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Home My WebLink AboutFAI15-0097 Fire Alarm Inspection 2022 Testing T • II .1 „IL _ �__ �, r r �. _ ._ _ 6t • pRoTEcToNc ' C 170 Erma Court, Chico, CA 95928 530-826-3013 C10#783132 SYSTEM RECORD OF INSPECTION AND TESTING This form is to be completed by the system inspection and testing contractor at 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. Inspection/Test Start Date/Time: 3/16/2022@8:OOAM Inspection/Test Completion Date/Time: 3/16/2022@2:OOPM Supplemental Form(s)Attached: No (yes/no) 1. PROPERTY INFORMATION Name of property: Feather Falls Casino - Annual Fire Alarm System Inspection Address: 3 Alverda Drive, Oroville, CA 95966 Description of property: Business Name of property representative: Randahl Nelson Address: Phone: 530-533-3885 Fax: E-mail: 2. TESTING AND MONITORING INFORMATION Testing organization: Foothill Fire Protection, Inc. Address: 170 Erma Court, Chico, CA 95928 Phone: 530-826-3013 Fax: E-mail: Monitoring organization: Voltage Specialists Central Station Address: Phone: 1-800-722-0364 Fax: E-mail: Account number: 47-3726 Phone line 1: Phone line 2: Means of transmission: On Board Dialer To IP Communicator Entity to which alarms are retransmitted: Monitoring Company Phone: 1-800-722-0364 3. DOCUMENTATION On-site location of the required record documents and site-specific software: At FACP 4. DESCRIPTION OF SYSTEM OR SERVICE 4.1 Control Unit Fire Lite Model number: MS-92000DLS Manufacturer: 4.2 Software and Firmware Firmware revision number: 4.3 System Power 4.3.1 Primary(Main)Power Nominal voltage: 1 20VAC Amps: 20 Location: Server Room Panel SP 2nd Floor Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied far commercial sale or distribution. SYSTEM RECORD OF INSPECTION AND TESTING(continued) Overcurrent protection type: Breaker Amps: 20 Disconnecting means location: Panel SP Breaker#32 4. DESCRIPTION OF SYSTEM OR SERVICE(continued) 4.3.2 Secondary Power Type: Battery Backup Location: FACP Battery type(if applicable): S LA capacity of batteries to drive the system: In standby mode(hours): 24 In alarm mode(minutes): 5 5. NOTIFICATIONS MADE PRIOR TO TESTING Monitoring organization Contact: Central Station Time: 8:00AM Building management Contact: Staff Time: 8:00AM Building occupants Contact: Time: Authority having jurisdiction Contact: Time: Other,if Contact: Time: required 6. TESTING RESULTS 6.1 Control Unit and Related Equipment Visual Functional Description Inspection Test Comments Control unit El 0 Lamps/LEDs/LCDs El 0 Fuses ❑ ❑ N/A Trouble signals ❑ ❑ Disconnect switches C) 0 Ground-fault monitoring CI CI Supervision El CI Local annunciator 0 0 Remote annunciators 0 CI Remote power panels 0 CI 0 0 , 6.2 Secondary Power Visual Functional Description Inspection Test Comments Battery condition 0 I 0 I Batteries In FACP Installed 12/9/2020 Load voltage I ❑ I CI I Discharge test I 0 I CI I Charger test I ❑ I Cl I Remote panel batteries I 0 I (] I FCPS Batteries Installed 12/9/2020 Copyright 0 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. 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 ❑ N/A Alarm restoration ❑ ❑ N/A Trouble signal 0 ❑ N/A Trouble restoration 0 ❑ N/A Supervisory signal 0 ❑ N/A Supervisory restoration ❑ ❑ N/A 6.7 Public Emergency Alarm Reporting System Description Yes No Time Comments Alarm signal ❑ ❑ N/A Alarm restoration 0 ❑ N/A Trouble signal 0 0 N/A Trouble restoration 0 0 N/A Supervisory signal ❑ ❑ N/A Supervisory restoration ❑ 0 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. SYSTEM RECORD OF INSPECTION AND TESTING(continued) 7. NOTIFICATIONS THAT TESTING IS COMPLETE Monitoring organization Contact: Central Station Time: 2:00PM Building management Contact: Staff Time: 2:00PM Building occupants Contact: Time: Authority having jurisdiction Contact: Time: Other,if Contact: Time: required 8. SYSTEM RESTORED TO NORMAL OPERATION Date: 3/16/2022 Time: 2:00PM 9. CERTIFICATION This system as specified herein has been inspected and tested according to NFPA 72,2013 edition,Chapter 14. Raymond E. o �signed by Raymond E. JordSigned: Jan Date 22.03.2015:2021 Printed name: Ray Jordan Date: 3/16/2022 Organization: Foothill Fire Protection,Inc. Title: Inspector Phone: 530-826-3031 Qualifications(refer to 10.5.3): C10 License(#783132) 10. DEFECTS OR MALFUNCTIONS NOT CORRECTED AT CONCLUSION OF SYSTEM INSPECTION, TESTING,OR MAINTENANCE No issues found at time of Annual Fire Alarm System Inspection. Passed 10.1 Acceptance by Owner or Owner's Representative: The undersigned accepted the test report for the system as specified herein: Signed: Printed name: Date: Organization: Title: Phone: Copyright 0 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.