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HomeMy WebLinkAboutFC FS 2022 72-48 NATIONALFIREALARMANDSIGNALINGCODE SYSTEM RECORD OF INSPECTION AND TESTING This form is to be completed by the system inspection and testing contractor et the time of a system test. 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,p Inspection/Test Start Date/Time:O&•l '�J Lt Inspection/Test Completion Date/Time:Di '(O lk `)01) Supplemental Form(s)Attached: (yes/no) 1. PROPERTY INFORMATION`, A. �1� Name ofpropertv:: ,1v ,�J,1�'(-' 'U Address: I, O8 ktct.10 4N17�� (__C2E9As:A-6� CA 959 2 Description of property: Gt VI VY\ �+ `' a , Name of property representative: 6Q,�GA A141VAl— Address: Phone: •_a8` 'S lax: E-mail: 2. TESTING AND MONITORING INFORMATION ` Testing organization:�iz � �� ��Ign IJtr Gal)P (68(..711.t, % � V1 1 Address: !/J iZ p II�ATa/ -g USV— C41 9b90! Phone:530•111 •5k;.`'I0 Fax: E-mail: Monitoring organization: 'TMSI lti�t� � 1141`T C N j* S ,Pt� Q �S Address: 119-43D to6 L . ca.A.,,EJ'Ct) CA Phone: Fax: E-mail: Account number:1. 532o Phone line 1: Phone line 2: Means oftransmission: Entity to which alarms are retransmitted: Phone: 3. DOCUMENTATION Onsite location of the required record documents and site-specific software: 4. DESCRIPTION OF SYSTEM OR SERVICE 4.1 Control Unit Manufacturer: DNA 7 Model number: 4.2 Software Firmware Firmware revision number: 4.3 System Power 4.3.1 Primary(Main)Power ^^•�11,,�� Nominal voltage: �{� l Amps: Location: Br11`�'�'_.1 Overcurrentprotect.ion type:-1 tbiWAte Amps: IA Disconnecting.means location: Kef tc2 m 2012 National Fire Protection Association NFPA 72(p.1 de) FIGURE 7.8.2(g) System Record of Inspection and Testing.(SIG-TMS) W 2013 Edition J DOCUMENTATION 72-49 SYSTEM RECORD OF INSPECTION AND TESTING (continued) 4. DESCRIPTION OF SYSTEM OR SERVICE(continued) 4.3.2 Secondary Power �` ------- SeintaImcation:—___e_FActi I . Battery type(if applicable):_(4 )1 >9Lh7 (cj %Vi Calculated capacity of batteries to drive the system: In standby mode(hours): In alarm mode(minutes): 5. NOTIFICATIONS MADE PRIOR TO TESTING -�.� Monitoring organization Contact: ` • - Time: lJ/4 Buildingmsnagement Contact: -VCS Time: / Buildingoccupants Contact: Time: Authority having jurisdiction Contact: bI.&V) f9 R6 Time: I 04 D Other.ifrequi red Contact: Time: 6. TESTING RESULTS 6.1 Control Unit and Related Equipment Visual Functional Description Inspection Test Comments Control unit J� Lamps/LEDs/LCDs — —Fuses Trouble signals -� Disconnect switches .g Ground-fault monitoring - A' Supervision Local annunciator Remotcannunciators .. _— _.._.,---- — --.. _ - --- - --------.—...------__.— /. ___._.._-----.._----- --- Remote 6.2 Secondary Power Visual Functional Description Inspection Test Comments 13atterycondition 0 I 0 1618 iciv„.113l Load voltage 0 0 Discharge test 0 0 Charger test 0 0 _ Remote pa nel batteries 0 I 0 0 2012 National Fire Protection Association NFPA 72(p.2 of 4) FIGURE 7.8.2(g) Continued 2013 Edition El 72-50 NATIONAL FIREALARM AND SIGNALING CODE SYSTEM RECORD OF INSPECTION AND TESTING (continued) 6. TESTING RESULTS (continued) 6.3 Alarm and Supervisory Alarm Initiating Device Attach supplementary device test sheets for all initiating devices. 6.4 Notification Appliances Attach supplementary appliance test sheets for all notification appliances. 6.5 Interface Equipment Attach supplementary interface component test sheets for all interface components. Circuit Interface/Signaling Line Circuit Interface/Fire Alarm Control Interface 6.6 Supervising Station Monitoring Description Yes No Time Comments Alarm signal 0 KAP Alarm restoration 0 Trouble signal -- - 0 Trouble restoration 0 Supervisory signal ,( 0 Supervisory restoration �-+ 0 )1 -- -6.7 Public Emergency Alarm Reporting System Description Yes I No I 3ime I Comments Alarm signal 0 I 0 —Alarm restoration - Tr ubleaignal Trouble restoration — --- - - — - — -Supervisory signal 0 0 - ----- Supervisory restoration 0 0 O 2012 National Fire Protection Association NFPA 72(p.3 of 4) FIGURE 7.18.2(g) Continued CI2013 Edition DOCUMENTATION 72-51 SYSTEM RECORD OF INSPECTION AND TESTING (continued) 7. NOTIFICATIONS THAT TESTING IS COMPLETE Monitoring organization Contact: C Time: I ISO Building management Contact: y6s-- Time: t Building occupants Contact: e�(1S Time: ( Authority having jurisdiction Contact: C- QA Lj,U1 f Time: It Ob Other.ifreyuired Contact: Time: 8. SYSTEM RESTORED TO NORMAL OPERATION I tOO Data:_01 'I�'LoLI Time: 9, CERTIFICATI N This syste pec• led h ein has been inspected and tested according to NFPA 72,2013 edition.Chapter 14- Signed: - - Printed name: 14 611A,1;S Date: 0%' g'ZbZ') Orga icati Title: 4:lPI-a 1 ,�- Phone: S;151_ Qualifications(r a10.5.3): a(p / C6T I- 10. DEFECTS OR MALFUNCTIONS NOT CORRECTED AT CONCLUSION OF SYSTEM INSPECTION, TESTING,OR MAINTENANCE 431S'ri?V(\ ?HS 5tso t,.,ttH t`) _D6PtCtf j3C) 10.1 Acceptance by Owner or Owner's Representative: The undersigned accepted the test report for the system as specified herein: Signed: Printed tin our_... Date: Organization: Title: _ �.----! Phone: 02012 National Fire Protection Association NFPA 72(p•4 at 4) FIGURE 7.8.2(g) Continued 2013 Eciboa ,.. 72-52 NATIONAL FIREALARM AND SIGNALING CODE NOTIFICATION APPLIANCE SUPPLEMENTARY RECORD OF INSPECTION AND TESTING This form is a supplement to the System Record of Inspection and Testing. It includes a notification appliance test record. This form is to be completed by the system inspection and testing contractor at the time of the inspection and/or test. 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. O 00 InspectionfTest Start Date/Time:01 '%2'?AZI t�°D Inspection/Test Completion Date/Time:Co l (B��Z1 ' Number of Supplemental Pages Attached: 1. PROPERTY INFORMATION (}-�. /� �/� Name ufpru city: q'Ity * sNA � 4 Address: t V6lA P,A 4; �/R 2. NOTIFICATION APPLIANCE TEST RESULTS Appliance Type Location/Identifier Test Results ...4T. _ 0 2012 National Fire Protection Association NFPA 72(p•1 of 2) FIGURE 7.8.2(h)Notif'cation Ap p I lance Supplementary Record of Inspection and Testing.(S IG-TM S) 14 2013 Edition 72-54 NATIONALFIREALARMANDSIGNALINGCODE INITIATING DEVICE SUPPLEMENTARY RECORD OF INSPECTION AND TESTING This form is a supplement to the System Record of Inspection end Testing. II includes an initiating device test record. This form is to be completed by the system inspection and testing contractor at the time of the inspection and/or test. 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. Inspection/Test Start Date/Time:Oi •18. 1.-1 I Inspection/Test Completion Date/Time:Q I•le.,1 SZ1 j(�J 7k Number of Supplemental Pages Attached: 1. PROPERTY INFORMATION _A CAA) Name ofproperty: Sl'lIt tr � SS Address:L1 ,a !xi 40tifAl 99 i 'atvok6,1) O 9[s 1'43 2. INITIATING DEVICE TEST RESULTS Device Type Address Location Test Results _ -.- QASS 1N -Evag "7.c_IJ6 I' — _ e RAS 6.t _PASS ivr,4 Aim N/74 NA . ©2012 National Fire Protection Association NFPA 72(p.1 ot2) FIGURE7.8.2(i)Initia ling Device Su pplementary Record of Inspection and Testing.(SIG-TMS) Et 2013 Edition L