Fillable Form 1: SS 3.1 - Automatic Doors (Invercargill City Council New Zealand)

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Form 1: SS 3.1 - Automatic Doors (Invercargill City Council New Zealand)

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SS 3.1 - Automatic Doors
Page 1 of 1
SBCG SS3.1 Version January 2018
The information above is used to help generate the compliance schedule. If you are unsure how to complete this
form, please consult an Independently Qualified Person (IQP) who is registered for the system above.
Address:
Building Name:
Provided by (name):
No. Make Model Location
1
2
3
4
5
6
Installation Standard:
NZS 4239:1993
AS 4085:1992
Specifically Designed Alternative Solution (please supply)
Inspections & Maintenance
Standard:
Compliance Schedule Handbook and NZS 4239:1993
Compliance Schedule Handbook and AS 4085:1992
Specifically Designed Alternative Solution (please supply)
Buildings Requiring Daily
Maintenance:
If ticked daily inspections are
required as stated below
CS Crowd Activity
CL Crowd Activity
CO Crowd Activity
CM Crowd Activity
Building undergoing building work affecting an auto door
Frequency:
Daily
Owner
Monthly
Owner
IQP
Annually
IQP
Inspections & Maintenance:
Minimum maintenance and testing as specified in Compliance
Schedule Handbook, to be performed in conjunction with
maintenance required by applicable standard.
Reporting:
The owner must keep records of all inspections, maintenance
and repairs undertaken in the previous 24 months. The records
must be kept with the compliance schedule and as a minimum,
include:
• Details of any inspection, test or preventative maintenance
c
arried out. Include dates, work undertaken, faults found,
remedies applied, and the person who performed the work.
• Details of any other faults found or maintenance and repair
work undertaken to maintain the system in working order,
including dates, work undertaken, faults found, remedies
applied and the person who performed the work.
• A Form 12A provided by an IQP annually.
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Form 1: SS 3.1 - Automatic Doors (Invercargill City Council New Zealand)

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Completed 14 November 2020

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