Before you use this sheet

This is a free record template from TradieRoles, provided by FTC Group Pty Ltd. It records a test, it does not perform or certify it.

Test method, test pressure and hold time must follow AS/NZS 3500 and any water authority or manufacturer requirement.
Pneumatic (air) testing stores dangerous energy. You are responsible for safe test method selection.
FTC Group accepts no liability for the completed record.

I understand this is a record template and I am responsible for compliance.

PressIQ

Pressure Test Sheet

Hydrostatic / pneumatic test record · AS/NZS 3500

Hydrostatic / pneumatic test record · AS/NZS 3500 & NZBC G12

AU · AS/NZS 3500

Project / Site

Client

Site address

System tested

Pipe material

Section / area tested

Contractor / Company

Plumbing licence no.

Date

Certifying plumber reg. no.

1Pressure test

Test medium

Working pressure (kPa)

Test pressure (kPa)

Hold duration

Start time

Start pressure (kPa)

End time

End pressure (kPa)

Pressure drop (kPa)

Permitted drop (kPa)

Gauge cal. due

Result

2Backflow prevention include

Device type

Serial no.

Hazard rating

Test result

3Thermostatic mixing valve (TMV) include

TMV location / ref.

Set temperature (°C)

Measured outlet (°C)

Result

4Disinfection / chlorination include

Method

Concentration (mg/L)

Contact time

Result

5Declaration

Notes / defects

I certify the section described was tested as recorded and complies with AS/NZS 3500. A plumbing compliance certificate is to be issued as required by the relevant State or Territory regulator and water authority.

I certify the section described was tested as recorded and complies with AS/NZS 3500 and NZBC clause G12. A Producer Statement / Record of Work is provided as required.

Tested by

Signature

Licence no.Registration no.

Date

Free record template · TradieRoles Tools · © FTC Group Pty Ltd (ABN 70 694 989 994). Provided as-is with no warranty. Test method, pressures, hold times and certification remain the responsibility of the licensed plumber. Verify against the current edition of AS/NZS 3500 and any water authority requirement.

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