Tampa-VAMC-Bldgs-_2-19-33-36-37-39-40-56_-_June_2018.pdf

Fire Alarm and Life Safety System

Inspection Certificate

For

Tampa VAMC Bldg 2

13000 Bruce B Downs Blvd

Tampa,FL 33637

Kinetix has performed this inspection and testing service in compliance with The Joint

Commission/VHA Standards. The inspection/testing frequencies adhered to for this service have been performed in accordance with The Joint Commission/VHA Memorandum 23 Concurrence on EC &

LS Standards effective September 2017. This Inspection was performed in accordance with applicable

NFPA Standards. The subsequent pages of this report provide performance measurements, listed ranges of acceptable results, and complete documentation of the inspection. Whenever discrepancies exist between acceptable performance standards and actual test results, notes and/or recommended solutions have been proposed or provided for immediate review and approval.

Inspection Completion Date

Jun 12, 2018

Building: Tampa VAMC Bldg 2 Company: Kinetix

Contact: Darren Matteson Contact: Michael Gill

Title: Biomedical Engineer Title: Field Supervisor/Technician

Kinetix 1 07/13/2018

Executive Summary Generated by: BuildingReports.com

Building Information

Building: Tampa VAMC Bldg 2 Contact: Darren Matteson

Address: 13000 Bruce B Downs Blvd Phone: 813-972-2000

Address: Fax:

City/State/Zip: Tampa, FL 33637 Mobile:

Country: United States of America Email:

Inspection Performed By

Company: Kinetix Inspector: Michael Gill

Address: 12 Creek Parkway Phone: 386-747-2294

Address: Fax: 3145020737

City/State/Zip: Boothwyn, PA 19061 Mobile:

Country: United States of America Email: michaelgill15@yahoo.com

Monitoring Company: Phone: Account #:

Central Station Signal Verification Type: Digital Communicator Mfg: Simplex Model #:

Test Time/Date: 6/12/18 11:07:50 AM Restore Time

Kinetix 2 07/13/2018

Inspection Completion Date: Jun 12, 2018

Building: Tampa VAMC Bldg 2

EC 02.03.05 EP 02

Semi-annual testing of water flow devices and valve tamper switches

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Tamper Switch 0 0 0 8 0 8

EC 02.03.05 EP 03

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Duct Detector 2 2 0 2 0 2

Heat Detector 3 3 0 3 0 3

Pull Station 13 13 0 13 0 13

Smoke Detector 33 33 0 33 0 33

EC 02.03.05 EP 04

Annual test of visual and audible fire alarms, including speakers and door releasing devices

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Releasing Device 2 2 0 2 0 2

Speaker/Strobe 13 13 0 13 0 13

EC 02.03.05 EP 05

Annual test of fire alarm equipment for notifying off-site fire responders

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Communicator 1 1 0 1 0 1

EC 02.03.05 EP 19

Annual test of automatic smoke-detection shutdown devices for air-handling equipment per NFPA 90A-2018

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Duct Detector 2 2 0 2 0 2

LS 02.01.34 EP 04

All other Life Safety Code fire alarm requirements related to NFPA 101-2018

18/19.3.4

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Battery 2 0 2 2 0 2

Total Device Count: 77

Kinetix 3 07/13/2018

Certification

Company: Kinetix Building: Tampa VAMC Bldg 2

Inspector: Michael Gill Contact: Darren Matteson

Signed: Signed:

Kinetix 4 07/13/2018

Discrepancy Report

Building: Tampa VAMC Bldg 2 Control Panel: 10

The Discrepancy Report consolidates each discrepancy listed within the various Testing sections of your Inspection.

Discrepancies are listed by Category, and grouped by device type. The description of the problem is provided and where appropriate, code references are listed for your convenience. Any item that was inspected that is listed on the Consumer

Product Safety Commission's website and is subject to a recall by the manufacturer is included.

Device Type Manufacturer ModelNumber Date Qty

Items listed for Recall by Manufacturer

No recalled items found during this inspection.

ScanID Location Problem Address Reference

LS 02.01.34 EP 04 All other Life Safety Code fire alarm requirements related to NFPA 101-2018 18/19.3.4

Battery

40664465 1st In room 124 - Control Panel 4100u Failed Test 10-12V/35Ah NFPA72 Table

14.4.2.2 (5)(b)

40664466 1st In room 124 - Control Panel 4100u Failed Test 10-12V/35Ah NFPA72 Table

14.4.2.2 (5)(b)

Code References NFPA72 Table

14.4.2.2 (5)(b)

Batteries shall be replaced in accordance with the recommendations of the alarm equipment manufacturer or when the recharged battery voltage or current falls below the manufacturer's recommendations

Kinetix 5 07/13/2018

Proposed Solutions Report

The Proposed Solution Report provides a solution for each discrepancy listed on the Discrepancy Report. Provide a check mark where indicated to approve repairs listed within the report. Items listed as T/M are available for repair on a

Time and Materials basis.

ScanID Location Solution Model # Cost Fix

LS 02.01.34 EP 04 All other Life Safety Code fire alarm requirements related to NFPA 101-2018 18/19.3.4

Battery

40664465 1st In room 124 - Control Panel 4100u Replace T/M

40664466 1st In room 124 - Control Panel 4100u Replace T/M

Kinetix 6 07/13/2018

Notes & Recommendations

The Notes & Recommendations Report details additional inspection notes made by the Inspectors during the course of the building inspection.

ScanID Note Device Type Location Comment

EC 02.03.05 EP 03 Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

40664502 1 Smoke Detector 2nd ELEV 7 SHAFT Passed

Recalls To Primary Floor

40664506 2 Duct Detector Penthouse Penthouse AC/15 Passed

Shuts Down Unit

40664507 3 Duct Detector Penthouse Penthouse AC/16 Passed

Shuts Down Unit

40664509 4 Smoke Detector Penthouse Elevator 7 Equipment Room Passed

Recalls To Primary Floor

Kinetix 7 07/13/2018

Inspection & Testing

The Inspection & Testing section lists all of the items inspected in your building, which are then categorized by the applicable code reference. The most recent inspection is listed in the far right column and is based on the Finish Date of that inspection. The latest inspection uploaded in each previous quarter appears in the four columns to the left.

Passed=P, Failed=F, Replaced=R

EC 02.03.05 EP 02

Semi-annual testing of water flow devices and valve tamper switches

Operate valve and verify signal receipt shall be verified to be within the first two revolutions of the hand wheel or within one-fifth of the travel distance, or per the manufacturer's published instructions. (NFPA 72 Table 14.4.3.2 (17)(j)(1))

Devices Tested Q2/18 Pass Q2/18 Fail Q2/18 Tested YTD (2018) Total Quantity

Tamper Switch 0 0 0 8 8

Device Type Location ScanID Address Q2/17 Q3/17 Q1/18 Q2/18

Tamper Switch Basement Pipe Basement East 40662936 10-10:M1-

07/21-P 01/18-P

Tamper Switch Basement Pipe Basement East 40662937 10-10:M1-

07/21-P 01/18-P

Tamper Switch Basement Pipe Basement East 40662938 10-10:M1-

07/21-P 01/18-P

Tamper Switch Basement PIPE BASEMENT FP

12 SECTIONAL VALVE

40664441 10-10:M1-

07/21-P 01/18-P

Tamper Switch 1st Stair 1 40662933 10-10:M1-

07/21-P 01/18-P

Tamper Switch 2nd Stair 1 40662932 10-10:M1-

07/21-P 01/18-P

Tamper Switch Ground Stair 1 West 40662935 10-10:M1-

07/21-P 01/18-P

Tamper Switch Ground Stair 2 East 40662934 10-10:M1-

07/21-P 01/18-P

Device Total: 8

Kinetix 8 07/13/2018

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Test duct smoke detectors that use sampling tubes to ensure that they will properly sample the airstream in the duct using a method acceptable to the manufacturer or in accordance with their published instructions. (NFPA 72 Table 14.4.3.2 (17)(g)(5))

Duct Detector 2 2 0 2 2

Duct Detector Penthouse Penthouse AC/15 40664506 10-10:M1-

06/28-P 06/06-P

Duct Detector Penthouse Penthouse AC/16 40664507 10-10:M1-

06/28-P 06/06-P

Device Total: 2

Kinetix 9 07/13/2018

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Restorable: Perform heat test with a listed and labeled heat source or in accordance with the manufacturer's published instructions. Non-

Restorable: Do not perform heat test. Test functionality mechanically and electrically. (NFPA 72 Table 14.4.3.2 (17)(d))

Heat Detector 3 3 0 3 3

Heat Detector Ground By Room 041 (Fixed

Temp)

40664447 10-10:M1-

06/30-P 06/12-P

Heat Detector Ground By Room 036 (Fixed

Temp)

40664446 10-10:M1-

06/30-P 06/12-P

Heat Detector Ground By Room 048 (Fixed

Temp)

40664448 10-10:M1-

06/30-P 06/12-P

Device Total: 3

Kinetix 10 07/13/2018

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Operate manual fire alarm boxes per the manufacturer's published instructions. Test both key-operated presignal and general alarm manual fire alarm boxes. (NFPA 72 Table 14.4.3.2 (17e))

Pull Station 13 13 0 13 13

Pull Station 1st Corridor SW 40664469 10-10:M1-

06/30-P 06/06-P

Pull Station 1st Corridor NW 40664470 10-10:M1-

06/30-P 06/06-P

Pull Station 1st Corridor NE 40664467 10-10:M1-

06/28-P 06/06-P

Pull Station 1st Corridor SE 40664468 10-10:M1-

06/28-P 06/06-P

Pull Station 2nd Corridor SW 40664489 10-10:M1-

06/28-P 06/06-P

Pull Station 2nd Corridor NW 40664490 10-10:M1-

06/28-P 06/06-P

Pull Station 2nd Corridor NE 40664487 10-10:M1-

06/28-P 06/06-P

Pull Station 2nd Corridor SE 40664488 10-10:M1-

06/28-P 06/06-P

Pull Station Penthouse Stair 1 NW 40664508 10-10:M1-

06/28-P 06/06-P

Pull Station Ground Corridor NE 40664449 10-10:M1-

06/27-P 06/06-P

Pull Station Ground Corridor SE 40664450 10-10:M1-

06/27-P 06/06-P

Pull Station Ground Corridor SW 40664451 10-10:M1-

06/28-P 06/06-P

Pull Station Ground Corridor NW 40664452 10-10:M1-

Device Total: 13

Kinetix 11 07/13/2018

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Test smoke detectors in place to ensure smoke entry into the sensing chamber and an alarm response. (NFPA 72 Table 14.4.3.2 (17)(g)(1))

Smoke Detector 33 33 0 33 33

Smoke Detector 1st BY ELEV 7 40664481 10-10:M1-

06/28-P 06/06-P

Smoke Detector 1st BY Room 103 40664471 10-10:M1-

06/28-P 06/06-P

Smoke Detector 1st BY Room 105 40664472 10-10:M1-

06/28-P 06/06-P

Smoke Detector 1st BY Room 111 40664473 10-10:M1-

06/28-P 06/06-P

Smoke Detector 1st BY Room 115 40664474 10-10:M1-

06/28-P 06/06-P

Smoke Detector 1st BY Room 121 40664475 10-10:M1-

06/28-P 06/06-P

Smoke Detector 1st BY Room 124 40664476 10-10:M1-

06/28-P 06/06-P

Smoke Detector 1st Electrical Room Above

FACP

40664482 10-10:M1-

06/28-P 06/06-P

Smoke Detector 1st BY Room 125 40664477 10-10:M1-

06/28-P 06/06-P

Smoke Detector 1st BY Room 131 40664478 10-10:M1-

06/28-P 06/06-P

Smoke Detector 1st BY Room 136 40664479 10-10:M1-

06/28-P 06/06-P

Smoke Detector 1st BY Room 142 40664480 10-10:M1-

06/28-P 06/06-P

Smoke Detector 2nd BY ELEV 7 40664501 10-10:M1-

06/30-P 06/06-P

Smoke Detector 2nd BY Room 201C 40664491 10-10:M1-

06/28-P 06/06-P

Smoke Detector 2nd BY Room 204 40664492 10-10:M1-

06/28-P 06/06-P

Smoke Detector 2nd BY Room 207 40664493 10-10:M1-

06/28-P 06/06-P

Smoke Detector 2nd BY Room 212 40664494 10-10:M1-

06/28-P 06/06-P

Smoke Detector 2nd BY Room 219 40664495 10-10:M1-

06/28-P 06/06-P

Smoke Detector 2nd BY Room 221 40664496 10-10:M1-

06/28-P 06/06-P

Smoke Detector 2nd BY Room 223 40664497 10-10:M1-

06/28-P 06/06-P

Smoke Detector 2nd BY Room 231 40664498 10-10:M1-

06/28-P 06/06-P

Smoke Detector 2nd BY Room 236 40664499 10-10:M1-

06/28-P 06/06-P

Smoke Detector 2nd BY Room 241 40664500 10-10:M1-

06/28-P 06/06-P

Smoke Detector 2nd ELEV 7 SHAFT 40664502 10-10:M1-

06/30-P 06/12-P

Smoke Detector Penthouse Elevator 7

Equipment Room

40664509 10-10:M1-

Smoke Detector Ground BY Room 028 40664457 10-10:M1- 06/27-P 06/06-P

Kinetix 12 07/13/2018

Smoke Detector Ground BY Room 029 40664458 10-10:M1-

06/27-P 06/06-P

Smoke Detector Ground BY Room 031 40664459 10-10:M1-

06/27-P 06/06-P

Smoke Detector Ground BY Room 001C 40664453 10-10:M1-

06/28-P 06/06-P

Smoke Detector Ground BY ELEV 7 40664460 10-10:M1-

06/30-P 06/06-P

Smoke Detector Ground BY Room 007 40664454 10-10:M1-

06/28-P 06/06-P

Smoke Detector Ground BY Room 014 40664455 10-10:M1-

06/28-P 06/06-P

Smoke Detector Ground BY Room 018 40664456 10-10:M1-

Device Total: 33

Kinetix 13 07/13/2018

Annual test of visual and audible fire alarms, including speakers and door releasing devices

Test interface equipment connections by operating or simulating the equipment being supervised. Verify signals required to be transmitted are received at the control unit. (NFPA 72 Table 14.4.3.2 (20))

Releasing Device 2 2 0 2 2

Releasing Device Penthouse AHU Shutdown AC

40664505 10 06/30-P 06/12-P

Releasing Device Penthouse AHU Shutdown AC

40664504 10 06/30-P 06/12-P

Kinetix 14 07/13/2018

Annual test of visual and audible fire alarms, including speakers and door releasing devices

For periodic testing, verify the operation of the notification appliances. (NFPA 72 Table 14.4.3.2 (22)(b))

Speaker/Strobe 13 13 0 13 13

Speaker/Strobe 1st BY 1-114 40664462 10 06/30-P 06/12-P

Speaker/Strobe 1st BY 1-124 40664463 10 06/30-P 06/12-P

Speaker/Strobe 1st BY 1-101C 40664461 10 06/30-P 06/12-P

Speaker/Strobe 1st BY 1-132 40664464 10 06/30-P 06/12-P

Speaker/Strobe 2nd BY Room 2-101C 40664483 10 06/30-P 06/12-P

Speaker/Strobe 2nd BY Room 2-210 40664484 10 06/30-P 06/12-P

Speaker/Strobe 2nd BY Room 2-221 40664485 10 06/30-P 06/12-P

Speaker/Strobe 2nd BY Room 2-234 40664486 10 06/30-P 06/12-P

Speaker/Strobe Penthouse Penthouse 40664503 10 06/30-P 06/12-P

Speaker/Strobe Ground BY MENS 029 40664445 10 06/30-P 06/12-P

Speaker/Strobe Ground BY G-040 40664444 10 06/30-P 06/12-P

Speaker/Strobe Ground BY G-015 40664443 10 06/30-P 06/12-P

Speaker/Strobe Ground BY G-001C 40664442 10 06/30-P 06/12-P

Kinetix 15 07/13/2018

Annual test of fire alarm equipment for notifying off-site fire responders

Test all system functions and features in accordance with the equipment manufacturer's published instructions for correct operation in conformance with the applicable sections of Chapter 26. Except for DACT, actuate initiating device and verify receipt of the correct initiating device signal at the supervising station within 90 seconds. Upon completion of the test, restore the system to its functional operating condition. (NFPA 72 Table 14.4.3.2 (4))

Communicator 1 1 0 1 1

Communicator 1st In Bldg 39 40662939 10 07/21-P 06/12-P

Device Total: 1

Kinetix 16 07/13/2018

Annual test of automatic smoke-detection shutdown devices for air-handling equipment per NFPA 90A-

Test duct smoke detectors that use sampling tubes to ensure that they will properly sample the airstream in the duct using a method acceptable to the manufacturer or in accordance with their published instructions. (NFPA 72 Table 14.4.3.2 (17)(g)(5))

Duct Detector Penthouse Penthouse AC/15 40664506 0-10:M1-54 06/28-P 06/06-P

Duct Detector Penthouse Penthouse AC/16 40664507 0-10:M1-55 06/28-P 06/06-P

Kinetix 17 07/13/2018

All other Life Safety Code fire alarm requirements related to NFPA 101-2018 18/19.3.4

With the batteries fully charged and connected to the charger, measure the voltage across the batteries with a voltmeter. Then, with the battery charger disconnected, load test the batteries following the manufacturer's recommendations. (NFPA 72 Table 14.4.3.2 (9))

Battery 2 0 2 2 2

Battery 1st In room 124 - Control

Panel 4100u

40664465 10-

12V/35Ah

06/28-F 06/06-F

Battery 1st In room 124 - Control

Panel 4100u

40664466 10-

12V/35Ah

06/28-P 06/06-F

Kinetix 18 07/13/2018

Service Summary

The Service Summary section provides an overview of the services performed in this report.

Device Type Service Quantity

Failed/Other Battery Tested 2

Total 2

Passed Communicator Tested 1

Duct Detector Tested 2

Heat Detector Tested 3

Pull Station Tested 13

Releasing Device Tested 2

Smoke Detector Tested/Cleaned 33

Speaker/Strobe Tested 13

Total 67

Untested Tamper Switch 8

Total 8

Kinetix 19 07/13/2018

Auxiliary Functions Testing

The Auxiliary Functions Testing section lists each of the ancillary items, systems, and emergency equipment that are controlled by the system control unit. Items are grouped by Passed or Failed/Other. The items are listed by device type, and a check box is provided to indicate if the test conducted was simulated.

Type Location Comment ScanID Simulated

Passed

Duct Detector

Fan Shut Down Penthouse Penthouse AC/15 Passed 40664506

Fan Shut Down Penthouse Penthouse AC/16 Passed 40664507

Smoke Detector

Elevator Recall 1st BY ELEV 7 Passed 40664481

Elevator Recall 2nd BY ELEV 7 Passed 40664501

Elevator Recall 2nd ELEV 7 SHAFT Passed 40664502

Elevator Recall Penthouse Elevator 7 Equipment Room Passed 40664509

Elevator Recall Ground BY ELEV 7 Passed 40664460

Releasing Device

AHU Shutdown Penthouse AHU Shutdown AC 15 Passed 40664504

AHU Shutdown Penthouse AHU Shutdown AC 16 Passed 40664505

Kinetix 20 07/13/2018

Battery & Power Supply Testing

The Control & Power Testing section details the readings and measurements of batteries and power supplies used to provide power to the fire alarm and life safety systems. Items are grouped by Passed or Failed/Other.

Type Location

Rated

Ah

Rated

Volts

Pre

Test

Post

Test

Min

Ah

Tested

Ah

Failed/Other

Battery

Sealed Lead Acid 1st In room 124 - Control

Panel 4100u

33Ah 12V 13.12 14

Sealed Lead Acid 1st In room 124 - Control

Panel 4100u

35Ah 12V 13.10 17

Kinetix 21 07/13/2018

Inventory & Warranty Report

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Device or Item Category % of Inventory Quantity

Tamper Switch Supervisory 10.39% 8

Pull Station Initiating 16.88% 13

Smoke Detector Initiating 42.86% 33

Battery Control 2.60% 2

Duct Detector Initiating 2.60% 2

Communicator Control 1.30% 1

Heat Detector Initiating 3.90% 3

Releasing Device Auxiliary 2.60% 2

Speaker/Strobe Indicating 16.88% 13

Type Qty Model # Description Install Date

In Service - 1 Year to 2 Years

Simplex

Communicator 1 Digital Communicator 08/19/2016

Tamper Switch 8 08/19/2016

In Service - 2 Years to 3 Years

Simplex

Battery 2 Sealed Lead Acid 06/30/2016

Duct Detector 2 Photoelectric 06/30/2016

Heat Detector 3 06/30/2016

Pull Station 13 06/30/2016

Releasing Device 2 AHU Shutdown 06/30/2016

Smoke Detector 1 06/30/2016

Smoke Detector 31 Photoelectric 06/30/2016

Smoke Detector 1 Photoelectric 06/16/2016

Speaker/Strobe 13 06/16/2016

Kinetix 22 07/13/2018

Zone Address Report

The Zone Address Report lists all of the devices and items that have an individual address, or are grouped together under a common zone. The device type, location, and description are included for your reference.

Address Device Type Location Type ScanID

10:M1-01 Pull Station Ground Corridor NE 40664449

10:M1-02 Pull Station Ground Corridor SE 40664450

10:M1-03 Pull Station Ground Corridor SW 40664451

10:M1-04 Pull Station Ground Corridor NW 40664452

10:M1-05 Pull Station 1st Corridor NE 40664467

10:M1-06 Pull Station 1st Corridor SE 40664468

10:M1-07 Pull Station 1st Corridor SW 40664469

10:M1-08 Pull Station 1st Corridor NW 40664470

10:M1-09 Pull Station 2nd Corridor NE 40664487

10:M1-10 Pull Station 2nd Corridor SE 40664488

10:M1-11 Pull Station 2nd Corridor SW 40664489

10:M1-12 Pull Station 2nd Corridor NW 40664490

10:M1-13 Pull Station Penthouse Stair 1 NW 40664508

10:M1-15 Smoke Detector Ground BY Room 001C Photoelectric 40664453

10:M1-16 Smoke Detector Ground BY Room 007 Photoelectric 40664454

10:M1-17 Smoke Detector Ground BY Room 014 Photoelectric 40664455

10:M1-18 Smoke Detector Ground BY Room 018 Photoelectric 40664456

10:M1-19 Smoke Detector Ground BY Room 028 Photoelectric 40664457

10:M1-20 Smoke Detector Ground BY Room 029 Photoelectric 40664458

10:M1-21 Smoke Detector Ground BY Room 031 Photoelectric 40664459

10:M1-22 Heat Detector Ground By Room 036 (Fixed Temp) 40664446

10:M1-23 Heat Detector Ground By Room 041 (Fixed Temp) 40664447

10:M1-24 Heat Detector Ground By Room 048 (Fixed Temp) 40664448

10:M1-25 Smoke Detector Ground BY ELEV 7 Photoelectric 40664460

10:M1-26 Smoke Detector 1st BY Room 103 Photoelectric 40664471

10:M1-27 Smoke Detector 1st BY Room 105 Photoelectric 40664472

10:M1-28 Smoke Detector 1st BY Room 111 Photoelectric 40664473

10:M1-29 Smoke Detector 1st BY Room 115 Photoelectric 40664474

10:M1-30 Smoke Detector 1st BY Room 121 Photoelectric 40664475

10:M1-31 Smoke Detector 1st BY Room 124 Photoelectric 40664476

10:M1-32 Smoke Detector 1st BY Room 125 Photoelectric 40664477

10:M1-33 Smoke Detector 1st BY Room 131 Photoelectric 40664478

10:M1-34 Smoke Detector 1st BY Room 136 Photoelectric 40664479

10:M1-35 Smoke Detector 1st BY Room 142 Photoelectric 40664480

10:M1-36 Smoke Detector 1st BY ELEV 7 Photoelectric 40664481

10:M1-37 Smoke Detector 2nd BY Room 201C Photoelectric 40664491

10:M1-38 Smoke Detector 2nd BY Room 204 Photoelectric 40664492

10:M1-39 Smoke Detector 2nd BY Room 207 Photoelectric 40664493

10:M1-40 Smoke Detector 2nd BY Room 212 Photoelectric 40664494

10:M1-41 Smoke Detector 2nd BY Room 219 Photoelectric 40664495

10:M1-42 Smoke Detector 2nd BY Room 221 Photoelectric 40664496

10:M1-43 Smoke Detector 2nd BY Room 223 Photoelectric 40664497

Kinetix 23 07/13/2018

10:M1-44 Smoke Detector 2nd BY Room 231 Photoelectric 40664498

10:M1-45 Smoke Detector 2nd BY Room 236 Photoelectric 40664499

10:M1-46 Smoke Detector 2nd BY Room 241 Photoelectric 40664500

10:M1-47 Smoke Detector 2nd BY ELEV 7 40664501

10:M1-48 Smoke Detector Penthouse Elevator 7 Equipment Room Photoelectric 40664509

10:M1-51 Smoke Detector 2nd ELEV 7 SHAFT Photoelectric 40664502

10:M1-54 Duct Detector Penthouse Penthouse AC/15 Photoelectric 40664506

10:M1-55 Duct Detector Penthouse Penthouse AC/16 Photoelectric 40664507

10:M1-64 Smoke Detector 1st Electrical Room Above FACP Photoelectric 40664482

12V/35Ah Battery 1st In room 124 - Control Panel 4100u Sealed Lead Acid 40664465

12V/35Ah Battery 1st In room 124 - Control Panel 4100u Sealed Lead Acid 40664466

10:M1-14 Tamper Switch Basement Pipe Basement East 40662936

10:M1-14 Tamper Switch Basement Pipe Basement East 40662937

10:M1-14 Tamper Switch Basement Pipe Basement East 40662938

10:M1-52 Tamper Switch Basement PIPE BASEMENT FP 12

SECTIONAL VALVE

40664441

10:M1-57 Tamper Switch Ground Stair 1 West 40662935

10:M1-59 Tamper Switch Ground Stair 2 East 40662934

10:M1-61 Tamper Switch 1st Stair 1 40662933

10:M1-63 Tamper Switch 2nd Stair 1 40662932

For

Tampa VAMC Bldg 19

13000 Bruce B Downs Blvd

Tampa,FL 33637

Kinetix has performed this inspection and testing service in compliance with The Joint

Commission/VHA Standards. The inspection/testing frequencies adhered to for this service have been performed in accordance with The Joint Commission/VHA Memorandum 23 Concurrence on EC &

LS Standards effective September 2017. This Inspection was performed in accordance with applicable

NFPA Standards. The subsequent pages of this report provide performance measurements, listed ranges of acceptable results, and complete documentation of the inspection. Whenever discrepancies exist between acceptable performance standards and actual test results, notes and/or recommended solutions have been proposed or provided for immediate review and approval.

Inspection Completion Date

Building: Tampa VAMC Bldg 19 Company: Kinetix

Building: Tampa VAMC Bldg 19 Contact: Darren Matteson

Address: 13000 Bruce B Downs Blvd Phone: 813-972-2000

Address: Fax:

City/State/Zip: Tampa, FL 33637 Mobile:

Country: United States of America Email:

Inspection Performed By

Company: Kinetix Inspector: Michael Gill

Address: 12 Creek Parkway Phone: 386-747-2294

Address: Fax: 3145020737

City/State/Zip: Boothwyn, PA 19061 Mobile:

Country: United States of America Email: michaelgill15@yahoo.com

Monitoring Company: Phone: Account #:

Central Station Signal Verification Type: Mfg: Model #:

Test Time/Date: Restore Time

Inspection Completion Date: -

Building: Tampa VAMC Bldg 19

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Tamper Switch 0 0 0 0 1 1 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Pull Station 0 0 0 0 1 1

Smoke Detector 0 0 0 0 2 2 releasing devices

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Speaker/Strobe 0 0 0 0 1 1

Total Device Count: 5

Company: Kinetix Building: Tampa VAMC Bldg 19

Building: Tampa VAMC Bldg 19 Control Panel: 1

The Notes & Recommendations Report details additional inspection notes made by the Inspectors during the course of the building inspection.

ScanID Note Device Type Location Comment

EC 02.03.05 EP 03 Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

40664517 1 Pull Station Ground Home Base Healthcare

Condemned

40664518 2 Smoke Detector Ground Room 1A

Condemned

40664519 3 Smoke Detector Ground Room 1B

Condemned

EC 02.03.05 EP 04 Annual test of visual and audible fire alarms, including speakers and door releasing devices

40664520 4 Speaker/Strobe Ground By Room G-005A

Condemned

EC 02.03.05 EP 02 Semi-annual testing of water flow devices and valve tamper switches

40665674 5 Tamper Switch Basement Basement wing D

Condemned

Building: Tampa VAMC Bldg 19 The Inspection & Testing section lists all of the items inspected in your building, which are then categorized by the applicable code reference. The most recent inspection is listed in the far right column and is based on the Finish Date of that inspection. The latest inspection uploaded in each previous quarter appears in the four columns to the left.

Passed=P, Failed=F, Replaced=R

EC 02.03.05 EP 02

Semi-annual testing of water flow devices and valve tamper switches

Operate valve and verify signal receipt shall be verified to be within the first two revolutions of the hand wheel or within one-fifth of the travel distance, or per the manufacturer's published instructions. (NFPA 72 Table 14.4.3.2 (17)(j)(1))

Tamper Switch 0 0 0 0 1

Device Type Location ScanID Address Q2/17 Q1/18

Tamper Switch Basement Basement wing D 40665674 1 01/12-P

Device Total: 0

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Operate manual fire alarm boxes per the manufacturer's published instructions. Test both key-operated presignal and general alarm manual fire alarm boxes. (NFPA 72 Table 14.4.3.2 (17e))

Pull Station 0 0 0 0 1

Pull Station Ground Home Base Healthcare 40664517 1 06/30-P

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Test smoke detectors in place to ensure smoke entry into the sensing chamber and an alarm response. (NFPA 72 Table 14.4.3.2 (17)(g)(1))

Smoke Detector 0 0 0 0 2

Smoke Detector Ground Room 1A 40664518 1 06/30-P

Smoke Detector Ground Room 1B 40664519 1 06/30-P

Annual test of visual and audible fire alarms, including speakers and door releasing devices

For periodic testing, verify the operation of the notification appliances. (NFPA 72 Table 14.4.3.2 (22)(b))

Speaker/Strobe 0 0 0 0 1

Speaker/Strobe Ground By Room G-005A 40664520 1 06/30-P

Building: Tampa VAMC Bldg 19 Control Panel: 1

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Device or Item Category % of Inventory Quantity

Pull Station Initiating 20.00% 1

Smoke Detector Initiating 40.00% 2

Speaker/Strobe Indicating 20.00% 1

Tamper Switch Supervisory 20.00% 1

Type Qty Model # Description Install Date

In Service - 1 Year to 2 Years Pull Station 1 03/02/2017

Smoke Detector 2 Photoelectric 03/02/2017

Speaker/Strobe 1 03/02/2017

Tamper Switch 1 03/02/2017

For

Tampa VAMC Bldg 33

13000 Bruce B Downs Blvd

Tampa,FL 33637

Kinetix has performed this inspection and testing service in compliance with The Joint

Commission/VHA Standards. The inspection/testing frequencies adhered to for this service have been performed in accordance with The Joint Commission/VHA Memorandum 23 Concurrence on EC &

LS Standards effective September 2017. This Inspection was performed in accordance with applicable

NFPA Standards. The subsequent pages of this report provide performance measurements, listed ranges of acceptable results, and complete documentation of the inspection. Whenever discrepancies exist between acceptable performance standards and actual test results, notes and/or recommended solutions have been proposed or provided for immediate review and approval.

Inspection Completion Date

Jun 14, 2018

Building: Tampa VAMC Bldg 33 Company: Kinetix

Building: Tampa VAMC Bldg 33 Contact: Darren Matteson

Address: 13000 Bruce B Downs Blvd Phone: 813-972-2000

Address: Fax:

City/State/Zip: Tampa, FL 33637 Mobile:

Country: United States of America Email:

Inspection Performed By

Company: Kinetix Inspector: Michael Gill

Address: 12 Creek Parkway Phone: 386-747-2294

Address: Fax: 3145020737

City/State/Zip: Boothwyn, PA 19061 Mobile:

Country: United States of America Email: michaelgill15@yahoo.com

Monitoring Company: Phone: Account #:

Central Station Signal Verification

Test Time/Date: 6/14/18 8:33:06 AM Restore Time

Inspection Completion Date: Jun 14, 2018

Building: Tampa VAMC Bldg 33

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Tamper Switch 0 0 0 1 0 1 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Heat Detector 1 1 0 1 0 1

Pull Station 2 2 0 2 0 2

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Total Device Count: 5

Company: Kinetix Building: Tampa VAMC Bldg 33

The Inspection & Testing section lists all of the items inspected in your building, which are then categorized by the applicable code reference. The most recent inspection is listed in the far right column and is based on the Finish Date of that inspection. The latest inspection uploaded in each previous quarter appears in the four columns to the left.

Passed=P, Failed=F, Replaced=R

EC 02.03.05 EP 02

Semi-annual testing of water flow devices and valve tamper switches

Operate valve and verify signal receipt shall be verified to be within the first two revolutions of the hand wheel or within one-fifth of the travel distance, or per the manufacturer's published instructions. (NFPA 72 Table 14.4.3.2 (17)(j)(1))

Tamper Switch 0 0 0 1 1

Tamper Switch Ground BLDG 33 GFL ROOM

001-33

40665136 0-17:M1-

07/21-P 01/12-P

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Restorable: Perform heat test with a listed and labeled heat source or in accordance with the manufacturer's published instructions. Non-

Restorable: Do not perform heat test. Test functionality mechanically and electrically. (NFPA 72 Table 14.4.3.2 (17)(d))

Heat Detector 1 1 0 1 1

Heat Detector Ground GFL ROOM 001-33 40665133 0-17:M1-

06/27-P 06/14-P

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Operate manual fire alarm boxes per the manufacturer's published instructions. Test both key-operated presignal and general alarm manual fire alarm boxes. (NFPA 72 Table 14.4.3.2 (17e))

Pull Station 2 2 0 2 2

Pull Station Ground GFL ROOM 001-33 40665134 0-17:M1-

06/27-P 06/14-P

Pull Station Ground GFL ROOM 001-33 40665135 0-17:M1-

06/27-P 06/14-P

Annual test of fire alarm equipment for notifying off-site fire responders

Test all system functions and features in accordance with the equipment manufacturer's published instructions for correct operation in conformance with the applicable sections of Chapter 26. Except for DACT, actuate initiating device and verify receipt of the correct initiating device signal at the supervising station within 90 seconds. Upon completion of the test, restore the system to its functional operating condition. (NFPA 72 Table 14.4.3.2 (4))

Communicator 1st In Bldg 39 40662944 1 07/21-P 06/14-P

Passed Communicator Tested 1

Heat Detector Tested 1

Pull Station Tested 2

Total 4

Untested Tamper Switch 1

Total 1

Building: Tampa VAMC Bldg 33 Control Panel: n/a

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Device or Item Category % of Inventory Quantity

Tamper Switch Supervisory 20.00% 1

Pull Station Initiating 40.00% 2

Heat Detector Initiating 20.00% 1

Communicator Control 20.00% 1

Type Qty Model # Description Install Date

In Service - 1 Year to 2 Years

Simplex

Tamper Switch 1 08/19/2016

In Service - 2 Years to 3 Years

Simplex

Heat Detector 1 06/14/2016

Pull Station 2 06/14/2016

Building: Tampa VAMC Bldg 33 Control Panel: 1

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Type Qty Model # Description Install Date

In Service - 1 Year to 2 Years

Simplex

Communicator 1 Digital Communicator 08/19/2016

Building: Tampa VAMC Bldg 33 Control Panel: n/a

The Zone Address Report lists all of the devices and items that have an individual address, or are grouped together under a common zone. The device type, location, and description are included for your reference.

Address Device Type Location Type ScanID

17:M1-207 Pull Station Ground GFL ROOM 001-33 40665134

17:M1-208 Heat Detector Ground GFL ROOM 001-33 40665133

17:M1-209 Pull Station Ground GFL ROOM 001-33 40665135

17:M1-210 Tamper Switch Ground BLDG 33 GFL ROOM 001-33 40665136

For

Tampa VAMC Bldg 36

13000 Bruce B Downs Blvd

Tampa,fl 33637

Kinetix has performed this inspection and testing service in compliance with The Joint

Commission/VHA Standards. The inspection/testing frequencies adhered to for this service have been performed in accordance with The Joint Commission/VHA Memorandum 23 Concurrence on EC &

LS Standards effective September 2017. This Inspection was performed in accordance with applicable

NFPA Standards. The subsequent pages of this report provide performance measurements, listed ranges of acceptable results, and complete documentation of the inspection. Whenever discrepancies exist between acceptable performance standards and actual test results, notes and/or recommended solutions have been proposed or provided for immediate review and approval.

Inspection Completion Date

Jun 14, 2018

Building: Tampa VAMC Bldg 36 Company: Kinetix

Building: Tampa VAMC Bldg 36 Contact: Darren Matteson

Address: 13000 Bruce B Downs Blvd Phone: 813-972-2000

Address: Fax:

City/State/Zip: Tampa, fl 33637 Mobile:

Country: United States of America Email:

Inspection Performed By

Company: Kinetix Inspector: Michael Gill

Address: 12 Creek Parkway Phone: 386-747-2294

Address: Fax: 3145020737

City/State/Zip: Boothwyn, PA 19061 Mobile:

Country: United States of America Email: michaelgill15@yahoo.com

Monitoring Company: Phone: Account #:

Central Station Signal Verification

Test Time/Date: 6/14/18 8:32:08 AM Restore Time

Building: Tampa VAMC Bldg 36

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Tamper Switch 0 0 0 1 0 1 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Pull Station 2 2 0 2 0 2

Smoke Detector 9 9 0 9 0 9 releasing devices

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Speaker/Strobe 2 2 0 2 0 2

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

18/19.3.4

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Battery 0 0 0 0 2 2

Total Device Count: 17

Company: Kinetix Building: Tampa VAMC Bldg 36

The Inspection & Testing section lists all of the items inspected in your building, which are then categorized by the applicable code reference. The most recent inspection is listed in the far right column and is based on the Finish Date of that inspection. The latest inspection uploaded in each previous quarter appears in the four columns to the left.

Passed=P, Failed=F, Replaced=R

EC 02.03.05 EP 02

Semi-annual testing of water flow devices and valve tamper switches

Operate valve and verify signal receipt shall be verified to be within the first two revolutions of the hand wheel or within one-fifth of the travel distance, or per the manufacturer's published instructions. (NFPA 72 Table 14.4.3.2 (17)(j)(1))

Tamper Switch 0 0 0 1 1

Device Type Location ScanID Address Q2/17 Q1/18 Q2/18

Tamper Switch 1 Outside Electrical Room 40665152 0-11:M1-09 01/12-P

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Operate manual fire alarm boxes per the manufacturer's published instructions. Test both key-operated presignal and general alarm manual fire alarm boxes. (NFPA 72 Table 14.4.3.2 (17e))

Pull Station 2 2 0 2 2

Pull Station 1 Main Entrance 40665141 0-11:M1-01 06/28-P 06/14-P

Pull Station 1 By Room 36-127 40665142 0-11:M1-04 06/28-P 06/14-P

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Test smoke detectors in place to ensure smoke entry into the sensing chamber and an alarm response. (NFPA 72 Table 14.4.3.2 (17)(g)(1))

Smoke Detector 9 9 0 9 9

Smoke Detector 1 By Room 36-112 40665147 0-11:M1-07 06/28-P 06/14-P

Smoke Detector 1 By Room 36-116A 40665146 0-11:M1-06 06/28-P 06/14-P

Smoke Detector 1 Waiting Area 40665148 0-11:M1-08 06/28-P 06/14-P

Smoke Detector 1 By Room 36-104 40665144 0-11:M1-03 06/28-P 06/14-P

Smoke Detector 1 By Room 36-128 40665149 0-11:M1-11 06/28-P 06/14-P

Smoke Detector 1 By Room 36-119 40665145 0-11:M1-05 06/28-P 06/14-P

Smoke Detector 1 ROOM 107-36 40665150 0-11:M1-13 06/28-P 06/14-P

Smoke Detector 1 By Room 36-117 40665143 0-11:M1-02 06/28-P 06/14-P

Smoke Detector 1 ROOM XXX-36 40665151 0-11:M1-18 06/28-P 06/14-P

Device Total: 9

Annual test of visual and audible fire alarms, including speakers and door releasing devices

For periodic testing, verify the operation of the notification appliances. (NFPA 72 Table 14.4.3.2 (22)(b))

Speaker/Strobe 2 2 0 2 2

Speaker/Strobe 1 Main Entrance 40665140 0 06/30-P 06/14-P

Speaker/Strobe 1 By Room 36-125 40665139 0 06/30-P 06/14-P

Annual test of fire alarm equipment for notifying off-site fire responders

Test all system functions and features in accordance with the equipment manufacturer's published instructions for correct operation in conformance with the applicable sections of Chapter 26. Except for DACT, actuate initiating device and verify receipt of the correct initiating device signal at the supervising station within 90 seconds. Upon completion of the test, restore the system to its functional operating condition. (NFPA 72 Table 14.4.3.2 (4))

Communicator 1st In Bldg 39 40662945 1 06/28-P 06/14-P

All other Life Safety Code fire alarm requirements related to NFPA 101-2018 18/19.3.4

With the batteries fully charged and connected to the charger, measure the voltage across the batteries with a voltmeter. Then, with the battery charger disconnected, load test the batteries following the manufacturer's recommendations. (NFPA 72 Table 14.4.3.2 (9))

Battery 0 0 0 0 2

Battery 1 In room - Control Panel 4100u 40665137 0-12V/18Ah 06/28-P

Battery 1 In room - Control Panel 4100u 40665138 0-12V/18Ah 06/28-P

Communicator Tested 1

Pull Station Tested 2

Smoke Detector Tested/Cleaned 9

Speaker/Strobe Tested 2

Total 14

Untested Battery 2

Tamper Switch 1

Total 3

Building: Tampa VAMC Bldg 36 Control Panel: n/a

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Device or Item Category % of Inventory Quantity

Battery Control 11.76% 2

Tamper Switch Supervisory 5.88% 1

Communicator Control 5.88% 1

Pull Station Initiating 11.76% 2

Smoke Detector Initiating 52.94% 9

Speaker/Strobe Indicating 11.76% 2

Type Qty Model # Description Install Date

In Service - 1 Year to 2 Years

Simplex

Tamper Switch 1 08/19/2016

In Service - 2 Years to 3 Years

Simplex

Battery 2 Sealed Lead Acid 07/01/2016

Pull Station 2 07/01/2016

Smoke Detector 9 Photoelectric 07/01/2016

Speaker/Strobe 2 07/01/2016

Building: Tampa VAMC Bldg 36 Control Panel: 1

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Type Qty Model # Description Install Date

In Service - 1 Year to 2 Years

Communicator 1 Digital Communicator 08/19/2016

Building: Tampa VAMC Bldg 36 Control Panel: n/a

The Zone Address Report lists all of the devices and items that have an individual address, or are grouped together under a common zone. The device type, location, and description are included for your reference.

Address Device Type Location Type ScanID

11:M1-01 Pull Station 1 Main Entrance 40665141

11:M1-02 Smoke Detector 1 By Room 36-117 Photoelectric 40665143

11:M1-03 Smoke Detector 1 By Room 36-104 Photoelectric 40665144

11:M1-04 Pull Station 1 By Room 36-127 40665142

11:M1-05 Smoke Detector 1 By Room 36-119 Photoelectric 40665145

11:M1-06 Smoke Detector 1 By Room 36-116A Photoelectric 40665146

11:M1-07 Smoke Detector 1 By Room 36-112 Photoelectric 40665147

11:M1-08 Smoke Detector 1 Waiting Area Photoelectric 40665148

11:M1-11 Smoke Detector 1 By Room 36-128 Photoelectric 40665149

11:M1-13 Smoke Detector 1 ROOM 107-36 Photoelectric 40665150

11:M1-18 Smoke Detector 1 ROOM XXX-36 Photoelectric 40665151

11:M1-09 Tamper Switch 1 Outside Electrical Room 40665152

12V/18Ah Battery 1 In room - Control Panel 4100u Sealed Lead Acid 40665137

12V/18Ah Battery 1 In room - Control Panel 4100u Sealed Lead Acid 40665138

For

Tampa VAMC Bldg 37

13000 Bruce B Downs Blvd

Tampa,FL 33637

Kinetix has performed this inspection and testing service in compliance with The Joint

Commission/VHA Standards. The inspection/testing frequencies adhered to for this service have been performed in accordance with The Joint Commission/VHA Memorandum 23 Concurrence on EC &

LS Standards effective September 2017. This Inspection was performed in accordance with applicable

NFPA Standards. The subsequent pages of this report provide performance measurements, listed ranges of acceptable results, and complete documentation of the inspection. Whenever discrepancies exist between acceptable performance standards and actual test results, notes and/or recommended solutions have been proposed or provided for immediate review and approval.

Inspection Completion Date

Jun 14, 2018

Building: Tampa VAMC Bldg 37 Company: Kinetix

Building: Tampa VAMC Bldg 37 Contact: Darren Matteson

Address: 13000 Bruce B Downs Blvd Phone: 8139722000

Address: Fax:

City/State/Zip: Tampa, FL 33637 Mobile:

Country: United States of America Email:

Inspection Performed By

Company: Kinetix Inspector: Michael Gill

Address: 12 Creek Parkway Phone: 386-747-2294

Address: Fax: 3145020737

City/State/Zip: Boothwyn, PA 19061 Mobile:

Country: United States of America Email: michaelgill15@yahoo.com

Monitoring Company: Phone: Account #:

Central Station Signal Verification Type: Digital Communicator Mfg: SimplexGrinnell Model #:

Test Time/Date: 6/14/18 7:56:40 AM Restore Time

Building: Tampa VAMC Bldg 37 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Heat Detector 1 1 0 1 0 1

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Total Device Count: 2

Company: Kinetix Building: Tampa VAMC Bldg 37

The Inspection & Testing section lists all of the items inspected in your building, which are then categorized by the applicable code reference. The most recent inspection is listed in the far right column and is based on the Finish Date of that inspection. The latest inspection uploaded in each previous quarter appears in the four columns to the left.

Passed=P, Failed=F, Replaced=R

EC 02.03.05 EP 03

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Restorable: Perform heat test with a listed and labeled heat source or in accordance with the manufacturer's published instructions. Non-

Restorable: Do not perform heat test. Test functionality mechanically and electrically. (NFPA 72 Table 14.4.3.2 (17)(d))

Heat Detector 1 1 0 1 1

Device Type Location ScanID Address Q2/17 Q2/18

Heat Detector 1st flammable storage 40665416 6-M1-165 06/30-P 06/14-P

Annual test of fire alarm equipment for notifying off-site fire responders

Test all system functions and features in accordance with the equipment manufacturer's published instructions for correct operation in conformance with the applicable sections of Chapter 26. Except for DACT, actuate initiating device and verify receipt of the correct initiating device signal at the supervising station within 90 seconds. Upon completion of the test, restore the system to its functional operating condition. (NFPA 72 Table 14.4.3.2 (4))

Communicator 1st in bldg 39 40665415 1 06/30-P 06/14-P

Communicator Tested 1

Heat Detector Tested 1

Total 2

Building: Tampa VAMC Bldg 37 Control Panel: 1

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Device or Item Category % of Inventory Quantity

Communicator Control 50.00% 1

Heat Detector Initiating 50.00% 1

Type Qty Model # Description Install Date

In Service - 5 Years to 10 Years

SimplexGrinnell

Communicator 1 Digital Communicator 08/07/2009

Building: Tampa VAMC Bldg 37 Control Panel: 6

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Type Qty Model # Description Install Date

In Service - 5 Years to 10 Years

SimplexGrinnell

Heat Detector 1 Rate-of-Rise 08/07/2009

Building: Tampa VAMC Bldg 37 Control Panel: 6

The Zone Address Report lists all of the devices and items that have an individual address, or are grouped together under a common zone. The device type, location, and description are included for your reference.

Address Device Type Location Type ScanID

M1-165 Heat Detector 1st flammable storage Rate-of-Rise 40665416

For

Tampa VAMC Bldg 39

13000 Bruce B Downs Blvd

Tampa,FL 33637

Kinetix has performed this inspection and testing service in compliance with The Joint

Commission/VHA Standards. The inspection/testing frequencies adhered to for this service have been performed in accordance with The Joint Commission/VHA Memorandum 23 Concurrence on EC &

LS Standards effective September 2017. This Inspection was performed in accordance with applicable

NFPA Standards. The subsequent pages of this report provide performance measurements, listed ranges of acceptable results, and complete documentation of the inspection. Whenever discrepancies exist between acceptable performance standards and actual test results, notes and/or recommended solutions have been proposed or provided for immediate review and approval.

Inspection Completion Date

Jun 15, 2018

Building: Tampa VAMC Bldg 39 Company: Kinetix

Building: Tampa VAMC Bldg 39 Contact: Darren Matteson

Address: 13000 Bruce B Downs Blvd Phone: 813-972-2000

Address: Fax:

City/State/Zip: Tampa, FL 33637 Mobile:

Country: United States of America Email:

Inspection Performed By

Company: Kinetix Inspector: Michael Gill

Address: 12 Creek Parkway Phone: 386-747-2294

Address: Fax: 3145020737

City/State/Zip: Boothwyn, PA 19061 Mobile:

Country: United States of America Email: michaelgill15@yahoo.com

System Control Unit Manufacturer: Simplex Inspection Date: 06/15/2018 IDC Style:

Model Number: Install Date: 06/30/2016 SLC Style:

Software Version: Version Date: 12/31/1969 NAC Style:

Location: Ground Panel 4100U - Control Center Current Protection: Breaker

Monitoring Company: Phone: Account #:

Central Station Signal Verification

Test Time/Date: 6/15/18 8:57:36 AM Restore Time

Inspection Completion Date: Jun 15, 2018

Building: Tampa VAMC Bldg 39

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Tamper Switch 0 0 0 4 0 4 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Duct Detector 2 2 0 2 0 2

Heat Detector 2 2 0 2 0 2

Pull Station 13 13 0 13 0 13

Smoke Detector 17 17 0 17 0 17 releasing devices

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Speaker/Strobe 10 10 0 10 0 10

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) handling equipment per NFPA 90A-2018

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Duct Detector 2 2 0 2 0 2

LS 02.01.34 EP 02

Protected master fire alarm control panel

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Control Panel 1 1 0 1 0 1

18/19.3.4

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Battery 6 4 2 6 0 6

Power Supply 2 2 0 2 0 2

Total Device Count: 58

Company: Kinetix Building: Tampa VAMC Bldg 39

Discrepancy Report

Building: Tampa VAMC Bldg 39 Control Panel: n/a

The Discrepancy Report consolidates each discrepancy listed within the various Testing sections of your Inspection.

Discrepancies are listed by Category, and grouped by device type. The description of the problem is provided and where appropriate, code references are listed for your convenience. Any item that was inspected that is listed on the Consumer

Product Safety Commission's website and is subject to a recall by the manufacturer is included.

Device Type Manufacturer…