Original to LSV (Regional Officer to return within seven days of completion)

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GEAR INSPECTION and AUDIT REPORT CLUB / SERVICE: DATE OF GEAR INSPECTION: DATE OF AUDIT: DATE INSPECTION APPROVED: Supervising Officer Other appropriate officer Original to LSV (Regional Officer to return within seven days of completion) Duplicates to Club NOTE: Refer to individual SLSA and LSV policies and specifications for further information - www.sls.com.au. Or www.lifesavingvictoria.com.au These inspection requirements are for patrol gear inspections only (safety and operational inspections). The items may be required to meeting further competition scrutineering requirements for surf sports purposes. Surf Life Saving Gear Inspections do not replace an authorised RTA inspection or registration or any other State or National regulatory requirements. 2014/2015 Gear Inspection / Audit Report. Page 1 of 10

General Gear Inspection / Audit Guidelines Please have ready for your Gear Inspection / Audit the items (as appropriate) listed herein. At least FOUR capable and able Club officials / members must be in attendance for the Gear Audit. To assist the Inspection Panel, Clubs are required to have ready the following: Kit items (e.g. first aid, airbag resuscitator) are to be spread out for inspection in an orderly manner. Patrol tent, enclosures and patrol screens are available as per State requirements. Rescue boards and tubes are laid out and not on racks. Serial numbers and equipment have been already listed in SurfGuard. Please note: Motors will have to be run and tested. Soft-hull IRB s to be inflated, with floorboards out. Radios will have to be turned on and tested All ATV s, RWC s, beach signage and flags are to be presented and available as per Branch and/or State requirements. Most items should be numbered refer to state requirements. The contents of kit items (e.g. first aid kits, shark bags) are state specific. Refer to attached documentation for confirmation of the makeup of these kits and appropriate documentation. Thank you for your anticipated cooperation and work in this area. Grading of Gear All items will be graded and if passed, approval stickers will be issued. P = PASS F = FAIR R = RE-INSPECT D = DISCARD Ok to use on Patrol & Club activities Item may require maintenance or attention before use Item needs major repair or was not ready for inspection Item is beyond repair discard and NEVER USE AGAIN 2014/2015 Gear Inspection / Audit Report. Page 2 of 10

LSV General Instructions All gear presented for inspection must be in good, safe working order. It should be free from any faults, which may cause lifesavers, bystanders or patients any unnecessary risk or injury. It should also appear in a condition to project an efficient image of the Club and of Life Saving Victoria to the public. It is the responsibility of the Club and respective office bearers to see that all gear is in a serviceable condition and passed the clubs Initial gear inspection prior to the official audit. As a guide to that standard they should take note of the instructions listed throughout and contained in this Gear Inspection Manual and any relevant circulars issued from time to time Note: that where a section is required for patrol, it is headed with "(Minimum Requirements)". Any gear rejected at the inspection is to be dismantled, if applicable, and clearly marked OUT OF SERVICE, with an designated Unserviceable Equipment Sticker as indicated below. Gear and equipment which has been rejected/not presented is not to be used for patrolling duties, training purposes for instruction and assessment or for competition of any nature. No insurance cover is provided when using such equipment. Standard Life Saving Victoria (LSV) 'Out of Service' Stickers will be used for identifying gear and equipment that is below standard. Only the person marking and placing the OUT OF SERVICE tag may authorize its removal. The Regional Officer or Chief Inspector is to ensure completion of this report, with remarks in the spaces provided and initial each page. The Club will be given a signed copy of this report to be produced on request by the relevant Regional Officer/Patrol Inspectors The Chief Inspector is to ensure that the names of all Inspectors assisting with the Inspection are recorded on the normal assessor attendance sheet and submitted to the State Centre. It is the clubs responsibility to ensure that any unserviceable equipment that is proposed to be used is repaired and the Unserviceable Equipment stickers may only then be removed when authorized by the person who originally marked it.. The unserviceable gear must be clearly identified and tagged by the Regional Officer or Inspector, e.g. sponsor's name, colours, serial numbers, etc.

F R D Stickers CLUB NAME FIRST AID (ROOM) (Minimum Requirements) P =Pass / F = Fair / R = Re-inspect / D = Discard INSPECTION ITEM QTY COMMENTS Notice Board Showing Resuscitation Flowchart Poster with current CPR rates Examination Couch/Bed 1 Pillows Plastic Cover & Pillow Case 2 Blankets Clean (cotton or woollen) 2 Stool or Chair 1 Sink with Preferably Hot & Cold Water 1 Hand Cleaner/Hand Wash Solution 1 Paper Towels & Dispenser 1 Contaminated Waste Disposal Bin and 5 bin liners 1 General Waste Bin and 5 bin liners 1 Sharps Disposal Unit 1 Ice packs in freezer or Instant Icepacks 4 Storage Cabinet Triangular Bandage Min 90cm 4 Crepe Bandage 10cm x 1.5m 3 Crepe Bandage 7.5cm x 1.5m 3 High Compression Bandage 1 Steri Strips or Cicagraph 2014/2015 Gear Inspection / Audit Report. Page 4 of 10 1 2 packets 7.5cm x 7.5cm sterile gauze pads (3 Pkt) 4 Non Adherent dressing 10cmx10cm (Melolin) 5 Combine dressing (Surgipad) 9cmx20cm OR 10 x 20cm Combine dressing (Surgipad) 20cmx20cm 2 Band Aids 100 Tape (transpore) 2.5cm 2 Saline Ampoules 30ml (eye/wound irrigation)300ml Total 10 Surgical shears 1 2

Ventolin puffer and spacer 1 Shock Blanket/Space Blanket 1 Vomit Bags 4 Disposable Gloves Small medium Large 10 pair of each size Safety goggles and non permeable apron for first aid work Drinking Cups (Vessel) (disposable) 10 First Aid log (club to choose best location to store) 1 SLS Incident log (club to choose best location to store) 1 Pocket Mask with oxygen inlet 1 Pencil / Pen 1 1 Note: First Aid Room requirements are as per your state s Standard Operating Procedures. F R D Stickers CLUB NAME FIRST AID (PATROL KIT) P =Pass / F = Fair / R = Re-inspect / D = Discard INSPECTION ITEM QTY KIT 1 KIT 2 KIT 3 KIT 4 Pocket Mask with oxygen inlet 1 Triangular Bandage minimum 90cm 4 Crepe Bandages 10cm x 1.5 m 2 Crepe Bandages 7.5cm X 1.5 m 2 High Compression Bandages 1 Steri Strips or Cicagraph 2 Packets Sterile Gauze Pads 7.5cm x 7.5cm 3 piece 4 Non-Adherent Sterile Dressing10cmx 10cm (Melolin) 5 Combine dressing 9x20cm or 10x20cm 2 Band-Aids 20 2.5cm tape (Transpore) 2 Saline Ampoules 30ml (eye/wound irrigation)(150ml total) 5 Surgical Shears 1 Gloves Disposable in self-sealing Bag 5 Pairs 2014/2015 Gear Inspection / Audit Report. Page 5 of 10

Instant cold packs 1 Blanket Emergency Shock (space blanket) 1 Biohazard Waste Snap Lock Bags 5 Vomit Bags 2 Notepad, pencil/pen First Aid Sheet 1 set Protective goggles 1 Sharps Disposal Unit 1 APPROVAL STICKER 1 Note: First Aid Kit requirements are as per your state s Standard Operating Procedures. F R D Stickers CLUB NAME PATROL EQUIPMENT (Minimum Equipment) P =Pass / F = Fair / R = Re-inspect / D = Discard INSPECTION CHECKLIST QTY P / F / R / D COMMENT Signs: Warning Swimming Not Advised 1 Caution Keep Clear Rescue Craft Access Area Surf Board riders directional Signs + Flags (Port Phillip Bay, Wonthaggi, Mildura and Port Campbell exempt) Signage Board to inform public of warning, safety, tide and patrol information 1 1 set Patrol Area Flags 2 Patrol Feathers 2 Signal Flags 2 Swim Fins (pairs) 1 2 pair Sun Block Cream 1 Loud Hailer/PA System 1 Tested Binoculars 1 2014/2015 Gear Inspection / Audit Report. Page 6 of 10 As per National Aquatic Signage Manual Refer LSV Website Minimum (1) Consideration should be given to the number of access points to main swim area Minimum (2) 2 signs needed to designate a set Training Area As per National Aquatic Signage Manual for Beach Signage (Note now a Black and White Quartered Flag) As per National Aquatic Signage Manual for Beach Signage refer to LSV Website With suitable stands to elevate to a height of approx. 3.6 metres. LSV requirement With suitable stands to elevate to a height of approx. 3.6 metres. LSV requirement SPF 30 (or greater) - 500ml for patrol members With an expiry date of not less than 2 months.

Evacuation Flag (Shark) 1 Evacuation Alarm (Shark) 1 Tested. Patrol Log (Books) 1 Incident Report Log (Book) 1 SOP / Policy Manual 1 Latest SOP s and Policy Manual as per the LSV Website Patrol Shelter/Tent 1 Ensure adequate shade for size of patrols Communicable Disease Kit (Bum Bags) Min 4. 1 Resuscitation Pocket Mask with one way valve, 3 pair Surgical gloves, 1 Triangular bandage, 1 Whistle and a waterproof bag holding 1 Notebook & 1 pen/pencil F R D Stickers CLUB NAME IRB (ANCILLARY EQUIPMENT (Minimum Requirements)) P =Pass / F = Fair / R = Re-inspect / D = = Compulsory SurfGuard Discard Information LIFE SAVING VICTORIA STATE REQUIREMENTS INSPECTION CHECKLIST P/F / R / D Requirements Inflation pump and hose (working) Spare propeller nuts or Spare split pins 1 PER MOTOR MAX OF 2 PER MOTOR TYPE 1 Propeller spanner 1 PER TYPE OF MOTOR Spare tilt pin 1 PER TYPE OF MOTOR 1 pair multi grips 1 flat & 1 Philips screw driver Spark plug spanner Spare spark plugs Puncture repair kit (patches, glue & abrasive agent) Fuel siphon hose or funnel 1 per type of motor 2 per type of motor 2014/2015 Gear Inspection / Audit Report. Page 7 of 10

Test tank or ear muffs. Note method of flushing / running motor De-watering agent Relevant operating hull pressure gauge As per manufacturer specifications Motor trolley or stand LSV IRB White Board Log Serviced Fire extinguisher Lifejackets Approved Flammable Liquids Storage Cabinet (dry chem. CO2) with signage Minimum of 12 that meet [AS:4758 or ISO:12402 - Level 50 standard As per AS1940:1993 where 40 litres of more of fuel is stored APPROVAL STICKER 2014/2015 Gear Inspection / Audit Report. Page 8 of 10

Summary of Minimum Patrol Requirements Status Section / Deficiency Summary Refer to Individual Sections for Details IRB safety and operation section requirements met Minimum 1 IRB IRB Motor section requirements met Minimum 2 Motors IRB Ancillary equipment section requirements met Trailer section requirements met Beach vehicle (ATV) section requirements met Beach Vehicle Mobile section requirements met Rescue Board section requirements met Minimum (2) Rescue Tube section requirements met Minimum (2) Manikin section requirements met Minimum (1) DEFIB section requirements met Minimum (1) Oxygen Resuscitation Unit section requirements met Minimum 1 unit Spinal Equipment section requirements met Minimum (1) Minimum 1 st Aid room section requirements met. Portable 1 st Aid Patrol / Kits section requirements met minimum 1 kit General Patrol Equipment section requirements met 2014/2015 Gear Inspection / Audit Report. Page 9 of 10

Radio section (LSVComms / local base and 2 hand held) requirements met 2014/2015 Gear Inspection / Audit Report. Page 10 of 10