External Wall Information
1. Building Identification
Name of Building
Address of Building
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2. Name and contact details of responsible person
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
Address of Responsible Person
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
3. Timber Construction
3. Are structural timber systems used in the construction of the external walls?
*
Yes
No
4. Masonry Construction
4. Are the external walls constructed from masonry materials?
*
Yes
No
4.1 Is there any form of cladding or finish present over the outer masonry layer?
Yes
No (to report additional wall systems go to section 4, otherwise go to section 5)
4.2 Select external facing materials present over the outer masonry layer
Aluminium composite materials
Metalsheet panels
Other metal composite materials
Render system
Brick slips
Stone panels
Glass
Tiling systems
High pressure laminate (HPL)
Timber
Other
4.3 Select materials used for insulation between external facing material and masonry layer
Mineral wool
Phenolic foam
Polyisocyanurate(PIR) or polyurethane (PUR) foam
Expanded polystyrene(EPS) or Extruded polystyrene (XPS)
None
Other
4.4 Are these walls likely to ignite and spread fire easily?
*
Yes
No
4.5 Outline the reasons why the walls are likely to ignite and spread fire easily
4.6 Identify the location of the walls, or sections thereof, which are likely to ignite or spread fire easily
5. Alternative External Wall Systems
Although only presented once below, the questions in section4 should be answered once for each different external wall system incorporatedinto the building design – i.e., section 4 may need to be repeated. This is to allow clear differentiationbetween multiple external wall systems and their associated risk.
5.1 Select external facing material
*
Aluminium composite materials
Metal sheet panels
Other metal composite materials
Render system
Brick slips
Stone panels
Glass
Tiling systems
High pressure laminate (HPL)
Timber
Other
5.2 Select material used for insulation
*
Mineral wool
Phenolic foam
Polyisocyanurate(PIR) or polyurethane (PUR) foam
Expanded polystyrene(EPS) or Extruded polystyrene (XPS)
None
Other
5.3 Are these walls likely to ignite and spread fire easily?
*
Yes
No
5.4 If Yes Outline the reasons why the walls are likely to ignite and spread fire easily
5.5 Outline where on the building this external wall system has been used, and where necessary, how it can be distinguished from the other external wall systems that form part the design?
*
6. Wall Attachments and Features
6.1 Does the building include any of the following attachments - Select all that apply
*
Balconies
Photo voltaic panels
Green walls
Solar shading devices
None
6.2 Where the attachments selected above are likely to contribute to external fire spread, provide further information below
*
7. Risk and Mitigation
7.1 Following the buildings fire risk assessment, was a further fire risk appraisal of the external walls required?
*
Yes, a further fire risk appraisal of the external walls has been completed
Yes, a further fire risk appraisal of the external walls is required but not yet completed
No, a further fire risk appraisal of the external walls was not required
7.2 What is the overall level of risk of fire spread due to the design and construction of the external walls?
*
Low risk
Medium risk
High
The overall level of risk of the external wall has not been determined
7.3 What actions have been taken to mitigate the risk relating to the external wall?
*
Change to simultaneous evacuation strategy
Remediation works to external wall
Installation of sprinklers
Removal of gas supply
No additional measures are necessary
8. Name and contact details of person completing form
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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