1
Construction statement
Plumbing pressure test
All sections of this form must be completed
TO BE COMPLETED BY THE PLUMBER WHO COMPLETED THE WORK
Name
Building consent
number
Company
Certifying plumber
registration number
Site address
Legal description
Description of
plumbing work
I have sighted the above building consent and read the attached conditions of consent, and confirm that the plumbing pipe
work and fittings have been selected and constructed to comply with the consented plans. I confirm that I have personally
tested the water supply system by the method indicated below:
by pressuring the pipe work to 1500kPa for a period of not less than 15 minutes (NZBC G12/AS1 7.5.1) (AS3500.4,
11.3 for 30 minutes, AS3500.5, 2.23.1 for 30 minutes) for both hot and cold water and checking to see that there are
no leaks
by pressure testing the upvc cold water pipe to 1.5 times the maximum working pressure for a period of not less
than 15 minutes and checking to see that there are no leaks (NZBC G12/AS1, NZS7643 9.3.2)
by pressure testing the pipe work in accordance with the manufacturer’s requirements (note most robust test must
be used)
Test report attached
Yes
No
I understand that Council will rely upon this construction statement, for the purposes of establishing compliance with the
above building consent.
Signature Date
Plumber contact details
Address Postcode
Company Fax
Email Mobile
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