Private Bag 9023 | Whangarei 0148 | New Zealand
T: 09 430 4200 | 0800 WDC INFO | 0800 932 463 | F: 09 438 7632
W: www.wdc.govt.nz | E: mailroom@wdc.govt.nz
13/75818 19 September 2013
Wet Area Producer Statement
This form is to be used by people undertaking wet area waterproofing to confirm that the works comply with
the NZ Building Code, the consented plans and specifications of a Building Consent / Certificate of
Acceptance.
Plumbers confirming test results should use the Certifying Plumbers producer statement form.
Office use Checked & complies Checked & does not comply l Not applicable
BC or COA number
Owners name
BC or COA
checked
At (address)
Product used
Location of work
I have read the above building consent and read the conditions of consent together with the waterproofing details contained
therein; and confirm that:
the substrate is suitable for the application of the above waterproof membrane.
the waterproof membrane has been applied in accordance with the manufacture’s specifications and technical
requirements.
All work has been carried out in accordance with the building consent and / or complies with the Building
Code
Attach copies of the following documents:
Product warranty
Workmanship warranty
Evidence of qualification/registration is attached
I understand that the Whangarei District Council will rely upon this producer statement, for the purposed of establishing compliance with
the NZ Building Code and the consented documents, or for the issuing of a Certificate of Acceptance.
Name
Signature
Date
Address
Postcode
Business
Fax
Mobile
Email
COUNCIL USE ONLY
Accepted
in support of inspection
instead of inspection
Date
Officers name
Signature
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