B08_Attachment_7_-__Fire_Alarm_Test_Form.pdf

Fire Alarm Page 1 of 3 Revised 12/16/15

National Park Service / AKRO

Inspection and Test Report (complete a separate form for each system)

FIRE ALARM SYSTEM – ADDRESSABLE CONVENTIONAL

Park Alpha Code: _________

Location Description : ______________________

Date of Test:_________________________

Time:_________________

System Make: ______________________ System Model: _____________________

Off Site Monitoring? Yes No Monitoring Company or Location

Name ________________________________

DEFICIENCIES FOUND? Yes No List items that were not corrected. Use the Deficiencies section or attach itemized sheet

REPAIRS: All deficiencies have been corrected N/A Yes No

This certifies that the fire and life safety system has been inspected and tested for functional operation in accordance with the current edition of NFPA 72, and has been properly tagged and/or labeled. Any discrepancies found are noted in this report with code references for corrective action by the Owner/Responsible Person.

Technician Name (printed): ______________________ Company: ______________________________

Signature: ___________________________________ Phone #: _______________________________

State Certification No.: _________________________

National/NICET No.: ___________________________

GENERAL

1. The key to the panel is available at the FACP. N/A Yes No

2. The operating instructions are available at the FACP. Yes No

3. Materials and equipment needed to restore pull stations are available at the main panel, e.g. glass rods, and plates; keys and allen wrenches, etc. N/A Yes No

FIRE ALARM CONTROL PANEL

4. All signals on the FACP operate on AC power. Yes No

5. All signals on the FACP operate on battery power. Yes No

6. All signals on the FACP operate on emergency generator/standby power N/A Yes No

7. A trouble signal activates upon loss of power, ground fault, and open circuit. Yes No

8. Circuit breaker location is identified at the FACP and all booster panels Yes No

INITIATING DEVICES AND NOTIFICATION APPLIANCES

9. All initiating and annunciating devices tested operate properly on AC power. Yes No

10. All initiating and annunciating devices tested operate properly on generator/standby power. Yes No

11. All initiating and annunciating devices tested operate properly on battery power. Yes No

12. 100% of the INITIATING DEVICES were tested per NFPA 72.

No. of Units Tested Manual Pull Stations ________________ Smoke Detectors ________________ Heat Detectors ________________ Sprinkler Waterflow ________________

Yes No

Karma Torres Text Box Asset No.:

Karma Torres Line

Karma Torres Snapshot

Karma Torres Line

Karma Torres Line

Fire Alarm Page 2 of 3 Revised 12/16/15

Dry Sprinkler High/Low Air ________________ Duct Smoke Detectors ________________ Tamper Switches ________________ Suppression Systems ________________ Other ________________

13. 100% of the NOTIFICATION APPLIANCES were tested per NFPA 72

No. of Units Tested Horns ________________ Horn/Strobes ________________ Speakers ________________ Speaker / Strobes ________________ Bells (interior) ________________ Exterior Horns/Bells ________________

Yes No

14. The audible alarm appliances tested operate at the levels designed by the manufacturer. Yes No

15. The audible appliances tested in residential areas generate a minimum of 70 dBA in sleeping areas.

N/A Yes No

16. The visual alarm appliances tested operate as designed. Yes No

BATTERIES

17. The batteries are rated for: ____ hours standby and ____ minutes alarm

18. Battery voltage (no load) ________ volts

19. Battery voltage (full load) ________ volts (signals operating)

20. Charge circuit voltage ________ volts

INTERFACE DEVICES

The FACP received signals from the following Interface devices: Tested by: Simulation Operation

21. Emergency Generator(s) N/A Yes No

22. Sprinkler Flow Switch(es) N/A Yes No

23. Supervisory Switch(es) N/A Yes No

24. Kitchen Hood Suppression System(s) N/A Yes No

25. Spray Booth Suppression System(s) N/A Yes No

26. Clean Agent System(s) N/A Yes No

27. Fire Pump(s) N/A Yes No

28. Other - N/A Yes No

OTHER EQUIPMENT CONTROLLED BY FACP

The following Fire Safety Functions responded to signals from the FACP. Tested by Simulation Operation

29. Fan controls N/A Yes No

30. Smoke Dampers N/A Yes No

31. Elevator Recall N/A Yes No

32. Elevator Shunt Trip N/A Yes No

33. Door hold release N/A Yes No

34. Fire Pump(s) N/A Yes No

35. Remote Annunciator Panels N/A Yes No

36. Other - N/A Yes No

MONITORING

37. Signals were received at the monitoring company or approved location. N/A Yes No

Fire Alarm Page 3 of 3 Revised 12/16/15

Deficiencies

Resolved

Location:

Deficiency:

Recommended Resolution:

NFPA 72 reference: