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HomeMy WebLinkAboutB21-3120 CF FA 2022 SYSTEM RECORD OF COMPLETION This form is to be completed by the system installation contractor at the time of system acceptance and approval. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Attach additional sheets, data,or calculations as necessary to provide a complete record. Form Completion Date: 08/17/2022 Supplemental Pages Attached: N/A 1. PROPERTY INFORMATION Name of property: FED EX GROUND#959 Address: 101 Book Farm Road, Durham CA 95938 Description of property: SHIPPING HUB Name of property representative: GENERAL MANAGER Address: SAME AS ABOVE Phone: 530-538-7888 Fax: N/A E-mail: FEDEX.COM 2. INSTALLATION, SERVICE, TESTING,AND MONITORING INFORMATION Installation contractor: JCI Address: 103 WOODMERE RD, FOLSOM CA,95630 Phone: 916-294-8800 Fax: N/A E-mail: JCI.COM Service organization: JCI Address: SAME AS ABOVE Phone: Fax: E-mail: Testing organization: JCI Address: SAME AS ABOVE Phone: Fax: E-mail: Effective date for test and inspection contract: Monitoring organization: TYCO INTEGRATED SECURITY Address: 14200 E Exposition Ave,Aurora,CO 80012 Phone: 800-428-7124 Fax: N/A E-mail: TYCOIS.COM Account number: U6870244232 Phone line 1: N/A Phone line 2: N/A Means of transmission: CELLULAR RADIO Entity to which alarms are retransmitted: BUTTE COUNTY FD Phone: 530-538-7111 3. DOCUMENTATION On-site location of the required record documents and site-specific software: FACP DOC BOX 4. DESCRIPTION OF SYSTEM OR SERVICE This is a: ®New system ❑Modification to existing system Permit number: B21-3120 NFPA 72 edition: 2022 4.1 Control Unit Manufacturer: FIRELITE Model number: MS92000DLS 4.2 Software and Firmware Firmware revision number: 4.3 Alarm Verification ❑This system does not incorporate alarm verification. Number of devices subject to alarm verification: 0 Alarm verification set for N/A seconds Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. (p. 1 of 3) SYSTEM RECORD OF COMPLETION (continued) 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: 100 VAC Control panel amps: 3.2 A Overcurrent protection: Type: CIRCUIT BREAKER Amps: 20 A Branch circuit disconnecting means location: OUTSIDE MAIN OFFICE Number: LAA-8 5.1.2 Secondary Power Type of secondary power: SEALED LEAD ACID BATTERIES Location,if remote from the plant: N/A Calculated capacity of secondary power to drive the system: In standby mode(hours): 4.093 In alarm mode(minutes): 4.1514(5) 5.2 Control Unit ❑ This system does not have power extender panels ® Power extender panels are listed on supplementary sheet A 6. CIRCUITS AND PATHWAYS Pathway Type Dual Media Pathway Separate Pathway Class Survivability Level Signaling Line X B 0 Device Power X B 0 Initiating Device X B 0 Notification Appliance X B 0 Other(specify): 7. REMOTE ANNUNCIATORS Type Location AUDIBLE/VISUAL MAIN OFFICE VESTIBULE 8. INITIATING DEVICES Addressable or Type Quantity Conventional Alarm or Supervisory Sensing Technology Manual Pull Stations 1 ADDRESSABLE ALARM N/A Smoke Detectors 3 ADDRESSABLE ALARM PHOTO ELECTRIC Duct Smoke Detectors 4 ADDRESSABLE SUPERVISORY PHOTO ELECTRIC Heat Detectors N/A Gas Detectors N/A Waterflow Switches 3 ADDRESSABLE ALARM N/A Tamper Switches 9 ADDRESSABLE SUPERVISORY N/A Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. (p.2 of 3) SYSTEM RECORD OF COMPLETION (continued) 9. NOTIFICATION APPLIANCES Type Quantity Description Audible Visible 11 STROBE ONLY Combination Audible and Visible 49 HORN/STROBE 10. SYSTEM CONTROL FUNCTIONS Type Quantity Hold-Open Door Releasing Devices N/A HVAC Shutdown 4 Fire/Smoke Dampers N/A Door Unlocking N/A Elevator Recall N/A Elevator Shunt Trip N/A 11. INTERCONNECTED SYSTEMS ® This system does not have interconnected systems. ❑ Interconnected systems are listed on supplementary sheet 12. CERTIFICATION AND APPROVALS 12.1 System Installation Contractor This system as specified herein has been installed according to all NFPA standards cited herein. Signed: Printed name: Chris Martin Date: Organization: JCI Title: SUB CONTRACTOR Phone: 916-240-1982 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed: Printed name: Chris Martin Date: Organization: JCI Title: SUB CONTRACTOR Phone: 916-240-1982 12.3 Acceptance Test Date and time of acceptance test: Installing contractor representative: Testing contractor representative: Property representative: AHJ representative: Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. (p.3 of 3)