Title Page
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Site conducted
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Date of Inspection
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Location of Pool
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Customer
Information
General Inspection Details
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Pool Safety Inspector and licence #
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Type of pool?
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Are all NCZ's compliant?
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Is there a designated access point with a compliant barrier?
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Premises Type?
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Any Exemptions?
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Details of Exemption
Barrier Details
Barrier Details
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Barrier material
- Aluminium/Metal
- Timber
- Glass
- Asbestos
- Brick
- Rock
- Perforated Material
- Other
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Details of material used
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Is Barrier height compliant?
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Are the vertical bars spaced no greater than 100mm apart?
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Explanation of N/A
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Maximum of 100mm under barrier to permanent stable ground?
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Compliant CPR sign attached to barrier and clearly visible?
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Any intersecting barriers?
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Does barrier intersect at a compliant angle? (between 45 and 135 degrees)
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Is intersecting barrier width compliant? (top part not greater than 50mm wide)
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Are all applicable NCZ's and clear areas compliant?
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Perforated Material
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Height of fence?
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Aperture size?
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Aperture size?
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Does barrier have a compliant cranked top? (min 450mm long at an angle between 90 & 135 degrees protruding away from pool area)
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Aperture size?
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Does barrier have strainer wire or rail at top & bottom of the fencing?
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Barrier less than 1800mm
1200mm - 1800mm
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NCZ of 900mm between Highest Lower rail and Lowest Upper rail compliant?
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NCZ of 900mm in Upper Quadrant compliant?
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Additional clear area of 1200mm compliant?
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Clear area of 300mm on inside of NCZ compliant?
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Barrier 1800mm or greater
1800mm or more
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Is NCZ on the inside or outside of pool area?
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Is there a compliant NCZ of 900mm?
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Is NCZ of 900mm in Upper Quadrant compliant?
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Additional clear area of 1200mm compliant?
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Does a building form part of the barrier to the pool area?
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Are there windows in the barrier?
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Is the height from sill to pool area ground less than 1800mm?
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Height from sill to floor on inside of building?
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Is the openable portion of the window compliant? (Completely covered by bars or mesh and comply with strength & rigidity tests and can only be removed by use of a tool)
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Is the openable portion of the window compliant? (fitted with a securely fixed flyscreen that can only be removed by use of a tool)
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Is there a balcony that either projects into pool area or is near the barrier of the pool area?
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is the height from balcony floor to ground <1800mm?
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Does balcony have a compliant balustrade?
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Is any part of the balcony floor within 900mm of the top of pool barrier?
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Does balcony have a compliant balustrade?
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Strength & Rigidity
Strength & Rigidity
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Vertical uprights passed "Squeeze Test" and did not expand greater than 105mm?
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Explanation of N/A
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Posts and footings passed test of 330N with no breakage or loosening?
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Explanation of N/A
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Fence panels passed initial test of 250N without permanent deformation?
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Explanation of N/A
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Fence panels passed final test of 330N without breakages, fractures, loosening or permanent deformation?
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Explanation of N/A
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Gate & Latch
Gate & Latch
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Does gate open away from Pool area?
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Explanation of N/A
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Does gate swing freely through its arc of operation?
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Does gate close and latch under its natural weight from various positions including resting on latch?
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Does gate close and latch after 250N force applied to the top rail 100mm in from edge?
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Latch release height?
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Is latching device adequately shielded with no gaps >10mm and an effective radius of 450mm with no sharp edges on the shield?
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Is there a compliant hand-hole in the barrier/gate? (bottom of the opening not less than 1200mm above finished ground and 1000mm above Highest Lower horizontal)
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Recommendations
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Issue Safety Certificate
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Issue Non-conformity
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Emergency Direction
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Other comments