a. Fire Alarm Outage Request Blank.docx

FIRE ALARM OUTAGE REQUEST FORM

Version dated 20250407

A. Step 1: Save this file in your desired location. Do not begin typing in the form, please, so others can use this form.

B. Step 2: Complete all sections below and obtain signatures from all responsible organizations to enable approval. Page 3 is the FireWorks/Panel cheat sheet to aid in completing system to be impacted. Then, print and hand deliver the approved form to Bldg 2 so it can be added and placed in the queue per Central Plant SOP for the outage/time/date.

C. Step 3. Event day, huddle in Central Plant. Create a text thread with central plant duty cell phone, onsite contract leadership(usually Supt, QC, USACE, CFM), Eli, and Myles.

D. Step 4. After work is completed. Postwork signatures are required to ensure the fire alarm system is not impaired by accidentally leaving a portion in bypass or the system in test.

FIRE ALARM OUTAGE REQUEST FORM

Version dated 20250407

PROJECT INFORMATION

PROJECT NUMBER Comment by Sisneros, Eli: Section-1234

PROJECT TITLE Comment by Sisneros, Eli: Related Project or Repair Name

DATE SUBMITTED

NATURE OF WORK

SYSTEM TO BE IMPACTED/ACTIVATED (Fire Alarm/Fire Sprinkler; Pulls, Smokes, Flows, Door Drop, Elevator Recall, and/or Place System in Test)

LOCATION

This permits applies only to areas specified; no system will be isolated or secured with approval. Use FireWorks Cheat sheet for building wings.

BUILDING NUMBER:

FLOOR:

WING:

ROOM NUMBER:

WHEN

No fire alarm tests between 7:30am and 8:00am due to patient care, clinical operation requirements.

START TIME:

END TIME:

PRE-WORK SAFETY CHECKLIST (CONTRACTOR)

Submit work request 14 prior to schedule work date. Required except for emergency repair.

Research area for isolation valves.

Fire Watch provided by contractor during a system shutdown longer than 10 hours (sprinklers) or 8 hours (fire alarm).

SDFD notified if duration of outage is longer than 10 hours (sprinklers) or 8 hours (fire alarm).

Provide supplemental fire extinguishing equipment on work site in case of fire.

Notify Central Plant, x3441, before and after work is completed.

PRE-WORK SAFETY CHECKLIST (VA PM)

Notify VA Police if work is in a secure space.

VA Project Manager on site for work duration.

Submit E-news announcement within 48 hours of start of work.

Personnel instructed in the fire alarm procedures (RACE).

APPROVAL AND CONTACT INFO

By signing below you are acknowledging that you understand all the provisions of this permit can be revoked at any time if I or my employees fail to follow the provisions above. Contractor and Subcontractor to contact VA Project Manager and Central Plant to request permission to start work prior to work commencing. No work will proceed without this from properly completed and approved (exception emergency repair which is only authorized by the contracted company Everon. Testing is not considered troubleshooting and is required to be planned in advance.)

Signature:

Date:

Phone:

Signature:

Date:

Phone:

Signature:

Signature:

VA AUTHORIZING OFFICIAL: DAVID ZAJAC, ELI SISNEROS, OR JEFF SALAS

Time:

☐ DISAPPROVED

POST WORK SAFETY CHECK

Bypass removed.

System taken off test.

Notify VA Police that work was completed if work was in a secure space

Fire Watch ended

SDFD notified outage is completed if required.

On-duty Utility System Operator notified

Outage logged in Fire Alarm Outage Logbook

Repair/troubleshooting logged in Fire Alarm Repair/troubleshooting Logbook.

VA keys returned

POST WORK INSPECTION

Contractor

VA PM

VA Project Supervisors

Fire Works Cheat Sheet

The Central Plant USS/USO(Utilities Systems Supervisor/Utilities Systems Operator can take out of service also known as Activate*, throughout the La Jolla Campus the fire alarm as follows:

A. Four types of initiating devices(smoke detectors, waterflows, tampers, and pull stations).

B. Two types of warnings notifications (audio which is overhead announcement/horns, and visual which is strobes lights).

C. Three types fire safety reactions(elevator recall, fire door drop, and air handler shutdown). These devices are smoke detectors, waterflows and pull stations.

D. Take out of Service the notification to the San Diego Fire Department by placing the system in “Test”. Placing the system in “Test” prevents the system from notifying the Fire Alarm’s emergency center from receiving a fire alarm and thereby preventing them from notifying the fire department in the event of a fire. This is not done via FireWorks so it is not called “activate” like the others.

*- Note that the Fireworks system uses the term “activate” to mean remove from service. This seems to be just backwards of what would be expected to take a device out of service and is a programming definition used by the FireWorks program. It is provided here in case you hear the term used as follows: “Roger, activating audio/visuals.” To which, you can clarify “did you mean that audio/visuals will be taken out of service?” for example. No such thing as a dumb question. In the end, it will ensure patient safety.

Other examples of standard terminology are:

“Activate Building 1, Smokes, 1st floor, Northwest” – This will take smoke detectors in the 1st floor Northwest zone out of service.

“Activate Building 1, Water flows, 3rd floor, East” – This will take waterflow alarms out of service in the 3rd floor East zone.

“Activate Building 1, Pulls, 6th floor, West” – This takes pull station alarms out of service in the 6th floor West zone.

“Troubles” – A notification on the fire alarm panel of a fault in the system which may be an impairment to a portion of the fire alarm system. Impairments require an Interim Life Safety Measure (ILSM), see Engr SOP: Life Safety Standad Operating Procedure(LSSOP) to ensure the applicable ILSM is completed correctly.

The table below identifies how each building’s fire alarm is zoned and provide are some examples of the terminology used to remove a particular type of signal for a zone.

Building 1

Door Drop/Elevator Smoke with recall

Elevator Smoke w recall

Elevator Smoke w recall

Building 11

Elevator Smoke w recall

Elevator Smoke w recall

Elevator Smoke w recall

Building 27

Elevator Smoke w recall

Elevator Smoke w recall

Elevator Smoke w recall

Building 14, 16, 20, 23, 25 are one level.

Parking Garage( Buildings 28, 29, 30, 31) Numbered West to East, i.e. furthest west is Bldg 28. Each is zoned by floor level.

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