2024 COI binder.pdf

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W912BU25QA010 - RECERTIFICATION OF DREDGE MCFARLAND FIREFIGHTING SYSTEM
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W912BU25QA010
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About this file

This document is a comprehensive fire system inspection report for the Dredge McFarland, performed by Keystone Fire and Security Co. on August 12, 2024. The report includes detailed inspections of multiple fire suppression systems across various locations on the vessel, including CO2, ABC, and K-type fire extinguishers. The inspection covered multiple decks and areas such as the bridge, engine rooms, storage lockers, and passageways, systematically checking equipment conditions, hydrostatic test dates, maintenance cycles, and operational readiness of fire safety equipment.

The inspection revealed one deficiency: two nitrogen tanks for the steering gear actuation system are out of hydrostatic test date. The report documents 127 fire extinguishers across different types and locations, with various upcoming maintenance and hydrostatic testing requirements. All systems were generally found to be compliant, with the report signed off by service technicians from Keystone Fire and Security, indicating a comprehensive review of the vessel's fire safety infrastructure. The document is part of the vessel's annual safety certification process, ensuring all fire suppression systems meet required standards and are prepared for potential emergency use.

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Dredge McFarland

SUMMARY OF FIRE SYSTEM INSPECTIONS

Work Performed By:

KEYSTONE FIRE AND SECURITY CO.

433 Industrial Drive North Wales, PA 19454

(215) 641-0100 P

(215) 641-9638 F www.keystonefire.com

CUSTOMER ACKNOWLEDGEMENT

Customer, by its signature on the front face of this form, acknowledges that it has read the statements below, understands them and agrees to be bound by them. The Customer further understands that Keystone Fire and Security. [herein referred to as “the Company”] is not an insurer of lives and/or property and is relying upon the limitation(s) below in determining the cost of services provided to you.

LIMITATION OF LIABILITY:

The Company shall have no liability for loss of anticipated profits, incidental, consequential, special or punitive damages and shall not be liable, for any reason, whether under this agreement or otherwise, for any loss, cost, expense or damage suffered by Customer or any other person, including, without limitation, cost, expense, loss or damage resulting directly or indirectly, from the use or loss of use of the Products or any fire suppression system related thereto, personal injury and property damage or any claim or demand against Customer by any third party. The Company’s total liability to Customer for any breach by Company under this Agreement or any claim of Customer against Company related to this Agreement, directly or indirectly, is limited to the lesser of a refund of the fees paid by Customer under this Agreement or the actual direct damage suffered by Customer.

WAIVER OF SUBROGATION:

It is understood that Company is not an insurer and that insurance shall be obtained by Customer to protect the premises where Services are to be performed (the “premises”) and to protect the property of Customer and others within the premises as well as to protect all persons within the premises. It is further understood by Customer that the amounts payable under this Agreement are based on the value of services and, among other considerations, the waiver of subrogation as set forth in the Agreement and are unrelated to the value of the Customer’s premises or property of Customer and/or others located within the premises.

Customer agrees to rely exclusively on Customer’s insurer to recover for injury, loss or damage in the event of any loss, injury or damages to the premises or any property therein. Customer does hereby for itself and all others claiming by or through it under this Agreement release and discharge Company from and against all damages covered by Customer’s insurance and Customer further waives all rights of recovery against Company arising by way of subrogation or assignment.

INDEMNIFY AND HOLD HARMLESS:

Customer assumes the entire responsibility and liability for any and all damage or injury of any kind (including death) to all persons, whether employees of Customer or otherwise, and for any and all property damage, or loss of use thereof, caused by, resulting from, arising out of, or occurring in connection with or involving the Services and/or goods (where applicable) provided under this Agreement or in association with or involving the operation or non-operation of any Equipment or System(s), which damage or loss is caused by or contributed to by any act, error or omission, solely or jointly, on the part of the Company or the Customer, their agents, servants, or employees, including any alleged breach of any statutory or codified obligation and including, but not limited to, any alleged or determined sole negligence and/or alleged or determined gross negligence on the part of Company, and/or its agents, servants or employees.

If any person, or Customer or assignee(s) of Customer, shall make a claim for any damage or injury (including death) as above described, Customer agrees to indemnify and hold harmless Company, its agents, servants and employees from and against any and all loss, expense, damage or injury (including death), Company and/or its agents, servants or employees may sustain as a result of any such claim and Customer agrees to assume the defense of Company and/or its agents, servants or employees upon such claim and to pay all costs and expenses, including but not limited to reasonable attorney’s fees, incurred in connection therewith. This Agreement shall continue in effect notwithstanding the fact Customer has accepted and paid for the Services.

The aforesaid indemnification obligation shall not be limited in any way by any limitation on the amount and type of damages, compensation or benefits payable by or for Customer’s Worker’s Compensation, Disability Benefit Acts or other employment benefit acts. Customer expressly and specifically waives any immunity provided against this indemnity by any statute, including but not limited to, worker’s compensation statutes. Customer further understands that Company is relying upon this limitation in determining the cost of the Services.

TIME LIMITATION:

All claims, actions or proceedings, legal or equitable against Company must be commenced in court within one (1) year after the cause of action has accrued, without judicial extension of time or said claim action or proceeding is barred, time being of the essence of this paragraph.

Rev 6_21

433 INDUSTRIAL DRIVE

NORTH WALES, PA 19454

PHONE (215) 641-0100 SYSTEM LOCATION DATE OF SERVICE

FAX (215) 641-9638

www.keystonefire.com NJ PERMIT NO. P-00037 CONTACT PHONE

COMPANY NAME INSPECTION TYPE

INITIAL ANNUAL SEMI-ANNUAL QUARTERLY REPAIR RE-INSPECTION

ADDRESS SYSTEM TYPE

FM200 NOVEC HALON CO2 LPCO2 DRY CHEM __________

CITY STATE ZIP SYSTEM MFG. PANEL MFG./MODEL DET. MFG./MODEL

TESTED

B System off-normal at time of arrival? (alarm, trouble, etc.) < Smoke detector(s) tested & operated properly?

C System tampered with? Disarmed? Releasing device removed? = Were tested smoke detector(s) cleaned?

D System cylinder(s) down in pressure? a Were tested smoke detector sensitivity tested?

E System discharged at time of technician's arrival? b Separate Field Detector Report or BRC attached?

F Has the room/hazard changed since the last inspection? c Restorable heat detector(s) tested & operated properly?

G Engineered drawings match installed system? d Non-restorable heat detector(s) tested?

H Protected room/underfloor area(s) clean? e Pneumatic heat detector(s) tested & operated properly?

INSTALLATION CONDITIONS Y N N/A f Fusible link(s) and/or ETL(s) replaced per mfgr requirement?

I Tanks mounted and secured ? g Air sampling detector(s) tested & operated properly?

J Tanks visually inspected to be free of rust & corrosion? h Waterflow device(s) tested & operated properly?

K Visible piping & conduit supported and in good condition? i Tamper and low-air switch(es) tested & operated properly?

L Proper pipe schedule and fitting weight(s) for hazard design? j Abort station(s) tested & operated properly?

M Correct nozzle type(s) for protected space/equipment? k System equipped with a key-operated bypass switch?

N Nozzle(s) properly positioned in or around the hazard? l Manual pull station(s) tested & operated properly?

O Pneumatic tubing/sub-manifold connected and free of defects? m Audible device(s) tested & operated properly?

P Discharge hoses inspected and within test date? n Visual device(s) tested & operated properly?

Q Warning/instructional signage in place and clearly legible? o Remote/graphic annunciator(s) tested & operated properly?

R System equipped with pneumatic time-delay and pneumatic siren? p Cust. permitted testing of system interface(s) & shutdown(s)?

S Clean agent portable extinguisher available and properly serviced? q System interface(s)/shut-down(s) operated as designed?

CONTROL PANEL TEST & INSPECTION Y N N/A r Auxiliary relay(s) tested & operated properly?

T Customer called system out of service with monitoring company? s Tank actuator(s)/solenoid(s) tested & operated properly?

U Ground fault detection circuitry tested and operated properly? t Supervised actuator removal device(s) installed & operated properly?

V Purge panel/soak timer tested and operated properly? u Low pressure supervisory switch(es) functioning properly?

W Power suppl(ies) tested and operated properly? v Supervised lock-out valve(s) tested & operated properly?

X Battery charger tested and operated properly? w Directional valve(s) tested and operated properly?

Y Batter(ies) passed load test? Size Amp Hour x Main to Reserve transfer switch(es) tested & operated properly?

Z Electronic time delay/countdown display operated properly? y 8 Cross zone circuit(s) tested and operated properly? z 9 Sequential (counting) circuit(s) tested and operated properly? LOW PRESSURE CO2 TANK & TRIM Y N N/A

: Agent release circuit(s) tested and operated properly? 4 LPCO2 tank agent level OK?

; Overcurrent (surge) suppressor(s) installed on system? 5 LPCO2 tank internal pressure level OK?

lb. lb. psi 7 Tank shut-off valve supervision present and operates properly?

lb. lb. psi ! Manual pilot cabinet(s) tested and operated properly?

lb. lb. psi " Bleeder valve(s) due for next 5-year pressure test? Date:

lb. lb. psi # Relief valve(s) due for next 5-year pressure test? Date:

SYSTEM INSPECTED COMPLIANT WITH MANUFACTURER'S GUIDELINES & ALL APPLICABLE AUTHORIZED CUSTOMER'S REPRESENTATIVE:

CODES AND STANDARDS.

SIGNATURE:

PRINT NAME:

AUTHORIZED SERVICE COMPANY REPRESENTATIVE:

SIGNATURE:

SYSTEM LEFT OUT OF SERVICE DATE: TECH NO.

(SYSTEM WILL NOT OPERATE) (NON COMPLIANT)

IMPORTANT: Please read the "ACKNOWLEDGEMENT" on the reverse side before signing. Customer further acknowledges and understands that a copy of this report may be provided to the authority having jurisdiction.

MENTS ON THE REVERSE SIDE, UNDERSTANDS THEM AND AGREES TO BE BOUND BY THEM.CERTIFICATE OF INSPECTION (INSPECTION REPORT NOT VALID UNLESS COMPLETED & SIGNED)

CUSTOMER BY ITS SIGNATURE BELOW, ACKNOWLEDGES THAT IT HAS READ THE STATE-

SYSTEM RE-INSPECTED COMPLIANT -- DEFICIENCIES CORRECTED; NO FURTHER DEFICIENCIES

PLEASE NOTE "RECOMMENDATIONS/COMMENTS" ON ATTACHED NOTIFICATION OF DEFICIENCY REPORT

SYSTEM RE-ARMED & LEFT IN SERVICE

N/AFIELD DEVICE TEST & INSPECTION

NUMBER

Y

SYSTEM INSPECTED NON COMPLIANT WITH APPLICABLE CODES AND STANDARDS. (SEE NOTIFICATION OF DEFICIENCY REPORT ATTACHED.) CUSTOMER ACKNOWLEDGES THAT THE NATURE OF THESE DEFICIENCIES

MAY RENDER SYSTEM INOPERABLE IN EVENT OF A FIRE.

SYS. RED TAGGED

Room integrity testing has been performed within the last year?

CYLINDER INFORMATION HYDRO CYLINDER FILL WEIGHT CYL. PRESSURE

SUPPRESSION SYSTEM INSPECTION REPORT (SSIR)

NN/ACONDITION OF SYSTEM AT TIME OF ARRIVAL Y N

DATE CAPACITY (LBS.) (PSI) READING

Pneumatic release(s) tested & operated properly?

6 Refrigeration unit energized and operating properly?LIQ. LEVEL

SERIAL NUMBER

Rev 6_21 iPad 9 Dredge McFarland iPad 9 6400 Hog Island rd iPad 9 Philadelphia iPad 9 Pa iPad 9 iPad 9 iPad 9 Kidde iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 Anchor Windlass iPad 9 August 12, 2024 iPad 9 Mark Saylor iPad 9 311073 iPad 9 81148 iPad 9 9/13 iPad 9 iPad 9 iPad 9 61037 iPad 9 9/13 iPad 9 iPad 9 iPad 9 August 12, 2024

PHONE (215) 641-0100 SYSTEM LOCATION DATE OF SERVICE

FAX (215) 641-9638

www.keystonefire.com NJ PERMIT NO. P-00037 CONTACT PHONE

COMPANY NAME INSPECTION TYPE

INITIAL ANNUAL SEMI-ANNUAL QUARTERLY REPAIR RE-INSPECTION

ADDRESS SYSTEM TYPE

FM200 NOVEC HALON CO2 LPCO2 DRY CHEM __________

CITY STATE ZIP SYSTEM MFG. PANEL MFG./MODEL DET. MFG./MODEL

TESTED

B System off-normal at time of arrival? (alarm, trouble, etc.) < Smoke detector(s) tested & operated properly?

C System tampered with? Disarmed? Releasing device removed? = Were tested smoke detector(s) cleaned?

D System cylinder(s) down in pressure? a Were tested smoke detector sensitivity tested?

E System discharged at time of technician's arrival? b Separate Field Detector Report or BRC attached?

F Has the room/hazard changed since the last inspection? c Restorable heat detector(s) tested & operated properly?

G Engineered drawings match installed system? d Non-restorable heat detector(s) tested?

H Protected room/underfloor area(s) clean? e Pneumatic heat detector(s) tested & operated properly?

INSTALLATION CONDITIONS Y N N/A f Fusible link(s) and/or ETL(s) replaced per mfgr requirement?

I Tanks mounted and secured ? g Air sampling detector(s) tested & operated properly?

J Tanks visually inspected to be free of rust & corrosion? h Waterflow device(s) tested & operated properly?

K Visible piping & conduit supported and in good condition? i Tamper and low-air switch(es) tested & operated properly?

L Proper pipe schedule and fitting weight(s) for hazard design? j Abort station(s) tested & operated properly?

M Correct nozzle type(s) for protected space/equipment? k System equipped with a key-operated bypass switch?

N Nozzle(s) properly positioned in or around the hazard? l Manual pull station(s) tested & operated properly?

O Pneumatic tubing/sub-manifold connected and free of defects? m Audible device(s) tested & operated properly?

P Discharge hoses inspected and within test date? n Visual device(s) tested & operated properly?

Q Warning/instructional signage in place and clearly legible? o Remote/graphic annunciator(s) tested & operated properly?

R System equipped with pneumatic time-delay and pneumatic siren? p Cust. permitted testing of system interface(s) & shutdown(s)?

S Clean agent portable extinguisher available and properly serviced? q System interface(s)/shut-down(s) operated as designed?

CONTROL PANEL TEST & INSPECTION Y N N/A r Auxiliary relay(s) tested & operated properly?

T Customer called system out of service with monitoring company? s Tank actuator(s)/solenoid(s) tested & operated properly?

U Ground fault detection circuitry tested and operated properly? t Supervised actuator removal device(s) installed & operated properly?

V Purge panel/soak timer tested and operated properly? u Low pressure supervisory switch(es) functioning properly?

W Power suppl(ies) tested and operated properly? v Supervised lock-out valve(s) tested & operated properly?

X Battery charger tested and operated properly? w Directional valve(s) tested and operated properly?

Y Batter(ies) passed load test? Size Amp Hour x Main to Reserve transfer switch(es) tested & operated properly?

Z Electronic time delay/countdown display operated properly? y 8 Cross zone circuit(s) tested and operated properly? z 9 Sequential (counting) circuit(s) tested and operated properly? LOW PRESSURE CO2 TANK & TRIM Y N N/A

: Agent release circuit(s) tested and operated properly? 4 LPCO2 tank agent level OK?

; Overcurrent (surge) suppressor(s) installed on system? 5 LPCO2 tank internal pressure level OK?

lb. lb. psi 7 Tank shut-off valve supervision present and operates properly?

lb. lb. psi ! Manual pilot cabinet(s) tested and operated properly?

lb. lb. psi " Bleeder valve(s) due for next 5-year pressure test? Date:

lb. lb. psi # Relief valve(s) due for next 5-year pressure test? Date:

SYSTEM INSPECTED COMPLIANT WITH MANUFACTURER'S GUIDELINES & ALL APPLICABLE AUTHORIZED CUSTOMER'S REPRESENTATIVE:

CODES AND STANDARDS.

SIGNATURE:

PRINT NAME:

AUTHORIZED SERVICE COMPANY REPRESENTATIVE:

SIGNATURE:

SYSTEM LEFT OUT OF SERVICE DATE: TECH NO.

(SYSTEM WILL NOT OPERATE) (NON COMPLIANT)

IMPORTANT: Please read the "ACKNOWLEDGEMENT" on the reverse side before signing. Customer further acknowledges and understands that a copy of this report may be provided to the authority having jurisdiction.

MENTS ON THE REVERSE SIDE, UNDERSTANDS THEM AND AGREES TO BE BOUND BY THEM.CERTIFICATE OF INSPECTION (INSPECTION REPORT NOT VALID UNLESS COMPLETED & SIGNED)

SYSTEM RE-ARMED & LEFT IN SERVICE

N/AFIELD DEVICE TEST & INSPECTION

NUMBER

Y

SYSTEM INSPECTED NON COMPLIANT WITH APPLICABLE CODES AND STANDARDS. (SEE NOTIFICATION OF DEFICIENCY REPORT ATTACHED.) CUSTOMER ACKNOWLEDGES THAT THE NATURE OF THESE DEFICIENCIES

MAY RENDER SYSTEM INOPERABLE IN EVENT OF A FIRE.

SYS. RED TAGGED

Room integrity testing has been performed within the last year?

CYLINDER INFORMATION HYDRO CYLINDER FILL WEIGHT CYL. PRESSURE

SUPPRESSION SYSTEM INSPECTION REPORT (SSIR)

NN/ACONDITION OF SYSTEM AT TIME OF ARRIVAL Y N

DATE CAPACITY (LBS.) (PSI) READING

Pneumatic release(s) tested & operated properly?

6 Refrigeration unit energized and operating properly?LIQ. LEVEL

SERIAL NUMBER

Rev 6_21 iPad 9 Dredge McFarland iPad 9 6400 Hog Island rd iPad 9 Philadelphia iPad 9 Pa iPad 9 iPad 9 iPad 9 Kidde iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 Aux Gen hose reel iPad 9 August 12, 2024 iPad 9 Mark Saylor iPad 9 311084 iPad 9 9/13 iPad 9 iPad 9 iPad 9 9/13 iPad 9 iPad 9 iPad 9 August 12, 2024 iPad 9 61033

61088

PHONE (215) 641-0100 SYSTEM LOCATION DATE OF SERVICE

FAX (215) 641-9638

www.keystonefire.com NJ PERMIT NO. P-00037 CONTACT PHONE

COMPANY NAME INSPECTION TYPE

INITIAL ANNUAL SEMI-ANNUAL QUARTERLY REPAIR RE-INSPECTION

ADDRESS SYSTEM TYPE

FM200 NOVEC HALON CO2 LPCO2 DRY CHEM __________

CITY STATE ZIP SYSTEM MFG. PANEL MFG./MODEL DET. MFG./MODEL

TESTED

B System off-normal at time of arrival? (alarm, trouble, etc.) < Smoke detector(s) tested & operated properly?

C System tampered with? Disarmed? Releasing device removed? = Were tested smoke detector(s) cleaned?

D System cylinder(s) down in pressure? a Were tested smoke detector sensitivity tested?

E System discharged at time of technician's arrival? b Separate Field Detector Report or BRC attached?

F Has the room/hazard changed since the last inspection? c Restorable heat detector(s) tested & operated properly?

G Engineered drawings match installed system? d Non-restorable heat detector(s) tested?

H Protected room/underfloor area(s) clean? e Pneumatic heat detector(s) tested & operated properly?

INSTALLATION CONDITIONS Y N N/A f Fusible link(s) and/or ETL(s) replaced per mfgr requirement?

I Tanks mounted and secured ? g Air sampling detector(s) tested & operated properly?

J Tanks visually inspected to be free of rust & corrosion? h Waterflow device(s) tested & operated properly?

K Visible piping & conduit supported and in good condition? i Tamper and low-air switch(es) tested & operated properly?

L Proper pipe schedule and fitting weight(s) for hazard design? j Abort station(s) tested & operated properly?

M Correct nozzle type(s) for protected space/equipment? k System equipped with a key-operated bypass switch?

N Nozzle(s) properly positioned in or around the hazard? l Manual pull station(s) tested & operated properly?

O Pneumatic tubing/sub-manifold connected and free of defects? m Audible device(s) tested & operated properly?

P Discharge hoses inspected and within test date? n Visual device(s) tested & operated properly?

Q Warning/instructional signage in place and clearly legible? o Remote/graphic annunciator(s) tested & operated properly?

R System equipped with pneumatic time-delay and pneumatic siren? p Cust. permitted testing of system interface(s) & shutdown(s)?

S Clean agent portable extinguisher available and properly serviced? q System interface(s)/shut-down(s) operated as designed?

CONTROL PANEL TEST & INSPECTION Y N N/A r Auxiliary relay(s) tested & operated properly?

T Customer called system out of service with monitoring company? s Tank actuator(s)/solenoid(s) tested & operated properly?

U Ground fault detection circuitry tested and operated properly? t Supervised actuator removal device(s) installed & operated properly?

V Purge panel/soak timer tested and operated properly? u Low pressure supervisory switch(es) functioning properly?

W Power suppl(ies) tested and operated properly? v Supervised lock-out valve(s) tested & operated properly?

X Battery charger tested and operated properly? w Directional valve(s) tested and operated properly?

Y Batter(ies) passed load test? Size Amp Hour x Main to Reserve transfer switch(es) tested & operated properly?

Z Electronic time delay/countdown display operated properly? y 8 Cross zone circuit(s) tested and operated properly? z 9 Sequential (counting) circuit(s) tested and operated properly? LOW PRESSURE CO2 TANK & TRIM Y N N/A

: Agent release circuit(s) tested and operated properly? 4 LPCO2 tank agent level OK?

; Overcurrent (surge) suppressor(s) installed on system? 5 LPCO2 tank internal pressure level OK?

lb. lb. psi 7 Tank shut-off valve supervision present and operates properly?

lb. lb. psi ! Manual pilot cabinet(s) tested and operated properly?

lb. lb. psi " Bleeder valve(s) due for next 5-year pressure test? Date:

lb. lb. psi # Relief valve(s) due for next 5-year pressure test? Date:

SYSTEM INSPECTED COMPLIANT WITH MANUFACTURER'S GUIDELINES & ALL APPLICABLE AUTHORIZED CUSTOMER'S REPRESENTATIVE:

CODES AND STANDARDS.

SIGNATURE:

PRINT NAME:

AUTHORIZED SERVICE COMPANY REPRESENTATIVE:

SIGNATURE:

SYSTEM LEFT OUT OF SERVICE DATE: TECH NO.

(SYSTEM WILL NOT OPERATE) (NON COMPLIANT)

IMPORTANT: Please read the "ACKNOWLEDGEMENT" on the reverse side before signing. Customer further acknowledges and understands that a copy of this report may be provided to the authority having jurisdiction.

MENTS ON THE REVERSE SIDE, UNDERSTANDS THEM AND AGREES TO BE BOUND BY THEM.CERTIFICATE OF INSPECTION (INSPECTION REPORT NOT VALID UNLESS COMPLETED & SIGNED)

SYSTEM RE-ARMED & LEFT IN SERVICE

N/AFIELD DEVICE TEST & INSPECTION

NUMBER

Y

SYSTEM INSPECTED NON COMPLIANT WITH APPLICABLE CODES AND STANDARDS. (SEE NOTIFICATION OF DEFICIENCY REPORT ATTACHED.) CUSTOMER ACKNOWLEDGES THAT THE NATURE OF THESE DEFICIENCIES

MAY RENDER SYSTEM INOPERABLE IN EVENT OF A FIRE.

SYS. RED TAGGED

Room integrity testing has been performed within the last year?

CYLINDER INFORMATION HYDRO CYLINDER FILL WEIGHT CYL. PRESSURE

SUPPRESSION SYSTEM INSPECTION REPORT (SSIR)

NN/ACONDITION OF SYSTEM AT TIME OF ARRIVAL Y N

DATE CAPACITY (LBS.) (PSI) READING

Pneumatic release(s) tested & operated properly?

6 Refrigeration unit energized and operating properly?LIQ. LEVEL

SERIAL NUMBER

Rev 6_21 iPad 9 Dredge McFarland iPad 9 6400 Hog Island rd iPad 9 Philadelphia iPad 9 Pa iPad 9 311080 iPad 9 Aux generator rm iPad 9 Mark Saylor iPad 9 iPad 9 iPad 9 Kidde iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 August 12, 2024 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 August 12, 2024 iPad 9 9/13 iPad 9 9/13 iPad 9 iPad 9 81148 245559 61084

9/13 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 Port Center Starboard

PHONE (215) 641-0100 SYSTEM LOCATION DATE OF SERVICE

FAX (215) 641-9638

www.keystonefire.com NJ PERMIT NO. P-00037 CONTACT PHONE

COMPANY NAME INSPECTION TYPE

INITIAL ANNUAL SEMI-ANNUAL QUARTERLY REPAIR RE-INSPECTION

ADDRESS SYSTEM TYPE

FM200 NOVEC HALON CO2 LPCO2 DRY CHEM __________

CITY STATE ZIP SYSTEM MFG. PANEL MFG./MODEL DET. MFG./MODEL

TESTED

B System off-normal at time of arrival? (alarm, trouble, etc.) < Smoke detector(s) tested & operated properly?

C System tampered with? Disarmed? Releasing device removed? = Were tested smoke detector(s) cleaned?

D System cylinder(s) down in pressure? a Were tested smoke detector sensitivity tested?

E System discharged at time of technician's arrival? b Separate Field Detector Report or BRC attached?

F Has the room/hazard changed since the last inspection? c Restorable heat detector(s) tested & operated properly?

G Engineered drawings match installed system? d Non-restorable heat detector(s) tested?

H Protected room/underfloor area(s) clean? e Pneumatic heat detector(s) tested & operated properly?

INSTALLATION CONDITIONS Y N N/A f Fusible link(s) and/or ETL(s) replaced per mfgr requirement?

I Tanks mounted and secured ? g Air sampling detector(s) tested & operated properly?

J Tanks visually inspected to be free of rust & corrosion? h Waterflow device(s) tested & operated properly?

K Visible piping & conduit supported and in good condition? i Tamper and low-air switch(es) tested & operated properly?

L Proper pipe schedule and fitting weight(s) for hazard design? j Abort station(s) tested & operated properly?

M Correct nozzle type(s) for protected space/equipment? k System equipped with a key-operated bypass switch?

N Nozzle(s) properly positioned in or around the hazard? l Manual pull station(s) tested & operated properly?

O Pneumatic tubing/sub-manifold connected and free of defects? m Audible device(s) tested & operated properly?

P Discharge hoses inspected and within test date? n Visual device(s) tested & operated properly?

Q Warning/instructional signage in place and clearly legible? o Remote/graphic annunciator(s) tested & operated properly?

R System equipped with pneumatic time-delay and pneumatic siren? p Cust. permitted testing of system interface(s) & shutdown(s)?

S Clean agent portable extinguisher available and properly serviced? q System interface(s)/shut-down(s) operated as designed?

CONTROL PANEL TEST & INSPECTION Y N N/A r Auxiliary relay(s) tested & operated properly?

T Customer called system out of service with monitoring company? s Tank actuator(s)/solenoid(s) tested & operated properly?

U Ground fault detection circuitry tested and operated properly? t Supervised actuator removal device(s) installed & operated properly?

V Purge panel/soak timer tested and operated properly? u Low pressure supervisory switch(es) functioning properly?

W Power suppl(ies) tested and operated properly? v Supervised lock-out valve(s) tested & operated properly?

X Battery charger tested and operated properly? w Directional valve(s) tested and operated properly?

Y Batter(ies) passed load test? Size Amp Hour x Main to Reserve transfer switch(es) tested & operated properly?

Z Electronic time delay/countdown display operated properly? y 8 Cross zone circuit(s) tested and operated properly? z 9 Sequential (counting) circuit(s) tested and operated properly? LOW PRESSURE CO2 TANK & TRIM Y N N/A

: Agent release circuit(s) tested and operated properly? 4 LPCO2 tank agent level OK?

; Overcurrent (surge) suppressor(s) installed on system? 5 LPCO2 tank internal pressure level OK?

lb. lb. psi 7 Tank shut-off valve supervision present and operates properly?

lb. lb. psi ! Manual pilot cabinet(s) tested and operated properly?

lb. lb. psi " Bleeder valve(s) due for next 5-year pressure test? Date:

lb. lb. psi # Relief valve(s) due for next 5-year pressure test? Date:

SYSTEM INSPECTED COMPLIANT WITH MANUFACTURER'S GUIDELINES & ALL APPLICABLE AUTHORIZED CUSTOMER'S REPRESENTATIVE:

CODES AND STANDARDS.

SIGNATURE:

PRINT NAME:

AUTHORIZED SERVICE COMPANY REPRESENTATIVE:

SIGNATURE:

SYSTEM LEFT OUT OF SERVICE DATE: TECH NO.

(SYSTEM WILL NOT OPERATE) (NON COMPLIANT)

IMPORTANT: Please read the "ACKNOWLEDGEMENT" on the reverse side before signing. Customer further acknowledges and understands that a copy of this report may be provided to the authority having jurisdiction.

MENTS ON THE REVERSE SIDE, UNDERSTANDS THEM AND AGREES TO BE BOUND BY THEM.CERTIFICATE OF INSPECTION (INSPECTION REPORT NOT VALID UNLESS COMPLETED & SIGNED)

SYSTEM RE-ARMED & LEFT IN SERVICE

N/AFIELD DEVICE TEST & INSPECTION

NUMBER

Y

SYSTEM INSPECTED NON COMPLIANT WITH APPLICABLE CODES AND STANDARDS. (SEE NOTIFICATION OF DEFICIENCY REPORT ATTACHED.) CUSTOMER ACKNOWLEDGES THAT THE NATURE OF THESE DEFICIENCIES

MAY RENDER SYSTEM INOPERABLE IN EVENT OF A FIRE.

SYS. RED TAGGED

Room integrity testing has been performed within the last year?

CYLINDER INFORMATION HYDRO CYLINDER FILL WEIGHT CYL. PRESSURE

SUPPRESSION SYSTEM INSPECTION REPORT (SSIR)

NN/ACONDITION OF SYSTEM AT TIME OF ARRIVAL Y N

DATE CAPACITY (LBS.) (PSI) READING

Pneumatic release(s) tested & operated properly?

6 Refrigeration unit energized and operating properly?LIQ. LEVEL

SERIAL NUMBER

Rev 6_21 iPad 9 Dredge McFarland iPad 9 6400 Hog Island rd iPad 9 Philadelphia iPad 9 Pa iPad 9 iPad 9 iPad 9 Kidde iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 August 12, 2024 iPad 9 Mark Saylor iPad 9 311089 iPad 9 August 12, 2024 iPad 9 AMR hose iPad 9 61066 iPad 9 154599 iPad 9 11/16 iPad 9 11/16 iPad 9 iPad 9 iPad 9

PHONE (215) 641-0100 SYSTEM LOCATION DATE OF SERVICE

FAX (215) 641-9638

www.keystonefire.com NJ PERMIT NO. P-00037 CONTACT PHONE

COMPANY NAME INSPECTION TYPE

INITIAL ANNUAL SEMI-ANNUAL QUARTERLY REPAIR RE-INSPECTION

ADDRESS SYSTEM TYPE

FM200 NOVEC HALON CO2 LPCO2 DRY CHEM __________

CITY STATE ZIP SYSTEM MFG. PANEL MFG./MODEL DET. MFG./MODEL

TESTED

B System off-normal at time of arrival? (alarm, trouble, etc.) < Smoke detector(s) tested & operated properly?

C System tampered with? Disarmed? Releasing device removed? = Were tested smoke detector(s) cleaned?

D System cylinder(s) down in pressure? a Were tested smoke detector sensitivity tested?

E System discharged at time of technician's arrival? b Separate Field Detector Report or BRC attached?

F Has the room/hazard changed since the last inspection? c Restorable heat detector(s) tested & operated properly?

G Engineered drawings match installed system? d Non-restorable heat detector(s) tested?

H Protected room/underfloor area(s) clean? e Pneumatic heat detector(s) tested & operated properly?

INSTALLATION CONDITIONS Y N N/A f Fusible link(s) and/or ETL(s) replaced per mfgr requirement?

I Tanks mounted and secured ? g Air sampling detector(s) tested & operated properly?

J Tanks visually inspected to be free of rust & corrosion? h Waterflow device(s) tested & operated properly?

K Visible piping & conduit supported and in good condition? i Tamper and low-air switch(es) tested & operated properly?

L Proper pipe schedule and fitting weight(s) for hazard design? j Abort station(s) tested & operated properly?

M Correct nozzle type(s) for protected space/equipment? k System equipped with a key-operated bypass switch?

N Nozzle(s) properly positioned in or around the hazard? l Manual pull station(s) tested & operated properly?

O Pneumatic tubing/sub-manifold connected and free of defects? m Audible device(s) tested & operated properly?

P Discharge hoses inspected and within test date? n Visual device(s) tested & operated properly?

Q Warning/instructional signage in place and clearly legible? o Remote/graphic annunciator(s) tested & operated properly?

R System equipped with pneumatic time-delay and pneumatic siren? p Cust. permitted testing of system interface(s) & shutdown(s)?

S Clean agent portable extinguisher available and properly serviced? q System interface(s)/shut-down(s) operated as designed?

CONTROL PANEL TEST & INSPECTION Y N N/A r Auxiliary relay(s) tested & operated properly?

T Customer called system out of service with monitoring company? s Tank actuator(s)/solenoid(s) tested & operated properly?

U Ground fault detection circuitry tested and operated properly? t Supervised actuator removal device(s) installed & operated properly?

V Purge panel/soak timer tested and operated properly? u Low pressure supervisory switch(es) functioning properly?

W Power suppl(ies) tested and operated properly? v Supervised lock-out valve(s) tested & operated properly?

X Battery charger tested and operated properly? w Directional valve(s) tested and operated properly?

Y Batter(ies) passed load test? Size Amp Hour x Main to Reserve transfer switch(es) tested & operated properly?

Z Electronic time delay/countdown display operated properly? y 8 Cross zone circuit(s) tested and operated properly? z 9 Sequential (counting) circuit(s) tested and operated properly? LOW PRESSURE CO2 TANK & TRIM Y N N/A

: Agent release circuit(s) tested and operated properly? 4 LPCO2 tank agent level OK?

; Overcurrent (surge) suppressor(s) installed on system? 5 LPCO2 tank internal pressure level OK?

lb. lb. psi 7 Tank shut-off valve supervision present and operates properly?

lb. lb. psi ! Manual pilot cabinet(s) tested and operated properly?

lb. lb. psi " Bleeder valve(s) due for next 5-year pressure test? Date:

lb. lb. psi # Relief valve(s) due for next 5-year pressure test? Date:

SYSTEM INSPECTED COMPLIANT WITH MANUFACTURER'S GUIDELINES & ALL APPLICABLE AUTHORIZED CUSTOMER'S REPRESENTATIVE:

CODES AND STANDARDS.

SIGNATURE:

PRINT NAME:

AUTHORIZED SERVICE COMPANY REPRESENTATIVE:

SIGNATURE:

SYSTEM LEFT OUT OF SERVICE DATE: TECH NO.

(SYSTEM WILL NOT OPERATE) (NON COMPLIANT)

IMPORTANT: Please read the "ACKNOWLEDGEMENT" on the reverse side before signing. Customer further acknowledges and understands that a copy of this report may be provided to the authority having jurisdiction.

MENTS ON THE REVERSE SIDE, UNDERSTANDS THEM AND AGREES TO BE BOUND BY THEM.CERTIFICATE OF INSPECTION (INSPECTION REPORT NOT VALID UNLESS COMPLETED & SIGNED)

SYSTEM RE-ARMED & LEFT IN SERVICE

N/AFIELD DEVICE TEST & INSPECTION

NUMBER

Y

SYSTEM INSPECTED NON COMPLIANT WITH APPLICABLE CODES AND STANDARDS. (SEE NOTIFICATION OF DEFICIENCY REPORT ATTACHED.) CUSTOMER ACKNOWLEDGES THAT THE NATURE OF THESE DEFICIENCIES

MAY RENDER SYSTEM INOPERABLE IN EVENT OF A FIRE.

SYS. RED TAGGED

Room integrity testing has been performed within the last year?

CYLINDER INFORMATION HYDRO CYLINDER FILL WEIGHT CYL. PRESSURE

SUPPRESSION SYSTEM INSPECTION REPORT (SSIR)

NN/ACONDITION OF SYSTEM AT TIME OF ARRIVAL Y N

DATE CAPACITY (LBS.) (PSI) READING

Pneumatic release(s) tested & operated properly?

6 Refrigeration unit energized and operating properly?LIQ. LEVEL

SERIAL NUMBER

Rev 6_21 iPad 9 Dredge McFarland iPad 9 6400 Hog Island rd iPad 9 Philadelphia iPad 9 Pa iPad 9 311077 iPad 9 Mark Saylor iPad 9 iPad 9 iPad 9 Kidde iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 August 12, 2024 iPad 9 9/13 iPad 9 9/13 iPad 9 August 12, 2024 iPad 9 Control room iPad 9 iPad 9 iPad 9 8113901 iPad 9 8120001 iPad 9 iPad 9 iPad 9

PHONE (215) 641-0100 SYSTEM LOCATION DATE OF SERVICE

FAX (215) 641-9638

www.keystonefire.com NJ PERMIT NO. P-00037 CONTACT PHONE

COMPANY NAME INSPECTION TYPE

INITIAL ANNUAL SEMI-ANNUAL QUARTERLY REPAIR RE-INSPECTION

ADDRESS SYSTEM TYPE

FM200 NOVEC HALON CO2 LPCO2 DRY CHEM __________

CITY STATE ZIP SYSTEM MFG. PANEL MFG./MODEL DET. MFG./MODEL

TESTED

B System off-normal at time of arrival? (alarm, trouble, etc.) < Smoke detector(s) tested & operated properly?

C System tampered with? Disarmed? Releasing device removed? = Were tested smoke detector(s) cleaned?

D System cylinder(s) down in pressure? a Were tested smoke detector sensitivity tested?

E System discharged at time of technician's arrival? b Separate Field Detector Report or BRC attached?

F Has the room/hazard changed since the last inspection? c Restorable heat detector(s) tested & operated properly?

G Engineered drawings match installed system? d Non-restorable heat detector(s) tested?

H Protected room/underfloor area(s) clean? e Pneumatic heat detector(s) tested & operated properly?

INSTALLATION CONDITIONS Y N N/A f Fusible link(s) and/or ETL(s) replaced per mfgr requirement?

I Tanks mounted and secured ? g Air sampling detector(s) tested & operated properly?

J Tanks visually inspected to be free of rust & corrosion? h Waterflow device(s) tested & operated properly?

K Visible piping & conduit supported and in good condition? i Tamper and low-air switch(es) tested & operated properly?

L Proper pipe schedule and fitting weight(s) for hazard design? j Abort station(s) tested & operated properly?

M Correct nozzle type(s) for protected space/equipment? k System equipped with a key-operated bypass switch?

N Nozzle(s) properly positioned in or around the hazard? l Manual pull station(s) tested & operated properly?

O Pneumatic tubing/sub-manifold connected and free of defects? m Audible device(s) tested & operated properly?

P Discharge hoses inspected and within test date? n Visual device(s) tested & operated properly?

Q Warning/instructional signage in place and clearly legible? o Remote/graphic annunciator(s) tested & operated properly?

R System equipped with pneumatic time-delay and pneumatic siren? p Cust. permitted testing of system interface(s) & shutdown(s)?

S Clean agent portable extinguisher available and properly serviced? q System interface(s)/shut-down(s) operated as designed?

CONTROL PANEL TEST & INSPECTION Y N N/A r Auxiliary relay(s) tested & operated properly?

T Customer called system out of service with monitoring company? s Tank actuator(s)/solenoid(s) tested & operated properly?

U Ground fault detection circuitry tested and operated properly? t Supervised actuator removal device(s) installed & operated properly?

V Purge panel/soak timer tested and operated properly? u Low pressure supervisory switch(es) functioning properly?

W Power suppl(ies) tested and operated properly? v Supervised lock-out valve(s) tested & operated properly?

X Battery charger tested and operated properly? w Directional valve(s) tested and operated properly?

Y Batter(ies) passed load test? Size Amp Hour x Main to Reserve transfer switch(es) tested & operated properly?

Z Electronic time delay/countdown display operated properly? y 8 Cross zone circuit(s) tested and operated properly? z 9 Sequential (counting) circuit(s) tested and operated properly? LOW PRESSURE CO2 TANK & TRIM Y N N/A

: Agent release circuit(s) tested and operated properly? 4 LPCO2 tank agent level OK?

; Overcurrent (surge) suppressor(s) installed on system? 5 LPCO2 tank internal pressure level OK?

lb. lb. psi 7 Tank shut-off valve supervision present and operates properly?

lb. lb. psi ! Manual pilot cabinet(s) tested and operated properly?

lb. lb. psi " Bleeder valve(s) due for next 5-year pressure test? Date:

lb. lb. psi # Relief valve(s) due for next 5-year pressure test? Date:

SYSTEM INSPECTED COMPLIANT WITH MANUFACTURER'S GUIDELINES & ALL APPLICABLE AUTHORIZED CUSTOMER'S REPRESENTATIVE:

CODES AND STANDARDS.

SIGNATURE:

PRINT NAME:

AUTHORIZED SERVICE COMPANY REPRESENTATIVE:

SIGNATURE:

SYSTEM LEFT OUT OF SERVICE DATE: TECH NO.

(SYSTEM WILL NOT OPERATE) (NON COMPLIANT)

IMPORTANT: Please read the "ACKNOWLEDGEMENT" on the reverse side before signing. Customer further acknowledges and understands that a copy of this report may be provided to the authority having jurisdiction.

MENTS ON THE REVERSE SIDE, UNDERSTANDS THEM AND AGREES TO BE BOUND BY THEM.CERTIFICATE OF INSPECTION (INSPECTION REPORT NOT VALID UNLESS COMPLETED & SIGNED)

SYSTEM RE-ARMED & LEFT IN SERVICE

N/AFIELD DEVICE TEST & INSPECTION

NUMBER

Y

SYSTEM INSPECTED NON COMPLIANT WITH APPLICABLE CODES AND STANDARDS. (SEE NOTIFICATION OF DEFICIENCY REPORT ATTACHED.) CUSTOMER ACKNOWLEDGES THAT THE NATURE OF THESE DEFICIENCIES

MAY RENDER SYSTEM INOPERABLE IN EVENT OF A FIRE.

SYS. RED TAGGED

Room integrity testing has been performed within the last year?

CYLINDER INFORMATION HYDRO CYLINDER FILL WEIGHT CYL. PRESSURE

SUPPRESSION SYSTEM INSPECTION REPORT (SSIR)

NN/ACONDITION OF SYSTEM AT TIME OF ARRIVAL Y N

DATE CAPACITY (LBS.) (PSI) READING

Pneumatic release(s) tested & operated properly?

6 Refrigeration unit energized and operating properly?LIQ. LEVEL

SERIAL NUMBER

Rev 6_21 iPad 9 Dredge McFarland iPad 9 6400 Hog Island rd iPad 9 Philadelphia iPad 9 Pa iPad 9 311078 iPad 9 Emergency diesel iPad 9 Mark Saylor iPad 9 iPad 9 iPad 9 Kidde iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 August 12, 2024 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 August 12, 2024 iPad 9 60942 iPad 9 222944 iPad 9 9/13 iPad 9 9/13 iPad 9 iPad 9

PHONE (215) 641-0100 SYSTEM LOCATION DATE OF SERVICE

FAX (215) 641-9638

www.keystonefire.com NJ PERMIT NO. P-00037 CONTACT PHONE

COMPANY NAME INSPECTION TYPE

INITIAL ANNUAL SEMI-ANNUAL QUARTERLY REPAIR RE-INSPECTION

ADDRESS SYSTEM TYPE

FM200 NOVEC HALON CO2 LPCO2 DRY CHEM __________

CITY STATE ZIP SYSTEM MFG. PANEL MFG./MODEL DET. MFG./MODEL

TESTED

B System off-normal at time of arrival? (alarm, trouble, etc.) < Smoke detector(s) tested & operated properly?

C System tampered with? Disarmed? Releasing device removed? = Were tested smoke detector(s) cleaned?

D System cylinder(s) down in pressure? a Were tested smoke detector sensitivity tested?

E System discharged at time of technician's arrival? b Separate Field Detector Report or BRC attached?

F Has the room/hazard changed since the last inspection? c Restorable heat detector(s) tested & operated properly?

G Engineered drawings match installed system? d Non-restorable heat detector(s) tested?

H Protected room/underfloor area(s) clean? e Pneumatic heat detector(s) tested & operated properly?

INSTALLATION CONDITIONS Y N N/A f Fusible link(s) and/or ETL(s) replaced per mfgr requirement?

I Tanks mounted and secured ? g Air sampling detector(s) tested & operated properly?

J Tanks visually inspected to be free of rust & corrosion? h Waterflow device(s) tested & operated properly?

K Visible piping & conduit supported and in good condition? i Tamper and low-air switch(es) tested & operated properly?

L Proper pipe schedule and fitting weight(s) for hazard design? j Abort station(s) tested & operated properly?

M Correct nozzle type(s) for protected space/equipment? k System equipped with a key-operated bypass switch?

N Nozzle(s) properly positioned in or around the hazard? l Manual pull station(s) tested & operated properly?

O Pneumatic tubing/sub-manifold connected and free of defects? m Audible device(s) tested & operated properly?

P Discharge hoses inspected and within test date? n Visual device(s) tested & operated properly?

Q Warning/instructional signage in place and clearly legible? o Remote/graphic annunciator(s) tested & operated properly?

R System equipped with pneumatic time-delay and pneumatic siren? p Cust. permitted testing of system interface(s) & shutdown(s)?

S Clean agent portable extinguisher available and properly serviced? q System interface(s)/shut-down(s) operated as designed?

CONTROL PANEL TEST & INSPECTION Y N N/A r Auxiliary relay(s) tested & operated properly?

T Customer called system out of service with monitoring company? s Tank actuator(s)/solenoid(s) tested & operated properly?

U Ground fault detection circuitry tested and operated properly? t Supervised actuator removal device(s) installed & operated properly?

V Purge panel/soak timer tested and operated properly? u Low pressure supervisory switch(es) functioning properly?

W Power suppl(ies) tested and operated properly? v Supervised lock-out valve(s) tested & operated properly?

X Battery charger tested and operated properly? w Directional valve(s) tested and operated properly?

Y Batter(ies) passed load test? Size Amp Hour x Main to Reserve transfer switch(es) tested & operated properly?

Z Electronic time delay/countdown display operated properly? y 8 Cross zone circuit(s) tested and operated properly? z 9 Sequential (counting) circuit(s) tested and operated properly? LOW PRESSURE CO2 TANK & TRIM Y N N/A

: Agent release circuit(s) tested and operated properly? 4 LPCO2 tank agent level OK?

; Overcurrent (surge) suppressor(s) installed on system? 5 LPCO2 tank internal pressure level OK?

lb. lb. psi 7 Tank shut-off valve supervision present and operates properly?

lb. lb. psi ! Manual pilot cabinet(s) tested and operated properly?

lb. lb. psi " Bleeder valve(s) due for next 5-year pressure test? Date:

lb. lb. psi # Relief valve(s) due for next 5-year pressure test? Date:

SYSTEM INSPECTED COMPLIANT WITH MANUFACTURER'S GUIDELINES & ALL APPLICABLE AUTHORIZED CUSTOMER'S REPRESENTATIVE:

CODES AND STANDARDS.

SIGNATURE:

PRINT NAME:

AUTHORIZED SERVICE COMPANY REPRESENTATIVE:

SIGNATURE:

SYSTEM LEFT OUT OF SERVICE DATE: TECH NO.

(SYSTEM WILL NOT OPERATE) (NON COMPLIANT)

IMPORTANT: Please read the "ACKNOWLEDGEMENT" on the reverse side before signing. Customer further acknowledges and understands that a copy of this report may be provided to the authority having jurisdiction.

MENTS ON THE REVERSE SIDE, UNDERSTANDS THEM AND AGREES TO BE BOUND BY THEM.CERTIFICATE OF INSPECTION (INSPECTION REPORT NOT VALID UNLESS COMPLETED & SIGNED)

SYSTEM RE-ARMED & LEFT IN SERVICE

N/AFIELD DEVICE TEST & INSPECTION

NUMBER

Y

SYSTEM INSPECTED NON COMPLIANT WITH APPLICABLE CODES AND STANDARDS. (SEE NOTIFICATION OF DEFICIENCY REPORT ATTACHED.) CUSTOMER ACKNOWLEDGES THAT THE NATURE OF THESE DEFICIENCIES

MAY RENDER SYSTEM INOPERABLE IN EVENT OF A FIRE.

SYS. RED TAGGED

Room integrity testing has been performed within the last year?

CYLINDER INFORMATION HYDRO CYLINDER FILL WEIGHT CYL. PRESSURE

SUPPRESSION SYSTEM INSPECTION REPORT (SSIR)

NN/ACONDITION OF SYSTEM AT TIME OF ARRIVAL Y N

DATE CAPACITY (LBS.) (PSI) READING

Pneumatic release(s) tested & operated properly?

6 Refrigeration unit energized and operating properly?LIQ. LEVEL

SERIAL NUMBER

Rev 6_21 iPad 9 Dredge McFarland iPad 9 6400 Hog Island rd iPad 9 Philadelphia iPad 9 Pa iPad 9 311080 iPad 9 Aux generator rm iPad 9 Mark Saylor iPad 9 iPad 9 iPad 9 Kidde iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 August 12, 2024 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 August 12, 2024 iPad 9 9/13 iPad 9 9/13 iPad 9 iPad 9 81148 245559 61084

9/13 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 iPad 9 Port Center Starboard

PHONE (215) 641-0100 SYSTEM LOCATION DATE OF SERVICE

FAX (215) 641-9638

www.keystonefire.com NJ PERMIT NO. P-00037 CONTACT PHONE

COMPANY NAME INSPECTION TYPE

INITIAL ANNUAL SEMI-ANNUAL QUARTERLY REPAIR RE-INSPECTION

ADDRESS SYSTEM TYPE

FM200 NOVEC HALON CO2 LPCO2 DRY CHEM __________

CITY STATE ZIP SYSTEM MFG. PANEL MFG./MODEL DET. MFG./MODEL

TESTED

B System off-normal at time of arrival? (alarm, trouble, etc.) < Smoke detector(s) tested & operated properly?

C System tampered with? Disarmed? Releasing device removed? = Were tested smoke detector(s) cleaned?

D System cylinder(s) down in pressure? a Were tested smoke detector sensitivity tested?

E System discharged at time of technician's arrival? b Separate Field Detector Report or BRC attached?

F Has the room/hazard changed since the last inspection? c Restorable heat detector(s) tested & operated properly?

G Engineered drawings match installed system? d Non-restorable heat detector(s) tested?

H Protected room/underfloor area(s) clean? e Pneumatic heat detector(s) tested & operated properly?

INSTALLATION CONDITIONS Y N N/A f Fusible link(s) and/or ETL(s) replaced per mfgr requirement?

I Tanks mounted and secured ? g Air sampling detector(s) tested & operated properly?

J Tanks visually inspected to be free of rust & corrosion? h Waterflow device(s) tested & operated properly?

K Visible piping & conduit supported and in good condition? i Tamper and low-air switch(es) tested & operated properly?

L Proper pipe schedule and fitting weight(s) for hazard design? j Abort station(s) tested & operated properly?

M Correct nozzle type(s) for protected space/equipment? k System equipped with a key-operated bypass switch?

N Nozzle(s) properly positioned in or around the hazard? l Manual pull station(s) tested & operated properly?

O Pneumatic tubing/sub-manifold connected and free of defects? m Audible device(s) tested & operated properly?

P Discharge hoses inspected and within test date? n Visual device(s) tested & operated properly?

Q Warning/instructional signage in place and clearly legible? o Remote/graphic annunciator(s) tested & operated properly?

R System equipped with pneumatic time-delay and pneumatic siren? p Cust. permitted testing of system interface(s) & shutdown(s)?

S Clean agent portable extinguisher available and properly serviced? q System interface(s)/shut-down(s) operated as designed?

CONTROL PANEL TEST & INSPECTION Y N N/A r Auxiliary relay(s) tested & operated properly?

T Customer called system out of service with monitoring company? s Tank actuator(s)/solenoid(s) tested & operated properly?

U Ground fault detection circuitry tested and operated properly? t Supervised actuator removal device(s) installed & operated properly?

V Purge panel/soak timer tested and operated properly? u Low pressure supervisory switch(es) functioning properly?

W Power suppl(ies) tested and operated properly? v Supervised lock-out valve(s) tested & operated properly?

X…

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File details come from the government source that posted it. Updated .