Certificate III in Carpentry blockchain is an exploration of its suitability Impact of Information Technology on business operat…

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Student Assessment Agreement
Make sure you read through the assessments in this booklet before you fill out and sign the agreement below.
If there is anything that you are unsure of, consult your assessor prior to signing this agreement.
Have you read the assessment requirements for this unit?  Yes  No
Do you understand the requirements of the assessments for this unit?  Yes  No
Do you agree to the way in which you are being assessed?  Yes  No
Do you have any specific needs that should be considered?  Yes  No
If so, explain these in the space below.
Do you understand your rights to re-assessment?  Yes  No
Do you understand your right to appeal the decisions made in an assessment?  Yes  No
Student name
Falgunkumar patel
Student number
Student signature


Qualification Code and Title
CPC30211: Certificate III in Carpentry
Unit Code and Title
CPCCCA2003A – Erect and dismantle formwork for footings and slabs on ground
Assessor name

Assessor signature


Assessment Task Cover Sheet
Student Declaration
To be filled out and submitted with assessment responses
 I declare that this task is all my own work and I have not cheated or plagiarised the work or colluded with any other student(s).
 I understand that if I If I am found to have plagiarised, cheated or colluded, action will be taken against me according to the process explained to me.
 I have correctly referenced all resources and reference texts throughout these assessment tasks.
Student name
Falgunkumar patel
Student ID number
Student signature


Assessor declaration
 I hereby certify that this student has been assessed by me and that the assessment has been carried out according to the required assessment procedures.
Assessor name

Assessor signature


Assessment outcome
Resubmission Y N
Student result response
 My performance in this assessment task has been discussed and explained to me.
 I would like to appeal this assessment decision.
Student signature


A copy of this page must be supplied to the office and kept in the student’s file with the evidence
Document Title: Student final assessment submission evidence
Document Subtitle: CPCCCA2003A – Erect and dismantle formwork for footings and slabs on ground
Disclaimer: This work is under copyright and permission is not given to make copies for hire or resale to third parties to use the document for their own or commercial use.
Universal Training Solutions does not give warranty or accept any legal liability in relation to the content of this work.Licenced to: RTO Name: Trinity Institute (Australia) RTO NO: 41310 CRICOS NO: 03556F RTO Address: Level 7 16-18 Wentworth St Parramatta NSW 2150
Copyright: Universal Training Solutions Developed by: Universal Training Solutions and validated by Trinity Institute (Australia)Acknowledgement: Thanks to Universal Training Solutions and Trinity Institute (Australia) staff for their consultation and development work.Version: Trinity Institute (Australia) V1
STUDENT DETAILS Please complete this declaration with the student
Unit of competency:
Unit Code

Unit Title

Trainer/Assessor Name:

Student Name:

Student ID:

Time Allocation
Refer to Training Plan
Due date:
Refer to you student program guide (training plan). Please insert the due date as confirmed by your assessor below:
Due Date: ……………/……………. /…………….
Declarations Task
Task 1 Knowledge Questionnaire
I confirm that I have read and understood the instructions, my responsibilities and requirements for this assessment

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Task 2 project
I confirm that I have read and understood the instructions, my responsibilities and requirements for this assessment

Task 3 Simulated Practical and/or workplace observation
I confirm that I have read and understood the instructions, my responsibilities and requirements for this assessment

Assessor declaration
The assessor is to complete this declaration with the student.
I have acknowledged the underpinning knowledge and skills may be assessed on or off the job.
I confirm that I am a qualified workplace assessor and will be conducting the assessment for this unit and student
Have all aspects of the student agreement been explained and understood?
Does the student understand they have three attempts to complete each task satisfactorily? If after the third attempt the student is deemed ‘Not Yet Competent’, they will be required to do further training before reattempting this unit.
I have explained the requirements for reasonable adjustment as a result of workplace constraints
I confirm that I have explained and confirmed all of the above items with the student.
Assessor Signature

Student declaration
Agreement by the student: Please sign below to demonstrate that you understand what is required of you in relation to this assessment.
Do you have any special needs or considerations to be made for this assessment? If yes, what are they?
Do you understand your rights to appeal the decisions made in an assessment?
I understand I have three attempts to complete each task satisfactorily. If after the third attempt I am deemed ‘Not Yet Competent’, I will be required to do further training before reattempting this unit
Reasonable adjustment: If you require any adjustments to accommodate a need in order to complete this assessment, please talk to your assessor. Arrangements will be put in place to ensure a fair and flexible approach is undertaken for this assessment. Please note that the range or nature of the adjustment will ensure that the outcomes of the unit are not compromised.
I agree to comply with all rules, regulations, policies and procedures provided as part of the simulated environment.
I give permission for the RTO to use my assignment at the workplace for assessment moderation / validation purposes.
I confirm that I have read and understood my responsibilities and requirements for assessment.
Student Signature

Submission evidence
What is the name of the Australian Standard relevant to formwork construction?

Refer to the SDS and TDA for Fosroc Form Release Agent, to complete questions 2, 3, 4, 5, 7 and 11.
SDS: http://www.parchem.com.au/public/pdfs/data-sheets/Form-Release-Agent-SDS.pdf TDS: www.parchem.com.au/public/pdfs/data-sheets/Form-Release-Agent-TDS.pdfHow is the product applied?


get medical attention immediately. If this chemical contacts the skin, wash the contaminated skin with soap and water. If this chemical contacts the skin, immediately wash the contaminated skin with soap and water. … If this chemical penetrates the clothing, immediately remove the clothing and flush the skin with water.
How should large spills be cleaned?

Cleaning large spills A scraper and pan should be used to remove the absorbed material. The area of the spill should then be cleaned with a mop, and bucket of warm water and detergent. The bucket and mop should be thoroughly cleaned after use and stored dry.

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List 5 hazards associated with the erection, alteration and/or dismantling of formwork on ground.

List the PPE to be worn when handling the product

A residential site has been cleared and construction works are about to commence. What safety signage should be placed at the entrance to the site? Provide an example of each of the different categories of safety signage.

Category of safety signage
Mandatory signs

Prohibition signs

Warning signs

Danger signs

What are the pre-operational checks you should conduct prior to using a circular saw? Outline 6.

You are setting up the formwork for a 3 m x 2 m driveway. You are using 100 mm x 50 mm timbers for the formwork side rails and are driving wooden stakes at no more than 1.2 m apart. You will place extra stakes at every joint in the rails and at corners. The timber comes in 3.6 m lengths.Calculate how many lengths of timber and how many wooden stakes you will need.

What is the application rate for a porous form surface?

You are directing a crane operator to unload formwork components and timber stacks. How would you tell the crane operator to hoist the load? Draw the signal you would use.

Provide 5 examples of release agents.

List 7 termite resistant materials.

Formwork components and forms are usually designed for re-use, either on the same project or on others. How can you contribute to the economic operation of the job? Give 4 examples.

List 8 materials/products in building and construction which have the potential to pollute stormwater systems.

What details should be included in formwork drawings? List 5.

What is formwork? Explain its purpose.

What materials are used in formwork construction? Give 7 examples.

Briefly describe the process to erect, strip, clean and stack simple formwork for a small garden shed concrete slab.



Clean and stack

Place the following steps in the correct order to build formwork for a slab.

Drive pegs into ground

Install braces

Mark height on pegs

Nail form boards to pegs

Trim pegs to height
What is block-outs?

Why are release agents applied to the surface of formwork? Provide 4 reasons.

What is the order of for removing formwork? List 3 steps in the correct order.

Outline 4 important factors to consider when storing forms, to ensure they can be reused on another project.

What are the specific care requirements for steel formwork components?

Detail 5 tasks that must be completed before leaving the site at the end of the day.

Provide 3 control measures to minimise the generation of contaminated stormwater.

Confirming the scope of works to be carried out is an essential requirement before commencing any project. Where could you find relevant instructions and information regarding work information? List 10 sources.

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To be completed by the assessor
Learner details
Assessor details


Unit Code
Unit Title
Erect and dismantle formwork for footings and slabs on ground
Record of assessment results (please tick appropriate box). ASSESSORS NOTE: Before making a final judgement on this assessment task, you must determine if the student is able to satisfactorily apply and perform the following criteria. Review the performance criteria by clicking on the link https://training.gov.au/Training/Details/CPCCCA2003A. Marking should be in line with the model answers required as the performance criteria (PCs) is underpinned by this assessment task. All questions must be deemed satisfactory to achieve a satisfactory outcome for this task. If a NS is provided for any section or questions relating to this task, then the task outcome should be treated as NS and the reassessment process should be applied. If a NS (not satisfactory) outcome is applied then you must inform the student in detail as to “why” this outcome was provided. Record your reasons in the section labelled “Not satisfactory (NS) outcomes”. See below for recording appropriate information
Assessment activity – The learner has completed all the assessments requirements for this unit of competency and has been deemed
Date of outcome
Task 1– Knowledge Questionnaire
☐Satisfactory ☐ Not satisfactory

Attempts –
Attempt 1
Attempt 2
Attempt 3
Not satisfactory (NS) Outcomes
Question number
Record in detail the reason for the NS outcome applied

Appeals – refer to the complaints and appeals policy and procedure
If you receive a Not Satisfactory assessment result you have the right to appeal. You have three assessment attempts. After the third attempt arrangements for payment will be made for reassessment purposes. Refer to your student hand book for more details on the complaints and appeals process.
Assessor Feedback to learner: The assessor must write full feedback to the learner that is constructive and not generic

Reasonable Adjustment (if applicable) explain why reasonable adjustment has been applied and the tasks it was applied to

Assessor Intervention (if applicable) – did you need to assist the student in this assessment. If so please explain:

Assessor Name

Assessor Signature


Student declaration – I hereby certify that this assessment is my own work, based on my personal study and/or research. I have acknowledged all material and resources used in the presentation of this assessment whether they are books, articles, reports, internet searched or any other document or personal communication. I also certify that the assessment has not previously been submitted for assessment in any other subject or any other time in the same subject and that I have not copied in part or whole or otherwise plagiarised the work of other learning and/or other persons. I confirm that I understand that I must complete this assessment on my own. I confirm that I will not cheat or plagiarise or copy from another student during the completion of this assessment.
Student name

Student signature


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