Lockyer Valley Certificate of Hydrostatic Testing and Commissioning Lockyer Valley Regional Council, PO Box 82, Gatton Qld 4343 Phone: 1300 005 872 Email: mailbox@lvrc.qld.gov.au

Form No E6305-502 Version 1.0 Page 1 of 1

Certificate of Hydrostatic Testing and Commissioning

Note: All pipe work must be inspected by a Council Plumbing & Drainage Inspector

This form is to be completed and emailed to mailbox@lvrc.qld.gov.au or alternatively returned to Lockyer

Valley Regional Councils Plumbing Department, PO Box 82, GATTON QLD 4343 prior to the final inspection.

This certificate is to be used for the Certification of Hydrostatic Testing on FWG branches/soil and waste stacks and pipework/pressure testing of the water supply rough-ins and the hot water delivery temperature in dwellings and duplexes only.

Property Description

Lot Number Plan Reference Number (RP, SP)

Plumbing Reference Number

Site Address

Owner Name

Plumber Certification

Being a licensed plumber and/or drainer, in accordance with the Plumbing and Drainage Act 2002, I hereby certify that the (tick the appropriate box)

Floor waste gully branches (including bath and shower connections) have been hydrostatically tested on ______________ and found to be satisfactory as per AS:3500.2:2003-13.2 (b)

Internal soil and waste stack (and or elevated plumbing/drainage) have been hydrostatically tested on ______________ and found to be satisfactory as per AS:3500.2:2003-Section 13

Water rough-in tested at 1500kpa for a minimum of 30 minutes on ______________ and found to be satisfactory as per AS:3500.1:2003-16.3.1

Sanitary fixtures delivery temperature tested on ______________ does not exceed 500C as per

AS:3500.4:2003-1.9.2

In-ground water service tested at 1500kpa for a minimum of 30 minutes on ______________ and found to be satisfactory

Full name of licenced holder

Licenced number/s

Licenced holder signature Date

CERTIFICATION WILL ONLY BE DEEMED VALID IF IT BEARS AN ORIGINAL SIGNATURE OF THE LICENSE HOLDER

Privacy Statement

These details will only be used for the purpose for which they have been collected and will not be used for any other purpose. We will not disclose the information you provide outside of Council unless we are required by law or you have given your consent. To the fullest extent allowed by law Council, its officers and employees will not be liable for any claims in respect of any loss arising out of, or in connection with, the use of any of the supplied information.