUBURB
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Report prepared by:
LEGACY and BACKGROUND INFORMATION
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Date and time of audit
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Weather at time of audit
- Raining
- Wet but not raining
- Dry
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Authority ID number
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FAR ID number
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GIS REF (OR USE GPS IF CONNECTED TO NETWORK)
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PHOTO (S) OF FACILITY
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Is this facility known to contain asbestos or does it have asbestos stickers ?
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Are stickers clearly visible and adequate for the facility ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY (Usually HIGH)
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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IS THE FACILITY LEASED ?
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IS THE FACILITY NORMALLY LOCKED DURING THE DAY ?
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KEY HOLDER ; NAME, ADDRESS AND TELEPHONE NUMBER
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Date placed in service if known
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Approx gross floor area of structure m2
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LEGACY INFORMATION / COMMENTS
ROOF & DRAINAGE
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Roof area m2
- Covering
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ROOF COVERING (Material)
- ZINC ALUM
- COLOURBOND
- CONCRETE TILES
- CLAY TILES
- REINFORCED CONCRETE
- POLYCARBONATE
- STAINLESS STEEL
- PVC
- UNKNOWN
- OTHER
- COMP FIBRE WITH COVERING
- CHAINS
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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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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Gutters
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ARE THERE GUTTERS ?
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IS THERE A DEFECT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Downpipes
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ARE THERE DOWNPIPES ?
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IS THERE A DEFECT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Eaves / soffits / Fascias
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Is there a defect with eaves/soffits/fascias ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
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General comments roof and drainage
External Elements
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Is there an outside tap ?
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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:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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Cost to rectify
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Is there an outside light ?
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IS THERE A DEFECT ?
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ENTER DEFECT DETAILS AND WORKS REQUIRED:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to repair
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Are there any trees or vegetation that are interfering with the facility or blocking gutters etc.?
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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:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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Cost to rectify
FINISHES - EXTERNAL
- Wall
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EXTERNAL Wall Finishes (Material) e.g. painted render
- BLOCKS/BRICKS - UNPAINTED
- BLOCKS/BRICKS - PAINTED
- BLOCKS - RENDERED - UNPAINTED
- BLOCKS - RENDERED - PAINTED
- TIMBER CLAD - UNPAINTED
- TIMBER CLAD - PAINTED
- METAL COVERED
- COMPOSITE
- FIBRO
- UNKNOWN
- OTHER
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PROVIDE DETAILS OF MATERIAL
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IS THERE A DEFECT WITH EXTERNAL WALL FINISHES .?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Windows / Louvres
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IS THERE A DEFECT WITH WINDOWS OR LOUVRES ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Security screens etc.
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IS THERE A DEFECT WITH SECURITY WINDOW: SCREENS, SHUTTERS OR BARS ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- External doors
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IS THERE A DEFECT WITH EXTERNAL DOORS ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
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EXTERNAL FINISHES - GENERAL COMMENTS
STRUCTURAL COMPONENTS
- Roof
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ROOF STRUCTURE (Material) - (NOT roof covering - e.g. timber trusses)
- TIMBER TRUSSES
- CONCRETE BEAMS
- COMPOSITE
- METAL
- MASONARY
- OTHER
- UNKNOWN
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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 REQUIRED:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to repair
- Walls
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WALLS / FRAME (Material) - (NOT FINISHES - e.g. Steel Frame)
- CLAY BRICK
- TIMBER
- COMPOSITE
- POLYCARBONATE
- OTHER
- UNKNOWN
- CONCRETE BLOCK
- METAL
- CONCRETE PANEL
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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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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Floor
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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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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Footings
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IS IT POSSIBLE TO SEE THE FOOTINGS / STUMPS THAT FORM PART OF THE FOUNDATION ?
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FOUNDATION (Material) - (NOT COVERINGS e.g. timber stumps)
- foundation
- CONC SLAB ON GROUND
- CONCRETE PILES/FOOTINGS
- WOODEN PILES/SUPPORTS
- OTHER
- UNKNOWN
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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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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
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ARE THERE ANY STRUCTURALLY SIGNIFICANT CRACKS, DEFORMATIONS IN THE FLOOR THAT WOULD INDICATE A FAILURE IN THE FLOOR / FOUNDATIONS ?
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PROVIDE DETAILS OF THE DEFECT TO ASSIST IN FOLLOW UP INSPECTION ...
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STRUCTURAL COMPONENTS - GENERAL COMMENTS
FINISHES INTERNAL
- Internal walls
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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
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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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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Internal ceiling
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CEILING FINISH (Material) e.g. painted boards
- underside of roof covering
- PAINTED BOARD/GYPROCK
- NATURAL TIMBER
- SHEET METAL
- UNPAINTED BOARDS
- VJ BOARDS - PAINTED
- ACOUSTIC TILES
- PAINTED CONCRETE
- UNPAINTED CONCRETE
- 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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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Internal floor covering
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FLOOR COVERING (Material) e.g. Tiled
- FINISHED CONCRETE
- TILED
- CARPET
- LINO
- FLOATING TIMBER
- RUBBER
- PAINTED CONCRETE
- STONES
- NONE - NATURAL
- 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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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Internal doors
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IS THERE A DEFECT with INTERNAL DOORS ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
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INTERNAL FINISHES - GENERAL COMMENTS
SERVICES
- Water
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IS THERE HOT WATER AVAILABLE ?
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PROVIDE DETAILS OF HEATING SOURCE ... And LOCATION
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WHAT IS THE GENERAL CONDITION OF THE HEATER ?
- VERY GOOD (20+yrs)
- GOOD (10 - 20yrs)
- AVERAGE (5 - 10 yrs)
- POOR (3-5 yrs)
- VERY POOR (<3 years)
- FAILED / DORMANT
- not applicable
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IS THERE A DEFECT IN THE HOT WATER SYSTEM ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Sewerage
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Is the facility connected to main sewerage reticulation?
- Electricity
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No. Of internal lighting units
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No. Of power points
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No. Of electrical extract fans
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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:
- HIGH PRIORITY DEFECT
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REPORT AS HIGH PRIORITY WORKS:
- HIGH PRIORITY DEFECT
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Cost to rectify
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IS THERE A DEFECT WITH ANY ELECTRICAL SUPPLY OR EQUIPMENT ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO OR ADD FROM LIBRARY
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Cost to rectify
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General comments on services
TOILET FACILITIES
- Toilet type
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Are there any cisterns that are single flush and not associated with a trough or urinal?
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IS THERE A DEFECT WITH ANY CISTERNS, PANS, URINALS OR TROUGHS ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO OR ADD FROM LIBRARY
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Cost to rectify
- Basins and Sinks
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IS THE CLEANERS TAP SHIELDED ?
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If "no" raise a defect
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IS THERE A DEFECT WITH SINKS OR BASINS ?
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ENTER DEFECT DETAILS AND WORKS REQ:
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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO
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Cost to rectify
- Showers
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Are there showers present?
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IS HOT WATER AVAILABLE FOR SHOWERS ?
Ancillary Equipment
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LIST ANCILLARY EQUIPMENT AND NUMBER OF EACH (e.g. NEEDLE BINS X 6)
ANCILLARY
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ANCILLARY DESCRIPTION
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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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ENTER WORKS PRIORITY:
- VERY HIGH - within 1 week
- HIGH - within 1 month
- MEDIUM - 3 - 6 months
- LOW - within 1 yr
- PROG - 1 - 2 yrs
- PROG - 3 - 5 yrs
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TAKE PHOTO OR ADD FROM LIBRARY
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Cost to rectify
FACILITY SUMMARY AND CONDITION RATING
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CR of ROOF COVERING, GUTTERS, DOWNPIPES and FASCIAS (RUL in Brackets)
- VERY GOOD (20+yrs)
- GOOD (10 - 20yrs)
- AVERAGE (5 - 10 yrs)
- POOR (3-5 yrs)
- VERY POOR (<3 years)
- FAILED / DORMANT
- not applicable
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CR of BUILDING STRUCTURE AS A WHOLE (RUL in Brackets)
- VERY GOOD (20+yrs)
- GOOD (10 - 20yrs)
- AVERAGE (5 - 10 yrs)
- POOR (3-5 yrs)
- VERY POOR (<3 years)
- FAILED / DORMANT
- not applicable
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CR of EXTERNAL FINISHES (RUL in Brackets)
- VERY GOOD (20+yrs)
- GOOD (10 - 20yrs)
- AVERAGE (5 - 10 yrs)
- POOR (3-5 yrs)
- VERY POOR (<3 years)
- FAILED / DORMANT
- not applicable
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CR of INTERNAL FINISHES (RUL in Brackets)
- VERY GOOD (20+yrs)
- GOOD (10 - 20yrs)
- AVERAGE (5 - 10 yrs)
- POOR (3-5 yrs)
- VERY POOR (<3 years)
- FAILED / DORMANT
- not applicable
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CR of TAP, BASIN & SANITARY WARE (RUL in Brackets)
- VERY GOOD (20+yrs)
- GOOD (10 - 20yrs)
- AVERAGE (5 - 10 yrs)
- POOR (3-5 yrs)
- VERY POOR (<3 years)
- FAILED / DORMANT
- not applicable
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CR of ELECTRICAL SERVICES (RUL in Brackets)
- VERY GOOD (20+yrs)
- GOOD (10 - 20yrs)
- AVERAGE (5 - 10 yrs)
- POOR (3-5 yrs)
- VERY POOR (<3 years)
- FAILED / DORMANT
- not applicable
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General comments about whole facility
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Actual condition score obtained
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Condition range . RUL. SCORE
1 - Very Good. 20+ years. . >60
2 - Good. 10-20 years. 55-60
3 - Average. 5-10 years. 31-54
4 - Poor. 3-5 years. 18-30
5 - Very Poor. . <3 years. <18 -
What is the actual Condition based on the total score ?
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Is the facility adequate for its intended use ?
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If it doesn't meet LoS requirement, provide details. Or use this space to provide general comments
