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HomeMy WebLinkAboutFAI15-0057 028-240-005 CF FA 3-19-2024 oOTHILL FIRE flo PROTECTION INC. ji 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: 3/19/2024@ 10:15AM Inspection/Test Completion Date/Time: 3/19/2024@ 11:15AM Supplemental Form(s)Attached: Yes (yes/no) 1. PROPERTY INFORMATION Name of property: Bangor Union Elementary School District - Semi-Annual Fire Alarm Inspection Address: 7549 Oro Bangor Highway Description of property: Name of property representative: Address: Phone: (530) 679-2434 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: Foothill Fire-Rapid Response Monitoring Services Address: 400 West Division Street,Syracuse, NY 13204 Phone: (800)932-3822 Fax: E-mail: Account number: Z570983 Phone line 1: 1-844-414-0165 Phone line 2: 1-855-259-2649 Means of transmission: On Board Built in Dialer to Cell Dialer Entity to which alarms are retransmitted: Rapid Response Phone: 1-800-932-3822 3. DOCUMENTATION On-site location of the required record documents and site-specific software: 4. DESCRIPTION OF SYSTEM OR SERVICE 4.1 Control Unit Silent Knight Model number: 6820EVS Manufacturer: 4.2 Software and Firmware Firmware revision number: N/A 4.3 System Power 4.3.1 Primary(Main)Power Nominal voltage: 120VAC Amps: 20 Location: Utility Room 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) Overcurrent protection type: Breaker Amps: 20 Disconnecting means location: Panel C3 Ckt 24 4. DESCRIPTION OF SYSTEM OR SERVICE (continued) 4.3.2 Secondary Power Type: Battery Backup Location: FACP Battery type(if applicable): Sealed Lead Acid 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: Rapid Response Time: 10:15AM Building management Contact: Time: Building occupants Contact: Staff Time: 10:15AM 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 0 0 Lamps/LEDs/LCDs 0 0 Fuses ❑ ❑ N/A Trouble signals 0 0 Disconnect switches ❑ ❑ Ground-fault monitoring 0 0 Supervision 0 0 Local annunciator 0 I= Remote annunciators 0 0 In Front Office Remote power panels 0 0 1Next to FACP &Above Ceiling in Pantry ❑ ❑ 6.2 Secondary Power Visual Functional Description Inspection Test Comments Battery condition 0 ❑ (2) 12v14ah FACP Inst 7/7/22 Load voltage ❑ 0 Discharge test ❑ 0 Charger test ❑ p (2) 12v8ah FAPS 1 Inst 7/7/22 Remote panel batteries ❑ 0 (2) 12v8ah FAPS 2 Inst 11/21/22 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) 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 ❑ ❑ N/A Alarm restoration ❑ ❑ N/A Trouble signal ❑ ❑ N/A Trouble restoration ❑ ❑ N/A Supervisory signal ❑ ❑ N/A Supervisory restoration ❑ ❑ N/A 6.7 Public Emergency Alarm Reporting System Description Yes No Time Comments Alarm signal ❑ ❑ N/A Alarm restoration ❑ ❑ N/A Trouble signal ❑ ❑ N/A Trouble restoration ❑ ❑ N/A Supervisory signal ❑ ❑ N/A Supervisory restoration ❑ ❑ 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: Rapid Response Time: 11:15AM Building management Contact: Time: Building occupants Contact: Staff Time: 11:15AM Authority having jurisdiction Contact: Time: Other,if Contact: Time: required 8. SYSTEM RESTORED TO NORMAL OPERATION Date: 3/19/2024 Time: 11:15AM 9. CERTIFICATION This system as specified herein has been inspected and tested according to NFPA 72,2013 edition,Chapter 14. Signed: Printed name: Tyler Smedley Date: 3/19/2024 Organization: Foothill Fire Protection, Inc. Title: Inspector Phone: (530) 826-3013 Qualifications(refer to 10.5.3): C10 License(#783132) 10. DEFECTS OR MALFUNCTIONS NOT CORRECTED AT CONCLUSION OF SYSTEM INSPECTION, TESTING, OR MAINTENANCE Fail- Panel in trouble upon arrival for Phone Line 2. Metered phone lines at panel and there is no voltage on phone line 2 Customer needs to contact phone company to come out and fix the issue 10.1 Acceptance by Owner or Owner's Representative: The undersigned accepted the test report for the system as specified herein: Signed: Printed name: Lily Date: 3/19/2024 Organization: Title: Phone: 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. 1 1 R E PROTECTION, INC. 170 Erma Court Chico CA 95928 (530)826-3013 C10#783132 INITIATING DEVICE SUPPLEMENTARY RECORD OF INSPECTION AND TESTING This form is a supplement to the System Record of Inspection and Testing. It 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: 3/1 9/2024@ 10:15AM Inspection/Test Completion Date/Time: 3/19/2024@ 11:15AM Number of Supplemental Pages Attached: 1 1. PROPERTY INFORMATION Name of property: Bangor Union Elementary School District Address: 7549 Oro Bangor Highway 2. INITIATING DEVICE TEST RESULTS Device Type Address Location Test Results Water Flow I M97:P043 Pump House Riser Pass Tamper M97:P044 Pump House Pass Tamper M97:P045 Pump House N/A Tamper M97:P046 Pump House Pass Tamper M97:P047 Pump House N/A Tamper M97:P048 Pump House Pass Supervisory Monitor M97:P049 Pump Running N/A Water Flow M97:P052 Gym Riser Pass Tamper I M97:P053 Gym Riser Pass Supervisory Monitor I M97:P057 Gym PS Low Battery Pass 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.