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Monitoring & Assessment Reporting

3rd Party Name
3rd Party Reference #
RM Reference #
Date of Attendance:
Attending Technician/s
- I confirm I have completed the Take5 & Submitted the electronic Take5 electronic form PRIOR to commencing works.
Attendance #
Who we Met on site?
- Business Hours
- After Hours
MONITORING & RESETTING EQUIPMENT - PROPERTY STILL WET

JSA site risk assessment carried out Implemented safety measures and discussed with the other staff and clients on site.
- Yes
- No
- N/A
Moisture Readings have been taken and recorded (moisture mapping)
- Yes
- No
- N/A
Recorded moisture readings show that a return to a dry standard has not yet been achieved at this time and that further drying is required
- Yes
- No
- N/A
Drying equipment has been relocated to assist in the drying process
- Yes
- No
- N/A
Additional drying equipment has been installed to assist in the drying process
- Yes
- No
- N/A
3rd Party has been advised of drying progress and that further monitoring is required and gained approval to complete work as required?
- Yes
- No
- N/A
Technician spoke with 3rd party representative ?
Restored rug / contents were returned to the Insured’s premises.
- Yes
- No
- N/A
Carried out the drilling of kicks to allow installation of direct-it-in kit / airflow to assist in the drying process
- Yes
- No
- N/A
Carried out the removal of damaged skirting boards to assist in the drying process
- Yes
- No
- N/A
Carried out invasive inspection to allow for additional reporting and completion of makesafe
- Yes
- No
- N/A

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Affected Room - 1
Room Size (mts)
ROOM 1 - RELATIVE HUMIDITY & MOISTURE READINGS

Relative Humidity %
Temperature (0 Celcius)
Carpet Moisture %
Gyprock Moisture %
Ceiling Moisture %
Concrete Moisture %
ROOM 1 - EQUIPMENT INSTALLED:

Equipment Status
Air Mover/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Dehumidifier/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Air Filtration Devices
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Boost Bar & Kit/Mats
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Direct-It-In Kit
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Containment Chamber
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Other:
------######### END OF THIS ROOM'S INFO #############------
1. Have more rooms got affected?*
- Yes
- No

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Affected Room - 2
Room Size (mts)
ROOM 2 - RELATIVE HUMIDITY & MOISTURE READINGS

Relative Humidity %
Temperature (0 Celcius)
Carpet Moisture %
Gyprock Moisture %
Ceiling Moisture %
Concrete Moisture %
ROOM 2 - EQUIPMENT INSTALLED:

Equipment Status
Air Mover/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Dehumidifier/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Air Filtration Devices
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Boost Bar & Kit/Mats
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Direct-It-In Kit
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Containment Chamber
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Other:
------######### END OF THIS ROOM'S INFO #############------
2. Have more rooms got affected?*
- Yes
- No

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Affected Room - 3
Room Size (mts)
ROOM 3 - RELATIVE HUMIDITY & MOISTURE READINGS

Relative Humidity %
Temperature (0 Celcius)
Carpet Moisture %
Gyprock Moisture %
Ceiling Moisture %
Concrete Moisture %
ROOM 3 - EQUIPMENT INSTALLED:

Equipment Status
Air Mover/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Dehumidifier/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Air Filtration Devices
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Boost Bar & Kit/Mats
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Direct-It-In Kit
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Containment Chamber
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Other:
------######### END OF THIS ROOM'S INFO #############------
3. Have more rooms got affected?*
- Yes
- No

Save and Continue Later

Affected Room - 4
Room Size (mts)
ROOM 4 - RELATIVE HUMIDITY & MOISTURE READINGS

Relative Humidity %
Temperature (0 Celcius)
Carpet Moisture %
Gyprock Moisture %
Ceiling Moisture %
Concrete Moisture %
ROOM 4 - EQUIPMENT INSTALLED:

Equipment Status
Air Mover/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Dehumidifier/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Air Filtration Devices
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Boost Bar & Kit/Mats
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Direct-It-In Kit
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Containment Chamber
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Other:
------######### END OF THIS ROOM'S INFO #############------
4. Have more rooms got affected?*
- Yes
- No

Save and Continue Later

Affected Room - 5
Room Size (mts)
ROOM 5 - RELATIVE HUMIDITY & MOISTURE READINGS

Relative Humidity %
Temperature (0 Celcius)
Carpet Moisture %
Gyprock Moisture %
Ceiling Moisture %
Concrete Moisture %
ROOM 5 - EQUIPMENT INSTALLED:

Equipment Status
Air Mover/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Dehumidifier/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Air Filtration Devices
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Boost Bar & Kit/Mats
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Direct-It-In Kit
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Containment Chamber
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Other:
------######### END OF THIS ROOM'S INFO #############------
5. Have more rooms got affected?*
- Yes
- No

Save and Continue Later

Affected Room - 6
Room Size (mts)
ROOM 6 - RELATIVE HUMIDITY & MOISTURE READINGS

Relative Humidity %
Temperature (0 Celcius)
Carpet Moisture %
Gyprock Moisture %
Ceiling Moisture %
Concrete Moisture %
ROOM 6 - EQUIPMENT INSTALLED:

Equipment Status
Air Mover/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Dehumidifier/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Air Filtration Devices
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Boost Bar & Kit/Mats
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Direct-It-In Kit
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Containment Chamber
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Other:
------######### END OF THIS ROOM'S INFO #############------
6. Have more rooms got affected?*
- Yes
- No

Save and Continue Later

Affected Room - 7
Room Size (mts)
ROOM 7 - RELATIVE HUMIDITY & MOISTURE READINGS

Relative Humidity %
Temperature (0 Celcius)
Carpet Moisture %
Gyprock Moisture %
Ceiling Moisture %
Concrete Moisture %
ROOM 7 - EQUIPMENT INSTALLED:

Equipment Status
Air Mover/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Dehumidifier/s
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Air Filtration Devices
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Boost Bar & Kit/Mats
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Direct-It-In Kit
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Containment Chamber
Enter Qty used, or if not used or applicable please enter 0 (the number 0)
Other:
------######### END OF THIS ROOM'S INFO #############------
Untitled*
- I confirm no more rooms were affected

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Additional Info:
Scoped / Recommended Approval is to be followed up by administration
- Yes
- No
- N/A
Request to Leave Damaged contents/flooring onsite has been signed off
- Yes
- No
- N/A
Authority to Remove & Dispose non-restorable flooring / contents has been signed off
- Yes
- No
- N/A
Authority to Carryout Invasive works has been signed off
- Yes
- No
- N/A
Authority to Leave on SIte form has been signed
- Yes
- No
- N/A
Health Information and Consent to Proceed Form has been signed
- Yes
- No
- N/A
Customer Responsibility Form - Instructions related to the restoration of your property
- Yes
- No
- N/A
Detailed scope of works will need to be completed for the remediation process
- Yes
- No
- N/A
Due to damage identified throughout property, it is recommended that insured be placed into emergency accommodation to allow the completion of structural drying and or mould remediation process
- Yes
- No
- N/A
Satisfaction Release form has been signed off
- Yes
- No
- N/A
Completion Certificate will be required to be completed
- Yes
- No
- N/A
Insured has provided a ‘comment’ and or ‘video testimonial.
- Yes
- No
- N/A
Technician has confirmed next attendance
- Yes
- No
- N/A
Date
Initials of Technician:
DISCLAIMER:

*Inspections are conducted in a conscientious and professional manner. However, it is possible that water [escape of liquid] may be present in areas that were inaccessible or visually obscured during the inspection. ReAssured Restoration takes no responsibility for water damage to contents and/or structure or mould growth that may occur as a result of the delayed response in allowing restorative drying or treatment to be carried out in a timely manner. Whilst all care is undertaken in the provision of contracted services, no responsibility is accepted for claims, losses or liability alleged by third parties (for whatever reason) and liability to any such party is expressly excluded to the extent permitted at law.*
Technicians to read thoroughly answer and initial the following
Description of Purchase Order correlates to works carried out for
- Qty rms to be remediated
- Qty and type of equipment being paid for
- Works listed to be carried out
- # of days authorised for remediation
Is longer dry time required?
- Yes
- N/A
If yes, has p.o been requested?
- Yes
- No
If yes, has authorisation been received?
- Yes
- No
Name of 3rd Party contact that gave authorisation to proceed with extra works, include time
Drill kicks required and not already in p/o?
- Yes
- N/A
Have kicks been drilled
- Yes
- N/A
If yes, has p.o been requested?
- Yes
- No
If yes, has authorisation been received?
- Yes
- No
Name of 3rd Party contact that gave authorisation to proceed with extra works, include time
Removal of skirting boards required
- Yes
- N/A
Have skirting boards been removed?
- Yes
- N/A
If yes, has p.o been requested?
- Yes
- No
If yes, has authorisation been received?
- Yes
- No
Name of 3rd Party contact that gave authorisation to proceed with extra works, include time
Containment established?
- Yes
- N/A
If yes, has p.o been requested?
- Yes
- No
If yes, has authorisation been received?
- Yes
- No
Name of 3rd Party contact that gave authorisation to proceed with extra works, include time
Air scrubber used?
- Yes
- N/A
If yes, has p.o been requested?
- Yes
- No
If yes, has authorisation been received?
- Yes
- No
Name of 3rd Party contact that gave authorisation to proceed with extra works, include time
Mould Testing required?
- Yes
- N/A
If yes, has p.o been requested?
- Yes
- No
If yes, has authorisation been received?
- Yes
- No
Name of 3rd Party contact that gave authorisation to proceed with extra works, include time
Drug testing required?
- Yes
- N/A
If yes, has p.o been requested?
- Yes
- No
If yes, has authorisation been received?
- Yes
- No
Name of 3rd Party contact that gave authorisation to proceed with extra works, include time
Items disposed of?
- Yes
- N/A
If yes, has p.o been requested?
- Yes
- No
If yes, has authorisation been received?
- Yes
- No
Name of 3rd Party contact that gave authorisation to proceed with extra works, include time
2 Staff required onsite to relocate heavy furnishings due to OH&S requirements?
- Yes
- N/A
If yes, has p.o been requested?
- Yes
- No
If yes, has authorisation been received?
- Yes
- No
Name of 3rd Party contact that gave authorisation to proceed with extra works, include time
Any other comments
Total Equipment installed
Additional Rooms - Other:
Technician Initials

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