AF PS3.3 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 WATERPROOFING WORK
Author name:
Site address:
Legal
description:
Product used:
Location:
(e.g. balcony)
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 the following clauses of the
Building Code (tick as applicable)
B2 Durability and E2 External Moisture – All external membranes (roofs, gutters, decks, balconies, etc.) have been flood
tested or electrically tested (mandatory) Test method: Electronic Flood
B2 Durability and E3 Internal Moisture – All tiled internal showers and wet areas have been flood tested (mandatory)
I attach copies of the following documents:
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:
Phone (Office): Fax:
Mobile: Email:
Producer Statement Construction (PS3)
Waterproofing
click to sign
signature
click to edit
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