ATTACHMENT VII - Annual CTI 2019 Building 9 - Aadco Alarm BUILDING 9 CSR.pdf

Aadco Alarms & Communication Systems

INSPECTION AND TESTING FORM

DATE: 9-12-19

TIME: 11:00pa.m.

SERVICE ORGANIZATION

NAME: Aadco Alarms & Communications

ADDRESS: 115 North 2nd Avenue, Beech Grove, IN 46107

REPRESENTATIVE: Adam P

LICENSE NO.: N/A

MONITORING ENTITY

CONTACT: General Emergency

TELEPHONE: (317)925-8919

MONITORING ACCOUNT REF. NO: 01-02-2604

TYPE TRANSMISSION

PROPERTY NAME (USER)

NAME: V.A. Blda. 9

ADDRESS:

2669 Cold Springs Road Indianapolis, IN 46222

OWNER CONTACT: Gabe Hobbs

TELEPHONE: (317)988-4089

APPROVING AGENCY

CONTACT: N/A

TELEPHONE: N/A

SERVICE

❑ McCulloh ❑ Weekly

❑ Multiplex ❑ Monthly

® Digital ❑ Quarterly

❑ Reverse Priority ❑ Semiannually

❑ RF ® Annually

❑ Other (Specify) ❑ Other (Specify)

N/A N/A

PANEL MFG: Siemens MODEL NO.

CIRCUIT STYLES: 4 & Y

NO. OF CIRCUITS: 4

SOFTWARE REV.: N/A

LAST DATE SYSTEM HAD ANY SERVICE PERFORMED: N/A

LAST DATE THAT ANY SOFTWARE OR CONFIGUARATION WAS REVISED

FC-901

N/A

115 North 2nd Avenue, Beech Grove, IN 46107 (317) 781-7680 1

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ALARM-INITIATING DEVICES AND CIRCUIT INFORMATION

QTY OF CIRCUIT STYLE

8 4 MANUAL STATIONS

N/A N/A ION DETECTORS

13 4 PHOTO DETECTORS

N/A N/A DUCT DETECTORS

2 4 HEAT DETECTORS

4 4 WATERFLOW SWITCHES

4 4 SUPERVISORY SWITCHES

N/A N/A OTHER (SPECIFY):

N/A

ALARM INDICATING APPLIANCES AND CIRCUIT INFORMATION

QTY OF CIRCUIT STYLE

N/A N/A BELLS

N/A N/A HORNS

N/A N/A CHIMES

4 Y STROBES

N/A N/A SPEAKERS

15 Y OTHER (SPECIFY):

Horn/Strobe

NO. OF ALARM INDICATING CIRCUITS: 3

ARE CIRCUITS SUPERVISED? EYES ❑ NO

SUPERVISORY SIGNAL INITIATING DEVICES AND CIRCUIT INFORMATION

QTY OF CIRCUIT STYLE

N/A N/A BUILDING TEMP.

N/A N/A SITE WATER TEMP.

N/A N/A SITE WATER LEVEL

N/A N/A FIRE PUMP POWER

N/A N/A FIRE PUMP RUNNING

115 North 2nd Avenue, Beech Grove, IN 46107 (317) 781-7680 2 i►~►aaco Alarms & communication systems

INSPECTION, TESTING, AND MAINTENANCE

CIRCUIT STYLE

N/A FIRE PUMP AUTO POSITION

N/A FIRE PUMP OR PUMP CONTOLLER

N/A FIRE PUMP RUNNING

N/A GENERATOR IN AUTO POSITION

N/A GENERATOR OR CONTROLLER TROUBLE

N/A SWITCH TRANSFER

N/A GENERATOR ENGINE RUNNING

OTHER:

N/A

QTY OF

N/A

N/A

N/A

N/A

N/A

N/A

N/A

SIGNALING LINE CIRCUITS

Quantity and style (See NFPA 72, Table 3-6) of signaling line circuits connected to system:

Quantity: 1 Style(s) 4

a. Primary (Main): Nominal Voltage

Overcurrent Protection: Type

Location (Panel Number):

SYSTEM POWER SUPPLIES

Breaker

N/A

SYSTEM POWER SUPPLIES

Amps 20

Amps 20

Amos N/A

b. Secondary (Standby):

2 X 12V.D.C. 2 X 12V.D.C. Storage Battery: Amp-Hr. Rating 12 / 7

Calculated capacity to operate system, in hours: X 24 60

N/A Engine-driven generator dedicated to fire alarm system:

Location of fuel storage: N/A

TYPE BATTERY

❑ Dry Cell

❑ Nickel-Cadmium

® Sealed Lead-Acid

❑ Lead-Acid

❑ Other (Specify):

N/A

c. emergency or standby system useo as a bacKup to primary power supply, instead of using a secondary power supply:

N/A Emergency system described in NFPA 70, Article 700

N/A Legally required standby described in NFPA 70, Article 701

Optional standby system described in NFPA 70, Article 702, which also meets the performance N/A requirements of Article 700 or 701.

115 North 2nd Avenue, Beech Grove, IN 46107 (317) 781-7680 3

PRIOR TO ANY TESTING

NOTIFICATIONS ARE MADE: YES NO WHO TIME

MONITORING ENTITY ® ❑ General Emergency 11:00pa.m.

BUILDING OCCUPANTS ❑ ® N/A N/A

BUILDING MANAGEMENT ® ❑ Gabe Hobbs 11:00pa.m.

OTHER (SPECIFY) ❑ ® N/A N/A

AHJ (NOTIFED) OF ANY IMPAIRMENTS ❑ ® N/A N/A

SYSTEM TESTS AND INSPECTIONS

TYPE

CONTROL PANEL

INTERFACE EQ.

LAMPS/LEDS

FUSES

PRIMARY POWER SUPPLY

TROUBLE SIGNALS

DISCONNECT SWITCHES

GROUND FAULT MONITORING

SECONDARY POWER

TYPE

BATTERY CONDITON

LOAD VOLTAGE

DISCHARGE TEST

CHARGER TEST

SPECIFIC GRAVITY

TRANSIENT SUPPRESSORS

REMOTE ANNUNCIATORS

NOTIFICATION APPLIANCES

AUDIBLE

VISUAL

SPEAKERS

VOICE CLARITY

VISUAL FUNCTIONAL COMMENTS

® ® N/A

® ® N/A

® ® N/A

❑ N/A

® ® N/A

® ® N/A

❑ ❑ N/A

® ® N/A

VISUAL FUNCTIONAL COMMENTS

® ® Good

26.1

26.6

27.0

LI

® ® N/A

® ® N/A

® ® N/A

❑ ❑ N/A

❑ ❑ N/A

115 North 2nd Avenue, Beech Grove, IN 46107 (317) 781-7680 4

INITIATING AND SUPERVISORY DEVICE TESTS AND INSPECTIONS

DEVICE VISUAL FUNCTIONAL FACTORY MEAS.

LOCATION TYPE CHECK TEST SETTING SETTING PASS FAIL

1-1 W. BSMT. RISER WATERFLOW HTRI-D ® ® N/A N/A ® ❑

1-1 W. BSMT. RISER VALVE TAMPER HTRI-D ® ® N/A N/A ® El

1-3 W. BSMT. WEST OP921 ® ® 1.08-2.72 N/A ® ❑

1-4 W. BSMT. EAST OP921 ® ® 1.08-2.72 N/A ® ❑

1-5 W. BSMT. EAST H1921 ® ® N/A N/A ® ❑

1-6 E. BSMT. WEST H1921 ® ® N/A N/A ® El

1-7 E. BSMT. WEST OP921 ® ® 1.08-2.72 N/A ® ❑

1-8 E. BSMT. EAST OP921 ® ® 1.08-2.72 N/A ® El 1-16 1ST FLR. N. MAIN ENTRY HMS-S ® ® N/A N/A ® El

1-17 1ST FLR. N. MAIN ENTRY OP921 ® ® 1.08-2.72 N/A ® El

1-18 W. BSMT. RISER 1ST FLR.

WATERFLOW HTRI-D ® N/A N/A ® ❑

1-18 W. BSMT. RISER 1ST FLR. VALVE

TAMPER HTRI-D N/A N/A ® ❑

1-19 1ST FLR. S.W. ENTRY OP921 ® ® 1.08-2.72 N/A Z ❑

1-20 1ST FLR. S.W. ENTRY HMS-S ® ® N/A N/A ® El 1-21 1ST FLR. S.E. ENTRY OP921 ® ® 1.08-2.72 N/A ® El

1-22 1ST FLR. S.E. ENTRY HMS-S ® ® N/A N/A ® ❑

1-31 2ND FLR. CENTER STAIR OP921 ® ® 1.08-2.72 N/A ® El 1-32 2ND FLR. CENTER STAIR HMS-S ® ® N/A N/A ® El

1-33 2ND FLR. CENTER OP921 ® ® 1.08-2.72 N/A ® ❑

1-34 W. BSMT. RISER 2ND FLR.

WATERFLOW HTRI-D ® N/A N/A ® ❑

1-34 W. BSMT. RISER 2ND FLR.

VALVE TAMPER HTRI-D ® ® N/A N/A ® El

1-352ND FLR. WEST STAIR HMS-S ® ® N/A N/A ® El

1-36 2ND FLR. WEST STAIR OP921 ® ® 1.08-2.72 N/A ® ❑

1-37 2ND FLR. EAST STAIR OP921 ® ® 1.08-2.72 N/A ® El

1-38 2ND FLR. EAST STAIR HMS-S ® ® N/A N/A ® El

1-46 W. BSMT. RISER ATTIC

® ❑ WATERFLOW HTRI-D N/A N/A

1-46 W. BSMT. RISER VALVE

® ® ® El TAMPER HTRI-D N/A N/A

1-47 WEST ATTIC HMS-S ® ® N/A N/A ® El

1-48 WEST ATTIC OP921 ® ® 1.08-2.72 N/A ® El

1-49 EAST ATTIC HMS-S ® ® N/A N/A ® El

1-50 EAST ATTIC OP921 ® ® 1.08-2.72 N/A ® El

COMMENTS:

115 North 2nd Avenue, Beech Grove, IN 46107 (317) 781-7680 5

EMERGENCY COMMUNICATIONS EQUIPMENT

TYPE VISUAL FUNCTIONAL COMMENTS

PHONE SET ❑ ❑ N/A

PHONE JACKS El ❑ N/A

OFF-HOOK INDICATOR ❑ ❑ N/A

AMPLIFIER(S) El El N/A

TONE GENERATOR(S) ❑ ❑ N/A

CALL IN SIGNAL El ❑ N/A

SYSTEM PERFORMANCE El ❑ N/A

El El N/A

INTERFACE EQUIPMENT

DEVICE

TYPE VISUAL OPERATION SIMULATED OPERATION

(SPECIFY) N/A ❑ El El

(SPECIFY) N/A El El El

(SPECIFY) N/A ❑ El ❑

SPECIAL HAZARD SYSTEMS

(SPECIFY) N/A El El ❑

(SPECIFY) N/A El ❑ ❑

(SPECIFY) N/A ❑ ❑ El

SPECIAL PROCEDURES:

Put Vet. House on test first.

COMMENTS: N/A

115 North 2nd Avenue, Beech Grove, IN 46107 (317) 781-7680 6

ON/OFF PREMISES MONITORING:

TYPE YES NO TIME COMMENTS

ALARM SIGNAL ® ❑ 11:00pa.m. N/A

ALARM RESTORAL ® ❑ 1:00p.m. N/A

TROUBLE SIGNAL ® ❑ 11:00pa.m. N/A

SUPERVISORY SIGNAL ® ❑ 11:00pa.m. N/A

SUPERVISORY RESTORAL ® ❑ 1:00p.m. N/A

NOTIFICATIONS THAT TESTING IS COMPLETE:

TYPE

BUILDING MANAGEMENT

MONITORING AGENCY

BUILDING OCCUPANTS

OTHER (SPECIFY)

THE FOLLOWING DID NOT OPERATE CORRECTLY:

NO TIME

❑ 1:00p.m

❑ N/A

❑ N/A

❑ N/A

❑ N/A

N/A

COMMENTS

N/A

N/A

N/A

N/A

N/A

SYSTEM RESTORED TO NORMAL OPERATION:

DATE

9-12-19

TIME

1:00p.m.

THIS TESTING WAS PERFORMED IN ACCORDANCE WITH

APPLICABLE NFPA STANDARDS.

NAME OF INSPECTOR:

DATE:

SIGNATURE:

NAME OF OWNER OR REPRESENTATIVE

DATE:

SIGNATURE:

Adam Petty

9-12-19

Gabe Hobbs

9-12-19

TIME: 1:00p.m.

TIME: 1:00p.m.

COMPANY:

REVIEWED BY:

115 North 2nd Avenue, Beech Grove, IN 46107 (317) 781-7680 7