Title Page

  • Site conducted

  • Site Name:

  • Asset reference number

  • Conducted on

  • Assessor

  • Location

QPWS CONDITION ASSESSMENT S3 Shelter (note: use 1 assessment per structure)

  • 96fc7b40-8a3c-11e8-a530-8d83b5fa8e0a.png


  • Foundation/footings (eg: undercutting erosion, concrete cracking, movement, not visible) - Specified Condition = 3

  • Retaining walls (e.g. rot, rust, splitting, movement, not visible for inspection) - Specified Condition = 3

  • Ground slab/ Apron/ Floor - Specified Condition = 3


  • Roof (inc gutters & downpipes) - Specified Condition = 3.5

  • Posts (e.g. rot, rust, splitting, movement, not visible for inspection) - Specified Condition = 3.5

  • Frame (e.g. rot, rust, splitting, movement, not visible for inspection) - Specified Condition = 3.5

  • Walls/Cladding - Specified Condition = 3.5

Furniture & fittings

  • Seating/Table/Signage mounts etc. (e.g. rot, splintering, rust, protruding fixings, warping, loose boards) - Specified Condition = 3

  • Brackets & fasteners (connector plates, bolts, etc. e.g. rust, lack of washers, movement, rusted triple grips, not as specified) - Specified Condition = 3.5

  • Electrical (eg: lighting, power etc.) - Specified Condition = 3.5


  • Protective finish (timber preservative, oil, galvanising, powder coat, paint e.g. blistering, cracking, lack of applied finish) - Specified Condition = 3


  • Have site conditions altered the structures effective fall height (heff)?

  • In Metres, what is the current heff ? "Effective Fall Height (heff) shall be calculated from the following: heff = hf + hi where: hf = maximum actual fall height within a distance of 2 metres from the edge of structure hi = the impact surface value (Extract from AS 2156.2-2001)"

GENERAL SITE CONDITIONS (including vegetation encroachment, drainage; site stability e.g. slip planes, rock fracturing etc.)

  • Description

OTHER NOTES/LIMITATIONS/SERIOUS HAZARDS (e.g. vegetation restricts access or views, trees against structure, vandalism, doesn’t match original drawings, elements obscured attach additional notes if not enough space):

  • Description


  • Actual condition

  • Task list (Condition based maintenance)
  • Asset Elements

  • Sub element

  • Sub element

  • Sub element

  • Sub element

  • Defect description

  • Task description (Note, include any specific location notes)

  • Task scope (i.e. Area/quantity involved; type of materials; service provider type required etc.)

  • Priority (1-4)

  • (A,S,E) Risk Type: the area of risk created by the defect. A = the asset, S = health and safety, E = the environment

  • Indicative Price (ex GST)


  • Engineering or other higher level inspections required ?

  • Signature
  • Sign

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