COMPLIANCE CERTIFICATE – TEMPERING VALVESIssued under Section 109C(1)(a) Environmental Planning & Assessment Act 1979

I "insert plumbers name" ……………………………………………………………………..

Certify that hot water tempering valve/s at:

Property details:

Lot No: …………………. DP:……………………………………………………….....

Address: ………………………………………………………………………………………

………………………………………………………………………………………

Construction Certificate Application No: …………………………………………………

Complying Development Certificate No: ………………………………………………….

Building Code of Australia (BCA) Classification: Class 1(a)

Has/have been installed in accordance with the Hot Water Installation Provisions of

Australian Standard AS 3500.4-2003 and the Plumbing Code of Australia.

Certified and dated this day: ………………………………………………………………

By Name:

(plumbers name): ……………………………………………………………………………

Licence No: …………………………………………………………………………………….

As a suitability qualified installation agent of:

Organisation:

(plumbers name):………………………………………………………………………………

Address: ………………………………………………………………………………………

………………………………………………………………………………………

Phone No:………………………………………………………………………………………..

Email address:…………………………………………………………………………………..

Signature:………………………………………………………………………………………..

Form No. – Tempering Valves Compliance Certificate 1 September 2013