ATTACHMENT VIII - Vet House CTI - 2019 - Aadco Alarm BUILDING 42 CSR.pdf

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

Aadco Alarms & Communication Systems

INSPECTION AND TESTING FORM

DATE: 10-12-19

TIME: 9:00a.m.

SERVICE ORGANIZATION PROPERTY NAME (USER)

NAME: Aadco Alarms & Communications NAME: Veteran's House

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

ADDRESS:

2669 Cold Springs Rd.

Indianapolis, IN. 46222

REPRESENTATIVE: Adam Petty OWNER CONTACT: Gabe Hobbs

LICENSE NO.: N/A TELEPHONE: 317-716-1347

MONITORING ENTITY APPROVING AGENCY

CONTACT: General Emergency CONTACT: N/A

TELEPHONE: 925-8919 TELEPHONE: N/A

MONITORING ACCOUNT REF. NO: 01-02-2604

TYPE TRANSMISSION SERVICE

McCulloh Weekly

Multiplex Monthly

Digital Quarterly

Reverse Priority Semiannually

RF Annually

Other (Specify) Other (Specify)

N/A N/A

PANEL MFG: Silent Knight MODEL NO.: IFP-2000

CIRCUIT STYLES: Y

NO. OF CIRCUITS: 9

SOFTWARE REV.: N/A

LAST DATE SYSTEM HAD ANY SERVICE PERFORMED: N/A

LAST DATE THAT ANY SOFTWARE OR CONFIGUARATION WAS REVISED: N/A

ALARM-INITIATING DEVICES AND CIRCUIT INFORMATION

QTY OF CIRCUIT STYLE

16 Y MANUAL STATIONS

N/A N/A ION DETECTORS

46 Y PHOTO DETECTORS

N/A N/A DUCT DETECTORS

6 Y HEAT DETECTORS

4 Y WATERFLOW SWITCHES

12 Y 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

22 N/A HORNS

N/A N/A CHIMES

6 Y STROBES

N/A N/A SPEAKERS

18 Y OTHER (SPECIFY):

Horn/Strobe

NO. OF ALARM INDICATING CIRCUITS: 8

ARE CIRCUITS SUPERVISED? YES 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

INSPECTION, TESTING, AND MAINTENANCE

QTY OF CIRCUIT STYLE

N/A N/A FIRE PUMP AUTO POSITION

N/A N/A FIRE PUMP OR PUMP CONTOLLER

N/A N/A FIRE PUMP RUNNING

N/A N/A GENERATOR IN AUTO POSITION

N/A N/A GENERATOR OR CONTROLLER TROUBLE

N/A N/A SWITCH TRANSFER

N/A N/A GENERATOR ENGINE RUNNING

OTHER:

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) Y

SYSTEM POWER SUPPLIES

a. Primary (Main): Nominal Voltage 120 , Amps 15

Overcurrent Protection: Type Breaker , Amps 20

Location (Panel Number): Not Given , Amps N/A

SYSTEM POWER SUPPLIES

b. Secondary (Standby):

2 x 12V D.C. Storage Battery: Amp-Hr. Rating 7AH

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 used 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

N/A

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

PRIOR TO ANY TESTING

NOTIFICATIONS ARE MADE: YES NO WHO TIME

MONITORING ENTITY General Emergency 9:00a.m.

BUILDING OCCUPANTS N/A N/A

BUILDING MANAGEMENT Gabe Hobbs 9:00a.m.

OTHER (SPECIFY) N/A N/A

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

SYSTEM TESTS AND INSPECTIONS

TYPE VISUAL FUNCTIONAL COMMENTS

CONTROL PANEL N/A

INTERFACE EQ. N/A

LAMPS/LEDS N/A

FUSES N/A

PRIMARY POWER SUPPLY N/A

TROUBLE SIGNALS N/A

DISCONNECT SWITCHES N/A

GROUND FAULT MONITORING N/A

SECONDARY POWER

TYPE VISUAL FUNCTIONAL COMMENTS

BATTERY CONDITON Good

LOAD VOLTAGE 26.1

DISCHARGE TEST 26.8

CHARGER TEST 27.0

SPECIFIC GRAVITY

TRANSIENT SUPPRESSORS

REMOTE ANNUNCIATORS N/A

NOTIFICATION APPLIANCES

AUDIBLE N/A

VISUAL N/A

SPEAKERS N/A

VOICE CLARITY N/A

INITIATING AND SUPERVISORY DEVICE TESTS AND INSPECTIONS

LOCATION

DEVICE

TYPE

VISUAL

CHECK

FUNCTIONAL

TEST

FACTORY

SETTING

MEAS.

SETTING

PASS

FAIL

M001 1ST FL SOUTH ENTRANCE MPS N/A N/A

M002 1ST FL SOUTH STAIR

ENTRANCE MPS N/A N/A

M003 PRIMARY RECALL M.M. N/A N/A

M004 ALT RECALL M.M. N/A N/A

M005 FIREHAT RECALL M.M. N/A N/A

M006 ATTIC DRY SYSTEM M.M. N/A N/A

M007 ATTIC SYSTEM LOW AIR M.M. N/A N/A

M008 1ST FL WEST ENTRANCE MPS N/A N/A

M009 1ST FL EAST ENTRANCE MPS N/A N/A

M010 1ST FL NORTH STAIR

ENTRANCE MPS N/A N/A

M011 1ST FL NORTH ENTRANCE MPS N/A N/A

M012 1ST FL RISER ROOM TAMPER M.M. N/A N/A

M013 2ND FL RISER TAMPER M.M. N/A N/A

M014 1ST FL RISER TAMPER M.M. N/A N/A

M015 BASEMENT RISER M.M. N/A N/A

M016 BACKFLOW TAMPER M.M. N/A N/A

M017 BACKFLOW TAMPER M.M. N/A N/A

M018 2ND FL RISER WATERFLOW M.M. N/A N/A

M019 1ST FL RISER WATERFLOW M.M. N/A N/A

M020 BASEMENT RISER

WATERFLOW M.M. N/A N/A

M021 OUTSIDE NORTH PIV M.M. N/A N/A

M022 BASEMENT SOUTH STAIR MPS N/A N/A

M023 BASEMENT NORTH STAIR MPS N/A N/A

M024 2ND FL SOUTH STAIR MPS N/A N/A

M025 2ND FL MIDDLE STAIR MPS N/A N/A

M026 2ND FL NORTH STAIR MPS N/A N/A

S001 1ST FL ELECTRICAL RM PHOTO N/A N/A

S002 1ST FL RM 120 PHOTO N/A N/A

S003 1ST FL RM 121 PHOTO N/A N/A

S004 1ST FL RM 119 PHOTO N/A N/A

COMMENTS: MPS= manual pull station HEAT= thermal detector

M.M.= monitor module

PHOTO= photo smoke detector

TYPE

VISUAL

CHECK

FUNCTIONAL

TEST

FACTORY

SETTING

S005 1ST FL RM 117 PHOTO N/A N/A

S006 1ST FL ELEVATOR EQUIP RM HEAT N/A N/A

S007 1ST FL ELEVATOR EQUIP RM PHOTO N/A N/A

S008 1ST FL ELEVATOR LOBBY PHOTO N/A N/A

S009 1ST FL RM 125 PHOTO N/A N/A

S010 1ST FL RM 127 PHOTO N/A N/A

S011 1ST FL RM 129 PHOTO N/A N/A

S012 1ST FL MECHANICAL RM PHOTO N/A N/A

S013 1ST FL RM 128 PHOTO N/A N/A

S014 1ST FL RM 126 PHOTO N/A N/A

S015 1ST FL RM 124 PHOTO N/A N/A

S016 1ST FL KITCHEN PHOTO N/A N/A

S017 1ST FL DINING RM PHOTO N/A N/A

S018 1ST FL CORRIDOR 107 PHOTO N/A N/A

S019 1ST FL RM 114 PHOTO N/A N/A

S020 1ST FL RM 116 PHOTO N/A N/A

S021 1ST FL RM 118 PHOTO N/A N/A

S022 BASEMENT STORAGE 005

SOUTH PHOTO N/A N/A

S023 BASEMENT STORAGE 005

NORTH PHOTO N/A N/A

S024 BASEMENT ELEVATOR LOBBY PHOTO N/A N/A

S025 BASEMENT FITNESS RM PHOTO N/A N/A

S026 BASEMENT STORAGE 003 PHOTO N/A N/A

S027 2ND FL STORAGE HEAT N/A N/A

S028 2ND FL RM 208 PHOTO N/A N/A

S029 2ND FL RM 206 PHOTO N/A N/A

S030 2ND FL RM 204 PHOTO N/A N/A

S031 2ND FL RM 212 PHOTO N/A N/A

S032 2ND FL RM 213 PHOTO N/A N/A

S033 2ND FL RM 214 PHOTO N/A N/A

S034 2ND FL RM 216 PHOTO N/A N/A

COMMENTS: N/A

TYPE

VISUAL

CHECK

FUNCTIONAL

TEST

FACTORY

SETTING

S035 2ND FL RM 218 PHOTO N/A N/A

S036 2ND FL RM 220 PHOTO N/A N/A

S037 2ND FL UTILITY RM HEAT N/A N/A

S038 2ND FL RM 219 PHOTO N/A N/A

S039 2ND FL RM 217 PHOTO N/A N/A

S040 2ND FL RM 215 PHOTO N/A N/A

S041 2ND FL RM 211 PHOTO N/A N/A

S042 2ND FL CORRIDOR PHOTO N/A N/A

S043 2ND FL ELEVATOR LOBBY PHOTO N/A N/A

S044 2ND FL RM 203 PHOTO N/A N/A

S045 2ND FL RM 205 PHOTO N/A N/A

S046 2ND FL RM 207 PHOTO N/A N/A

S047 BASEMENT MECH RM HEAT N/A N/A

COMMENTS:

EMERGENCY COMMUNICATIONS EQUIPMENT

TYPE VISUAL FUNCTIONAL COMMENTS

PHONE SET N/A

PHONE JACKS N/A

OFF-HOOK INDICATOR N/A

AMPLIFIER(S) N/A

TONE GENERATOR(S) N/A

CALL IN SIGNAL N/A

SYSTEM PERFORMANCE N/A

N/A

INTERFACE EQUIPMENT

TYPE

VISUAL

OPERATION

SIMULATED OPERATION

(SPECIFY) N/A

(SPECIFY) N/A

(SPECIFY) N/A

SPECIAL HAZARD SYSTEMS

(SPECIFY) N/A

(SPECIFY) N/A

(SPECIFY) N/A

SPECIAL PROCEDURES:

COMMENTS: N/A

ON/OFF PREMISES MONITORING:

TYPE YES NO TIME COMMENTS

ALARM SIGNAL 9:00a.m. N/A

ALARM RESTORAL 11:30a.m. N/A

TROUBLE SIGNAL 9:00a.m. N/A

SUPERVISORY SIGNAL 9:00a.m. N/A

SUPERVISORY RESTORAL 11:30a.m. N/A

NOTIFICATIONS THAT TESTING IS COMPLETE:

TYPE YES NO TIME COMMENTS

BUILDING MANAGEMENT 11:30a.m. N/A

MONITORING AGENCY 11:30a.m. N/A

BUILDING OCCUPANTS N/A N/A

OTHER (SPECIFY) N/A N/A

N/A N/A

THE FOLLOWING DID NOT OPERATE CORRECTLY: N/A

SYSTEM RESTORED TO NORMAL OPERATION: DATE 10-12-19 TIME 11:30a.m.

THIS TESTING WAS PERFORMED IN ACCORDANCE WITH

APPLICABLE NFPA STANDARDS.

NAME OF INSPECTOR: Adam Petty

DATE: 10-12-19 TIME: 11:30a.m.

SIGNATURE:

NAME OF OWNER OR REPRESENTATIVE: Gabe Hobbs

DATE: 10-12-19 TIME: 11:30a.m.

SIGNATURE:

COMPANY:

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