Attachment_A.6.6.8_Building_Automation_System.pdf

Value Percent Of Text

Total BLNs 1

P2 1

38,400 baud 1

Total workstations 4

Workstations with BLNs 1 25 % of Total workstations

Total Graphics 304

Total Reports 70

AEMs 0

TECs 267

UCs 0

Custom Alarm Sounds 0

Total Panels 43 have more than one PPCL program 25

MBCs 20

MECs 1

AHUCs 19

MODULARs 3

Total Points 8972

LAI Points 1500 16.72 % of total points

LAO Points 4952 55.19 % of total points

LDI Points 783 8.73 % of total points

LDO Points 1575 17.55 % of total points

LFSSL Points 8 0.09 % of total points

LFSSP Points 0 0 % of total points

LOOAL Points 0 0 % of total points

LOOAP Points 0 0 % of total points

LPACI Points 0 0 % of total points

L2SL Points 118 1.32 % of total points

L2SP Points 0 0 % of total points

LENUM Points 36 0.4 % of total points

Pts using Dynamic COVs 151 1.68 % of total points

Virtural Points 2173 24.22 % of total points using RENO 30 0.33 % of total points using CSO 0 0 % of total points

Trended Points 732 8.16 % of total points

Item

Section: BLNs

Section: Insights

Section: Other

Section: Panels

Section: Points

Trend Definitions 747

Totalized Points 72 0.8 % of total points

Points with Memos 105 1.17 % of total points

Have Informational Text 108 1.2 % of total points

Point w/diff User Name 7 0.08 % of total points

Use POPUP messages 0 0 % of total points

Using enhanced alarming 213 2.37 % of total points

Broken mode or set point 1 Enchanced Alarm Points with invalid setpoint

Enchanced Alarm Points with invalid mode point

Unbundled Team Points 5199 57.95 % of all points at this site

Modified from Team Descriptor 220 95.77 % of unbundled points have not been modified from the team descriptor

Event Defs 1

EQS Zones 5 command point is in another panel on the same BLN command point requires uses of

CrossTrunk Service using SSTO 0 0 % of all EQS zones

TOD Zones 0

Section: Zones

NO.

Print Date:

REVISION

TYPE

Y/N NOTE# Y/N

NOTE #

#N/A #N/A #N/A NOTE #

#N/A #N/A #N/A

NOTE #

#N/A

NOTE #

COPS

NORMAL / FAIL

CUSTOMER CONTACT

-CIRCUIT BREAKER-

#N/A

CONTACT'S DIRECT PHONE NUMBER

DEDICATED

#N/A

R E S P O N S E T O T R O U B L E C O N D I T I O N S p2d

PANEL FUSE(S) WERE REMOVED, PANEL WENT INTO TROUBLE & THE AMP RATING(S) WERE VERIFIED.

THE WARRANTY OR

INSPECTION CONTRACT

START DATE IS:

#N/A

SIEMENS INDUSTRY, INC. BRANCH OFFICE

MODEL NO.

T Y P E O F S I G N A L I N G

SIEMENS MXL-IQ

May 21, 2013msb 17.02

MIKE ONEILL19038

SELECTIVE PRESIGNAL

CONTRACT NO.

CIRCUIT BREAKER

LOCATION

LOCKED P O W E R S O U R C E

MANUFACTURER

CITY STATE ZIP CODE

WYNDMOOR PA

CITY CONNECTION

#N/A

GROUND FAULT TROUBLE PRIMARY POWER LOAD

TEST

AC LOSS TROUBLE

LED TEST

BATTERY LOSS TROUBLE

GENERAL ALARM

ALTERNATE ELEVATOR FIRE RECALL

HVAC SHUTDOWN

NORMAL / FAIL

INSPECTOR/S NAME/S PRESENT

#N/A

CITY / MONITORING RESPONSE TO ALARM CENTRAL MONITORING STATION (CS) CITY / MONITORING RESPONSE TO TROUBLE

CODED

Timothy O'Connor

INSPECTION NO.

5100739003

NAME

May 28, 2013

USDA MSB 05/21/2013

INSPECTION DATE

C O N T R O L P A N E L

Fire Safety Division

F I R E S A F E T Y S Y S T E M I N S P E C T I O N A N D T E S T R E P O R T

Siemens Industry, Inc.

5100739003

#N/A

CONTACT/S PRESENT EMAIL

NOTE:

ELEVATOR FIRE RECALL

FUNCTION PASS / FAIL

NONE

NOTE#

FIRE ALARM LICENSE NO. - STATE CERTIFICATION NO.:

A U X I L I A R Y F U N C T I O N S

#N/A

SIGNALS NOT SOUNDED

BY CUSTOMER REQUEST

Timothy O'Connor & Sean O'Brien

600 MERMAID LANE

I&T CREATED BYORIGINAL JOB #CSGM FILE NAME VERSION I&T CREATION DATE

I N S P E C T I O N

NOTE #

CIRCUIT BREAKER

FREQUENCY / TYPE OF INSPECTION

A N N U A L

2ND FL AREA 254

LOCATION

BREAKER #

ADDRESS

mike.onem.ars.udsa.gov

215-233-6631

OPEN CIRCUIT TROUBLE

REVISION DATE

SIGNALS

TOTAL TOTAL TESTED % SOLD % LISTED TOTAL TOTAL TESTED % SOLD % LISTED

SOLD LISTED TO DATE COMPLETED COMPLETED SOLD LISTED TO DATE COMPLETED COMPLETED

0 26 25 250000000000000000000000000000000000000000000000000000% 96% 0 0% 0 1 1 10000000000000000000000000000000000000000000000000000% 100% 0 0%

0 18 4 40000000000000000000000000000000000000000000000000000% 22% 0 0% 0 0 0 0% 0% 0 0%

0 3 3 30000000000000000000000000000000000000000000000000000% 100% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 1 1 10000000000000000000000000000000000000000000000000000% 100% 0 0% 0 0 0 0% 0% 0 0%

0 8 7 70000000000000000000000000000000000000000000000000000% 88% 0 0% 0 0 0 0% 0% 0 0%

0 1 0 0% 0% 0.0 0% 0 0 0 0% 0% 0 0%

0 3 0 0% 0% 0.0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 60 40 400000000000000000000000000000000000000000000000000000% 67% 0 0% 0 1 1 10000000000000000000000000000000000000000000000000000% 100% 0 0%

0 0 0 0% 0% 0 0% AS-BUILT DRAWINGS ARE ON SITE TRUE/FALSE:

0 0 0 0% 0% 0 0% BATTERY TESTING HAS BEEN COMPLETED TRUE/FALSE:

0 0 0 0% 0% 0 0% PANEL F FUNCTION BYPASS KEYS HAVE BEEN PROGRAMMED TRUE/FALSE:

0 0 0 0% 0% 0 0% BYPASS PROCEDURES HAVE BEEN DOCUMENTED TRUE/FALSE:

0 0 0 0% 0% 0 0% MONITORED BY CALIFORNIA SECURITY TRUE/FALSE:

0 0 0 0% 0% 0 0% FUNCTIONING PRINTER IS ON SITE TRUE/FALSE:

0 0 0 0% 0% 0 0% LOG BOOK IS ON SITE (Support Link only) TRUE/FALSE:

0 0 0 0% 0% 0 0% SPECIAL INSTRUCTIONS ARE IN THE FILE TRUE/FALSE:

0 0 0 0% 0% 0 0% 0 61 41 410000000000000000000000000000000000000000000000000000% 68% 0 0% apcrev0902

TIME OUT OF SERVICE TIME BACK IN SERVICE

#N/ACOPS

PANEL TOTALS

THE "TOTAL SOLD" COLUMNS HAVE NOT BEEN POPULATED!

SIEMENS INDUSTRY, INC.

FIREMAN'S PH/JACK TOTALS

VOICE EVAC SPEAKER

NOTIFICATION DEVICE TOTALS

NCC

FSI INTERFACE

GRAND TOTAL

DIALER

PAD / AUX PWR SUPPLIES

FIRE DPT. / CS OFFICIAL TOTAL MAN HOURS

SMOKE DETECTOR FIRE ALARM PANEL

May 21, 2013 PANELS May 21, 2013

TAMPER SWITCH

BEAM DETECTOR

DUCT DETECTOR

HEAT DETECTOR

MONITORING DEVICE

MONITORING ACCOUNT #FIRE DPT. / CS PHONE #

FAN CONTROL PANEL

DEVICES

INSPECTED ONINSPECTED ON

P E R I P H E R A L F U N C T I O N T E S T I N G A U T O A U D I T

LOCAL FIRE DPT.

#N/A

AIR SAMPLING

DOOR RELEASE TOTALS

WATERFLOW

PRINTER

ANNUNCIATOR

DISPLAY TERMINAL

VOICE EVAC PANEL

FIREMAN'S JACK

FIRE SMOKE DAMPER

PULL STATION

INITIATING DEVICE TOTALS

AUDIBLE

VISUAL

AUDIBLE / VISUAL

FIREMAN'S PHONE

NONE

SIEMENS FIRE INSPECTION REPORT 5/28/2013 10:27 AM

NO:

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

(L e a v e T h e F i r s t F e w L i n e s O p e n)

2 253 FACP 02 MXL-IQ AREA 254 PASS PASS TO SO 05/20/13

2 001 001 HD 02 HEAT MSB 2ND FLR LAB 210

2 001 002 HD 02 HEAT MSB 2ND FLR LAB 210

2 001 003 HD 02 HEAT MSB 2ND FLR LAB/PROCESS 203

2 001 004 HD 02 HEAT MSB 2ND FLR PROCESS RM.200

2 001 005 HD 02 HEAT MSB 2ND FLR PROCESS RM.200

2 001 006 HD 02 HEAT MSB 2ND FLR STAGING.205

2 001 007 HD 02 HEAT MSB 2ND FLR DECON RM.204

2 001 008 HD 02 HEAT MSB 2ND FLR WAREHOUSE 254 PASS 05/20/13 TO SO 05/20/13

2 001 010 SD 02 SMOKE MSB 2ND FLR LAB 210 PASS 05/20/13 TO SO 05/20/13 3.40

2 001 011 SD 02 SMOKE MSB 2ND FLR LAB 210 PASS 05/20/13 TO SO 05/20/13 3.40

2 001 012 SD 02 SMOKE MSB 2ND FLR CLEANUP RM.202 PASS 05/20/13 TO SO 05/20/13 3.40

2 001 013 SD 02 SMOKE MSB 2ND FLR CLEANUP RM.202 PASS TO SO 05/20/13 3.12

2 001 014 SD 02 SMOKE MSB 2ND FLR PROCESS RM.200 PASS TO SO 05/20/13 3.12

2 001 015 SD 02 SMOKE MSB 2ND FLR PROCESS RM.200 PASS TO SO 05/20/13 3.12

2 001 016 SD 02 SMOKE MSB 2ND FLR STAGING RM.205 PASS TO SO 05/20/13 3.12

2 001 017 SD 02 SMOKE MSB 2ND FLR PROCESS RM.200 PASS TO SO 05/20/13 3.12

2 001 018 PS 02 PULL MSB 2ND FLR STAGING RM.205 PASS TO SO 05/20/13

2 001 019 SD 02 SMOKE MSB 2ND FLR LAB PROCESS PASS TO SO 05/20/13 3.12

2 001 020 HD 02 HEAT MSB 2ND FLR WOMENS RM.208 PASS 05/20/13 TO SO 05/20/13

2 001 021 HD 02 HEAT MSB 2ND FLR MENS RM.209 05/20/13

2 001 022 PS 02 PULL MSB 2ND FLR VESTIBULE 201 PASS 05/20/13 TO SO 05/20/13

2 001 023 PS 02 PULL MSB 2ND FLR LAB 210 PASS 05/20/13 TO SO 05/20/13

2 001 024 SD 02 SMOKE MSB 2ND FLR AREA 254 PASS TO SO 05/20/13 3.12

2 001 025 SD 02 SMOKE MSB 2ND FLR AREA 254 PASS TO SO 05/20/13 3.12

2 001 026 SD 02 SMOKE MSB 2ND FLR AREA 254 PASS TO SO 05/20/13 3.12

2 001 027 SD 02 SMOKE MSB 2ND FLR AREA 254 PASS TO SO 05/20/13 3.12

2 001 028 HD 02 HEAT DETECTOR OUTSIDE RM 212 PASS ` TO SO 05/20/13

2 001 029 WF 01 FLOW SWITCH ABOVE ENTR DOOR 05/20/13 1

2 001 030 TS 01 SPRINKLER TAMPER 05/20/13 1

2 001 031 DD 02 DUCT FLR2 AHU 1 PASS 05/20/13 TO SO 05/20/13 2.25

2 001 032 MSC 02 HVAC FLR 2 UNIT 1 SHUTDOWN PASS TO SO 05/20/13

2 001 050 SD 01 FOOD SAFTEY OFFICE PASS TO SO 05/20/13 3.12

2 002 001 PS 01 PULL RM 121 REAR EXIT PASS TO SO 05/20/13

2 002 002 PS 01 PULL RM 120 REAR EXIT

2 002 003 HD 01 HEAT IN RM 121

2 002 004 HD 01 HEAT IN RM 121

2 002 005 HD 01 HEAT IN RM 120 PASS 05/20/13 TO SO 05/20/13

2 002 006 SD 01 SMOKE FLR 1 IN REAR LOBBY PASS 05/20/13 TO SO 05/20/13 3.12

2 002 007 PS 01 PULL FLR 1 IN REAR LOBBY PASS 05/20/13 TO SO 05/20/13

2 002 008 WF 01 FLOW FOR RM 120 (IN REAR LOBBBY) 05/20/13 1

2 002 009 SD 01 SMOKE IN RM 116B PASS TO SO 05/20/13 3.12

2 002 010 HD 01 HEAT IN RM 114 (CONV 200 DEGREE)

2 002 011 SD 01 SMOKE HALL BY RM 113 PASS TO SO 05/20/13 3.12

2 002 012 WF 01 FLOW FOR RM 109 (IN HALL BY 109) 1

2 002 013 HD 01 HEAT IN RM 109

2 002 014 HD 01 HEAT IN RM 105

2 002 015 SD 01 SMOKE HALL BY RM 105 PASS TO SO 05/20/13 3.12

2 002 016 HD 01 HEAT IN RM 101

2 002 017 WF 01 FLOW FOR WHOLE BLDG 1

2 002 018 TS 01 TAMPER FOR WHOLE BLDG 1

2 002 019 PS 01 PULL FRONT ENTRANCE BY RM 100 PASS TO SO 05/20/13

2 002 020 SD 02 SMOKE FLR 2 REAR PASS TO SO 05/20/13 3.12

2 002 021 SD 02 SMOKE FLR 2 REAR PASS TO SO 05/20/13 3.12

2 002 022 PS 02 PULL FLR 2 ENTRANCE TO REAR PASS TO SO 05/20/13

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

USDA MSB

apcrev0902 PAGE 1 OF 2

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

USDA MSB

2 002 023 WF 02 FLOW FLR 2 REAR 1

2 002 024 SD 02 SMOKE ELEV TOP OF SHAFT 3.12

2 002 025 SD 02 SMOKE FLR 2 REAR LOBBY PASS TO SO 05/20/13 3.12

2 002 026 SD 03 SMOKE FLR 3 IN MECH RM PASS TO SO 05/20/13 3.12

2 002 027 SD 03 SMOKE FLR 3 ELEV MACH RM PASS TO SO 05/20/13 3.12

2 002 028 SD 04 SMOKE FLR 4 TOP OF STAIR PASS TO SO 05/20/13 3.12

2 002 029 SD 04 SMOKE FLR 4 IN MECH RM PASS TO SO 05/20/13 3.12

2 002 030 DD 04 DUCT FLR 4 MECH RM SUPPLY PASS TO SO 05/20/13 2.25

2 002 031 DD 04 DUCT FLR 4 MECH RM RETURN PASS TO SO 05/20/13 2.25

apcrev0902 PAGE 2 OF 2

PASS FAIL PASS FAIL PASS FAIL PASS FAIL

# 1

#2

#3

#4

#5

USDA MSB

INSPECTION #

FAILURES AND RECOMMENDATIONS ENCOUNTERED DURING INSPECTIONS AND TESTING

N O T A T I O N S

TO BE TESTED BY SPRINKLER COMPANY.

BATTERIES IN MXL-IQ PANEL FAILED AMP HOUR TESTING AND NEED TO BE REPLACE 2 12 VOLT 18AH.

TWO SEPARATE AND FUNCTIONING MEANS OF REPORTING ALARM REPORTING WITH PRIMARY DISCONNECTED

PRIMARY LINE FAIL REPORTING PRIMARY LINE SEIZURE SECONDARY LINE FAIL REPORTING

DATE INSPECTION # DATEINSPECTION # DATE INSPECTION # DATE

5100739003

I N S P E C T I O N D A T E S

INSPECTION #

F I R E I N S P E C T I O N R E C O R D S NO.

DATE

B A T T E R Y T E S T I N G

CONNECTION

CHECK

DATE INSTALLEDLOCATION CHARGER VOLTAGE STATIC VOLTAGE AMP HOURSIZE / TYPE DATE TESTED

27.05MXL PANEL 12 VOLT 18AH 5-20-13

C O M M U N I C A T O R T E S T I N G

May 28, 2013

60% / 60% 7/9/201213.5 / 13.58 OK

#5

#6

#7

#8

#9

#10

#11

#12

#13

#14

#15

Date Name Title

Date apcrev0902

SIEMENS INDUSTRY, INC.

The undersigned Siemens representative certifies that the equipment has been completely checked and performs in all respects as designed, and all auxiliary equipment functions as desired.

Siemens Building Technologies, Inc. Rep.

The fire life safety system has been placed in operation and as the owner's representative, I have been instructed in the operation of the system.

V E R I F I C A T I O N O F S Y S T E M T E S T

REVISION

TYPE

Y/N NOTE# Y/N

NOTE #

#N/A #N/A #N/A NOTE #

#N/A #N/A #N/A

NOTE #

BREAKER #

ADDRESS

mike.onem.ars.udsa.gov

215-233-6631

OPEN CIRCUIT TROUBLE

REVISION DATE

I N S P E C T I O N

NOTE #

CIRCUIT BREAKER

FREQUENCY / TYPE OF INSPECTION

A N N U A L

FRONT DOOR

600 MERMAID LANE

I&T CREATED BYORIGINAL JOB #CSGM FILE NAME VERSION I&T CREATION DATE

A U X I L I A R Y F U N C T I O N S

#N/A

SIGNALS NOT SOUNDED

BY CUSTOMER REQUEST

FIRE ALARM LICENSE NO. - STATE CERTIFICATION NO.:

Timothy O'Connor & Sean O'Brien

#N/A

CONTACT/S PRESENT EMAIL

NOTE:

ELEVATOR FIRE RECALL

FUNCTION PASS / FAIL

NONE

NOTE#NORMAL / FAIL

Fire Safety Division

F I R E S A F E T Y S Y S T E M I N S P E C T I O N A N D T E S T R E P O R T

Siemens Industry, Inc.

5100739003

SIGNALS

CODED

Timtohy O'Connor

INSPECTION NO.

5100739003

NAME

May 28, 2013

USDA HAZ OP 05/22/2013

INSPECTOR/S NAME/S PRESENT

#N/A

CITY / MONITORING RESPONSE TO ALARM CENTRAL MONITORING STATION (CS) CITY / MONITORING RESPONSE TO TROUBLE

#N/A

INSPECTION DATE

ALTERNATE ELEVATOR FIRE RECALL

HVAC SHUTDOWN

CITY CONNECTION

COPS

#N/A

GROUND FAULT TROUBLE PRIMARY POWER LOAD

TEST

AC LOSS TROUBLE

LED TEST

BATTERY LOSS TROUBLE

GENERAL ALARM SELECTIVE PRESIGNAL

C O N T R O L P A N E L

LOCATION MANUFACTURER

CITY STATE ZIP CODE

Mike Oneill19038

CONTRACT NO.

CIRCUIT BREAKER

LOCATION

LOCKED P O W E R S O U R C E

#N/A

SIEMENS INDUSTRY, INC. BRANCH OFFICE

MODEL NO.

T Y P E O F S I G N A L I N G

SIEMENS MXL-IQ

May 22, 2013HAZOP 17.02

WYNDMOOR PA

THE WARRANTY OR

INSPECTION CONTRACT

START DATE IS:

CONTACT'S DIRECT PHONE NUMBER

DEDICATED

#N/A

R E S P O N S E T O T R O U B L E C O N D I T I O N S PANEL FUSE(S) WERE REMOVED, PANEL WENT INTO TROUBLE & THE AMP RATING(S) WERE VERIFIED.

CUSTOMER CONTACT

-CIRCUIT BREAKER-

#N/A

NORMAL / FAIL NOTE #

TOTAL TOTAL TESTED % SOLD % LISTED TOTAL TOTAL TESTED % SOLD % LISTED

SOLD LISTED TO DATE COMPLETED COMPLETED SOLD LISTED TO DATE COMPLETED COMPLETED

0 1 1 10000000000000000000000000000000000000000000000000000% 100% 0 0% 0 1 1 10000000000000000000000000000000000000000000000000000% 100% 0 0%

0 8 5 50000000000000000000000000000000000000000000000000000% 63% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 8 8 80000000000000000000000000000000000000000000000000000% 100% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0.0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0.0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 17 14 140000000000000000000000000000000000000000000000000000% 82% 0 0% 0 1 1 10000000000000000000000000000000000000000000000000000% 100% 0 0%

0 0 0 0% 0% 0 0% AS-BUILT DRAWINGS ARE ON SITE TRUE/FALSE:

0 0 0 0% 0% 0 0% BATTERY TESTING HAS BEEN COMPLETED TRUE/FALSE:

0 0 0 0% 0% 0 0% PANEL F FUNCTION BYPASS KEYS HAVE BEEN PROGRAMMED TRUE/FALSE:

0 0 0 0% 0% 0 0% BYPASS PROCEDURES HAVE BEEN DOCUMENTED TRUE/FALSE:

0 0 0 0% 0% 0 0% MONITORED BY CALIFORNIA SECURITY TRUE/FALSE:

0 0 0 0% 0% 0 0% FUNCTIONING PRINTER IS ON SITE TRUE/FALSE:

0 0 0 0% 0% 0 0% LOG BOOK IS ON SITE (Support Link only) TRUE/FALSE:

0 0 0 0% 0% 0 0% SPECIAL INSTRUCTIONS ARE IN THE FILE TRUE/FALSE:

0 0 0 0% 0% 0 0% 0 18 15 150000000000000000000000000000000000000000000000000000% 83% 0 0% apcrev0902

NONE #N/A

INITIATING DEVICE TOTALS

AUDIBLE

VISUAL

AUDIBLE / VISUAL

FIREMAN'S PHONE

DEVICES

AIR SAMPLING

DOOR RELEASE TOTALS

WATERFLOW

PRINTER

ANNUNCIATOR

DISPLAY TERMINAL

VOICE EVAC PANEL

FIREMAN'S JACK

FIRE SMOKE DAMPER

PULL STATION

INSPECTED ONINSPECTED ON

P E R I P H E R A L F U N C T I O N T E S T I N G A U T O A U D I T

LOCAL FIRE DPT. FIRE DPT. / CS PHONE #

May 22, 2013

TAMPER SWITCH

BEAM DETECTOR

DUCT DETECTOR

HEAT DETECTOR

MONITORING DEVICE

SMOKE DETECTOR

FAN CONTROL PANEL

FIRE ALARM PANEL

May 22, 2013 PANELS

COPS

FIRE DPT. / CS OFFICIAL TOTAL MAN HOURS

NCC

FSI INTERFACE

GRAND TOTAL

DIALER

PAD / AUX PWR SUPPLIES

PANEL TOTALS

THE "TOTAL SOLD" COLUMNS HAVE NOT BEEN POPULATED!

SIEMENS INDUSTRY, INC.

FIREMAN'S PH/JACK TOTALS

VOICE EVAC SPEAKER

NOTIFICATION DEVICE TOTALS

TIME OUT OF SERVICE TIME BACK IN SERVICE

#N/A

MONITORING ACCOUNT #

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

(L e a v e T h e F i r s t F e w L i n e s O p e n)

5 253 FACP 02 MXL-IQ BY FRONT DOOR PASS PASS TO SO 05/22/13

5 17-001 PS 01 BOILER RM PASS TO SO 05/22/13

5 17-001 HD 02 TOP OF STAIRS

5 17-001 PS 01 VEHICLE STORAGE PASS TO SO 05/22/13

5 17-001 HD 01 VEHICLE STORAGE

5 17-001 HD 01 VEHICLE STORAGE

5 001 001 PS 01 PULL HAZ-OP BOILER ROOM PASS TO SO 05/22/13

5 001 002 HD 01 HEAT HAZ-OP BOILER ROOM PASS TO SO 05/22/13

5 001 003 PS 01 PULL HAZ-OP BOILER ROOM PASS TO SO 05/22/13

5 001 004 HD 01 HEAT HAZ-OP LABORATORY"B" PASS TO SO 05/22/13

5 001 005 PS 01 PULL HAZ-OP LABORATORY"B" PASS TO SO 05/22/13

5 001 006 PS 01 PULL HAZ-OP VESTIBULE ENTRANCE PASS TO SO 05/22/13

5 001 007 SD 01 SMOKE HAZ-OP VESTIBULE ENTRANCE PASS TO SO 05/22/13 3.12

5 001 008 PS 01 PULL HAZ-OP LABORATORY"A" PASS TO SO 05/22/13

5 001 009 HD 01 HEAT HAZ-OP LABORATORY"A" PASS TO SO 05/22/13

5 001 010 PS 01 PULL HAZ-OP LABORATORY"C" PASS TO SO 05/22/13

5 001 011 HD 01 HEAT HAZ-OP LABORATORY"C" PASS TO SO 05/22/13

5 001 012 HD 02 HEAT HAZ-OP 2ND.FLOOR PASS TO SO 05/22/13

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

USDA HAZOP

apcrev0902 PAGE 1 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 2 OF 36

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DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 3 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 4 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 5 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 6 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 7 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 8 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 9 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 10 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 11 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 12 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 13 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 14 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 15 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 16 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 17 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 18 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 19 OF 36

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NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 20 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 21 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 22 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 23 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 24 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 25 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 26 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 27 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 28 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 29 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 30 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 31 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 32 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 33 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 34 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 35 OF 36

SEE ABOVE TECHS LAST PAGE

NODE LOOP ADDR.

DEVICE

TYPE

FLOOR D E V I C E L O C A T I O N QTR

TESTED

ALARM SUPV/TBL

HD TEST

PERIOD

TECH

TESTED

DATE SENS NOTE #

5100739003

PASSING TEST DATE & TECH #SYSTEM ADDRESS

DEVICE TYPES: SD-Smoke Detector, HD-Heat Detector, DD-Duct Detector, BD-Beam Detector, AS-Air Sampling Tube, MSC-Miscellaneous Device, PS-Manual Pull Station, TS-Valve Tamper Switch, WF-Water Flow Switch, FSD-Damper Position Monitor, DH-Door Holder Release, AUD-Audible, VIS-Visual, AV-Audio/Visual, SPKR-Voice EVAC Speaker, FP-Fire Phone, FJ-Fire Phone Jack, FACP-

Fire Control Panel, EVAC-Voice Evac. Panel, NCC-Network Command Center, PWR-Power Supply, FAN-Fan Damper Panel, ANN-Annunciator, PRT-Printer, VDT-Display Terminal, DIAL-Dialer, FSI

DATE TESTED

apcrev0902 PAGE 36 OF 36

# 1

#2

#3

#4

#5

OK100% 100%13.49 13.62

May 28, 2013

9-Feb

C O M M U N I C A T O R T E S T I N G

27.13MXL PANEL 12 VOLT 7AH 5-22-13

CONNECTION

CHECK

DATE INSTALLEDLOCATION CHARGER VOLTAGE STATIC VOLTAGE AMP HOURSIZE / TYPE DATE TESTED

B A T T E R Y T E S T I N G

5100739003

I N S P E C T I O N D A T E S

INSPECTION #

F I R E I N S P E C T I O N R E C O R D S NO.

DATE DATE INSPECTION # DATEINSPECTION # DATE INSPECTION # DATE

TWO SEPARATE AND FUNCTIONING MEANS OF REPORTING ALARM REPORTING WITH PRIMARY DISCONNECTED

PRIMARY LINE FAIL REPORTING PRIMARY LINE SEIZURE SECONDARY LINE FAIL REPORTING

FAILURES AND RECOMMENDATIONS ENCOUNTERED DURING INSPECTIONS AND TESTING

N O T A T I O N S

USDA HAZ OP

INSPECTION #

#5

#6

#7

#8

#9

#10

#11

#12

#13

#14

#15

Date Name Title

Date

The fire life safety system has been placed in operation and as the owner's representative, I have been instructed in the operation of the system.

V E R I F I C A T I O N O F S Y S T E M T E S T

Siemens Building Technologies, Inc. Rep.

apcrev0902

SIEMENS INDUSTRY, INC.

The undersigned Siemens representative certifies that the equipment has been completely checked and performs in all respects as designed, and all auxiliary equipment functions as desired.

REVISION

TYPE

Y/N NOTE# Y/N

NOTE #

#N/A #N/A #N/A NOTE #

#N/A #N/A #N/A

NOTE #

BREAKER #

ADDRESS

mike.onem.ars.udsa.gov

215-233-6631

OPEN CIRCUIT TROUBLE

REVISION DATE

SIGNALS NOTE #

CIRCUIT BREAKER

FREQUENCY / TYPE OF INSPECTION

A N N U A L

MAIN ENTRANCE

LOCATION

Timothy O'Connor & Sean O'Brien

600 MERMAID LABE

I&T CREATED BYORIGINAL JOB #CSGM FILE NAME VERSION I&T CREATION DATE

I N S P E C T I O N

A U X I L I A R Y F U N C T I O N S

#N/A

SIGNALS NOT SOUNDED

BY CUSTOMER REQUEST

#N/A

CONTACT/S PRESENT EMAIL

NOTE:

ELEVATOR FIRE RECALL

FUNCTION PASS / FAIL

NONE

NOTE#

FIRE ALARM LICENSE NO. - STATE CERTIFICATION NO.:

Fire Safety Division

F I R E S A F E T Y S Y S T E M I N S P E C T I O N A N D T E S T R E P O R T

Siemens Industry, Inc.

5100739003

CODED

Timothy O'Connor

INSPECTION NO.

5100739003

NAME

May 28, 2013

USDA LEATHER RESEARCH 05/23/2013

INSPECTION DATE

C O N T R O L P A N E L

INSPECTOR/S NAME/S PRESENT

#N/A

CITY / MONITORING RESPONSE TO ALARM CENTRAL MONITORING STATION (CS) CITY / MONITORING RESPONSE TO TROUBLE

ALTERNATE ELEVATOR FIRE RECALL

HVAC SHUTDOWN

NORMAL / FAIL

CITY CONNECTION

#N/A

GROUND FAULT TROUBLE PRIMARY POWER LOAD

TEST

AC LOSS TROUBLE

LED TEST

BATTERY LOSS TROUBLE

GENERAL ALARM

MANUFACTURER

CITY STATE ZIP CODE

WYNDMOOR PA Mike Oneill19038

SELECTIVE PRESIGNAL

CONTRACT NO.

CIRCUIT BREAKER

LOCATION

LOCKED P O W E R S O U R C E

#N/A

SIEMENS INDUSTRY, INC. BRANCH OFFICE

MODEL NO.

T Y P E O F S I G N A L I N G

SIEMENS MXL-IQ

May 23, 2013LRB 17.02

THE WARRANTY OR

INSPECTION CONTRACT

START DATE IS:

CONTACT'S DIRECT PHONE NUMBER

DEDICATED

#N/A

R E S P O N S E T O T R O U B L E C O N D I T I O N S PANEL FUSE(S) WERE REMOVED, PANEL WENT INTO TROUBLE & THE AMP RATING(S) WERE VERIFIED.

CUSTOMER CONTACT

-CIRCUIT BREAKER-

#N/A

#N/A

NOTE #

COPS

NORMAL / FAIL

TOTAL TOTAL TESTED % SOLD % LISTED TOTAL TOTAL TESTED % SOLD % LISTED

SOLD LISTED TO DATE COMPLETED COMPLETED SOLD LISTED TO DATE COMPLETED COMPLETED

0 0 0 0% 0% 0 0% 0 1 1 10000000000000000000000000000000000000000000000000000% 100% 0 0%

0 2 1 10000000000000000000000000000000000000000000000000000% 50% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 8 8 80000000000000000000000000000000000000000000000000000% 100% 0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0.0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0.0 0% 0 0 0 0% 0% 0 0%

0 0 0 0% 0% 0 0% 0 0 0 0% 0% 0 0%

0 10 9 90000000000000000000000000000000000000000000000000000% 90% 0 0% 0 1 1 10000000000000000000000000000000000000000000000000000% 100% 0 0%

0 0 0 0% 0% 0 0% AS-BUILT DRAWINGS ARE ON SITE TRUE/FALSE:

0 0 0 0% 0% 0 0% BATTERY TESTING HAS BEEN COMPLETED TRUE/FALSE:

0 0 0 0% 0% 0 0% PANEL F FUNCTION BYPASS KEYS HAVE BEEN PROGRAMMED TRUE/FALSE:

0 0 0 0% 0% 0 0% BYPASS PROCEDURES HAVE BEEN DOCUMENTED TRUE/FALSE:

0 0 0 0% 0% 0 0% MONITORED BY CALIFORNIA SECURITY TRUE/FALSE:

0 0 0 0% 0% 0 0% FUNCTIONING PRINTER IS ON SITE TRUE/FALSE:

0 0 0 0% 0% 0 0% LOG BOOK IS ON SITE (Support Link only) TRUE/FALSE:

0 0 0 0% 0% 0 0% SPECIAL INSTRUCTIONS ARE IN THE FILE TRUE/FALSE:

0 0 0 0% 0% 0 0% 0 11 10 100000000000000000000000000000000000000000000000000000% 91% 0 0% apcrev0902

NONE

INITIATING DEVICE TOTALS

AUDIBLE

VISUAL

AUDIBLE / VISUAL

FIREMAN'S PHONE

AIR SAMPLING

DOOR RELEASE TOTALS

WATERFLOW

PRINTER

ANNUNCIATOR

DISPLAY TERMINAL

VOICE EVAC PANEL

FIREMAN'S JACK

FIRE SMOKE DAMPER

PULL STATION

#N/A

INSPECTED…