City of Monash. Possible Class 1b, High Risk inspection

• Customer Request Number

• This Inspection is to determine if the building is a Class 1b, Class 3 or High risk. If a clear determination on the use of the building refer to the MBS or DMBS.

• Property Address
  Address

• Conducted on

  Date

• Contact persons Name

• Contact Persons Contact Number/s

• Contact persons EMail address

• Prepared by

• This report/template is for City of Monash use only and no responsibility is taken for the accuracy of information contained within by the City of Monash, report/template creators or the reporting officer.
  
  Any use, recreation (whether in full or in part) may not be undertaken without permission from the City of Monash or the report creators.

Formal Request for Access to the building

• Has an access letter be sent to the owner/agent and or tenant

  Yes

  No

  Unknown

• Has the Section 231 "consent to entry" sheet been completed

  Yes

  No

  owner refused to sign

  tenant refused to sign

Description of the building

• Take photo of the front of the property

  Media

• Type of wall construction of the building

  Select B/V Dwelling Solid Brick Waterboard Other

  • B/V Dwelling
  • Solid Brick
  • Waterboard
  • Other

• If other provide details

• Type of roof construction

  Tile

  steel

  Other

• External condition of the building

  Good

  Fair

  Poor

• If Poor provide details of concern/s

• If Poor take photo/s of concern/s

  Media

• If Other provide details

General Information

• Are there smoke alarms in the hallway. If so what type

  No alarms

  Have alarms battery

  Have alarms h/wired

• Is there a evacuation light?

  No

  Yes

• Is the front door keyed lock on the inside

  No

  Yes

• Number of bedrooms

  Select 1 2 3 4 5 6 7 or more

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7 or more

• Do the bedrooms have smoke alarms? If yes what type

  Select No alarms Have alarms battery Have alarms h/wired

  • No alarms
  • Have alarms battery
  • Have alarms h/wired

• Are there locks on the bedroom doors on the inside

  No

  Yes

• Is anyone sleeping in the living room/s

  Yes

  No

  Unknown

• Take photos of hallways, bedrooms etc

  Media

• Number of occupants

  Select 1 2 3 4 5 6 7 or more

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7 or more

• Any other information that me be applicable

Wet areas

• Condition of the kitchen

  Good

  Fair

  Poor

• Take photo

  Media

• Condition of bathroom/s

  Good

  Fair

  Poor

• Take photo of bathroom

  Media

Any other details / information

• Any other details / information

• Do you believe the dwelling is being used as a Class 1b

  Yes

  No

  Unknown