SS 3.3 - Interfaced Fire or Smoke Doors or Windows
Page 1 of 2
SBCG SS3.3 Version January 2018
Address:
Building Name:
Provided by (name):
No.
Make
Model
Location
1
2
3
4
5
6
7
8
9
10
Installation Standard:
(specify year)
AS 4178:
AS1851:2005
Specifically Designed Alternative Solution (please supply)
Other (Historical) ________________________________
Inspections & Maintenance
Standard:
(specify year)
Compliance Schedule Handbook and AS 4178:
Compliance Schedule Handbook and AS1851:2005
Specifically Designed Alternative Solution (please supply)
Other (Historical) ________________________________
Buildings Requiring Daily
Maintenance:
If selected 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
Monthly
Annually
Inspections & Maintenance:
Minimum maintenance and testing as specified in Compliance
Schedule Handbook, to be performed in conjunction with
maintenance required by applicable standard.
SS 3.3 - Interfaced Fire or Smoke Doors or Windows
Page 2 of 2
SBCG SS3.3 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.
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
carried 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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