Title Page

  • Site conducted

  • Site Name:

  • Asset reference number

  • Conducted on

  • Assessor

  • Location

QPWS CONDITION ASSESSMENT • S3 Comm Tower Condition Assessment Template (note: use 1 assessment per structure)

Substructure

  • 6c7cd2c3-11c1-4bb6-b524-0be19d50453d.png
  • Tower foundations/footings - Specified Condition = 3

  • Guy anchor foundation/footings - Specified Condition = 3

  • Tower anchor point- Specified Condition = 3.5

  • guy anchor points - Specified Condition = 3.5

Superstructure

  • Tower frame/members - Specified Condition = 3

  • Tower connections/bolts - Specified Condition = 3.5

  • Ladder/climbing safety device - Specified Condition = 3

  • Anti-climb system- Specified Condition = 3

  • Tower alignment - Specified Condition = 3.5

  • Guys wires - Specified Condition = 3.5

  • Guy turnbuckles/hardware- Specified Condition = 3.5

Finishes

  • Paint system - Specified Condition = 3

  • Galvanising - Specified Condition = 3

Fittings and services

  • Antennas and antenna mountings - Specified Condition = 4

  • Grounding/lighting protection - Specified Condition = 3

  • Communication cables - Specified Condition = 3.5

  • Navigation devices - Specified Condition = 4

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

  • Description

CRITICAL INFRASTRUCTURE SPECFIC QUESTIONS

  • fall height diagram.png
  • 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 (see illustration left) hi = the impact surface value (Extract from AS 2156.2-2001)"

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

AVERAGE ELEMENTSPECIFIED CONDITION 3.32

  • Actual condition

  • Task list (Condition based maintenance)
  • Asset Elements

  • Sub element

  • Sub elements

  • 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

  • Engineering or other higher level inspections required ?

  • Signature
  • Sign

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.