Doc#473008
Page1of1 Ref:PS‐04.1D
Complianceschedulespecifiedsystems
Informationtobeprovided(inconjunctionwithBAForm2)
Version: 4
Date: December2019
Code: PS‐04.1D
ThischecklistshouldbeusedtoidentifyspecifiedsystemswithinbuildingsinaccordancewithBuildingAct2004.
Pleaseidentifyspecifiedsystemsbytickingappropriateboxes.Pleaseincludecopiesoftheindividualspecified
systemsforms.Theseformscanbeaccessedviahttps://icc.govt.nz/building/sbcg‐forms/
Siteaddress: Firehazardcategory:
Buildingname: Purposegroup:
Ownersname: Totaloccupantload:
Specifiedsystems Existing Add Alter Remove
SS1‐SS16
Form
Attached
SS1 AutomaticSprinklerSystems
SS2 EmergencyWarningSystems
SS3.1 AutomaticDoorsandWindows
SS3.2 AccessControlledDoors
SS3.3 InterfacedFireorSmokeDoorsorWindows
SS4 EmergencyLightingSystems
SS5 EscapeRoutesPressurisationSystems
SS6 RiserMains
SS7 AutoBack‐FlowPreventers
SS8.1 PassengerCarryingLifts
SS8.2 ServiceLifts
SS8.3 EscalatorsandMovingWalks
SS9 MechanicalVentilation/AirConSystems
SS10 BuildingMaintenanceUnits
SS11 LaboratoryFumeCupboards
SS12.1 AudioLoops
SS12.2 FMRadioFrequencySystems
SS13.1 MechanicalSmokeControl
SS13.2 NaturalSmokeControl
SS13.3 SmokeCurtains
SS14.1 EmergencyPowerSystemsforSS1‐13
SS14.2 SignsforSS1‐13
SS15.1 SystemsforCommunicatingEvacuation
SS15.2 FinalExits
SS15.3 FireSeparations
SS15.4 Signs
SS15.5 SmokeSeparations
SS16 CableCars
Specifiedsystemsplanattached: Yes
Chrome Web Store
It looks like you haven't installed the Fill Chrome Extension Add to Chrome