Fire Penetration Schedule

• Report type

  Fire Peno Schedule

• Inspection performed by

  Select

• Date of inspection

  Date

• Report number

SITE DETAILS

• Project Name:

• Level/Unit Number:

• Site address
  Address

• Description of work:

DEVELOPMENT CONSENT

• DA/CDC No.

• Consent Authority:

• Pursuant to the provisions of the Environment Planning and Assessment Regulations 2000 and Clause A2.2 of the Building Code of Australia:

• Holland Bros Plumbing (NSW) Pty Ltd hereby certify that the following services penetrations through fire rated building elements, together with the relevant data sheet as list below, have been installed in accordance with AS 1530.4, AS4072.1 AND BCA PART C3.15 Specification of the NCC Building Code of Australia and manufacturers specification.

Penetration

• Photo of the fire penetration

  Media

• Penertration Number

• Location of penetration

• Type of the penetration

  Select

• Please specify type of penetration

  Yes

  No

  N/A

• Fire Stopping Product/s Name

  Select

• What is the fire stopping product name?

• Test Report Reference

  Select

• Please write down Test report reference?

• FRL (Fire Resistance Level)

  Select

Other practices or standards relied upon for this certification

• This certificate relates to

  Whole Building

  Part of the building

• Nominate part of the building

Exclusions

• Exclusions

  Yes

  No

• Exclusions must be clearly outlined

• Details

  New Hydraulic WORKS

  Existing Hydraulic WORKS

  Other

• Please specify WORKS

Consultant to disclose any exclusion from specific certification

• Name: James Brassil
  Qulification / Licence Number: 8786C
  Company Name: Holland Bros Plumbing (NSW) Pty. Ltd.
  ABN: 51 003 968 616
  
  Company Address: Unit 2, 14 CHICAGO Avenue, BLACKTOWN, NSW 2148
  Tel: 0431 314 714
  
  Position Title: General Manager

• Date

  Date

• Signature

  Sign

• Note:
  Attach all referenced data sheets to this certificate.
  

TEST REPORT

• TRAFALGAR TWRAP and FyreFLEX Sealant

• FCO 1579 Rev D - FyreFLEX and TWrap Nov 2020

• FYREPEX SEALANT (Report number: FRT 180354.1)

• Promat retro fit fire collars

• Promaseal A Acrylic Sealant

• Snap cast in fire collar