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HomeMy WebLinkAboutFAI21-0014 CF FA 2021 (1700 Wing) LPHS 1700 WING FA 10.15.21.pdf ALARM AND DETECTION REPORT Page ____ of _____ Site: Street: City/State: Date: Customer: Contact: 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: _____________________ ___________ Type of Inspection: 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 NOTE # LEGEND COMMENT Owners Rep Sign: ________________________________ Date: ________________ Inspector Sign: ________________________________ LPHS Ag Shop FA 11.15.21.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 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: ________________________________