HomeMy WebLinkAboutFAI15-0009 Alarm Test 2020
paradise schools/Cedarwood FA 05.07.20.pdf
ALARM AND DETECTION REPORT Page ____ of _____ Type of Inspection: Date: Property Name: Site: Street: Contact: City/State: Phone #: Fax #: 1. Before Test Notify Proper Authorities:
Phone # A. Owner or Owner's Rep B. Fire Department C. Central Station D. Central Station Acct # 2. Control Panel Status Yes No Note # A. Is the system monitored
by Central Station? B. Is the Power Light on? C. Does the Panel indicate Normal conditions? D. Are all indicating Lamp Bulbs in Operator order? E. Does the Trouble
Light operate? F. Does the Silence Switch Operate? H. Does the Panel have Inactive Zones? I. Does the Panel have Battery Backup? J. Do the batteries indicate they are
Properly Charged? Note # 3. FACP Manufacturer: Location of Primary Power Source: FCPS: Manufacturer: Model # Battery Voltage with A/C Power: Date: FCPS: Manufacturer: Model
# Battery Voltage with A/C Power: Date: FCPS: Manufacturer: Model # Battery Voltage with A/C Power: Date: Owner/Rep: Phone #: Date: Inspector: Phone #: Model # System Type: Panel
# Breaker Condition of Batteries: Battery Voltage without AC Power: w/o A/C Power Panel/Brker: Panel/Brker: Comments: Note # Note # Date: ALARM & DETECTION
EQUIPMENT TEST REPORT Name On Test Time: Return to Service Time: G. Battery A.H. Date Batteries Installed: Panel/Brker: Location:
w/o A/C Power Inspection # Location: Note # K. List any trouble conditions on panel before test: Note # Battery Voltage with AC Power: Location of Annunciators:
Comments: Note # Note # Location: w/o A/C Power Owners Rep Sign: ________________________________ Date: ________________
Inspector Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ Total # # Tested This Report Yes N/A Note # 16. Did the Monitoring Center (Fire
Dept, Central Station, Lease Line) receive signal? 17. Is system reset for normal conditions? 18. Is system restored to operational service? 19. Have Proper Authorities (see #1)
been notified system is back in service? List Proper Authorities: 20. Indicate % of equipment tested this report 25% 50% 75% 100% 21. Indicate % of equipment tested YTD
25% 50% 75% 100% 5. Zones Comments for any "no" answers or explanations (Note #): Property Site: __________________________ Operational Equipment 4. Remote Annunciators 14.
15. Did test of Duct Detectors shut down air handling units? 13. PIV OS & Y 8. Horn / Strobe Strobe Only Bell Speakers Horn 7. Detectors
Photoelectric Flame Ionization Heats / Fixed or R of R 9. 10. Automatic Door Release 11. Water Flow switches Did W/F Ring Outside Bell?
Did W/F Activate Alarm Panel? 12. Tamper Switches Duct (See #15) Addressable 6. Manual Stations (Pull) Hardwire Owners Rep Sign: ________________________________
Date: ________________ Inspector Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ DEVICE TYPE DEVICE
LOCATION PASS FAIL NOTE # SLC Channel ZONE # DEVICE # Device Count Owners Rep Sign: ________________________________ Date: ________________
Inspector Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # SLC Channel ZONE # DEVICE # Device
Count NOTE # LEGEND COMMENT Owners Rep Sign: ________________________________ Date: ________________ Inspector Sign: ______________________________
__
paradise schools/Cedarwood Sprink 05.07.20.pdf Microsoft InfoPath - NFPA 25 Form AES 1 Cover Sheet 2013
Inspection, Testing, and Maintenance Cover Sheet NFPA25 as amended by CCR, Title 19 Property Information: Name: Occupancy/Use: Address: Construction Type: City: No. Stories:
ZIP: Year Constructed: Contact: Telephone: Contractor Information: Number of System Risers Name: Copy sent to: Address: Owner Date: City: Fire AHJ Date: State:
Contractor Date: Telephone: NOTES: 1)For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011 Edition as amended by California Code of Regulations,
Title 19, §901 to §906. 2)Inspection items may be performed by the owner in accordance with California Code of Regulations, Title 19, §904.1(a) CA License#: Job #: Performed by:
Check box for each system inspected and enter the number of forms used for inspection. Check boxes (Fail or Pass) to indicate status of inspected system at end of inspection. Forms
Included with this Report NFPA 25 Chapter Number of Forms N/A Fail* Pass Automatic Sprinkler System 5 Standpipe and Hose System 6 Private Water Supply System 7 Fire Pump 8 Water Storage
Tank 9 Water Spray System 10 Foam Water Sprinkler System 11 Water Mist System 12 Concerns that are not deficiencies (i.e. Non-Sprinklered Areas) Yes No *See "Deficiencies and Comments"
section at end of each respective form. AES 1 September 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly
and Annual Report 1 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job #
CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This
building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass
F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2
1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5 I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi
1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed
systems) 5.2.6 1.10 I General Information Sign (not required for system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department
Connections 13.7 1.14 I Alarm Valves – Exterior Inspection 13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve*
5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems 13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include
Class I, II, or III standpipe systems. Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly
and Annual Report 2 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL
Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only
P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1
T Field Service Test Required (Send Report to Fire Code Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass;
If present = Fail Title 19 904.1(c) 2.3 T Water Flow Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form)
13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2 2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T
Small Hose Connections* w/PRV Hose Valves – Partial Flow Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections*
13.5.6.3 3.3 M Obstruction Investigation required (If “Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small
hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment
(Indicate type ) Item Date Riser D C Deficiencies and Comments Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler
System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information
Building Name Name Address Job # City D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts
that were repaired or replaced Check here if additional Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number
attached: I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance
with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection,
Testing & Maintenance Items are Completed in the Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3,
2013
paradise schools/Discrepancy Report Paradise High FA 05.06.20 Quoted.pdf
530-624-4514 Page _____ of _____ CUSTOMER: Site Name Inspection # Page # & Note # Discrepancy Description Voltage Cost to Repair Notes Date Quote given to customer Owner opt to Repair?
Date Repaired INSPECTION TYPE: INSPECTION DATE: INSPECTION DISCREPANCY REPORT
paradise schools/Paradise HS FA 05.06.20.pdf
ALARM AND DETECTION REPORT Page ____ of _____ Type of Inspection: Date: Property Name: Site: Street: Contact: City/State: Phone #: Fax #: 1. Before Test Notify Proper Authorities:
Phone # A. Owner or Owner's Rep B. Fire Department C. Central Station D. Central Station Acct # 2. Control Panel Status Yes No Note # A. Is the system monitored
by Central Station? B. Is the Power Light on? C. Does the Panel indicate Normal conditions? D. Are all indicating Lamp Bulbs in Operator order? E. Does the Trouble
Light operate? F. Does the Silence Switch Operate? H. Does the Panel have Inactive Zones? I. Does the Panel have Battery Backup? J. Do the batteries indicate they are
Properly Charged? Note # 3. FACP Manufacturer: Location of Primary Power Source: FCPS: Manufacturer: Model # Battery Voltage with A/C Power: Date: FCPS: Manufacturer: Model
# Battery Voltage with A/C Power: Date: FCPS: Manufacturer: Model # Battery Voltage with A/C Power: Date: Owner/Rep: Phone #: Date: Inspector: Phone #: Model # System Type: Panel
# Breaker Condition of Batteries: Battery Voltage without AC Power: w/o A/C Power Panel/Brker: Panel/Brker: Comments: Note # Note # Date: ALARM & DETECTION
EQUIPMENT TEST REPORT Name On Test Time: Return to Service Time: G. Battery A.H. Date Batteries Installed: Panel/Brker: Location:
w/o A/C Power Inspection # Location: Note # K. List any trouble conditions on panel before test: Note # Battery Voltage with AC Power: Location of Annunciators:
Comments: Note # Note # Location: w/o A/C Power Owners Rep Sign: ________________________________ Date: ________________
Inspector Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ Total # # Tested This Report Yes N/A Note # 16. Did the Monitoring Center (Fire
Dept, Central Station, Lease Line) receive signal? 17. Is system reset for normal conditions? 18. Is system restored to operational service? 19. Have Proper Authorities (see #1)
been notified system is back in service? List Proper Authorities: 20. Indicate % of equipment tested this report 25% 50% 75% 100% 21. Indicate % of equipment tested YTD
25% 50% 75% 100% 5. Zones Comments for any "no" answers or explanations (Note #): Property Site: __________________________ Operational Equipment 4. Remote Annunciators 14.
15. Did test of Duct Detectors shut down air handling units? 13. PIV OS & Y 8. Horn / Strobe Strobe Only Bell Speakers Horn 7. Detectors
Photoelectric Flame Ionization Heats / Fixed or R of R 9. 10. Automatic Door Release 11. Water Flow switches Did W/F Ring Outside Bell?
Did W/F Activate Alarm Panel? 12. Tamper Switches Duct (See #15) Addressable 6. Manual Stations (Pull) Hardwire Owners Rep Sign: ________________________________
Date: ________________ Inspector Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ DEVICE TYPE DEVICE
LOCATION PASS FAIL NOTE # SLC Channel ZONE # DEVICE # Device Count Owners Rep Sign: ________________________________ Date: ________________
Inspector Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # SLC Channel ZONE # DEVICE # Device
Count Owners Rep Sign: ________________________________ Date: ________________ Inspector Sign: ________________________________ ALARM
AND DETECTION REPORT Page ____ of _____ DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # SLC Channel ZONE # DEVICE # Device Count Owners Rep Sign: ________________________________
Date: ________________ Inspector Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ DEVICE TYPE DEVICE
LOCATION PASS FAIL NOTE # SLC Channel ZONE # DEVICE # Device Count Owners Rep Sign: ________________________________ Date: ________________
Inspector Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # SLC Channel ZONE # DEVICE # Device
Count NOTE # LEGEND COMMENT Owners Rep Sign: ________________________________ Date: ________________ Inspector Sign: ______________________________
__
paradise schools/Paradise Intermediate FA 05.07.20.pdf
ALARM AND DETECTION REPORT Page ____ of _____ Type of Inspection: Date: Property Name: Site: Street: Contact: City/State: Phone #: Fax #: 1. Before Test Notify Proper Authorities:
Phone # A. Owner or Owner's Rep B. Fire Department C. Central Station D. Central Station Acct # 2. Control Panel Status Yes No Note # A. Is the system monitored
by Central Station? B. Is the Power Light on? C. Does the Panel indicate Normal conditions? D. Are all indicating Lamp Bulbs in Operator order? E. Does the Trouble
Light operate? F. Does the Silence Switch Operate? H. Does the Panel have Inactive Zones? I. Does the Panel have Battery Backup? J. Do the batteries indicate they are
Properly Charged? Note # 3. FACP Manufacturer: Location of Primary Power Source: FCPS: Manufacturer: Model # Battery Voltage with A/C Power: Date: FCPS: Manufacturer: Model
# Battery Voltage with A/C Power: Date: FCPS: Manufacturer: Model # Battery Voltage with A/C Power: Date: Owner/Rep: Phone #: Date: Inspector: Phone #: Model # System Type: Panel
# Breaker Condition of Batteries: Battery Voltage without AC Power: w/o A/C Power Panel/Brker: Panel/Brker: Comments: Note # Note # Date: ALARM & DETECTION
EQUIPMENT TEST REPORT Name On Test Time: Return to Service Time: G. Battery A.H. Date Batteries Installed: Panel/Brker: Location:
w/o A/C Power Inspection # Location: Note # K. List any trouble conditions on panel before test: Note # Battery Voltage with AC Power: Location of Annunciators:
Comments: Note # Note # Location: w/o A/C Power Owners Rep Sign: ________________________________ Date: ________________
Inspector Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ Total # # Tested This Report Yes N/A Note # 16. Did the Monitoring Center (Fire
Dept, Central Station, Lease Line) receive signal? 17. Is system reset for normal conditions? 18. Is system restored to operational service? 19. Have Proper Authorities (see #1)
been notified system is back in service? List Proper Authorities: 20. Indicate % of equipment tested this report 25% 50% 75% 100% 21. Indicate % of equipment tested YTD
25% 50% 75% 100% 5. Zones Comments for any "no" answers or explanations (Note #): Property Site: __________________________ Operational Equipment 4. Remote Annunciators 14.
15. Did test of Duct Detectors shut down air handling units? 13. PIV OS & Y 8. Horn / Strobe Strobe Only Bell Speakers Horn 7. Detectors
Photoelectric Flame Ionization Heats / Fixed or R of R 9. 10. Automatic Door Release 11. Water Flow switches Did W/F Ring Outside Bell?
Did W/F Activate Alarm Panel? 12. Tamper Switches Duct (See #15) Addressable 6. Manual Stations (Pull) Hardwire Owners Rep Sign: ________________________________
Date: ________________ Inspector Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ DEVICE TYPE DEVICE
LOCATION PASS FAIL NOTE # SLC Channel ZONE # DEVICE # Device Count Property Site: __________________________ Owners Rep Sign: ________________________________
Date: ________________ Inspector Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ DEVICE TYPE DEVICE LOCATION PASS
FAIL NOTE # SLC Channel ZONE # DEVICE # Device Count Owners Rep Sign: ________________________________ Date: ________________ Inspector
Sign: ________________________________ ALARM AND DETECTION REPORT Page ____ of _____ DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # SLC Channel ZONE # DEVICE # Device Count Owners Rep
Sign: ________________________________ Date: ________________ Inspector Sign: ________________________________ ALARM AND DETECTION
REPORT Page ____ of _____ DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # SLC Channel ZONE # DEVICE # Device Count NOTE # LEGEND COMMENT Owners Rep Sign: ________________________________
Date: ________________ Inspector Sign: ________________________________
paradise schools/PHS Stage Sprink 05.06.20.pdf Microsoft InfoPath - NFPA 25 Form AES 1 Cover Sheet 2013
Inspection, Testing, and Maintenance Cover Sheet NFPA25 as amended by CCR, Title 19 Property Information: Name: Occupancy/Use: Address: Construction Type: City: No. Stories:
ZIP: Year Constructed: Contact: Telephone: Contractor Information: Number of System Risers Name: Copy sent to: Address: Owner Date: City: Fire AHJ Date: State:
Contractor Date: Telephone: NOTES: 1)For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011 Edition as amended by California Code of Regulations,
Title 19, §901 to §906. 2)Inspection items may be performed by the owner in accordance with California Code of Regulations, Title 19, §904.1(a) CA License#: Job #: Performed by:
Check box for each system inspected and enter the number of forms used for inspection. Check boxes (Fail or Pass) to indicate status of inspected system at end of inspection. Forms
Included with this Report NFPA 25 Chapter Number of Forms N/A Fail* Pass Automatic Sprinkler System 5 Standpipe and Hose System 6 Private Water Supply System 7 Fire Pump 8 Water Storage
Tank 9 Water Spray System 10 Foam Water Sprinkler System 11 Water Mist System 12 Concerns that are not deficiencies (i.e. Non-Sprinklered Areas) Yes No *See "Deficiencies and Comments"
section at end of each respective form. AES 1 September 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly
and Annual Report 1 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job #
CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This
building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass
F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2
1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5 I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi
1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed
systems) 5.2.6 1.10 I General Information Sign (not required for system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department
Connections 13.7 1.14 I Alarm Valves – Exterior Inspection 13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve*
5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems 13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include
Class I, II, or III standpipe systems. Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly
and Annual Report 2 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL
Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only
P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1
T Field Service Test Required (Send Report to Fire Code Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass;
If present = Fail Title 19 904.1(c) 2.3 T Water Flow Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form)
13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2 2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T
Small Hose Connections* w/PRV Hose Valves – Partial Flow Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections*
13.5.6.3 3.3 M Obstruction Investigation required (If “Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small
hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment
(Indicate type ) Item Date Riser D C Deficiencies and Comments Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler
System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information
Building Name Name Address Job # City D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts
that were repaired or replaced Check here if additional Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number
attached: I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance
with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection,
Testing & Maintenance Items are Completed in the Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3,
2013
paradise schools/Pine Ridge FA 05.11.20 (1).pdf
ALARM AND DETECTION REPORT 530-624-4514 Page 1 of 35 VOLTAGE SPECIALISTS #880862 i.e. Quarterly, Annual Date: Contact: Type of Inspection: Site Name: Street: City & State:
Phone: 1. Before Test Notify Proper Authorities: A. Owner or Owner's Rep B. Fire Department C. Central Station D. Central Station Acct # 2. Control Panel Status YES NO NOTE# A. Is
the system monitored by Central Station? On Test Time: _______ Return to Service Time: _________ B. Is the Power Light on? C. Does the Panel indicate Normal conditions? D. Are all
indicating Lamp Bulbs in Operator order? E. Does the Trouble Light operate? F. Does the Silence Switch Operate? G. Battery A.H. Date Batteries Installed: H. Does the Panel have non
operational zones? I. Does the Panel have Battery Backup? J. Do the batteries indicate they are Properly Charged? Condition of Batteries: _____________________________________ Battery
Voltage with AC Power: Battery Voltage without AC Power: K. List any trouble conditions on panel before test: Comments: 3. FACP Manufacturer: Model #:
Type of System: Location of Annunciators: Location of Primary Power Source: ____________________ Panel #: ______________ Brk #___________________ Comments: Owner/Rep:
______________________________________________ Phone #: ________________________ Date: Printed Name Inspector: ________________________________________________ Phone #: ________________________
Date: SEE PAGE 1A FOR ADDITIONAL PANEL INFORMATION _______________ _______________________ _______________ _______________________ ALARM & DETECTION EQUIPMENT TEST REPORT Name Phone
# _______________________ _______________ Inspection # Customer Name: Panel Report 530-624-4514 Page 1A to Fire Alarm Report VOLTAGE SPECIALISTS #880862 Type of Inspection: ANNUAL
i.e. Quarterly, Annual Property Name: ENLOE PARKING GARAGE Street: 130 W 6th Ave City & State: Chico, CA Date: Contact: Bruce Clark Phone: FCPS: FCPS #1 Manufacturer: ____________
Model #: _________ Panel/Breaker #: ________ Location: _________________________ Battery Voltage with A/C Power: _________ without A/C Power _______ Date: ______________
_________________________ FCPS: FCPS #2 Manufacturer: ____________ Model #: _________ Panel/Breaker #: ________ Location: _________________________ Battery Voltage with A/C Power:
_________ without A/C Power _______ Date: ______________ _________________________ FCPS: FCPS #3 Manufacturer: ____________ Model #: _________ Panel/Breaker #: ________
Location: _________________________ Battery Voltage with A/C Power: _________ without A/C Power _______ Date: ______________ _________________________ FCPS: FCPS #4 Manufacturer:
____________ Model #: _________ Panel/Breaker #: ________ Location: _________________________ Battery Voltage with A/C Power: _________ without A/C Power _______ Date: ______________
_________________________ FCPS: FCPS #5 Manufacturer: ____________ Model #: _________ Panel/Breaker #: ________ Location: _________________________ Battery Voltage with A/C Power:
_________ without A/C Power _______ Date: ______________ _________________________ FCPS: FCPS #6 Manufacturer: ____________ Model #: _________ Panel/Breaker #: ________
Location: _________________________ Battery Voltage with A/C Power: _________ without A/C Power _______ Date: ______________ _________________________ FCPS: FCPS #4 Manufacturer:
____________ Model #: _________ Panel/Breaker #: ________ Location: _________________________ Battery Voltage with A/C Power: _________ without A/C Power _______ Date: ______________
_________________________ FCPS: FCPS #5 Manufacturer: ____________ Model #: _________ Panel/Breaker #: ________ Location: _________________________ Battery Voltage with A/C Power:
_________ without A/C Power _______ Date: ______________ _________________________ FCPS: FCPS #6 Manufacturer: ____________ Model #: _________ Panel/Breaker #: ________
Location: _________________________ Battery Voltage with A/C Power: _________ without A/C Power _______ Date: ______________ _________________________ Owners Rep Sign: Date:
____________ Inspector Sign: . Customer Name: ALARM AND DETECTION REPORT 530-624-4514 Page 3 of 35 VOLTAGE SPECIALISTS #880862 Total # # Tested This Report Yes N/A Note # 16. Did
the Monitoring Center (Fire Dept, Central Station, Lease Line) receive signal? 17. Is system reset for normal conditions? 18. Is system restored to operational service? 19. Have Proper
Authorities (see #1) been notified system is back in service? List Proper Authorities: 20. Indicate % of equipment tested this report ____ 25 ____ 50 ____ 75 ____ 100 21. Indicate
% of equipment tested YTD ____ 25 ____ 50 ____ 75 ____ 100 Comments for any "no" answers or explanations (Note #): ___________________________________________________________________________________
_________________________________ OS & Y 14. 15. Did test of Duct Detectors shut down air handling units? 11. Water Flow switches Did W/F Ring Outside Bell? Did
W/F Activate Alarm Panel? 12. Tamper Switches 13. PIV Horn 9. 10. Automatic Door Release Duct (See #15) 8. Horn / Strobe Strobe Only Bell Speakers
7. Detectors Photoelectric Ionization Heats / Fixed or R of R Flame 4. Remote Annunciators 5. Zones 6. Manual Stations (Pull) Hardware Addressable
Property Site: __________________________ Operational Equipment ALARM AND DETECTION REPORT Page ____ of _____ DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # SLC Channel ZONE # DEVICE
# Device Count Owners Rep Sign: ________________________________ Date: ________________ Inspector Sign: ________________________________ Property Site: 530-624-4514
VOLTAGE SPECIALISTS #880862 ALARM AND DETECTION REPORT 530-624-4514 Page 18 of 35 VOLTAGE SPECIALISTS #880862 DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # ZONE OR SLC CHANNEL DEVICE
# Property Site: __________________________ ALARM AND DETECTION REPORT 530-624-4514 Page 19 of 35 VOLTAGE SPECIALISTS #880862 DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # ZONE OR
SLC CHANNEL DEVICE # Property Site: __________________________ ALARM AND DETECTION REPORT 530-624-4514 Page 20 of 35 VOLTAGE SPECIALISTS #880862 DEVICE TYPE DEVICE LOCATION PASS
FAIL NOTE # ZONE OR SLC CHANNEL DEVICE # Property Site: __________________________ ALARM AND DETECTION REPORT 530-624-4514 Page 21 of 35 VOLTAGE SPECIALISTS #880862 DEVICE TYPE DEVICE
LOCATION PASS FAIL NOTE # ZONE OR SLC CHANNEL DEVICE # Property Site: __________________________ ALARM AND DETECTION REPORT 530-624-4514 Page 22 of 35 VOLTAGE SPECIALISTS #880862
DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # ZONE OR SLC CHANNEL DEVICE # Property Site: __________________________ ALARM AND DETECTION REPORT 530-624-4514 Page 23 of 35 VOLTAGE
SPECIALISTS #880862 DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # ZONE OR SLC CHANNEL DEVICE # Property Site: __________________________ ALARM AND DETECTION REPORT 530-624-4514 Page
24 of 35 VOLTAGE SPECIALISTS #880862 DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # ZONE OR SLC CHANNEL DEVICE # Property Site: __________________________ ALARM AND DETECTION REPORT
530-624-4514 Page 25 of 35 VOLTAGE SPECIALISTS #880862 DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # ZONE OR SLC CHANNEL DEVICE # Property Site: __________________________ ALARM AND
DETECTION REPORT 530-624-4514 Page 26 of 35 VOLTAGE SPECIALISTS #880862 DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # ZONE OR SLC CHANNEL DEVICE # Property Site: __________________________
ALARM AND DETECTION REPORT 530-624-4514 Page 35 of 35 VOLTAGE SPECIALISTS #880862 DEVICE TYPE DEVICE LOCATION PASS FAIL NOTE # ZONE OR SLC CHANNEL DEVICE # Property Site: ________________________
__ NOTES
paradise schools/Discrepancy Report Pineridge FA 05.11.20.pdf
530-624-4514 Page _____ of _____ CUSTOMER: Site Name Inspection # Page # & Note # Discrepancy Description Voltage Cost to Repair Notes Date Quote given to customer Owner opt to Repair?
Date Repaired INSPECTION TYPE: INSPECTION DATE: INSPECTION DISCREPANCY REPORT