AF PS3.2 Page 1 of 1 Last Updated: 10/01/2018
Revision:2
All sections of this form must be completed
TO BE COMPLETED BY THE CERTIFIED PLUMBER WHO COMPLETED THE WORK
Author’s
name:
Building consent
No
:
Author’s
company:
Description of
Plumbing
work:
Site address:
Legal
description:
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 understand that Queenstown Lakes District Council is reliant on this producer statement in order to establish compliance with
the requirements of the Building Act 2004, Building Code and the consented plans and will use this statement in order to issue
the code compliance certificate for this application.
I confirm that I have personally tested the water supply system by the method indicated below:
By pressurising 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 30mins, AS3500.5, 2.23.1 for 30mins) for both hot and cold water and checking to see that there are no
leaks.
By pressurising the u.p.v.c. cold water pipe work to 1.5 times the maximum working pressure for a period of not less
that 15 minutes and checking to see that there are no leaks (NZBC G12/AS1, NZS7643 9.3.2)
By pressurising the pipe work in accordance with the manufacturer’s requirements (note the most robust test must
be used)
Test report attached Yes No
Signature: Date:
Certifying plumber registration No:
Plumber contact details:
Address:
Phone
(office):
Fax:
Mobile: Email:
Producer Statement Construction (PS3)
Plumbing
click to sign
signature
click to edit
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