CYCLONE INSPECTION FORM

Building Name: ________________________________ ​P.O. Box 998369 Pago Pago, AS 96799 ​Inspectors
Name: _​ ___________________________________ ​684-254-6404 pioaconsulting@gmail.com
PIOA Consulting & Engineering Cyclone Inspection Report
TJ FITNESS
DENNIS GALLARDO
SECTION 1
1-1 BUILDING OWNER: ____________________________
TAUILAGI ASUEGA
1-2 MORTGAGEE: ______________________
TJ FITNESS
1-3 PROPERTY LOCATION: Village of ______________________
TAFUNA
1-4 BRIEF DESCRIPTION OF BUILDING STRUCTURE: ________________________________
SECTION 2
2-1 CLASSIFICATION FOR RESISTANCE TO CYCLONE DAMAGE
(a) Purpose of Inspection: To note any deficiencies and recommend remedial action (if necessary), to
make good, deficiencies within a reasonable time in an effort to minimize potential, future cyclone
damage.
(b) Classifications for cyclone resistance are scheduled for the building components in their present state
and for the same components after completion. Recommended action based on the following scale which
indicates along the top of the scale the range of basic wind speeds in miles per hour.
Less than average (55-73mph) Category 1 (74-95mph) Category 2 (96-110mph) Category 3 (111-129) 3 –
4 5 – 6 7 – 8 9 - 10 BAD FAIR GOOD VERY GOOD
2.1.1 ​EXTERIOR ROOF SURFACE ​(Take 2 Photos labelled ERS1 & ERS2)
Observe and note the condition of the following roof elements
Indicate general condition Good A ​ dequate ​Poor
( i ) Roof cladding ​Good ​Adequate Poor
(i.e. rusting , holes, openings , debris)
( ii ) Roof fixings and fasteners Good A ​ dequate ​Poor
(​i.e. correct types , spacing of screws, none loose , missing)
( iii) Gutters and Down-pipes Good Adequate Poor
( iv) Flashing and Ridge Capping Good Adequate Poor
(​i.e. adequately fixed and sealed)
( v ) Roof Ventilators Good Adequate Poor
(​i.e. clear of debris, adequately secured)
(vi ) Exposed Timber Work Good A ​ dequate ​Poor
(​i.e. split or rotten boards or eaves)
2.1.2 ​ROOF STRUCTURE ​(Take 2 Photos labelled RS1 &
RS2)
Inspect and note condition of the following roof structural members (​i.e. damp rot, inspect for
infestation, cracking etc and whether fixed to supporting structural members (not visible))

​ oor
(i) Purlins and Battens Good ​Adequate P

(ii) Rafters Good ​Adequate ​Poor

 (iii) Trusses Good ​Adequate ​Poor

(iv) Fixing Methods Good ​Adequate ​Poor

(​i.e. correct types, location of
fasteners)

(v) Fixing methods trusses/rafter to Good ​Adequate ​Poor

top
plate.

(vi) Observe and note condition of the Good ​Adequate ​Poor

Underside of roof cladding i.e.
rusting, denting from debris etc...

2.1.3 ​CONCRETE BLOCK WALLS ​(Take 2 Photos labelled CBW1 &

CBW2)
Inspect and note general condition of concrete block
walls

( i.) Are there any settlement or movement cracks through Yes ​No
brick or mortar
joints?

(ii) Has water penetrated into any cracks and rusted re-enforcing Yes ​No
steel ​(i.e. rust
stains)

(iii) Is there any cracking or separation between any Yes ​No

‘inset-cast’ concrete columns and brick/block
walls

2.1.4 ​INSPECT WALL TOP PLATE OR BOND BEAM: ​(Take 2 Photos labelled BB1 & BB2)

(i) Is timber top plate and or bond beam in satisfactory Yes No

condition? ​(i.e. no cracking rust in steel or
rot in
timber?
)

(ii) Are all ‘tie-down’ bolts/cast-in rods correct type Yes No

and
spacing?

(iii) Are ‘ tie-down’ bolts/cast-in rods rust free and

securely fastened? Yes No
2.1.5. ​TIMBER FRAME WALL ​(Take 2 Photos labelled TFW1 &
TFW2)
During ceiling inspection of roof structure check and note condition of top plate ​(i.e. wood
rot, insect infestation, splitting etc......)

(i) Are the correct type and spacing of ‘tie-downs’ Good Adequate Poor
bolts/rods passing through the top plate
provided?

(ii) Are ‘tie-down’ bolts/rods securely tightened and Good Adequate Poor
corrosion
free?

PIOA Consulting & Engineering Cyclone Inspection Report ​2

If building elevated on stumps or posts, inspect and note conditions of bottom plate
connection to floor substructure?

(i.) Are the tie down rods securely fixed to floor Good Adequate Poor
substructure and securely
tightened?

(ii.) Is there adequate cross bracing between stumps Good Adequate Poor
or
posts?

2.1.6. ​TIMBER FRAME WALL ON CONCRETE SLAB ​(Take 2 Photos labelled TFWC1 & TFWC2)

(i.) Are the ‘tie down’ rods securely fixed to

bottom plate and at correct spacing? Good Adequate Poor

(ii) Are stud framing securely fixed to bottom

plate with cyclone ties? Good Adequate Poor

2.1.7. ​WALL CLADDING ​(Take 2 Photos labelled WC1 & WC2)

Inspect and note condition of cladding (i.e. rotten chamber boards, debris damage, moisture
penetration at joints etc.) Inspect fixing and fastening method of securing cladding to timber wall
framework:

(a) Are fixing the correct type number and spacing? Good Adequate Poor

(b) Is cladding securely fixed to timber framework? Good Adequate Poor

 (i.e. no loose or rusty screws or
nails)

2.1.8 ​WINDOWS FRAMES, EXTERNAL DOORS and DOOR FRAMES​. ​(Take photos labelled W
for
window, WF for window frames, D for doors and DF for door frames.) ​Inspect windows and
window frames and note general conditions:

(a.) Are there any broken louvers or window panes? Yes No

(b) Are frames secure and fixed firmly into wall openings Yes No
and no missing fixing
screws?

(c) Are door frames secure and firmly secured into wall openings? Yes No
Did not open doors, no one home on
residential side

(d) Are door stops and door hinges adequate to secure door Yes No
and frame against cyclonic winds? ​(i.e. ensure
screws are in all hinge holes)

(e) Are glazing (glass) thickness can withstand minimum wind Yes No
speed of 100
mph?

2.1.9 ​PROTECTION OF EXTERNAL GLASS DOORS WINDOWS FIXED GLASS ​(Take photos labelled
glass door GD1, glass window GW1,
etc...)

CYCLONE
SHUTTERS;

(a) Are there any cyclone shutters? Yes No

(b) Are the shutters in good state of repair? Yes No

PIOA Consulting & Engineering Cyclone Inspection Report ​3

(c) Do shutters open easily and close securely? Yes No

(d) Are shutter hinges (or tracks if sliding) Yes No

securely fixed to
wall?

(e) If shutters are not permanently attached to exterior walls: Yes No

 Are they adequately
stored?

2.1.10 ​THE SITE ​(Take photos labelled S1, S2,

etc...)
Observe and note surroundings terrain and classify terrain category including possible future
developments which may alter terrain category.

TERRAIN CATEGORY (​check ONLY

one)​ :

Terrain Category 1

Terrain Category 2

Terrain Category 3
wns)
TERRAIN CATEGORY 3
TERRAIN CATEGORY 1 TERRAIN CATEGORY 3

Exposed open terrain with Terrains of closely

no or few scattered spaced obstructions
obstructions and in which having the size of
surrounding objects are domestic houses (well
less than 5 feet high (flat wooded areas, suburbs,
treeless plains, open sea and towns)
coast) Terrains of closely
CATEGORY 2 spaced obstructions
having the size of
ain with well domestic houses (well
objects having wooded areas, suburbs,
enerally 5-30 feet and towns)
kland, sparsely

2.1.11 ​Observe structural condition ​of neighbouring

buildings
and surrounding area ​(i.e. None close enough to cause damage) ​Yes No

2.1.12 ​Observe condition and proximity of nearby

trees​.
Could trees fall, or lose limbs during a cyclone? Yes No ​(i.e. dead trees, brittle
branches etc.)
2.1.13 ​Observe condition of surrounding area. ​Is there any
loose
material or rubbish littered about? ​(i.e. behind parking on northeast side (minor))
Yes No

PIOA Consulting & Engineering Cyclone Inspection Report ​4

2.2 UPGRADING WORKS REQUIRED:

1. FOR REPAIR:THERE ARE HOLES IN THE ROOF CLADDING AS EVIDENCE BY WATER

LEAK MARK ON THE CEILING (SEE FIGURE 1 BELLOW) 2. REPLACE BROKEN WINDOW
GLASS NEAR THE GYM ENTRANCE DOOR 3. INSTALL GUTTER AND DOWN PIPES. 4.
REPLACE WALL CLADDING WITH DENT. 5. DOORS & WINDOWS NO CYCLONE
SHUTTERS.

2.3 GENERAL
NOTES:

THIS IS A 2 STORY BUILDING WITH EXTENSION,MADE OF CONCRETE WALL AND

TIMBER WALL.UPON INSPECTION, THE BUILDING WAS OBSERVED TO HAVE
PIOA Consulting & Engineering Cyclone Inspection Report ​5
2.4 CERTIFICATION:
We certify that we have inspected the premises described above and have made the recommendation
detailed herein for upgrading this premises. The report however recognizes that only representative
sampling of the structural components which are embedded, or otherwise out of view. In such cases the
structural components which cannot be seen are deemed to be either similar to those within view or in the
case of embedded items, of sufficient strength to resist the design loading.
TJ FITNESS ​Building Name: __________________________
Date of inspection: __________________________
DEC. 6, 2019
Date report signed: __________________________
Signed: __________________________
Inspectors Name: __________________________
DENNIS GALLARDO
Engineering Firm: PIOA Consulting & Engineering
PIOA Consulting & Engineering Cyclone Inspection Report ​6
INSPECTION PHOTOS ​(Edit and create more photo pages
as needed with proper labelling)
PIOA Consulting & Engineering Cyclone Inspection Report ​7
INSPECTION PHOTOS ​(Edit and create more photo pages
as needed with proper labelling)
PIOA Consulting & Engineering Cyclone Inspection Report ​8
INSPECTION PHOTOS ​(Edit and create more photo pages
as needed with proper labelling)
PIOA Consulting & Engineering Cyclone Inspection Report ​9
INSPECTION PHOTOS ​(Edit and create more photo pages
as needed with proper labelling)
PIOA Consulting & Engineering Cyclone Inspection Report ​10