Fire Damper Testing Checklist.docx

DOCX document 25 KB Posted

Attached to
Inspect/Test Fire Dampers Federal contract opportunity
Solicitation number
36C26324Q0211
Issued by
Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 23

About this file

This document is a fire damper testing checklist template. The checklist is used to document the inspection and testing of fire dampers, including their location, size, temperature rating, method of actuation, and any notes on safety precautions, accessibility, or suggested improvements. Photographic documentation is also required, with pictures of the damper in the open, closed, and re-opened positions as well as of any new identification tags.

The related federal contract opportunity is a solicitation from the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 23 to provide inspection and testing services for fire dampers. The solicitation number is 36C26324Q0211 and is seeking contractors to perform the work outlined in the checklist template.

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Text version

FIRE DAMPER TESTING FORM Date of Test: ___________________

Initialed By: _____________________

Damper Label (new): ______________________________________________________

Damper Label (old – if applicable): ___________________________________________

Location: ________________________________________________________________

Damper Size: _____________________________ Temperature Rating: ___________

Method used for closing damper during test:

Power Cut-off

Pneumatic Disconnect

Fusible Link _

Other

End Switch or Actuator Feedback Signal:

Testing Failed

Passed Operational Test

Not Applicable

Other

Damper’s Normal Means of Actuation:

Fusible Link

Equipment Isolation

Heat Detector

Unknown

If Applicable, fusible link part #: ____________________________________________

If link part # not available, physical description: _______________________________

ADDITIONAL NOTES:

Safety Precautions Taken: ______________________________________________________________

Accessibility Notes: ____________________________________________________________________

Suggestions for Improvements for Safety or Access: __________________________________________

--- REFER TO REVERSE SIDE OF FORM FOR REQUIRED DAMPER PICTURES ---

DAMPER TESTING PHOTOS FOR DOCUMENTATION

Picture of Damper Original (Open) Picture of Damper Closed

Picture of Damper Re-Opened Picture of New Damper Tag/Equipment

All photographs shall contain written card indicating damper label, or visibility of damper equipment tag, within frame of photo.

File details come from the government source that posted it. Updated .