Fire separation inspection - duplicate

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Fire separation wall

  Yes

  No

  N/A

• Non-combustible insulation installed & compressed<br>

  Yes

  No

  N/A

• Brickwork to roof frame

  Yes

  No

  N/A

• Non-combustible fascia

  Yes

  No

  N/A

• Non-combustible eaves

  Yes

  No

  N/A

• Non-combustible vertical lining installed to common eaves space

  Yes

  No

  N/A

• Allowable encroachments

  Yes

  No

  N/A

• Skylight location to fire separating wall

  Yes

  No

  N/A

INSPECTION RESULT

• Inspection result

  Satisfactory - proceed to next stage

  Unsatisfactory - defects to be completed & written advice received from builder

  Re-inspection - work cannot proceed until defects completed and re-inspected

• Inspections defects:

INSPECTOR

• Select date

  Date

• Inspector:

  Peter Lusio

  Greg Roberts

  Peter Fahey

• Inspector signature

  Sign

CERTIFICATES (FORM 15/16) REQUIRED

• Passive fire-rated construction (BSA Licensed installer) certificate

  Yes

  No

  N/A

BUILDERS ADVICE

• I confirm that the outstanding defects listed above have been completed.

• Name

• License class & number

• Signature