Tampa-VAMC-Bldgs-_T33-T61-T62-T73-T74-T75-T76-T77-T78-T80-T81-T82-T83_-_June_2018.pdf

Fire Alarm and Life Safety System

Inspection Certificate

For

Tampa VAMC Bldg T-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 T-33 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 T-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 Type: Digital Communicator Mfg: SimplexGrinnell Model #:

Test Time/Date: 6/14/18 8:14:30 AM Restore Time

Kinetix 2 07/13/2018

Inspection Completion Date: Jun 14, 2018

Building: Tampa VAMC Bldg T-33

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

Pull Station 2 2 0 2 0 2

Smoke Detector 6 6 0 6 0 6

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

Speaker/Strobe 2 2 0 2 0 2

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) Total Quantity

Communicator 1 1 0 1 0 1

Total Device Count: 11

Kinetix 3 07/13/2018

Certification

Company: Kinetix Building: Tampa VAMC Bldg T-33

Inspector: Michael Gill Contact: Darren Matteson

Signed: Signed:

Kinetix 4 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 03

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))

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

Pull Station 2 2 0 2 2

Device Type Location ScanID Address Q2/17 Q2/18

Pull Station Ground CLINICAL GROUP 40666434 0-9:M1-27 06/27-P 06/14-P

Pull Station Ground CLINICAL GROUP 40666433 0-9:M1-26 06/27-P 06/14-P

Device Total: 2

Kinetix 5 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 6 6 0 6 6

Smoke Detector 1st ROOM 007 40666436 0-16:M2-45 06/27-P 06/14-P

Smoke Detector 1st ROOM 002 40666435 0-16:M2-44 06/27-P 06/14-P

Smoke Detector 1st ROOM 009 40666438 0-16:M2-47 06/28-P 06/14-P

Smoke Detector 1st ROOM 008A 40666437 0-16:M2-46 06/28-P 06/14-P

Smoke Detector 1st BY ROOM 005 40666439 0-16:M2-48 06/27-P 06/14-P

Smoke Detector 1st ROOM 001 40666440 0-16:M2-49 06/27-P 06/14-P

Device Total: 6

Kinetix 6 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 2 2 0 2 2

Speaker/Strobe Ground Entrance 33A 40666431 0 06/30-P 06/14-P

Speaker/Strobe Ground Entrance 33B 40666432 0 06/30-P 06/14-P

Kinetix 7 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 40665419 1 06/30-P 06/14-P

Device Total: 1

Kinetix 8 07/13/2018

Service Summary

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

Device Type Service Quantity

Passed Communicator Tested 1

Pull Station Tested 2

Smoke Detector Tested/Cleaned 6

Speaker/Strobe Tested 2

Total 11

Kinetix 9 07/13/2018

Inventory & Warranty Report

Building: Tampa VAMC Bldg T-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

Communicator Control 9.09% 1

Pull Station Initiating 18.18% 2

Smoke Detector Initiating 54.55% 6

Speaker/Strobe Indicating 18.18% 2

Type Qty Model # Description Install Date

In Service - 2 Years to 3 Years

Simplex

Pull Station 2 Dual Action 06/16/2016

Smoke Detector 6 Photoelectric 06/16/2016

Speaker/Strobe 2 06/16/2016

Kinetix 10 07/13/2018

Building: Tampa VAMC Bldg T-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

SimplexGrinnell

Communicator 1 Digital Communicator 08/07/2016

Kinetix 11 07/13/2018

Zone Address Report

Building: Tampa VAMC Bldg T-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

16:M2-44 Smoke Detector 1st ROOM 002 Photoelectric 40666435

16:M2-45 Smoke Detector 1st ROOM 007 Photoelectric 40666436

16:M2-46 Smoke Detector 1st ROOM 008A Photoelectric 40666437

16:M2-47 Smoke Detector 1st ROOM 009 Photoelectric 40666438

16:M2-48 Smoke Detector 1st BY ROOM 005 Photoelectric 40666439

16:M2-49 Smoke Detector 1st ROOM 001 Photoelectric 40666440

9:M1-26 Pull Station Ground CLINICAL GROUP Dual Action 40666433

9:M1-27 Pull Station Ground CLINICAL GROUP Dual Action 40666434

For

Tampa VAMC Bldg T-61

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 T-61 Company: Kinetix

Building: Tampa VAMC Bldg T-61 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: Restore Time

Inspection Completion Date: -

Building: Tampa VAMC Bldg T-61 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Pull Station 0 0 0 0 2 2

Smoke Detector 0 0 0 0 3 3 releasing devices

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Speaker/Strobe 0 0 0 0 1 1

Strobe 0 0 0 0 2 2

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018)

Communicator 0 0 0 0 1 1

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 0 0 0 0 2 2

Total Device Count: 11

Company: Kinetix Building: Tampa VAMC Bldg T-61

Building: Tampa VAMC Bldg T-61 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

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 2

Device Type Location ScanID Address Q2/17

Pull Station Ground T-61 SOUTH EXIT 40666460 0-22:M1-67 06/27-P

Pull Station Ground T-61 NORTH EXIT 40666459 0-22:M1-68 06/27-P

Device Total: 0

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 3

Smoke Detector Ground T-61 CLOSET 40666461 0-22:M1-66 06/27-P

Smoke Detector Ground T-61 OFFICE AREA NORTH 40666462 0-22:M1-65 06/27-P

Smoke Detector Ground T-61 OFFICE AREA SOUTH 40666463 0-13:M2-97 06/28-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 front door 40665442 0 06/30-P

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

For periodic testing, verify that each appliance flashes. (NFPA 72 Table 14.4.3.2 (22c))

Strobe 0 0 0 0 2

Strobe Ground by back door 40665443 0 06/30-P

Strobe Ground in bathroom 40665444 0 06/30-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 0 0 0 0 1

Communicator 1st in bldg 39 40665441 0 06/28-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 1st Comm ROOM 42020004 1-12V-10Ah 06/28-P

Battery 1st Comm ROOM 42020005 1-12V-10Ah 06/28-P

Building: Tampa VAMC Bldg T-61 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

Communicator Control 9.09% 1

Speaker/Strobe Indicating 9.09% 1

Strobe Indicating 18.18% 2

Pull Station Initiating 18.18% 2

Smoke Detector Initiating 27.27% 3

Battery Control 18.18% 2

Type Qty Model # Description Install Date

In Service - 5 Years to 10 Years

Simplex

Communicator 1 Digital Communicator 06/16/2009

Pull Station 2 Dual Action 06/16/2009

Smoke Detector 3 Photoelectric 06/16/2009

Speaker/Strobe 1 06/16/2009

Strobe 2 06/16/2009

Building: Tampa VAMC Bldg T-61 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 - 5 Years to 10 Years

Simplex

Battery 2 Sealed Lead Acid 06/16/2009

For

Tampa VAMC Bldg T-62

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 T-62 Company: Kinetix

Building: Tampa VAMC Bldg T-62 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 8:09:47 AM Restore Time

Building: Tampa VAMC Bldg T-62 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Pull Station 3 3 0 3 0 3

Smoke Detector 10 10 0 10 0 10 releasing devices

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Speaker/Strobe 24 24 0 24 0 24

Strobe 3 3 0 3 0 3

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: 43

Company: Kinetix Building: Tampa VAMC Bldg T-62

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

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 3 3 0 3 3

Pull Station Ground Southeast Exit 40666465 0-13:M2-67 06/27-P 06/14-P

Pull Station Ground North Exit 40666464 0-13:M2-66 06/27-P 06/14-P

Pull Station Ground Southwest Exit 40666466 0-13:M2-68 06/27-P 06/14-P

Device Total: 3

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 10 10 0 10 10

Smoke Detector Ground T-62 BY STAFF RESTROOM 40666468 0-13:M2-81 06/27-P 06/14-P

Smoke Detector Ground T-62 DIRTY ROOM 40666469 0-13:M2-82 06/27-P 06/14-P

Smoke Detector Ground T-62 BY TRIAGE 4 40666471 0-13:M2-84 06/27-P 06/14-P

Smoke Detector Ground T-62 BY TRIAGE 1 40666472 0-13:M2-85 06/27-P 06/14-P

Smoke Detector Ground T-62 CLEAN ROOM 40666470 0-13:M2-83 06/27-P 06/14-P

Smoke Detector Ground T-62 BY PCP 1 40666473 0-13:M2-86 06/27-P 06/14-P

Smoke Detector Ground T-62 BY PCP 4 40666474 0-13:M2-87 06/27-P 06/14-P

Smoke Detector Ground COMM ROOM ABOVE 4009 40666467 0-13:M2-65 06/30-P 06/14-P

Smoke Detector Ground T-62 BY PCP 6 40666475 0-13:M2-88 06/27-P 06/14-P

Smoke Detector Ground T-62 JANITORS CLOSET 40666476 0-13:M2-89 06/27-P 06/14-P

Device Total: 10

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 24 24 0 24 24

Speaker/Strobe Ground Room 105 40666481 0 06/30-P 06/14-P

Speaker/Strobe Ground Rear Exit S 40666479 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 101 40666480 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 106 40666482 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 115 40666491 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 113 40666489 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 114 40666490 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 116 40666492 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 117 40666493 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 119 40666495 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 110 40666486 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 111 40666487 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 112 40666488 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 118 40666494 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 120 40666496 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 121 40666497 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 122 40666498 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 109 40666485 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 108 40666484 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 107 40666483 0 06/30-P 06/14-P

Speaker/Strobe Ground Room 123 40666499 0 06/30-P 06/14-P

Speaker/Strobe Ground Rear Exit N 40666478 0 06/30-P 06/14-P

Speaker/Strobe Ground Waiting Area 40666500 0 06/30-P 06/14-P

Speaker/Strobe Ground Main Entrance 40666477 0 06/30-P 06/14-P

Device Total: 24

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

For periodic testing, verify that each appliance flashes. (NFPA 72 Table 14.4.3.2 (22c))

Strobe 3 3 0 3 3

Strobe Ground Room 126 40666502 0 06/30-P 06/14-P

Strobe Ground Room 127 40666503 0 06/30-P 06/14-P

Strobe Ground Room 103 Restroom 40666501 0 06/30-P 06/14-P

Device Total: 3

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 40665446 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 1st In Room 128 42020003 1-12V-10Ah 06/28-P

Battery 1st In Room 128 42020002 1-12V-10Ah 06/28-P

Communicator Tested 1

Pull Station Tested 3

Smoke Detector Tested/Cleaned 10

Speaker/Strobe Tested 24

Strobe Tested 3

Total 41

Untested Battery 2

Total 2

Building: Tampa VAMC Bldg T-62 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 4.65% 2

Communicator Control 2.33% 1

Pull Station Initiating 6.98% 3

Smoke Detector Initiating 23.26% 10

Speaker/Strobe Indicating 55.81% 24

Strobe Indicating 6.98% 3

Type Qty Model # Description Install Date

In Service - 2 Years to 3 Years

Simplex

Pull Station 2 Dual Action 06/16/2016

Smoke Detector 10 Photoelectric 06/16/2016

Speaker/Strobe 24 06/16/2016

Strobe 3 06/16/2016

In Service - 5 Years to 10 Years

Simplex

Pull Station 1 Dual Action 06/16/2009

Kinetix 12 07/13/2018

Building: Tampa VAMC Bldg T-62 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 - 5 Years to 10 Years

SimplexGrinnell

Battery 2 Sealed Lead Acid 08/08/2009

Communicator 1 Digital Communicator 08/08/2009

Kinetix 13 07/13/2018

Building: Tampa VAMC Bldg T-62 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

13:M2-65 Smoke Detector Ground COMM ROOM ABOVE 4009 Photoelectric 40666467

13:M2-66 Pull Station Ground North Exit Dual Action 40666464

13:M2-67 Pull Station Ground Southeast Exit Dual Action 40666465

13:M2-68 Pull Station Ground Southwest Exit Dual Action 40666466

13:M2-81 Smoke Detector Ground T-62 BY STAFF RESTROOM Photoelectric 40666468

13:M2-82 Smoke Detector Ground T-62 DIRTY ROOM Photoelectric 40666469

13:M2-83 Smoke Detector Ground T-62 CLEAN ROOM Photoelectric 40666470

13:M2-84 Smoke Detector Ground T-62 BY TRIAGE 4 Photoelectric 40666471

13:M2-85 Smoke Detector Ground T-62 BY TRIAGE 1 Photoelectric 40666472

13:M2-86 Smoke Detector Ground T-62 BY PCP 1 Photoelectric 40666473

13:M2-87 Smoke Detector Ground T-62 BY PCP 4 Photoelectric 40666474

13:M2-88 Smoke Detector Ground T-62 BY PCP 6 Photoelectric 40666475

13:M2-89 Smoke Detector Ground T-62 JANITORS CLOSET Photoelectric 40666476

Kinetix 14 07/13/2018

Building: Tampa VAMC Bldg T-62 Control Panel: 1

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

12V-10Ah Battery 1st In Room 128 Sealed Lead Acid 42020002

12V-10Ah Battery 1st In Room 128 Sealed Lead Acid 42020003

For

Tampa VAMC Bldg T73

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 13, 2018

Building: Tampa VAMC Bldg T73 Company: Kinetix

Building: Tampa VAMC Bldg T73 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

Test Time/Date: 6/13/18 2:31:21 PM Restore Time

Inspection Completion Date: Jun 13, 2018

Building: Tampa VAMC Bldg T73 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Smoke Detector 2 2 0 2 0 2 releasing devices

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Speaker/Strobe 1 1 0 1 0 1

Strobe 1 1 0 1 0 1

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Total Device Count: 7

Company: Kinetix Building: Tampa VAMC Bldg T73

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

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 1st east exit 40665360 1-M1-95 06/27-P 06/13-P

Pull Station 1st West exit 40665361 1-M1-92 06/27-P 06/13-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 2 2 0 2 2

Smoke Detector 1st room 105-T73 40665362 1-M1-94 06/27-P 06/13-P

Smoke Detector 1st office area 40665363 1-M1-93 06/27-P 06/13-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 1 1 0 1 1

Speaker/Strobe 1st office area 40665364 1 06/30-P 06/13-P

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

For periodic testing, verify that each appliance flashes. (NFPA 72 Table 14.4.3.2 (22c))

Strobe 1 1 0 1 1

Strobe 1st in restroom 40665365 1 06/30-P 06/13-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 40665359 1 06/30-P 06/13-P

Communicator Tested 1

Pull Station Tested 2

Smoke Detector Tested/Cleaned 2

Speaker/Strobe Tested 1

Strobe Tested 1

Total 7

Building: Tampa VAMC Bldg T73 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 14.29% 1

Pull Station Initiating 28.57% 2

Smoke Detector Initiating 28.57% 2

Speaker/Strobe Indicating 14.29% 1

Strobe Indicating 14.29% 1

Type Qty Model # Description Install Date

In Service - 5 Years to 10 Years

SimplexGrinnell

Communicator 1 Digital Communicator 08/07/2009

Pull Station 2 Dual Action 08/07/2009

Smoke Detector 2 Photoelectric 08/07/2009

Speaker/Strobe 1 08/07/2009

Strobe 1 08/07/2009

Building: Tampa VAMC Bldg T73 Control Panel: 1

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

M1-92 Pull Station 1st West exit Dual Action 40665361

M1-93 Smoke Detector 1st office area Photoelectric 40665363

M1-94 Smoke Detector 1st room 105-T73 Photoelectric 40665362

M1-95 Pull Station 1st east exit Dual Action 40665360

For

Tampa VAMC Bldg T74

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 13, 2018

Building: Tampa VAMC Bldg T74 Company: Kinetix

Building: Tampa VAMC Bldg T74 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

Test Time/Date: 6/13/18 1:43:51 PM Restore Time

Building: Tampa VAMC Bldg T74 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity releasing devices

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Company: Kinetix Building: Tampa VAMC Bldg T74

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

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 1st by west exit 40665356 1-M1-88 06/27-P 06/13-P

Pull Station 1st east exit 40665353 1-M1-91 06/27-P 06/13-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 1st in office area 40665355 1-M1-89 06/27-P 06/13-P

Smoke Detector 1st in room 105-T74 40665354 1-M1-90 06/28-P 06/13-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 1st Office area 40665357 1 06/30-P 06/13-P

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

For periodic testing, verify that each appliance flashes. (NFPA 72 Table 14.4.3.2 (22c))

Strobe 1st in restroom 40665358 1 06/30-P 06/13-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 40665352 1 06/30-P 06/13-P

Communicator Tested 1

Pull Station Tested 2

Smoke Detector Tested/Cleaned 2

Speaker/Strobe Tested 1

Building: Tampa VAMC Bldg T74 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 28.57% 2

Communicator Control 14.29% 1

Smoke Detector Initiating 28.57% 2

Speaker/Strobe Indicating 14.29% 1

Strobe Indicating 14.29% 1

Type Qty Model # Description Install Date

In Service - 1 Year to 2 Years

SimplexGrinnell

Communicator 1 Digital Communicator 08/07/2016

In Service - 5 Years to 10 Years

SimplexGrinnell

Pull Station 2 Dual Action 08/07/2009

Smoke Detector 2 Photoelectric 08/07/2009

Building: Tampa VAMC Bldg T74 Control Panel: 1

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

M1-88 Pull Station 1st by west exit Dual Action 40665356

M1-89 Smoke Detector 1st in office area Photoelectric 40665355

M1-90 Smoke Detector 1st in room 105-T74 Photoelectric 40665354

M1-91 Pull Station 1st east exit Dual Action 40665353

For

Tampa VAMC Bldg T75

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 13, 2018

Building: Tampa VAMC Bldg T75 Company: Kinetix

Building: Tampa VAMC Bldg T75 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

Test Time/Date: 6/13/18 1:43:23 PM Restore Time

Building: Tampa VAMC Bldg T75 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity releasing devices

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Company: Kinetix Building: Tampa VAMC Bldg T75

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

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 1st by East exit 40665346 1-M1-87 06/27-P 06/13-P

Pull Station 1st by west exit 40665347 1-M1-84 06/27-P 06/13-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 1st in room 105-T75 40665348 1-M1-86 06/28-P 06/13-P

Smoke Detector 1st in office area 40665349 1-M1-85 06/27-P 06/13-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 1st office area 40665350 1 06/30-P 06/13-P

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

For periodic testing, verify that each appliance flashes. (NFPA 72 Table 14.4.3.2 (22c))

Strobe 1st in bathroom 40665351 1 06/30-P 06/13-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 40665345 1 06/30-P 06/13-P

Communicator Tested 1

Pull Station Tested 2

Smoke Detector Tested/Cleaned 2

Speaker/Strobe Tested 1

Building: Tampa VAMC Bldg T75 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 14.29% 1

Pull Station Initiating 28.57% 2

Smoke Detector Initiating 28.57% 2

Speaker/Strobe Indicating 14.29% 1

Strobe Indicating 14.29% 1

Type Qty Model # Description Install Date

In Service - 5 Years to 10 Years

SimplexGrinnell

Communicator 1 Digital Communicator 08/07/2009

Pull Station 2 Dual Action 08/07/2009

Smoke Detector 2 Photoelectric 08/07/2009

Building: Tampa VAMC Bldg T75 Control Panel: 1

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

M1-84 Pull Station 1st by west exit Dual Action 40665347

M1-85 Smoke Detector 1st in office area Photoelectric 40665349

M1-86 Smoke Detector 1st in room 105-T75 Photoelectric 40665348

M1-87 Pull Station 1st by East exit Dual Action 40665346

For

Tampa VAMC Bldg T76

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 13, 2018

Building: Tampa VAMC Bldg T76 Company: Kinetix

Building: Tampa VAMC Bldg T76 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

Test Time/Date: 6/13/18 1:42:57 PM Restore Time

Building: Tampa VAMC Bldg T76 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity releasing devices

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Company: Kinetix Building: Tampa VAMC Bldg T76

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

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 1st by East exit 40665339 1-M1-83 06/27-P 06/13-P

Pull Station 1st by west exit 40665342 1-M1-80 06/27-P 06/13-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 1st in room 105-T76 40665340 1-M1-82 06/27-P 06/13-P

Smoke Detector 1st in office area 40665341 1-M1-81 06/27-P 06/13-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 1st in office area 40665343 1 06/30-P 06/13-P

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

For periodic testing, verify that each appliance flashes. (NFPA 72 Table 14.4.3.2 (22c))

Strobe 1st in restroom 40665344 1 06/30-P 06/13-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 40665352 1 06/30-P 06/13-P

Communicator Tested 1

Pull Station Tested 2

Smoke Detector Tested/Cleaned 2

Speaker/Strobe Tested 1

Building: Tampa VAMC Bldg T76 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 14.29% 1

Pull Station Initiating 28.57% 2

Smoke Detector Initiating 28.57% 2

Speaker/Strobe Indicating 14.29% 1

Strobe Indicating 14.29% 1

Type Qty Model # Description Install Date

In Service - 5 Years to 10 Years

SimplexGrinnell

Communicator 1 Digital Communicator 08/07/2009

Pull Station 2 Dual Action 08/07/2009

Smoke Detector 2 Photoelectric 08/07/2009

Building: Tampa VAMC Bldg T76 Control Panel: 1

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

M1-80 Pull Station 1st by west exit Dual Action 40665342

M1-81 Smoke Detector 1st in office area Photoelectric 40665341

M1-82 Smoke Detector 1st in room 105-T76 Photoelectric 40665340

M1-83 Pull Station 1st by East exit Dual Action 40665339

For

Tampa VAMC Bldg T-77

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 T-77 Company: Kinetix

Building: Tampa VAMC Bldg T-77 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 8:05:50 AM Restore Time

Building: Tampa VAMC Bldg T-77 and smoke detectors

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Smoke Detector 1 1 0 1 0 1 releasing devices

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Devices Tested This

Quarter Pass Fail

Tested YTD

(2018)

Untested YTD

(2018) Total Quantity

Company: Kinetix Building: Tampa VAMC Bldg T-77

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

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 Ground T77 EAST EXIT 40666511 0-17:M3-57 06/27-P 06/14-P

Pull Station Ground T77 WEST EXIT 40666512 0-17:M3-55 06/27-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 1 1 0 1 1

Smoke Detector Ground T77 STORAGE ROOM 40666513 0-17:M3-56 06/27-P 06/14-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 Ground by front door 40665153 1 06/30-P 06/14-P

Speaker/Strobe Ground by back door 40665154 1 06/30-P 06/14-P

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