AF PS3.4 Page 1 of 1 Last Updated: 10/01/2018
Revision:2
All sections of this form must be completed
TO BE COMPLETED BY THE APPLICATOR WHO CARRIED OUT THE WORK
Author name:
Author company:
Location e.g.
basement walls
Site address:
Product used:
I have sighted the above building consent and read the attached 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 manufacturer’s specifications and technical
requirements
• all work has been carried out in accordance with the building consent and complies with clauses B2, E1, E2 and E3 of
the NZ Building Code
I attach copies of the following warranties:
Product warranty Workmanship warranty LBP record of work (if RBW - external W/P only)
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.
Producer statements are accepted solely at Queenstown Lakes District Council discretion
Signature: Date:
Applicator’s contact details:
Address:
Business: Fax:
Mobile: Email:
Producer Statement Construction (PS3)
Tanking (below ground)
click to sign
signature
click to edit
![]()
