Template Compliance Schedule

The owner	ㅤ	ㅤ	ㅤ
Name of owner		ㅤ	ㅤ
Contact person		ㅤ	ㅤ
Mailing address		ㅤ	ㅤ
Street address/registered office		ㅤ	ㅤ
Phone number		Mobile
E-mail address		Website

Street address of building	ㅤ		ㅤ	ㅤ
Legal description of land	ㅤ		ㅤ	ㅤ
Building name	ㅤ		ㅤ	ㅤ
Location of building within site/block number	ㅤ	`<insert picture>` Description:	ㅤ	ㅤ
Levels or unit numbers	ㅤ		ㅤ	ㅤ
Year of first construction	ㅤ		ㅤ	ㅤ
Intended life of the building	ㅤ		ㅤ	ㅤ
Highest fire hazard category	ㅤ		ㅤ	ㅤ
Risk group(s)	ㅤ		ㅤ	ㅤ
Compliance schedule is kept at:	ㅤ		ㅤ	ㅤ
Building use & occupancy (current lawfully established use)	ㅤ	ㅤ	ㅤ	ㅤ
Level	Classified use from NZBC A1 (plus description)	ㅤ	Use (NZBRegs 2005 Schedule 2)	Occupancy load
		ㅤ
		ㅤ
		ㅤ
	ㅤ	ㅤ	ㅤ	$XXX$ `<Total>`

Specified systems contained in this compliance schedule	ㅤ
SS 1	Automatic systems for fire suppression
SS 2	Automatic or manual emergency warning systems for fire or other dangers
SS 3 Electromagnetic or automatic doors or windows	ㅤ
SS 3/1	Automatic doors
SS 4	Emergency lighting systems
SS 7	Automatic back-flow preventers connected to a potable water supply
SS 8 Lifts, escalators, travelators or other systems for moving people or goods within buildings	ㅤ
SS 8/1	Passenger-carrying lifts
SS 9	Mechanical ventilation or air conditioning systems
SS 12 Audio loops or other assistive listening systems	ㅤ
SS 12/2	FM radio frequency systems & infra-red beam transmission systems
SS 13 Smoke control systems	ㅤ
SS 13/1	Mechanical smoke control
SS 14 Emergency power systems for, or signs relating to, a system or feature specified for any of the above systems or features	ㅤ
SS 14/2	Signs relating to a system or feature specified in any of clauses 1 to 13
SS 15 Any or all of the following features, so long as: they form part of a building’s means of escape from fire; those means also contain any or all of the systems or features specified in clauses 1-6, 9 and 13	ㅤ
SS 15/2	Final exits (as defined by clause A2 of the Building Code)
SS 15/3	Fire separations (as so defined)
SS 15/4	Signs for communicating information intended to facilitate evacuation

ㅤ	Version Control	ㅤ
Version #	Notes or changes	Date
Version 0	Original building consent (number # refers)
Version 1
Version 2

SS 1 Automatic systems for fire suppression	ㅤ	ㅤ	ㅤ	ㅤ
Description (incl type)		ㅤ	ㅤ	ㅤ
Specified system photo/s		ㅤ	ㅤ	ㅤ
Make (if known)		ㅤ	Installation Date	ㅤ
Model (if known)		ㅤ		ㅤ
Location/s		ㅤ	ㅤ	ㅤ
Performance standard		ㅤ	ㅤ	ㅤ
Inspection procedures		ㅤ	ㅤ	ㅤ
Inspection frequencies	Weekly	Monthly	Quarterly	Annually
Inspection personnel	IQP	IQP	IQP	IQP
Maintenance procedures		ㅤ	ㅤ	ㅤ
System interfacing		ㅤ	ㅤ	ㅤ
Reporting procedures		ㅤ	ㅤ	ㅤ
Signage		ㅤ	ㅤ	ㅤ
Comments/notes		ㅤ	ㅤ	ㅤ

SS 2 Automatic or manual emergency warning systems for fire or other dangers	ㅤ	ㅤ	ㅤ
Description (incl type)		ㅤ	ㅤ
Specified system photo/s		ㅤ	ㅤ
Make (if known)	`[``brand name & series` `number``]`	Installation date	ㅤ
Model (if known)	`[``model number``]`	ㅤ	ㅤ
Location/s		ㅤ	ㅤ
Performance standard		ㅤ	ㅤ
Inspection procedures		ㅤ	ㅤ
Inspection frequencies	Monthly	ㅤ	Annually
Inspection personnel	IQP	ㅤ	IQP
Maintenance procedures		ㅤ	ㅤ
System interfacing		ㅤ	ㅤ
Reporting procedures		ㅤ	ㅤ
Signage		ㅤ	ㅤ
Comments/notes		ㅤ	ㅤ

SS 3/1 Automatic doors	ㅤ	ㅤ	ㅤ	ㅤ
Description (incl type)		ㅤ	ㅤ	ㅤ
Specified system photo/s		ㅤ	ㅤ	ㅤ
Make (if known)	`[``manufacturer``]`	ㅤ	Installation date	ㅤ
Models (if known)	`[``model number``]`	ㅤ	ㅤ	ㅤ
Location/s		ㅤ	ㅤ	ㅤ
Performance standard		ㅤ	ㅤ	ㅤ
Inspection procedures		ㅤ	ㅤ	ㅤ
Inspection frequencies	Daily (when in use)	Monthly	ㅤ	Annually
Inspection personnel	Owner or Agent	Owner or Agent	ㅤ	IQP
Maintenance procedures		ㅤ	ㅤ	ㅤ
System interfacing		ㅤ	ㅤ	ㅤ
Reporting procedures		ㅤ	ㅤ	ㅤ
Signage		ㅤ	ㅤ	ㅤ
Comments/notes		ㅤ	ㅤ	ㅤ

SS 4 Emergency lighting systems	ㅤ	ㅤ	ㅤ	ㅤ	ㅤ
Description (incl type)		ㅤ	ㅤ	ㅤ	ㅤ
Specified system photo/s		ㅤ	ㅤ	ㅤ	ㅤ
Make (if known)	`[``brand name``]`	ㅤ	Installation date	ㅤ	ㅤ
ㅤ	`[``brand name``]`	ㅤ	ㅤ	ㅤ	ㅤ
ㅤ	`[``brand name``]`	ㅤ	ㅤ	ㅤ	ㅤ
Models (if known)	`[``model name``]`	`[``model name``]`	ㅤ	ㅤ	`[``model name``]`
Location			ㅤ	ㅤ
ㅤ	Refer to attached plans	ㅤ	ㅤ	ㅤ	ㅤ
Performance standard		ㅤ	ㅤ	ㅤ	ㅤ
Inspection procedures		ㅤ	ㅤ	ㅤ	ㅤ
Inspection frequencies	Six Monthly	ㅤ	ㅤ	Annually	ㅤ
Inspection personnel	IQP	ㅤ	ㅤ	IQP	ㅤ
Maintenance procedures		ㅤ	ㅤ	ㅤ	ㅤ
System interfacing		ㅤ	ㅤ	ㅤ	ㅤ
Reporting procedures		ㅤ	ㅤ	ㅤ	ㅤ
Signage		ㅤ	ㅤ	ㅤ	ㅤ
Comments/notes		ㅤ	ㅤ	ㅤ	ㅤ

SS 7 Automatic back-flow preventers connected to a potable water supply	ㅤ	ㅤ
Description (incl type)		ㅤ
Specified system photo/s		ㅤ
Make (if known)	[manufacturer name]	Installation date
Models (if known)	[model name]	ㅤ
Location		ㅤ
Performance standard		ㅤ
Inspection procedures		ㅤ
Inspection frequencies	Annually	ㅤ
Inspection personnel	IQP	ㅤ
Maintenance procedures		ㅤ
System interfacing		ㅤ
Reporting procedures		ㅤ
Signage		ㅤ
Comments/notes		ㅤ

SS 8/1 Passenger-carrying lifts	ㅤ	ㅤ
Description (incl type)		ㅤ
Specified system photo/s		ㅤ
Make (if known)	[manufacturer name]	Installation date
Models (if known)	[model name]	ㅤ
Location		ㅤ
Performance standard		ㅤ
Inspection procedures		ㅤ
Inspection frequencies	Annually	ㅤ
Inspection personnel	IQP	ㅤ
Maintenance procedures		ㅤ
System interfacing		ㅤ
Reporting procedures		ㅤ
Signage		ㅤ
Comments/notes		ㅤ

SS 9 Mechanical ventilation or air conditioning systems	ㅤ	ㅤ	ㅤ
Description (incl type)		ㅤ	ㅤ
Specified system photo/s		ㅤ	ㅤ
Make (if known)	[manufacturer name]	ㅤ	Installation date
ㅤ	[manufacturer name]	ㅤ	ㅤ
ㅤ	[manufacturer name]	ㅤ	ㅤ
Model (if known)
Location
Performance standard		ㅤ	ㅤ
ㅤ		ㅤ	ㅤ
Inspection procedures		ㅤ	ㅤ
ㅤ		ㅤ	ㅤ
Inspection frequencies	Monthly	Quarterly	Annually
Inspection personnel	IQP	IQP	IQP
Maintenance procedures		ㅤ	ㅤ
ㅤ		ㅤ	ㅤ
System interfacing		ㅤ	ㅤ
Reporting procedures		ㅤ	ㅤ
Signage		ㅤ	ㅤ
Comments/notes		ㅤ	ㅤ

SS 12/2 FM radio frequency systems & infra-red beam transmission systems	ㅤ	ㅤ	ㅤ
Description (incl type)		ㅤ	ㅤ
Specified system photo/s		ㅤ	ㅤ
Make (if known)		Installation date	ㅤ
Models (if known)	[model name]	ㅤ	ㅤ
Location		ㅤ	ㅤ
Performance standard		ㅤ	ㅤ
Inspection procedures		ㅤ	ㅤ
Inspection frequencies	Six Monthly	ㅤ	Annually
Inspection personnel	IQP	ㅤ	IQP
Maintenance procedures		ㅤ	ㅤ
System interfacing		ㅤ	ㅤ
Reporting procedures		ㅤ	ㅤ
Signage		ㅤ	ㅤ
Comments/notes		ㅤ	ㅤ

SS 13/1 Mechanical smoke control	ㅤ	ㅤ	ㅤ
Description (incl type)		ㅤ	ㅤ
Specified system photo/s		ㅤ	ㅤ
Make (if known)	[manufacturer name]	Installation date	ㅤ
Model (if known)	[brand name]	ㅤ	ㅤ
Location		ㅤ	ㅤ
Performance standard		ㅤ	ㅤ
Inspection procedures		ㅤ	ㅤ
Inspection frequencies	Six Monthly	ㅤ	Annually
Inspection personnel	IQP	ㅤ	IQP
Maintenance procedures		ㅤ	ㅤ
System interfacing		ㅤ	ㅤ
Reporting procedures		ㅤ	ㅤ
Signage		ㅤ	ㅤ
Comments/notes		ㅤ	ㅤ

SS 14/2 Signs relating to a system or feature specified in any of clauses 1 to 13	ㅤ	ㅤ	ㅤ	ㅤ
Description (incl type)		ㅤ	ㅤ	ㅤ
Specified system photo/s		ㅤ	ㅤ	ㅤ
Make (if known)	[manufacturer name]	ㅤ	ㅤ	Installation date
Model (if known)		ㅤ	ㅤ	ㅤ
Related specified systems
ㅤ
Location		ㅤ	ㅤ	ㅤ
Performance standard		ㅤ	ㅤ	ㅤ
Inspection procedures		ㅤ	ㅤ	ㅤ
Inspection frequencies	Annually	ㅤ	ㅤ	ㅤ
Inspection personnel	IQP	ㅤ	ㅤ	ㅤ
Maintenance procedures		ㅤ	ㅤ	ㅤ
System interfacing		ㅤ	ㅤ	ㅤ
Reporting procedures		ㅤ	ㅤ	ㅤ
Signage		ㅤ	ㅤ	ㅤ
Comments/notes		ㅤ	ㅤ	ㅤ

SS 15/2 Final exits	ㅤ	ㅤ	ㅤ	ㅤ	ㅤ
Description (incl type)		ㅤ	ㅤ	ㅤ	ㅤ
Specified system photo/s		ㅤ	ㅤ	ㅤ	ㅤ
Make (if known)	[manufacturer name]	ㅤ	Installation date	ㅤ	2020
Models (if known)	[brand name]	ㅤ	ㅤ	ㅤ	ㅤ
Location		ㅤ	ㅤ	ㅤ	ㅤ
Performance standard		ㅤ	ㅤ	ㅤ	ㅤ
Inspection procedures		ㅤ	ㅤ	ㅤ	ㅤ
Inspection frequencies	Daily (when in use)	Monthly	ㅤ	Annually	ㅤ
Inspection personnel	Owner or Agent	Owner or Agent	ㅤ	IQP	ㅤ
Maintenance procedures		ㅤ	ㅤ	ㅤ	ㅤ
System interfacing		ㅤ	ㅤ	ㅤ	ㅤ
Reporting procedures		ㅤ	ㅤ	ㅤ	ㅤ
Signage		ㅤ	ㅤ	ㅤ	ㅤ
Comments/notes		ㅤ	ㅤ	ㅤ	ㅤ

SS 15/3 Fire separations	ㅤ	ㅤ	ㅤ	ㅤ	ㅤ
Description (incl type)		ㅤ	ㅤ	ㅤ	ㅤ
Specified system photo/s		ㅤ	ㅤ	ㅤ	ㅤ
Make (if known)		ㅤ	Installation date		ㅤ
Models (if known)		ㅤ	ㅤ	ㅤ	ㅤ
Location		ㅤ	ㅤ	ㅤ	ㅤ
Performance standard		ㅤ	ㅤ	ㅤ	ㅤ
Inspection procedures		ㅤ	ㅤ	ㅤ	ㅤ
Inspection frequencies	Daily (when in use)	Monthly	Six Monthly	ㅤ	Annually
Inspection personnel	Owner or Agent	Owner or Agent	IQP	ㅤ	IQP
Maintenance procedures		ㅤ	ㅤ	ㅤ	ㅤ
System interfacing		ㅤ	ㅤ	ㅤ	ㅤ
Reporting procedures		ㅤ	ㅤ	ㅤ	ㅤ
Signage		ㅤ	ㅤ	ㅤ	ㅤ
Comments/notes		ㅤ	ㅤ	ㅤ	ㅤ

SS 15/4 Signs for communicating information intended to facilitate evacuation	ㅤ	ㅤ	ㅤ
Description (incl type)		ㅤ	ㅤ
Specified system photo		ㅤ	ㅤ
Make (if known)	[manufacturer name]	ㅤ	Installation date
Model (if known)		ㅤ	ㅤ
Location		ㅤ	ㅤ
Performance standard		ㅤ	ㅤ
Inspection procedures		ㅤ	ㅤ
Inspection frequencies	Monthly	Annually	ㅤ
Inspection personnel	Owner or Agent	IQP	ㅤ
Maintenance procedures		ㅤ	ㅤ
System interfacing		ㅤ	ㅤ
Reporting procedures		ㅤ	ㅤ
Signage		ㅤ	ㅤ
Comments/notes		ㅤ	ㅤ

	Signed on behalf of the Council
Name
Position		Date
Signature
Address

ㅤ	Appendices/Attachments	ㅤ
Appendix	Documents (including drawings)	Page number
Appendix A
Appendix B
Appendix C
Appendix D
Appendix E
Appendix F

Appendix A: Location & site plan of Bulls Community Centre

Appendix B: Floor plans showing locations of exit signs & manual call points

Appendix C: Cross-sections showing fire cells within the building

Appendix D: Extract from fire engineering strategy report

Appendix E: Producer statement

Appendix F: Evacuation floor maps