This inspection testing is performed : [( ) Monthly]{.underline} [( )
Quarterly]{.underline} [( ) Semi-annual]{.underline} [( )
Annual]{.underline}

***(Note that all tests are required by NFPA 72 annually unless
otherwise identified.)***

Identify portion of building or alarm system being
tested:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

PART I. EQUIPMENT AND ALARMS **\[TOTAL SYSTEM INVENTORY\]**

A. Fire Department Notified/alarms silenced \_\_\_\_\_\_\_\_ AM/PM:
Alarms Restored \_\_\_\_\_\_\_ AM/PM.

B. Control Panel
Manufacturer:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_
Model\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C. Battery Type: (Nickel Cadmium/Sealed Lead
Acid/)\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

C. Total Number of Zones/Points:\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_***(Update
these with new construction activities.)***

> D. Initiating Devices/Total: Smoke Detectors( ) \_\_\_\_\_\_ Duct
> Detectors ( ) \_\_\_\_\_\_ Manual Stations ( ) \_\_\_\_\_\_\_ Valve
> Tamper Switches ( ) \_\_\_\_\_\_ Waterflow Switches ( ) \_\_\_\_\_\_\_
> Heat Detectors ( ) \_\_\_\_\_\_ Other ( ) \_\_\_\_\_\_
>
> E. Notification Appliances: Bells/Horns ( ) \_\_\_\_\_\_ Chimes ( )
> \_\_\_\_\_\_ Speakers ( ) \_\_\_\_\_\_ Strobes/Lights ( ) \_\_\_\_\_\_

  ------------------------------------------------------------------------ ---------------------------------------------------- ----- ---- -----
  PART II. EQUIPMENT INFORMATION: (Explain any "NO" answers on the                                                              YES   NO   N/A
  attached sheets).                                                                                                                        

  A. Are drawings and wiring diagrams available at the panel?                                                                              

  B. Are operating instruction posted at the panel?                                                                                        

  C. Are the zones labeled and identified?                                                                                                 

  D. Is there a standby power source? Battery ( ) Amp. Hr. Rating                                                                          
  \_\_\_\_\_\_\_\_\_\_ Generator ( )                                                                                                       

  E. Is the control panel green? (no trouble conditions)                                                                                   

                                                                                                                                           

  PART III. EQUIPMENT TEST AND INSPECTION **\[FOR THIS INSPECTION\]**                                                           YES   NO   N/A

  Control Unit Requirements:                                                                                                               

  A. Battery charger and voltage? Volts DC \_\_\_\_\_\_ Battery VDC in                                                                     
  alarm \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                                                                     

  B. Ground fault detection and trouble tested satisfactorily?                                                                             

  C. Fuses checked for proper ratings?                                     #checked\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                

  Fire Alarm System Input Requirements                                                                                                     

  D. Manual stations tested satisfactorily?                                \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  E. Method of testing detectors: Testgas ( ) Heat ( ) Other ( )                                                                           
  \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_                                                                   

  F. Smoke detectors tested satisfactorily? ***(req^d^ annual)***          \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  G. Smoke detector sensitivity tested? ***(5 yrs see NFPA 72)***          \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  H. Duct detectors tested satisfactorily? ***(req^d^ annual)***           \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  I. Heat detectors tested satisfactorily?                                 \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  J. Tamper switches tested satisfactorily? ***(req^d^ semi-annual)***     \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  K. Waterflow switches tested satisfactorily? ***(req^d^ semi-annual)***  \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  L. Fire pump signals tested satisfactorily?(pump running/power                                                                           
  failure/phase reversal)                                                                                                                  

  Fire Alarm System Output Requirements                                                                                                    

  S. Audio/visual alarms tested satisfactorily?                            \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  T. Annunciators tested satisfactorily?                                   \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  U. Voice alarm clarity satisfactory?                                                                                                     

  V. Remote (FD) connection tested satisfactorily? ***(req^d^                                                                              
  quarterly)***                                                                                                                            

  Fire Safety Functions                                                                                                                    

  W. HVAC shutdown tested satisfactorily?                                  \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  X. Elevator Recall tested satisfactorily?                                \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  Y. Elevator power shutdown tested satisfactorily?                        \#                                                              
                                                                           tested\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_              

  Z. Door releases tested satisfactorily?                                                                                                  

  Others not mentioned above (Kitchen/CO~2~/Phone Jacks/Deluge)                                                                            
  ------------------------------------------------------------------------ ---------------------------------------------------- ----- ---- -----

> PART IV. CHECK THIS BOX IF ADJUSTMENS OR CORRECTIONS WERE MADE DURING
> THIS INSPECTION AND NOTE THEM ON THE ATTACHED SHEETS.
>
> PART V. THIS INSPECTION WAS PERFORMED SUBSTANTIALLY IN ACCORDANCE WITH
> NFPA 72 . ALTHOUGH THESE COMMENTS ARE NOT THE RESULT OF AN ENGINEERING
> REVIEW, THE FOLLOWING DESIRABLE IMPROVEMENTS ON THE ATTACHED SHEETS
> ARE RECOMMENDED. \[See attached sheets if this box is checked.\]

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  **Identify PART from Page 1 that is continued.**

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