Title Page
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Site conducted
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Conducted on
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Prepared by
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DA Number
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Address
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Building Company undertaking works?
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Inspect internal pool barrier. Photograph the areas.
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Inspect the gate check latch and location height. Is this compliant?
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Photograph of gate(s) & latch(es)
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Photograph to include tape measure indicating latch height
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Barrier - Min -1200mm height, 100mm max openings, 900mm NCZ
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Photograph to show tape measure indicating pool barrier height
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Barrier - Free of climbable surfaces within the NCZ
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Boundary - Min 1800mm height. Are rails compliant if any? 900 NCZ
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Photograph of Boundary Barrier
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Photograph of boundary barrier to show tape measure indicating height.
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Intersecting Barriers - Internal barrier into boundary barrier ≤ 50mm wide or 900mm long
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Barrier - dwelling (openings, sills, ledges)
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Photo of barrier in relation to dwelling openings (if relevant)
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Is the pool/spa within a building enclosure?
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Are doors to the indoor pool compliant with Child resistant door set requirements?
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In ground skimmer - Skimmer box hole 280mm<width> 150mm ≥ 200mm or ≤ 150mm; ≥ 100mm separation to pool wall; 2nd outlet point ≥600mm
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Above ground - Skimmer basket hole ≥ 200mm deep; pool wall extending ≥75mm above skimmer; 2nd outlet point ≥600mm
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Without skimmer box - Minimum 2 outlet points ≥600mm apart / compliant cover
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CPR signage?
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Photograph of CPR signage
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Is the pool and spa barrier compliant with approved plans?
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is an amendment or variation to the DA required?
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Signature