HomeMy WebLinkAboutInspection OverviewPARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
Playground needs updated age appropriate and warning labels.
Non -Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Blue Plane
Playground Equipment
Spring Items
Sitting spring rider
Manufacturer:
AgeGroup:
Status:
Priority:
Item: Spring Rider Manufacturer:
Equipment Category: Playground Equipment AgeGroup:
Equipment Type: Spring Items Status:
Equipment Item: Sitting spring rider Priority:
City of Sebastian
Playgrounds
Airport Park
Low Frequency
Complete
Eddie La Roque
6/15/2017
Unknown/None
2-5
Okay
None
Inventory
Unknown/None
2-5
Okay
None
Inventory
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Red Spring Rider
Status:
Needs Maintenance
Playground Equipment
Part:
Body
Spring Items
Problem:
Head entrapment
Sitting spring rider
Action:
Other (See Comments)
Unknown/None
Priority:
4
2-5
Repair Notes: N/A
Comments: Head Entrapment on body of
plane, opening needs to be
closed to under 3.5 inches
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Issue
Inventory
Surfacing
Status:
Needs Maintenance
Surface
Part:
Not applicable
Surface
Problem:
Non Compliant
Other
Action:
Correct
Unknown/None
Priority:
3 - Medium
All
N / A
Issue
Inventory
Grass is not considered a
compliant safety surfacing.
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / 5=Non Compliant
Inspector Signature �)
X
Manager Signature
X
The Inspection Is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an initial compliance Inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior inspections, (c) whenever the equipment Is subject to
damage, abuse or unusual wear and tear, and (d) as drcum3ronces otherwise warrant.
The inspection is not Invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. latent, concealed and hidden defects and deficiencles are specifically exduded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this contact. Playground Guardian has no liability, and assumes
no liability, In connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided In the limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the Items inspected are designed or constructed in a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of Inspection.
This inspection does not address the protective surfacing for compliance as it pertains to Impact attenuating results such as HIC & GMAX.
Important: This information Is for internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
PLAYGROU NQ -
GUARDIAN
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the HIC shall not
exceed 1000 from the drop height stipulated by the owner/operator prior to purchase.
Agency requesting the tests
Playground Site
Manu actured/nstaller o Sur ace
Name: City of Sebastian
Name: Airport Park
Name:
Address: 1225 Main Street
Address: 202 East Airport Drive
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Country
Zi: 32958 Country
Zip: Country
Contact name Margarita Hernandez
Contact name
Contact name
Contact phone 772-228-7054
Contact phone
Contact phone
Description of Test Area - AirportPark
Date of Test - 6/15/17
Description of Surface: Type Grass
Condition: N/A Seams: N/A
Fasteners: N/A
Test Apparatus Triax 2010
Date Installed
Wear: N/A
Condition:N/A
Weather: Clear 85 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
Physically measured. The drops are performed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
46
2'5" Blue Plane
#1 Grass 60
112
47
2'6"
79
177
48
2'6"
69
154
4
165.5
Drop # Drop
height
Drop location in relation to structure Picture Surfacing
Gmax HIC
49 2'8"
Red Spring Rider #2 Grass
51 96
50 27"
105
56 102
51 27'
64
55 100
54
3'0"
55.5 101
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
52
2'11" Shuttle — Spring Rider
#3 Grass 53
105
53
3'0"
64
144
54
3'0"
54
105
59
124.5
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
Authorized signature.
Pic #I
Pic #2
Pic #3
• PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization: City of Sebastian
Grass is not an accessible or compliant safety surfacing. The route to the play area is accessible.
Non -Defective Items
Item: ADA Inspection Item 1
Status: Okay
Priority: None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item:
Playgrounds
Site:
Airport Park
Type:
A D A
Status:
Complete
Inspector:
Eddie La Roque
Completed on:
6/15/2017
Grass is not an accessible or compliant safety surfacing. The route to the play area is accessible.
Non -Defective Items
Item: ADA Inspection Item 1
Status: Okay
Priority: None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item:
ADA Inspection Item
12
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
13
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
14
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
15
Status:
Okay
Priority:
None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item: ADA Inspection Item 17
Status: Okay
Priority: None
Item: ADA Inspection Item 18
Status: Okay
Priority: None
Item: ADA Inspection Item 19
Status: Okay
Priority: None
Item:
ADA Inspection Item 2
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 20
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 21
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 4
Status:
Okay
Priority:
None
Item: ADA Inspection Item 6
Status: Okay
Priority: None
Item: ADA Inspection Item 7
Status: Okay
Priority: None
Item: ADA Inspection Item 8
Status: Okay
Priority: None
X Spector Signature '- P -7 -
Manager
7
Manager Signature
X
The inspection Is Intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the Inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the Inspection. We recommend that an Initial compliance Inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment Is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection Is not Invasive or technically exhaustive, and our inspectors will not attempt to access Inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the Inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the Umtted Warranty, Playground Guardian makes no representations or warranties of any kind or nature, Including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. further, Playground Guardian makes no representations or
warranties that any of the items Inspected are designed or constructed in a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of inspection.
This Inspection does not address the protective surfacing for compliance as It pertains to Impact attenuating results such as HIC & GMAX.
Important: This information Is for Internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
• PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization: City of Sebastian
Due to excessive rusting on welds and joints we recommend closing down the 5 to 12 Miracle Unit until replacement
parts can be used.
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
5 to 12 modular unit
Playgrounds
Site:
Barber Street Sports
Climbing Equipment
Complex
Type:
Low Frequency
Status:
Complete
Inspector:
Eddie La Roque
Completed on:
6/15/2017
Due to excessive rusting on welds and joints we recommend closing down the 5 to 12 Miracle Unit until replacement
parts can be used.
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
5 to 12 modular unit
Status:
Playground Equipment
Part:
Climbing Equipment
Problem:
Composite structure
Action:
Miracle
Priority:
All
Needs Maintenance
Stairs
Damaged
Replace
2
N / A Issue
N/A
..t
5 to 12 modular unit
Playground Equipment
Climbing Equipment
Composite structure
Miracle
All
N/A
Missing hand grip
Inventory
Status:
Needs Maintenance
Part:
Not applicable
Problem:
Missing
Action:
Replace
Priority:
2
Issue Inventory
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
5 to 12 modular unit
Playground Equipment
Climbing Equipment
Composite structure
Miracle
All
N/A
N/A
5 to 12 modular unit
Playground Equipment
Climbing Equipment
Composite structure
Miracle
All
N/A
Missing entire piece, opening
is a straight drop off.
5 to 12 modular unit
Playground Equipment
Climbing Equipment
Composite structure
Miracle
All
Repair Notes: N/A
Comments: There is so much rust and
damage to decks, this unit
feels unsafe -recommend
complete overhaul or closing
on this piece.
Status:
Needs Maintenance
Part:
Stairs
Problem:
Corrosion
Action:
Replace
Priority:
2
Issue Inventory
Status:
Needs Maintenance
Part:
Ladder
Problem:
Missing
Action:
Replace
Priority:
1 - High
Issue
Inventory
Status:
Needs Maintenance
Part:
Entire unit
Problem:
Dangerous
Action:
Close
Priority:
1 - High
Issue Inventory
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Belt swing
Playground Equipment
Swings
2 -leg swing
Miracle
All
N/A
Close S hooks or replace with
proper clevis
Belt swing
Playground Equipment
Swings
2 -leg swing
Miracle
All
N/A
Hardware and chains showing
lots of rust
Pirate ship
Playground Equipment
Climbing Equipment
Composite structure
Playworld
All
N/A
Deck coatings peeling and
exposing metal.
Status:
Needs Maintenance
Part:
S hook
Problem:
Non Compliant
Action:
Clean
Priority:
3 - Medium
Issue Inventory
Status:
Needs Maintenance
Part:
Hardware
Problem:
Rusted
Action:
Inform staff
Priority:
4
Issue
Status:
Needs Maintenance
Part:
Coating
Problem:
Separating
Action:
Repair
Priority:
4
Issue Inventory
WPM=
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Pirate ship
Playground Equipment
Climbing Equipment
Composite structure
Playworld
All
N/A
N/A
Pirate ship
Playground Equipment
Climbing Equipment
Composite structure
Playworld
All
N/A
Fabric coming up through
surfacing. Needs to be
trimmed or with new
surfacing, covered.
Safety surface
Surface
Surface
Sand
Unknown/None
All
N/A
Sand is not recommended for
this high of a fall height.
Status:
Needs Maintenance
Part:
Not applicable
Problem:
Missing
Action:
Replace
Priority:
5 - Low
Issue Inventory
.1,0*
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Not applicable
Trip hazard
Cut back
5 - Low
Inventory
.W&9
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Not applicable
N/A (See Comments)
Correct
1 - High
Inventory
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Safety surface Pirate Ship
Surface
Surface
Loose Rubber
Unknown/None
All
N/A
Surfacing should be a
minimum of 6 inches deep.
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Not applicable
Insufficient Surface Depth
Add surface level
2
Inventory
Tot swing
Status:
Needs Maintenance
Playground Equipment
Part:
S hook
Swings
Problem:
Non Compliant
2 -leg swing
Action:
Close
Unknown/None
Priority:
3 - Medium
All
N/A
N/A
Issue
Inventory
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / S=Non Compliant
Inspector Signature
X
Manager Signature
X
�dw V1 -
The Inspection Is Intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspecdon. We recommend that an initial compliance Inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior inspections, (c) whenever the equipment Is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection is not invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. Latent, concealed and hidden defects and defidendes are specifically excluded from the Inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or Infringement. Further, Playground Guardian makes no representations or
warranties that any of the Items inspected are designed or constructed in a good or workmanlike manner or will continue to perforin In the future as they are performing at
the time of inspection.
This Inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This information Is for Internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
PLAYG'RO'UN;D-
rj-GUARDIAN
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the HIC shall not
exceed 1000 from the drop height stipulated by the owner/operator prior to purchase.
Agency requesting the tests
Playground Site
Manufacturer/Installer of Surface
Name: City of Sebastian
Name: Barber Street Sports Complex [Creative
Playground]
Name:
Address: 1225 Main Street
Address: 1101 Barber Street
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Country
Zip: 32958 Country
Zip: Country
Contact name Margarita Hernandez
Contact name
Contact name
Contact phone 772-228-7054
Contact phone
Contact phone
Description of Test Area - Creative Playground [Ship]
Date of Test : 6/15/17 Test Apparatus Triax 2010
Description of Surface: Rubber Mulch Date Installed
Condition: N/A Seams: N/A Wear: N/A
Fasteners: N/A Condition: N/A
Weather: Clear 77 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
Dhvsically measured. The drops are performed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
10
5'8" Pirate ship near coil slide
#1 Rubber Mulch 185
1112
11
57'
198
1175
12
518"
214
1318
206
2
Drop # Drop
height
Drop location in relation to structure Picture Surfacing Gmax
HIC
13 5'7"
Pirate ship between slides #2 Rubber Mulch 187
963
14 518"
189
936
15 518"
192
932
190.5
934
Drop # Drop Drop location in relation to structure Picture
height
Surfacing Gmax HIC
16 518. High side of pirate ship #3
Rubber Mulch 165 950
17 '9"
170 966
18 '8"
172 977
171 971.5
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
Authorized signature.
RIMA
- �Ti7
0
000=00% Inspection Overview
PARK9P Organization: City of Sebastian
PROTECTOR Playgrounds
Site: Barber Street Sports
Complex
Type: A D A
Status: Complete
Inspector: Eddie La Roque
Completed on: 6/15/2017
General Inspection Comments
Sand is not considered an accessible surface.
Non -Defective Items
Item: ADA Inspection Item 1
Status: Okay
Priority: None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item: ADA Inspection Item 12
Status: Okay
Priority: None
Item: ADA Inspection Item 13
Status: Okay
Priority: None
Item: ADA Inspection Item 14
Status: Okay
Priority: None
Item: ADA Inspection Item 15
Status: Okay
Priority: None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item:
ADA Inspection Item
17
Status:
Okay
None
Priority:
None
Item:
ADA Inspection Item
18
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
19
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
2
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 20
Status:
Okay
Priority:
None
Item: ADA Inspection Item 21
Status: Okay
Priority: None
Item: ADA Inspection Item 4
Status: Okay
Priority: None
Item: ADA Inspection Item 6
Status: Okay
Priority: None
Item:
ADA Inspection Item 7
Status:
Okay
Priority:
None
Item: ADA Inspection Item 8
Status: Okay
Priority: None
Inspector Signature
X �" V7
Manager Signature
X
The inspection is Intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the Inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an initial compliance inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low ftequency Inspection at least once per year. Playground Guardian also suggests an inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered In prior inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as clrcumstances otherwise warrant.
The inspection is not invasive or technically exhaustive, and our Inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, In connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided In the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, Including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the items Inspected are designed or constructed In a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of Inspection.
This inspection does not address the protective surfacing for compliance as It pertains to impact attenuating results such as HIC & GMAX.
Important: This information is for internal use only and Is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative
PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization: City of Sebastian
Needs updated age appropriate and warning labels. Sign at front says 2 to 5, but there are belt swings on the swing.
Tot seats should be on a 2 to 5 swing.
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Belt swing
Playgrounds
Site:
Blossom Street Park
Type:
Low Frequency
Status:
Complete
Inspector:
Eddie La Roque
Completed on:
6/15/2017
Needs updated age appropriate and warning labels. Sign at front says 2 to 5, but there are belt swings on the swing.
Tot seats should be on a 2 to 5 swing.
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Belt swing
Status:
Needs Maintenance
Playground Equipment
Part:
Legs
Swings
Problem:
Insufficient area
2 -leg swing
Action:
Correct
Playworld
Priority:
3 - Medium
All
Repair Notes: N/A
Comments: Let's should have 6 feet of
clear fall zone protection.
Issue
Inventory
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Belt swing
Playground Equipment
Swings
2 -leg swing
Playworld
All
N/A
N/A
Belt swing
Playground Equipment
Swings
2 -leg swing
Playworld
All
Repair Notes: N/A
Comments: Chains and hardware showing
rust. Hardware on clamps is
upside down, rounded head
should be on top.
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Seat
Worn
Replace
4
Status:
Part:
Problem:
Action:
Priority:
Issue
Inventory
Needs Maintenance
Hardware
Worn
Replace
3 - Medium
Inventory
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Playworld
All
N/A
Deck rusting where coating
has been separated.
Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Playworld
All
N/A
N/A
Safety surface
Surface
Surface
Poured Rubber
Unknown/None
All
N/A
Multiple spots .
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Deck
Rusted
Repair
3 - Medium
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Hardware
Missing
Replace
5 -Low
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Coating
Broken
Repair
5 -Low
Inventory
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / 5=Non Compliant
Inspector Signature
X `�C0-27 -
Manager Signature
X
The inspection is Intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the Inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the Inspection. We recommend that an initial compliance inspection be conducted by a knowledgeable, trained playgmund equipment inspector followed
up by a low frequency inspection at least once per year. Playground Guardian also suggests an inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior inspections, (c) whenever the equipment Is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection Is not Invasive or technically exhaustive, and our Inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. Latent, concealed and hidden defects and deficlencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the limited Warranty (as defined In the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, In connection with any services, general Items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the Items inspected are designed or constructed in a good or workmanlike manner or will continue to perform In the future as they are performing at
the time of inspection.
This Inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This Information is for internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative
PLAYGROUND
GUARDIAN
s1AYG.<`.�Nf. "1�n::(+fni MdGR..N
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the HIC shall not
exceed 1000 from the drop height stipulated by the owner/operator prior to purchase.
Agency requesting the tests
PlaygroundSite
Manrr actured/nstaller of Surface
Name: City of Sebastian
Name: Blossom Street Park
Name:
Address: 1225 Main Street
Address: 940 Cody Avenue
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Country
Zip: 32958 Country
Zip: Country
Contact name Margarita Hernandez
Contact name
Contact name
Contact phone 772-228-7054
Contact phone
Contac[ phone
Description of Test Area - Blossom Street Park
Date of Test : 6/15/17 Test Apparatus Triax 2010
Description of Surface: PIP Date Installed
Condition: N/A Seams: N/A Wear: N/A
Fasteners: N/A Condition: N/A
Weather: Clear 80 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
physically measured. The drops are performed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
MC
19
4'5" Between slide and climber
#1 PIP 133
596
20
4'5"
129
559
21
4'5"
134
593
120.5 47
131.5
6
Drop # Drop
height
Drop location in relation to structure Picture Surfacing Gmax
RIC
22 3'11"
New double slide #2 PIP 123
486
23 4'0"
120
474
24 4'5"
127
539
23.5
506.5
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
/1
Authorized signature.
Drop # Drop Drop location in relation to structure Picture Surfacing
Gmax HIC
25 4'1" Near coil climber #3 PIP
I 1I 1 416
26 4'3"
119 469
27 3"
1122 487
120.5 47
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
/1
Authorized signature.
1�� Inspection Overview
PARKOrganization: City of Sebastian
PROTECTOR Playgrounds
9P
Site: Blossom Street Park
Type: A D A
Status: Complete
Inspector: Eddie La Roque
Completed on: 6/15/2017
General Inspection Comments
There is no accessible route to play area.
Non-Defective Items
Item: ADA Inspection Item 1
Status: Okay
Priority: None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item: ADA Inspection Item 12
Status: Okay
Priority: None
Item: ADA Inspection Item 13
Status: Okay
Priority: None
Item: ADA Inspection Item 14
Status: Okay
Priority: None
Item: ADA Inspection Item 15
Status: Okay
Priority: None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item:
ADA Inspection Item 17
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 18
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 19
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 2
Status:
Okay
Priority:
None
Item: ADA Inspection Item 20
Status: Okay
Priority: None
Item: ADA Inspection Item 21
Status: Okay
Priority: None
Item: ADA Inspection Item 4
Status: Okay
Priority: None
Item: ADA Inspection Item 6
Status: Okay
Priority: None
Item:
Status:
Priority:
Item:
Status:
Priority:
ADA Inspection Item 7
Okay
None
ADA Inspection Item 8
Okay
None
Inspector Signature
X
Manager Signature
X
The inspection is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the Inspection. We recommend that an initial compliance inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered In prior inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The Inspection is not Invasive or technically exhaustive, and our Inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the Inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, Including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or Infringement. Further, Playground Guardian makes no representations or
warranties that any of the items inspected are designed or constructed in a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of inspection.
This Inspection does not address the protective surfacing for compliance as it pertains to Impact attenuating results such as HIC & GMAX.
Important: This information is for internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
PARK'
PROTECTOR
General Inspection Comments
Inspection Overview
Organization: City of Sebastian
Playground needs updated age appropriate and warning labels.
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Modular Unit
Playgrounds
Site:
Bryant Court Park
Type:
Low Frequency
Status:
Complete
Inspector:
Eddie La Roque
Completed on:
6/15/2017
Playground needs updated age appropriate and warning labels.
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Modular Unit
Status:
Needs Maintenance
Playground Equipment
Part:
Coating
Climbing Equipment
Problem:
Damaged
Composite structure
Action:
Replace
Unknown/None
Priority:
5 - Low
5 - 12
Manufacturer:
Unknown/None
N/A
Coatings peeling
Issue
Inventory
Item:
Safety Surface
Status:
Needs Maintenance
Equipment Category:
Surface
Part:
Coating
Equipment Type:
Surface
Problem:
Separating
Equipment Item:
Poured Rubber
Action:
Repair
Manufacturer:
Unknown/None
Priority:
3 - Medium
AgeGroup:
All
Repair Notes: N/A
Comments: N/A
Issue
Inventory
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / 5=Non Compliant
Inspector Signature
X `�Q g'
Manager Signature
X
The Inspection Is Intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the Inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the Inspection. We recommend that an initial compliance inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an inspection be conducted (a) whenever equipment Is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection is not invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. Latent, concealed and hidden defects and deficiencies are spedf cally excluded from the Inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general Items or materials provided, or any safety suggestions made, by Playground Guardian. The inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment
Except as expressly provided in the limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, Including without limitation any
representations or warmnUes as to merchantability, fitness for any particular purpose or Infringement Further, Playground Guardian makes no representations or
warranties that any of the Items inspected are designed or constructed In a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of Inspection.
This Inspection does not address the protective surfacing for compliance as It pertains to Impact attenuating results such as HIC @ GMAX.
Important: This Information is for Internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
r PLAYG'ROUNID
GUARDIAN
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the HIC shall not
exceed 1000 from the drop height stipulated by the owner/operator prior to purchase.
Agency requesting the tests
PlaygroundSite
Manu acturerl7nstaller of Surface
Name: City of Sebastian
Name: Bryant Court Park
Name:
Address: 1225 Main Street
Address: 117 Bryant Court
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Country
Zip: 32958 Country
Zip: Country
Contact name Margarita Hernandez
Contact name
Contact name
Contac[ phone 772-228-7054
Contact phone
Contact phone
Description of Test Area - Bryant Court Park
Date of Test : 6/14/17 Test Apparatus Triax 2010
Description of Surface: PIP Date Installed
Condition: N/A Seams: N/A Wear: N/A
Fasteners: N/A Condition: N/A
Weather: Overcast 84 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
physically measured. The drops are performed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing
Gmax
HIC
76
7'2" Near bubble panel
#1 PIP
93
291
77
6'1"
PIP
156
857
78
5'11"
PIP
157
865
156.5
861
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing
Gmax
HIC
79
6'5" Near coil climber
#2 PIP
162
903
80
5'10"
PIP
171
958
81
6'1:
PIP
191
1147
181
1052.5
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing
Gmax
HIC
82
5'8" Near float station
#2 IP
165
901
83
5'10"
IP
169
962
84
5'11"
IP
181
1065
175
1013.5
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
j.�
Authorized signature.
cin �taaa �.•._.
�, I Te�iil,
v
PARK'
PROTECTOR
General Inspection Comments
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
City of Sebastian
Playgrounds
Bryant Court Park
ADA
Complete
Eddie La Roque
6/15/2017
No accessible path to play area.
Non -Defective Items
Item:
ADA Inspection Item
1
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
11
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
12
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
13
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
14
Status:
Okay
Priority:
None
Item: ADA Inspection Item 15
Status: Okay
Priority: None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item: ADA Inspection Item 17
Status: Okay
Priority: None
Item: ADA Inspection Item 18
Status: Okay
Priority: None
Item:
ADA Inspection Item 19
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 2
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 20
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 21
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 4
Status:
Okay
Priority:
None
Item: ADA Inspection Item 6
Status: Okay
Priority: None
Item:
Status:
Priority:
Item:
Status:
Priority:
ADA Inspection Item 7
Okay
None
ADA Inspection Item 8
Okay
None
Inspector Signature Q
X
Manager Signature
X
The inspection is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an initial compliance Inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency inspection at least once per year. Playground Guardian also suggests an inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior inspections, (c) whenever the equipment Is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection is not Invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. latent, concealed and hidden defects and deficiencies are specifically excluded from the Inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, In connection with any services, general Items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations; or
warranties that any of the items inspected are designed or constructed in a good or workmanlike manner or will continue to perform In the future as they are performing at
the time of inspection.
This inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This information is for internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative
• PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization: City of Sebastian
CPSC recommends 6 inches of loose rubber in all fall zones.
Non -Defective Items
Item:
Playgrounds
Site:
Community Center
Type:
Low Frequency
Status:
Complete
Inspector:
Eddie La Roque
Completed on:
6/14/2017
CPSC recommends 6 inches of loose rubber in all fall zones.
Non -Defective Items
Item:
Modular Unit
Manufacturer:
Playworld
Equipment Category:
Playground Equipment
AgeGroup:
All
Equipment Type:
Climbing Equipment
Status:
Okay
Equipment Item:
Composite structure
Priority:
None
Inventory
i
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Border
Perimeter
Perimeter
Plastic Curb
Unknown/None
All
N/A
Spikes need to be pounded
down.
Safety Surface
Surface
Loose fill
Rubber
Unknown/None
All
N/A
Fabric showing through
surfacing.
Status:
Part:
Problem
Action:
Priority:
Needs Maintenance
Not applicable
Trip hazard
Tighten
5 - Low
Inventory
Status: Needs Maintenance
Problem: Trip hazard
Action: Cut back
Priority: 5 - Low
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting In temporary disability / 4=Minor Injury / 5=Non Compliant
Inspector Signature � D
X d'pw V7
Manager Signature
X
The inspection Is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the Inspection. We recommend that an initial compliance Inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency inspection at least once per year. Playground Guardian also suggests an inspection be conducted (a) whenever equipment Is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior Inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The Inspection Is not invasive or technically exhaustive, and our inspectors will not attempt to access Inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the Inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined In the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, In connection with any services, general Items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided In the limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, Including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or Infringement. Further, Playground Guardian makes no representations or
warranties that any of the Items Inspected are designed or constructed In a good or workmanlike manner or will continue to perform In the future as they are performing at
the time of inspection.
This inspection does not address the protective surfacing for compliance as It pertains to Impact attenuating results such as HIC & GMAX.
Important: This information Is for internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative
PLAYGROUND
+G El4Y4c 1!M, I
.�.cw"uo wwnwc["[nr morswn
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the HIC shall not
exceed 1000 from the drop height stipulated by the owner/operator prior to purchase.
Agency requestingrequestingg the tests
PlaygroundSite
Manufacturer/Installer of Surface
Name: City of Sebastian
Name: Community Center
Name:
Address: 1225 Main Street
Address: 1805 N. Central Avenue
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Country
Zip: 32958 Country
Zip: Country
Contact name Margarita Hernandez
Contact name
Contact name
Contact phone 772-228-7054
Contact phone
Contact phone
Description of Test Area - Community Center
Date of Test : 6/14/17 Test Apparatus Trlax 2010
Description of Surface: Rubber Fiber Date Installed
Condition: N/A Seams: N/A Wear: N/A
Fasteners: N/A Condition: N/A
Weather: Overcast 86 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
ahvsically measured. The drops are performed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
40
5'5" New Double Slide
#1 Rubber Fiber 74
255
41
515"
66
205
42
5'4"
57
162
61.5
1
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
43
5'3" Highest end of structure
#2 Rubber Fiber 76
266
44
515"
83
310
45
515"
79
273
81
291.
Drop # Drop Drop location in relation to structure
height
Picture
Surfacing Gmax HIC
46 5'4" Near Highest ladder climber
#2
Rubber Fiber 97 392
47 5'3"
87 322
48 5'2"
83 305
85 1
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
Authorized signature. /
Pic #1
Pic #2
Pic #3
v
PRRK'
PROTECTOR
General Inspection Comments
Inspection Overview
Playground passes this inspection at the time of inspection.
Non -Defective Items
Item: ADA Inspection Item 1
Status: Okay
Priority: None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Organization: City of Sebastian
Item:
Playgrounds
Site:
Community Center
Type:
A D A
Status:
Complete
Inspector:
Eddie La Roque
Completed on:
6/14/2017
Item:
ADA Inspection Item
12
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
13
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
14
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
15
Status:
Okay
Priority:
None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item: ADA Inspection Item 17
Status: Okay
Priority: None
Item:
ADA Inspection Item 18
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 19
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 2
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 20
Status:
Okay
Priority:
None
Item: ADA Inspection Item 21
Status: Okay
Priority: None
Item: ADA Inspection Item 4
Status: Okay
Priority: None
Item: ADA Inspection Item 6
Status: Okay
Priority: None
Item:
Status:
Priority:
Item:
Status:
Priority:
ADA Inspection Item 7
Okay
None
ADA Inspection Item 8
Okay
None
Inspector Signature
X e�
Manager Signature
X
The Inspection is Intended solely to evaluate whether the playground equipment meets curtent safety standards. This report addresses the condition of playground
equipment as of the date and time of the Inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the Inspection. We recommend that an Initial compliance Inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children In age groups other than those considered In prior Inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection is not invasive or technically exhaustive, and our inspectors will not attempt to access Inaccessible areas or open or unlock any secured playground
equipment In connection with the inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined In the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided In the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the items inspected are designed or constructed in a good or workmanlike manner or will continue to perform In the future as they are performing at
the time of Inspection.
This inspection does not address the protective surfacing for compliance as It pertains to impact attenuating results such as HIC & GMAX.
Important: This Information is for Internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
v
PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization: City of Sebastian
Playground needs updated age appropriate and warning labels. Sand is not recommended for the fall height of this
unit, and the swing needs a safety surface as soon as possible.
Non -Defective Items
Item:
Playgrounds
Site:
George Street Park
Type:
Low Frequency
Status:
Complete
Inspector:
Eddie La Roque
Completed on:
6/15/2017
Playground needs updated age appropriate and warning labels. Sand is not recommended for the fall height of this
unit, and the swing needs a safety surface as soon as possible.
Non -Defective Items
Item:
Border
Manufacturer:
Unknown/None
Equipment Category:
Perimeter
AgeGroup:
All
Equipment Type:
Perimeter
Status:
Okay
Equipment Item:
PVC
Priority:
None
Item: Safety surface Manufacturer:
Equipment Category: Surface AgeGroup:
Equipment Type: Surface Status:
Equipment Item: Sand Priority:
Inventory
Unknown/None
All
Okay
None
Inventory
Item
Equipment Category:
Equipment Type:
Equipment Item:
Spring rider
Playground Equipment
Spring Items
Sitting spring rider
Manufacturer:
Burke
AgeGroup:
All
Status:
Okay
Priority:
None
Inventory
--mss
Defective Items
Item: Modular unit
Equipment Category: Playground Equipment
Equipment Type:
Climbing Equipment
Equipment Item:
Composite structure
Manufacturer:
Burke
AgeGroup:
All
Repair Notes:
N/A
Comments:
N / A
Item: Modular unit
Equipment Category: Playground Equipment
Equipment Type:
Climbing Equipment
Equipment Item:
Composite structure
Manufacturer:
Burke
AgeGroup:
All
Repair Notes:
N/A
Comments:
N / A
Item: Swing
Equipment Category: Playground Equipment
Equipment Type:
Swings
Equipment Item:
2 -leg swing
Manufacturer:
Burke
AgeGroup:
All
Repair Notes:
N/A
Comments:
N/A
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Plastic slide
Cracking
Repair
5 - Low
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Handrail
Rusted
Remove rust
4
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Seat
Worn
Replace
3 - Medium
Inventory
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / 5=Non Compliant
Inspector Signature cUg—
X 27-
Manager Signature
X
The Inspection Is intended solely to evaluate whether the playground equipment meets cument safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an initial compliance Inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior Inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The Inspection is not invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment
Except as expressly provided in the Limited Warranty, Playground Guardian makes no representations or wananties of any kind or nature, including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the Items inspected are designed or constructed in a good or workmanlike manner or will continue to perform in the Future as they are performing at
the time of Inspection.
This inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as MIC & GMAX.
Important: This information is for Internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
PLAYGROUND'
GUARDIAN
>Iw�C..O�nm-.�na('1(�r tyOG4wM1
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the HIC shall not
exceed 1000 from the drop height stipulated by the owner/operator prior to purchase.
Agency requesting the tests
PlaygroundSite
Manufacturer/Installer of Surface
Name: City of Sebastian
Name: George Street Park
Name:
Address: 1225 Main Street
Address: 1270 George Street
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Count
Zip: 32958 Country
Zip: Country
Contact name Margarita Hernandez.
Contact name
Contact name
Contact phone 772-228-7054
Contact phone
Contact phone
Description of Test Area - George Street Park
Date of Test : 6/15/17 Test Apparatus Triax 2010
Description of Surface: Sand Date Installed
Condition: N/A Seams: N/A Wear: N/A
Fasteners: N/A Condition: N/A
Weather: Clear 77 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
nhvsically measured. The drops are Derformed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
1
51111, Highest deck between climber slide
#I Sand 47
76
2
6'0"
63
161
3
5110"
107
359
85
260
Drop # Drop
height
Drop location in relation to structure Picture Surfacing Gmax
HIC
4 5'7"
Highest deck between slide & railing #2 Sand 52
105
5 518"
58
114
6 518"
53
108
9
55.5
111
Drop #
Drop
height
Drop location in relation to structure
Picture Surfacing Gmax HIC
7
5'1"
In front of vertical ladder
#2 Sand 57 109
8
5'5"
73 178
9
5'4"
49 103
1 140.5
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
Lel �/4
Authorized signature. /
Pic #1
All�r'
Pic #3
:�k-, T
• PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization: City of Sebastian
No Accessible route to playground, and sand is not considered an accessible surface.
Non -Defective Items
Item:
Status:
Priority:
ADA Inspection Item 1
Okay
None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item: ADA Inspection Item 12
Status: Okay
Priority: None
Item: ADA Inspection Item 13
Status: Okay
Priority: None
Item: ADA Inspection Item 14
Status: Okay
Priority: None
Item: ADA Inspection Item 15
Status: Okay
Priority: None
Playgrounds
Site:
George Street Park
Type:
A D A
Status:
Complete
Inspector:
Eddie La Roque
Completed on:
6/15/2017
No Accessible route to playground, and sand is not considered an accessible surface.
Non -Defective Items
Item:
Status:
Priority:
ADA Inspection Item 1
Okay
None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item: ADA Inspection Item 12
Status: Okay
Priority: None
Item: ADA Inspection Item 13
Status: Okay
Priority: None
Item: ADA Inspection Item 14
Status: Okay
Priority: None
Item: ADA Inspection Item 15
Status: Okay
Priority: None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item: ADA Inspection Item 17
Status: Okay
Priority: None
Item:
ADA Inspection Item 18
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 19
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 2
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 20
Status:
Okay
Priority:
None
Item: ADA Inspection Item 21
Status: Okay
Priority: None
Item: ADA Inspection Item 4
Status: Okay
Priority: None
Item: ADA Inspection Item 6
Status: Okay
Priority: None
Item:
Status:
Priority:
ADA Inspection Item 7
Okay
None
Item: ADA Inspection Item 8
Status: Okay
Priority: None
Inspector Signature
X �Q g- P7 --
Manager
Manager Signature
X
The Inspection is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the Inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the Inspection. We recommend that an Initial compliance Inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency inspectlon at least once per year. Playground Guardian also suggests an inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children In age groups other than those considered In prior inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection is not invasive or technically exhaustive, and our inspectors will not attempt to access Inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined In the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided In the limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, including without limitation any
representations or warranties as to memhantablllty, fitness for any particular purpose or Infringement. Further, Playground Guardian makes no representations or
warranties that any of the Items Inspected are designed or constructed In a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of inspection.
This inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This Information Is for internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
CPSC recommends 6 inches minimum for loose rubber in all fall zones.
Non -Defective Items
Item:
Modular Unit
Manufacturer:
Equipment Category:
Playground Equipment
AgeGroup:
Equipment Type:
Climbing Equipment
Status:
Equipment Item:
Composite structure
Priority:
Item: Safety Surface Manufacturer:
Equipment Category: Surface AgeGroup:
Equipment Type: Surface Status:
Equipment Item: Loose Rubber Priority:
City of Sebastian
Playgrounds
Hardee Park
Low Frequency
Complete
Eddie La Roque
6/15/2017
Unknown/None
All
Okay
None
Inventory
Unknown/None
All
Okay
None
Inventory
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Swing
Playground Equipment
Swings
2 -leg swing
Unknown/None
All
N/A
N/A
Swing
Playground Equipment
Swings
2 -leg swing
Unknown/None
All
N/A
Benches are in fall zone, they
need to be removed.
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Seat
Non Compliant
Replace
4
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Legs
Insufficient area
Remove
3 - Medium
Inventory
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / 5=Non Compliant
Inspector Signature
X
Manager Signature
X
The Inspection Is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an initial compliance inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior inspections, (c) whenever the equipment Is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection Is not invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the Inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Umited Warranty (as defined in the attached terms and conditions) under this Contract Playground Guardian has no liability, and assumes
no liability, in connection with any services, general Items or materials provided, or any safety suggestions made, by Playground Guardian. The inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided In the Umited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, Including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or Infringement. Further, Playground Guardian makes no representations or
warranties that any of the Items inspected are designed or constructed In a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of Inspection.
This Inspection does not address the protective surfacing for compliance as It pertains to Impact attenuating results such as HIC & GMAX.
Important: This Information is for Internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative
�'[r� PLAYGROUND"
[[��r.GUARDIAN
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the HIC shall not
exceed 1000 from the drop height stipulated by the owner/operator prior to purchase.
Agency requesting the tests
Playground Site
Manufacturer/Installer of Surface
Name: City of Sebastian
Name: Hardee Park
Name:
Address: 1225 Main Street
Address: 530 Barber Street
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Count
Zip: 32958 Country
Zip: Country
Contact name Margarita Hernandez
Contact name
Contact name
Contact phone 772-228-7054
Contact phone
Contact phone
Description of Test Area - Hardee Park
Date of Test : 6/15/17
Description of Surface: Rubber Mulch
Condition: N/A Seams: N/A
Fasteners: N/A
Test Apparatus Triax2010
Date Installed
Wear: N/A
Condition: N/A
Weather: Clear 82 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
physically measured. The drops are performed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
28
4'1" Rear step
#1 Rubber Mulch 82
277
29
4'1"
87
288
30
4'1"
74
218
3'11"
80.5
253
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing
Gmax
HIC
31
3'10" Near slide
#2 Rubber Mulch
93
309
32
3'9"
36
91
300
33
3'11"
88
288
5
194
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
34
4'0" Between slide and panel
#2 Rubber Mulch 92
323
35
4'2"
104
384
36
4'5"
99
355
1
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
tel' _4
Authorized signature.
r-
v
PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization: City of Sebastian
No accessible route to playground. Loose rubber needs to be maintained so that the drop from the sidewalk/entrance
to surfacing is less than 1/4 of an inch.
Non -Defective Items
Item:
Status:
Priority:
ADA Inspection Item 1
Okay
None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item: ADA Inspection Item 12
Status: Okay
Priority: None
Item: ADA Inspection Item 13
Status: Okay
Priority: None
Item: ADA Inspection Item 14
Status: Okay
Priority: None
Item: ADA Inspection Item 15
Status: Okay
Priority: None
Playgrounds
Site:
Hardee Park
Type:
A D A
Status:
Complete
Inspector:
Eddie La Roque
Completed on:
6/15/2017
No accessible route to playground. Loose rubber needs to be maintained so that the drop from the sidewalk/entrance
to surfacing is less than 1/4 of an inch.
Non -Defective Items
Item:
Status:
Priority:
ADA Inspection Item 1
Okay
None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item: ADA Inspection Item 12
Status: Okay
Priority: None
Item: ADA Inspection Item 13
Status: Okay
Priority: None
Item: ADA Inspection Item 14
Status: Okay
Priority: None
Item: ADA Inspection Item 15
Status: Okay
Priority: None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item: ADA Inspection Item 17
Status: Okay
Priority: None
Item: ADA Inspection Item 18
Status: Okay
Priority: None
Item: ADA Inspection Item 19
Status: Okay
Priority: None
Item: ADA Inspection Item 2
Status: Okay
Priority: None
Item: ADA Inspection Item 20
Status: Okay
Priority: None
Item: ADA Inspection Item 21
Status: Okay
Priority: None
Item: ADA Inspection Item 4
Status: Okay
Priority: None
Item:
ADA Inspection Item 6
Status:
Okay
Priority:
None
Item:
Status:
Priority:
Item:
Status:
Priority:
ADA Inspection Item 7
Okay
None
ADA Inspection Item 8
Okay
None
Inspector Signature
X fit. -'
Manager Signature
X
The inspection Is Intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condidon of playground
equipment as of the date and time of the Inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an Initial compliance Inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency inspection at least once per year. Playground Guardian also suggests an inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection is not invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided In the Limited Warranty, Playgmund Guardian makes no representadons or warranties of any kind or nature, including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representadons or
warranties that any of the Items inspected are designed or constructed in a good or workmanlike manner or will continue to perform In the future as they are performing at
the time of inspection.
This inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This Information is for internal use only and Is not to be released or otherwise disseminated to anyone other than an agency official, or designated representadve
v
PARK
PROTECTOR
Non -Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Safety surface
Surface
Surface
Sand
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
Manufacturer:
AgeGroup:
Status:
Priority:
City of Sebastian
Playgrounds
Riverview Park
Low Frequency
Complete
Eddie La Roque
6/15/2017
Unknown/None
All
Okay
None
Inventory
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
2 to 5 modular unit
Playground Equipment
Climbing Equipment
Composite structure
Unknown/None
All
N/A
N/A
5 to 12 Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Unknown/None
All
N/A
N/A
5 to 12 Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Unknown/None
All
N/A
N/A
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Hardware
Non Compliant
Cut back
5 -Low
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Plastic slide
Cracking
Replace
5 -Low
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Not applicable
Missing
Replace
5 -Low
Inventory
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
5 to 12 Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Unknown/None
All
Repair Notes: N/A
Comments: Space between deck and rail
needs to be closed to under
3.5 inches
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
5 to 12 Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Unknown/None
All
N/A
Unit needs a minimum of 6
feet of clearance around it.
5 to 12 Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Unknown/None
All
N/A
N/A
Status:
Part:
Problem
Action:
Priority:
Issue
Needs Maintenance
Handrail
Head entrapment
Close
1 - High
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Plastic slide
Insufficient area
increase surface size
4
Inventory
Status:
Part:
Problem
Action:
Priority:
Issue
Needs Maintenance
Hardware
Entanglement
Cut back
2
Inventory
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
5 to 12 Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Unknown/None
All
N/A
N/A
5 to 12 Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Unknown/None
All
N/A
N/A
Status:
Part:
Problem
Action:
Priority:
Issue
Needs Maintenance
Hardware
Rusted
Remove rust
3 - Medium
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Stairs
Insufficient area
Increase surface size
5 -Low
Inventory
Priority Key:
I=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / 5=Non Compliant
Inspector Signature
Manager Signature
X
The inspection is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playgmund
equipment as of the date and time of the Inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the Inspection. We recommend that an Initial compliance Inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment Is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered In prior Inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The Inspection Is not Invaslveor technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general Items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided In the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, Including without limitation any
representations or wanandes as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the items inspected are designed or constructed in a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of Inspection.
This inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This information Is for internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
PLAY GA O UiND
GUARDIAN.
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the HIC shall not
exceed 1000 from the drop height stipulated by the owner/operator prior to purchase.
Agency requesting the tests
Pla round Site
Manufacturer/Installer of Surface
Name: City of Sebastian
Name: Riverview Park
Name:
Address: 1225 Main Street
Address: 600 U.S. Hwy I
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Country
Zip: 32958 Country
Zip: Country
Contact name Margarita Hernandez
Contact name
Contact name
Contact phone 772-228-7054
Contact phone
Contact phone
Description of Test Area - Riverview Park
Date of Test: 6/14/17
Description of Surface: Sand
Condition: N/A Seams: N/A
Fasteners: N/A
Test Apparatus Triax 2010
Date Installed
Wear: N/A
Condition: N/A
Weather: 87 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
phvsically measured. The drops are performed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
Inc
58
5191' 5 to 12 Unit slide
#1 Sand 94
384
59
5'10"
118
519
60
6'0"
115
506
116.5
2.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
61
519" 5 to 12 track ride
#2 Sand 83
243
62
6'0"
84
316
63
6'1"
54
150
69
233
Drop #
Drop Drop location in relation to structure Picture Surfacing Gmax
height
111C
64
5111" 2 to 5 slide #2 Sand 74
173
65
5'11" 76
246
66
5'11" 61
171
68.5
208.5
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
j'< I
Authorized signature.
Pic #1
Pic #2
Pic #3
PARK
PROTECTOR
General Inspection Comments
Sand is not an accessible surface.
Non -Defective Items
Item: ADA Inspection Item 1
Status: Okay
Priority: None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
City of Sebastian
Playgrounds
Riverview Park
ADA
Complete
Eddie La Roque
6/15/2017
Item:
ADA Inspection Item
12
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
13
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
14
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
15
Status:
Okay
Priority:
None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item: ADA Inspection Item 17
Status: Okay
Priority: None
Item:
Status:
Priority:
ADA Inspection Item 18
Okay
None
Item: ADA Inspection Item 19
Status: Okay
Priority: None
Item: ADA Inspection Item 2
Status: Okay
Priority: None
Item: ADA Inspection Item 20
Status: Okay
Priority: None
Item: ADA Inspection Item 21
Status: Okay
Priority: None
Item: ADA Inspection Item 4
Status: Okay
Priority: None
Item: ADA Inspection Item 8
Status: Okay
Priority: None
Defective Items
Item:
ADA Inspection Item 6
Status:
Needs Maintenance
Part:
Deck
Problem:
Non Compliant
Action:
Replace
Priority:
None
Repair Notes:
N/A
Comments:
No Transfer station on unit
Item:
ADA Inspection Item 7
Status:
Needs Maintenance
Part:
Deck
Problem:
Non Compliant
Action:
Replace
Priority:
None
Repair Notes:
N/A
Comments:
No Transfer station on unit
Inventory
Inventory
Inspector Signature
X
Manager Signature
X
'ea� V7"
The Inspection Is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the Inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an initial compliance Inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment Is damaged, added,
removed or altered, (b) when the equipment will be used by children In age groups other than those considered in prior Inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The Inspection is not Invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, In connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the Limited warranty, Playground Guardian makes no representations or warranties of any kind or nature, including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or Infringement Further, Playground Guardian makes no representations or
warranties that any of the Items Inspected are designed or constructed In a good or workmanlike manner or will continue to perform In the future as they are performing at
the time of inspection.
This inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This Information Is for intemal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
v
PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
Playground needs updated age appropriate and warning labels.
Non -Defective Items
Item: Border
Equipment Category: Perimeter
Equipment Type: Perimeter
Equipment Item: Plastic Curb
Manufacturer:
AgeGroup:
Status:
Priority:
Item: Safety surface Manufacturer:
Equipment Category: Surface AgeGroup:
Equipment Type: Surface Status:
Equipment Item: Loose Rubber Priority:
City of Sebastian
Playgrounds
Schumann Park
Low Frequency
Complete
Eddie La Roque
6/15/2017
Little Tykes
All
Okay
None
Inventory
Unknown/None
All
Okay
None
Inventory
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Little Tykes
All
N/A
Needs updated age
appropriate and warning
labels
Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Little Tykes
All
N/A
Decks PVC coating is peeling
up
Modular unit
Playground Equipment
Climbing Equipment
Composite structure
Little Tykes
All
N/A
Bolt on handrail loose
Status:
Part:
Problem:
Action:
Priority:
Issue
U,
Needs Maintenance
Entire unit
Non Compliant
Add New Labels
3 - Medium
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Coating
Cracking
Repair
3 - Medium
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Hardware
Loose
Tighten
5 -Low
Inventory
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / 5=Non Compliant
Inspector Signature
X EES2"- Pr�
Manager Signature
X
The Inspection Is Intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the Inspection. We recommend that an Initial compliance inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior Inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection Is not invasive or technically exhaustive, and our inspectors will not attempt to access Inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general Items or materials provided, or any safety suggestions made, by Playground Guardian. The inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, Including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or Infringement. Further, Playground Guardian makes no representations or
warranties that any of the Items inspected are designed or constructed in a good or workmanlike manner or will continue to perform In the future as they are performing at
the time of Inspection.
This Inspection does not address the protective surfacing for compliance as It pertains to Impact attenuating results such as HIC & GMAX.
Important: This information Is for internal use only and Is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
PLAYGROUND -
GUARDIAN _
f�f Fes* f'f.7 f.RAM
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the HIC shall not
exceed 1000 from the drop height stipulated by the owner/operator prior to purchase.
Agency requesting the tests
Playground Site
Manufacturer/Installer of Surface
Name: City of Sebastian
Name: Schumann Park
Name:
Address: 1225 Main Street
Address: 1096 Schumann Drive
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Country
Zip: 32958 Country
Zip: Country
Contact name Margarita Hernandez
Contact name
Contact name
Contact phone 772-228-7054
Contact phone
Contact phone
Description of Test Area - Shumann Park
Date of Test : 6/15/17
Description of Surface: Loose Rubber
Condition: N/A Seams: N/A
Fasteners: N/A
Test Apparatus Triax 2010
Date Installed
Wear: N/A
Condition: N/A
Weather: Cloudy 86 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
physically measured. The drops are performed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
55
5'8" Near slide and tall deck
#1 Loose Rubber 104
457
56
5'9"
112
506
57
519"
106
451
5'9"
109
478.5
Drop #
Drop Drop location in relation to structure
height
Picture
Surfacing Gmax
Inc
58
5'8" Near ladder
#2
Loose Rubber 80
303
59
519"
63
105
443
60
5'9"
112
487
108.5
465
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
61
57' Horizontal climber
#2 Loose Rubber 117
556
62
5'8"
148
789
63
518"
166
922
157
855.5
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
/nom
L/'
Authorized signature.
j:
I
PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
City of Sebastian
Playgrounds
Schumann Park
ADA
Complete
Eddie La Roque
6/15/2017
Loose fill needs to be maintained so that ramp and surfacing have not greater than 1/4 inch drop.
Non -Defective Items
Item: ADA Inspection Item 1
Status: Okay
Priority: None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item:
ADA Inspection Item
12
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
13
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
14
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
15
Status:
Okay
Priority:
None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item:
ADA Inspection Item 17
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 18
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 19
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 2
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 20
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 21
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 4
Status:
Okay
Priority:
None
Item: ADA Inspection Item 6
Status: Okay
Priority: None
Item: ADA Inspection Item 7
Status: Okay
Priority: None
Item: ADA Inspection Item 8
Status: Okay
Priority: None
Inspector Signature
X �-�>V7
Manager Signature
X
The inspection is intended solely to evaluate whether the playground equipment meets current safety standards. This reportaddresses the condition of playground
equipment as of the date and time of the Inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an Initial compliance inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment Is damaged, added,
removed or altered, (b) when the equipment will be used by children In age groups other than those considered in prior inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as dreumsWnces otherwise warrant.
The inspection Is not Invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the limited Warranty (as defined in the attached terms and conditions) under Ibis Contract Playground Guardian has no liability, and assumes
no liability, in connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the limited Warranty, Playground Guardian makes no representations or warranties of any land or nature, Including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the items inspected are designed or constructed in a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of Inspection.
This Inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This information Is for internal use only and Is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
v
PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization
Site:
Type:
Status:
Inspector:
Completed on:
Playground needs updated age appropriate and warning labels.
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
City of Sebastian
Playgrounds
Easy Street Park
Low Frequency
Complete
Eddie La Roque
6/15/2017
Modular unit
Status:
Needs Maintenance
Playground Equipment
Part:
Plastic slide
Climbing Equipment
Problem:
Insufficient area
Composite structure
Action:
Increase surface size
Unknown/None
Priority:
3 - Medium
All
N/A
Needs at least 72 inches
Safety surface
Surface
Surface
Loose Rubber
Unknown/None
All
N/A
Stickers on posts show where
surfacing level should be.
Issue
Inventory
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Coating
Insufficient Surface Depth
Add surface level
3 - Medium
Inventory
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / 5=Non Compliant
Inspector Signature ����
X
Manager Signature
X
The Inspection Is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an initial compliance Inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children In age gmups other than those considered In prior inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The Inspection Is not invasive or technically exhaustive, and our Inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment In connection with the inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the Inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, In connection with any services, general Items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided In the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, Including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the items Inspected are designed or constructed In a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of Inspection.
This inspection does not address the protective surfacing for compliance as It pertains to impact attenuating results such as HIC & GMAX.
Important: This information is for internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
PLAYG`ROUNIt'
GUARDIAN
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the HIC shall not
exceed 1000 from the drop height stipulated by the owner/operator prior to purchase.
Agency requesting the tests
Playground Site
Manufacturer/Installer of Surface
Name: City of Sebastian
Name: Easy Street Park
Name:
Address: 1225 Main Street
Address: 458 Easy Street
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Country
Zip: 32958 Country
Zip: Country
Contact name Margarita Hernandez
Contact name
Contact name
Contact phone 772-228-7054
Contact phone
Contact phone
Description of Test Area - Easy Street Park
Date of Test : 6/15/17
Description of Surface: Rubber Mulch
Condition: N/A Seams: N/A
Fasteners: N/A
Test Apparatus Triax 2010
Date Installed
Wear: N/A
Condition: N/A
Weather : 85 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
phvsically measured. The drops are performed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
Inc
37
5'0" Between climber and slide
# 1 Rubber Mulch 160
745
38
4'9"
153
695
39
4'11"
146
646
149.5
671
Drop #
Drop
height
Drop location in relation to structure Picture Surfacing Gmax HIC
40
4'10"
Between slide and climber #2 Rubber Mulch 150 742
41
511"
149 745
42
5'2"
144 704
45
4'10"
146.5 724.5
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC.
43
4'11" Between rock climber and climber access
#2 Rubber Mulch 119
530
44
510"
119
521
45
4'10"
106
428
112.5
474.5
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocclue
i7
Authorized signature.
Ilk till,
Oil
• PARK
PROTECTOR
General Inspection Comments
Play area passes at time of inspection.
Non -Defective Items
Item: ADA Inspection Item 1
Status: Okay
Priority: None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
City of Sebastian
Playgrounds
Easy Street Park
ADA
Complete
Eddie La Roque
6/15/2017
Item:
ADA Inspection Item
12
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
13
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
14
Status:
Okay
Priority:
None
Item:
ADA Inspection Item
15
Status:
Okay
Priority:
None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item: ADA Inspection Item 17
Status: Okay
Priority: None
Item: ADA Inspection Item 18
Status: Okay
Priority: None
Item: ADA Inspection Item 19
Status: Okay
Priority: None
Item:
ADA Inspection Item 2
Status:
Okay
Priority:
None
Item: ADA Inspection Item 20
Status: Okay
Priority: None
Item:
ADA Inspection Item 21
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 4
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 6
Status:
Okay
Priority:
None
Item: ADA Inspection Item 7
Status: Okay
Priority: None
Item: ADA Inspection Item 8
Status: Okay
Priority: None
Inspector Signature
X �r
Manager Signature
X
The Inspection is Intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an initial compliance inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered In prior Inspections, (c) wheneverthe equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The Inspection Is not invasive or technically exhaustive, and our Inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. latent, concealed and hidden defects and deficiencies are specifically excluded from the Inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, In connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, Including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the items inspected are designed or constructed in a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of inspection.
This inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This information Is for internal use only and Is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
• PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization: City of Sebastian
Both swings need safety surfacing as soon as possible. Park needs updated age appropriate and warning labels.
Non -Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Border
Playgrounds
Site:
Filbert Street Park
Type:
Low Frequency
Status:
Complete
Inspector:
Eddie La Roque
Completed on:
6/15/2017
Both swings need safety surfacing as soon as possible. Park needs updated age appropriate and warning labels.
Non -Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Border
Manufacturer:
Perimeter
AgeGroup:
Perimeter
Status:
PVC
Priority:
Unknown/None
All
Okay
None
Inventory
Y
Item:
Tire swing
Manufacturer:
Unknown/None
Equipment Category:
Playground Equipment
AgeGroup:
All
Equipment Type:
Swings
Status:
Okay
Equipment Item:
Tire Swing
Priority:
None
Inventory
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Belt swing
Playground Equipment
Swings
2 -leg swing
Unknown/None
All
Repair Notes: N/A
Comments: S hooks need to be closed to
within .04 of an inch or
replaced with proper clevis
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Belt swing
Playground Equipment
Swings
2 -leg swing
Unknown/None
All
N/A
N/A
Modular Unit
Playground Equipment
Climbing Equipment
Composite structure
Burke
All
Repair Notes: N/A
Comments: Rust needs to removed then
recoated before metal
degrading is a problem.
Status:
Needs Maintenance
Part:
S hook
Problem:
Non Compliant
Action:
Replace
Priority:
3 - Medium
Issue Inventory
p l.F
l '4 J •
Status:
Needs Maintenance
Part:
Entire unit
Problem:
Rusted
Action:
Remove rust
Priority:
4
Issue Inventory
1 .0007
pap
Status:
Needs Maintenance
Part:
Entire unit
Problem:
Rusted
Action:
Repair
Priority:
4
Issue Inventory
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Modular Unit
Playground Equipment
Climbing Equipment
Composite structure
Burke
All
Repair Notes: N/A
Comments: Gap on bracket is a possible
entanglement. Suggest fixing
immediately.
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Status:
Part:
Problem:
Action:
Priority:
Safety surface
Surface
Surface
Sand
Unknown/None
All
Needs Maintenance
Not applicable
N/A (See Comments)
Replace
2
Repair Notes: N/A
Comments: Sand is not recommended for
any fall height over 4 feet.
Status:
Needs Maintenance
Part:
Plastic slide
Problem:
Entanglement
Action:
Repair
Priority:
1 - High
Issue Inventory
Inventory
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / S=Non Compliant
Inspector Signature
X Wig-. Wi_--
Manager Signature
X
The inspection is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an initial compliance Inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The Inspection Is not Invasive or technically exhaustive, and our Inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined In the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liabllity, In connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, Including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the Items inspected are designed or constructed In a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of inspection.
This inspection does not address the protective surfacing for compliance as It pertains to impact attenuating results such as HIC & GMAX.
Important: This information is for internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
A PLAYGROUND"
Ic'I GUARDIAN'I.
nn. o• uo ,....ar+c.r mo,a�n
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the HIC shall not
exceed 1000 from the drop height stipulated by the owner/operator prior to purchase.
Agency requesting the tests
PlaygroundSite
Manu aeturer/lnstaiter of Surface
Name: City of Sebastian
Name: Filbert Street Park
Name:
Address: 1225 Main Street
Address: 170 Filbert Street
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Country
Zip: 32958 Country
Zip: Country
Contact name Mar arta Hernandez
Contact name
Contact name
Contact phone 772-228-7054
Contact phone
Contact phone
Description of Test Area - Filbert Street Park
Date of Test : 6/14/17 Test Apparatus Triax 2010
Description of Surface: Sand Date Installed
Condition: N/A Seams: N/A Wear: N/A
Fasteners: N/A Condition: N/A
Weather: Overcast 85 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
physically measured. The drops are performed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
67
7'2" Between disc climber and slide
#1 Sand 114
395
68
6'9"
154
693
69
7'1"
120
473
6'11"
137
583
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing
Gmax
HIC
70
7'4" New triple slide
#2 Sand
78
193
71
7'1"
75
104
335
72
6'11"
99
328
101.5
331.5
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
HIC
73
4'2" Disc climber
#2 Sand 78
272
74
6'11"
89
248
75
TV
56
116
72.5
182
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
Authorized signature. `
Pic 3
.e;
r�M11% Inspection Overview
PARK9P Organization: City of Sebastian
PROTECTOR Playgrounds
Site: Filbert Street Park
Type: A D A
Status: Complete
Inspector: Eddie La Roque
Completed on: 6/15/2017
General Inspection Comments
No Accessible route to play areas. Sand is not considered an accessible surfacing.
Non -Defective Items
Item: ADA Inspection Item 1
Status: Okay
Priority: None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item: ADA Inspection Item 12
Status: Okay
Priority: None
Item: ADA Inspection Item 13
Status: Okay
Priority: None
Item: ADA Inspection Item 14
Status: Okay
Priority: None
Item: ADA Inspection Item 15
Status: Okay
Priority: None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item: ADA Inspection Item 17
Status: Okay
Priority: None
Item: ADA Inspection Item 18
Status: Okay
Priority: None
Item: ADA Inspection Item 19
Status: Okay
Priority: None
Item: ADA Inspection Item 2
Status: Okay
Priority: None
Item:
ADA Inspection Item 20
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 21
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 4
Status:
Okay
Priority:
None
Item: ADA Inspection Item 6
Status: Okay
Priority: None
Item: ADA Inspection Item 7
Status: Okay
Priority: None
Item: ADA Inspection Item 8
Status: Okay
Priority: None
Inspector Signature
X
Manager Signature
X
The Inspection is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the Inspection. We recommend that an initial compliance inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment Is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior inspections, (c) whenever the equipment Is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection Is not Invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. Latent, concealed and hidden defects and deficiencies are spedfically excluded from the Inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, In connection with any services, general Items or materials provided, or any safety suggestions made, by Playground Guardian. The inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the Limited Warranty, Playground Guardian makes no representations or warrentles of any kind or nature, Including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the Items inspected are designed or constructed in a good or workmanlike manner or will continue to perform In the future as they are performing at
the time of Inspection.
This Inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This information Is for internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
This was a safety inspection on spray park using playground inspection.
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
City of Sebastian
Playgrounds
Splash Pad
Low Frequency
Complete
Eddie La Roque
6/15/2017
Spray Park
Status:
Needs Maintenance
Site
Part:
Not applicable
Site
Problem:
Broken
Other
Action:
N/A (See Comments)
Unknown/None
Priority:
5 - Low
All
Repair Notes: N/A
Comments: Green spray unit was not
working at time of inspection.
Issue
Inventory
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / 5=Non Compliant
Inspector Signature
X meg. V7 _
Manager Signature
X
The inspection is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the inspection only and does not address any changes In, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the Inspection. We recommend that an initial compliance Inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an inspection be conducted (a) whenever equipment Is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior Inspections, (c) whenever the equipment Is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The inspection Is not Invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. Latent, concealed and hidden defects and defidencles are spedfically excluded from the Inspection. Abnormal cr unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the limited Warranty (as defined In the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general Items or materials provided, or any safety suggestions made, by Playground Guardian. The inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided In the Umited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or Infringement Further, Playground Guardian makes no representations or
warranties that any of the Items inspected are designed or constructed In a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of Inspection.
This inspection does not address the protective surfacing for compliance as it pertains to Impact attenuating results such as HIC & GMAX.
Important: This Information Is for internal use only and is not to be released or othemise disseminated to anyone other than an agency official, or designated representative.
PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
City of Sebastian
Playgrounds
Splash Pad
ADA
Complete
Eddie La Roque
6/15/2017
ADA access to splash pad passes. The accessible path was the only thing checked.
Non -Defective Items
Item: ADA Inspection Item 1
Status: Okay
Priority: None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item: ADA Inspection Item 12
Status: Okay
Priority: None
Item: ADA Inspection Item 13
Status: Okay
Priority: None
Item: ADA Inspection Item 14
Status: Okay
Priority: None
Item: ADA Inspection Item 15
Status: Okay
Priority: None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item: ADA Inspection Item 17
Status: Okay
Priority: None
Item: ADA Inspection Item 18
Status: Okay
Priority: None
Item: ADA Inspection Item 19
Status: Okay
Priority: None
Item: ADA Inspection Item 2
Status: Okay
Priority: None
Item:
ADA Inspection Item 20
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 21
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 4
Status:
Okay
Priority:
None
Item: ADA Inspection Item 6
Status: Okay
Priority: None
Item: ADA Inspection Item 7
Status: Okay
Priority: None
Item: ADA Inspection Item 8
Status: Okay
Priority: None
Inspector Signature Q j_
X
Manager Signature
X
The inspection is Intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the Inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an initial compliance inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior Inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The Inspection Is not invasive or technically exhaustive, and our inspectors will not attempt to access Inaccessible areas or open or unlock any secured playground
equipment in connection with the Inspection. Latent, concealed and hidden defects and deficiencies are specifically excluded from the Inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations,
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided In the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or Infringement. Further, Playground Guardian makes no representations or
wamantles that any of the items inspected are designed or constructed in a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of inspection.
This Inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This information is for internal use only and is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
• PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
Playground needs updated age appropriate and warning labels.
Non -Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Safety Surface
Surface
Loose fill
EWF
Manufacturer:
AgeGroup:
Status:
Priority:
City of Sebastian
Playgrounds
Friendship Park
Low Frequency
Complete
Eddie La Roque
6/14/2017
Unknown/None
All
Okay
None
Inventory
Defective Items
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Modular Unit
Playground Equipment
Climbing Equipment
Composite structure
Playworld
5 - 12
N/A
Slide connection is broken
Modular Unit
Playground Equipment
Climbing Equipment
Composite structure
Playworld
5 - 12
Repair Notes: N/A
Comments: Deck coating has been worn
off and is exposing metal to
rusting.
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Modular Unit
Playground Equipment
Climbing Equipment
Composite structure
Playworld
5 - 12
N/A
N/A
Status:
Part:
Problem:
Action:
Priority:
Issue
Needs Maintenance
Plastic slide
Broken
Replace
2
Status:
Needs Maintenance
Part:
Deck
Problem:
Rusted
Action:
Repair
Priority:
3 - Medium
Issue Inventory
Status:
Needs Maintenance
Part:
Crawl tube
Problem:
Dirty
Action:
Clean
Priority:
5 - Low
Issue Inventory
Item:
Equipment Category:
Equipment Type:
Equipment Item:
Manufacturer:
AgeGroup:
Repair Notes:
Comments:
Modular Unit
Playground Equipment
Climbing Equipment
Composite structure
Playworld
5 - 12
N/A
Missing bolt on slide hood.
Status:
Needs Maintenance
Part:
Hardware
Problem:
Missing
Action:
Replace
Priority:
4
Issue Inventory
Priority Key:
1=Permanent Disability, loss of life or limb in a high risk area / 2=Permanent Disability, loss of life or limb in a low
risk arera / 3=Serious injury resulting in temporary disability / 4=Minor Injury / S=Non Compliant
Inspector Signature—
X
Manager Signature
X
The Inspection is Intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the Inspection only and does not address any changes in, damage, additions or alterations to, or removal of any of the equipment after
the date and time of the inspection. We recommend that an Initial compliance inspection be conducted by a knowledgeable, trained playground equipment Inspector followed
up by a low frequency Inspection at least once per year. Playground Guardian also suggests an Inspection be conducted (a) whenever equipment is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior Inspections, (c) whenever the equipment Is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The Inspection is not invasive or technically exhausbve, and our inspectors will not attempt to access Inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect to the playground equipment.
Except as expressly provided in the Limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, including without limitation any
representations or warranties as to merchantability, fitness for any particular purpose or infnngement. Further, Playground Guardian makes no representations or
warranties that any of the items inspected are designed or constructed In a good or workmanlike manner or will continue to perform in the future as they are performing at
the time of Inspection.
This inspection does not address the protective surfacing for compliance as it pertains to Impact attenuating results such as HIC & GMAX.
Important: This information is for Internal use only and Is not to be released or otherwise disseminated to anyone other than an agency official, or designated representative.
PLAYCC'ROU N!Q'
GUARDIAN
There shall be one report for each play structure or functionally linked play structures and for each type of surface material. Each test
shall comprise of a minimum of 3 impact locations per play space or type of surfacing material with three drops from the same height
to the same point. The report shall be descriptive enough to assist the user of the report in determining compliance with contracts and
Standards. The CSA Z614-03 and the ASTM F1292 set minimum values as the Gmax shall not exceed 200 and the RIC shall not
exceed 1000 from the drop height stipulated by the owner/o erator prior to purchase.
Agency requesting the tests
Playground Site
Manufacturer/Installer of Surface
Name: City of Sebastian
Name: Friendship Park
Name:
Address: 1225 Main Street
Address: 1440 Friendship Lane
Address:
City: Sebastian State: FL
City: Sebastian State: FL
City: State:
Zip: 32958 Country
Zip: 32958 Country
Zip: Country
Contact name Margarita Hernandez
Contact name
Contact name
Contac[ phone 772-228-7054
Contact phone
Contact phone
Description of Test Area - Friendship Park
Date of Test: 6/14/17
Description of Surface: Rubber Fiber
Condition: N/A Seams: N/A
Fasteners: N/A
Test Apparatus Triax 2010
Date Installed
Wear: N/A
Condition: N/A
Weather: Overcast 87 degrees
Critical Height
The drop height each test location shall be the greater of the critical height for the surface material, the fall height for the play structure
as stated in the relevant playground Standard or the height specified by the owner/operator prior to purchase. The drop height is
physically measured. The drops are performed from the same drop height to the same point on the surface.
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
MC
49
4'8" Near slide
#1 84
289
50
4'3"
78
246
51
4'6"
74
221
76
233.5
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmax
MC
52
4'7" Near climber
#2 108
419
53
4'9"
115
460
54
4'8"
126
517
120,5
488.5
Drop #
Drop Drop location in relation to structure
height
Picture Surfacing Gmsx
HIC
55
4'6" Between tube slide and climber
#2 75
235
56
4'8"
88
302
57
47"
92
332
90
31
The results herein reflect the performance of the tested playground surface at the time of testing and at the temperature(s) and ambient
conditions reported. Performance will vary with temperature, moisture content and other factors.
Test performed by Ed LaRocque
Authorized signature.
"O.
0" goo
= r,,
PARK
PROTECTOR
General Inspection Comments
Inspection Overview
Organization:
Site:
Type:
Status:
Inspector:
Completed on:
City of Sebastian
Playgrounds
Friendship Park
ADA
Complete
Eddie La Roque
6/14/2017
Playground passes this ADA audit. EWF needs to be maintained to be compliant so that entrance has less than a
1/4" drop into surfacing.
Non -Defective Items
Item: ADA Inspection Item 1
Status: Okay
Priority: None
Item: ADA Inspection Item 11
Status: Okay
Priority: None
Item: ADA Inspection Item 12
Status: Okay
Priority: None
Item:
Status:
Priority:
ADA Inspection Item 13
Okay
None
Item: ADA Inspection Item 14
Status: Okay
Priority: None
Item: ADA Inspection Item 15
Status: Okay
Priority: None
Item: ADA Inspection Item 16
Status: Okay
Priority: None
Item: ADA Inspection Item 17
Status: Okay
Priority: None
Item:
ADA Inspection Item 18
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 19
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 2
Status:
Okay
Priority:
None
Item:
ADA Inspection Item 20
Status:
Okay
Priority:
None
Item: ADA Inspection Item 21
Status: Okay
Priority: None
Item: ADA Inspection Item 4
Status: Okay
Priority: None
Item: ADA Inspection Item 6
Status: Okay
Priority: None
Item:
ADA Inspection Item 7
Status:
Okay
Priority:
None
Item: ADA Inspection Item 8
Status: Okay
Priority: None
Inspector Signature �)�
X ��G �
Manager Signature
X
The Inspection is intended solely to evaluate whether the playground equipment meets current safety standards. This report addresses the condition of playground
equipment as of the date and time of the Inspection only and does not address any changes in, damage, additions or alterationsto, or removal of any of the equipment after
the date and time of the inspection. We recommend that an initial compliance Inspection be conducted by a knowledgeable, trained playground equipment inspector followed
up by a low frequency inspection at least once per year. Playground Guardian also suggests an inspection be conducted (a) whenever equipment Is damaged, added,
removed or altered, (b) when the equipment will be used by children in age groups other than those considered in prior inspections, (c) whenever the equipment is subject to
damage, abuse or unusual wear and tear, and (d) as circumstances otherwise warrant.
The Inspection is not Invasive or technically exhaustive, and our inspectors will not attempt to access inaccessible areas or open or unlock any secured playground
equipment in connection with the inspection. latent, concealed and hidden defects and deficiencies are specifically excluded from the inspection. Abnormal or unusual
circumstances may warrant or require further or additional safety procedures and considerations.
Playground Guardian provides the Limited Warranty (as defined in the attached terms and conditions) under this Contract. Playground Guardian has no liability, and assumes
no liability, in connection with any services, general items or materials provided, or any safety suggestions made, by Playground Guardian. The Inspection may not disclose
or report every possible safety procedure that could be recommended or made with respect W the playground equipment.
Except as expressly provided in the limited Warranty, Playground Guardian makes no representations or warranties of any kind or nature, including without llmitatlon any
representations or warranties as to merchantability, fitness for any particular purpose or infringement. Further, Playground Guardian makes no representations or
warranties that any of the Items Inspected are designed or constructed in a good or workmanlike manner or will continue to perforin in the future as they are performing at
the time of Inspection.
This inspection does not address the protective surfacing for compliance as it pertains to impact attenuating results such as HIC & GMAX.
Important: This Information Is for internal use only and Is not to be released or otherwise disseminated to anyone other than an agency officlai, or designated representative