SOS_Attach_11_DEVA_336624_AS1A_AS2A_FS1A_RFP1_Part_1.pdf
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- Attached to
- STRUCTURAL FIRE SYSTEMS REPAIR AND ITM, DEATH VALL Federal contract opportunity
- Solicitation number
- 140P8124Q0055
About this file
This document is the National Park Service Residential Fire Protection System Annual Inspection and Testing Form (Form RFP-1). It details the annual inspection and testing requirements for residential fire protection systems at National Park Service locations. The form instructs inspectors to visually inspect smoke alarms, carbon monoxide detectors, fire extinguishers, and fire sprinkler systems, and record the observations and any deficiencies identified. It requires the inspector to provide comments on any issues found and recommend corrective actions. The completed form must be uploaded annually to the NPS Structural Fire Data Management System (SFDMS). This document appears to be a template or form, and does not specifically address a federal contract opportunity.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| SOS_Attach_11_DEVA_336624_AS1A_AS2A_FS1A_RFP1_Part_2.pdf | ||
| Attach_1_Scope_of_Services_(SOS).pdf | ||
| SOS_Attach_12_DEVA_336624_Reference_Manual_58_Structural_Fire_Management_reduced.pdf | ||
| SOS_Attach_1_2A_2B_3_DEVA_336624_Structural_Fire_-_Maps.pdf | ||
| SOS_Attach_8_DEVA_336624_-_Residential_Sprinkler_Systems_List_for_ITM.pdf | ||
| Attach_3_SCA_Wage_Determination.pdf | ||
| SOS_Attach_6_DEVA_336624_-_Fire_Alarm_Systems_List_for_ITM.pdf | ||
| Sol_140P8124Q0055.pdf | ||
| SOS_Attach_10_DEVA_336624_-_NPS_Standard_ITM_Forms.pdf | ||
| Attach_2_Contract_Price_Schedule.docx | DOCX document | |
| SOS_Attach_5_DEVA_336624_Scope_of_Repairs_by_Building_Number.pdf | ||
| SOS_Attach_7_DEVA_336624_-_Commercial_Sprinkler_Systems_List_for_ITM.pdf |
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National Park Service
Residential Fire Protection System Annual Inspection and Testing Form (Form RFP-1)
Location No.
Park: Site No. and Park Name:
Location Description:
Sq. Ft.:
Occupancy Type: Tenant Type:
Location Type: Rental Class:
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
'required' to be installed near the floor.
10 Did carbon monoxide detectors work when tested?
11 Were detectors inspected for physical damage?
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments and Recommended Corrective Actions
Item No.
Signatures
Tenant's Name: Park Inspector's Name:
Signature: Signature:
Date: Date:
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Date Work Order: Work Order Status: Date of Last Change:
Work Order Description:
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
Are there carbon monoxide detectors installed outside of each bedroom door?
If the unit has a basement, are there carbon monoxide detectors installed in the basement?
Carbon monoxide detectors are properly connected to the device base and the ceiling/wall, and free of physical damage?
Carbon monoxide detectors are not
Where carbon monoxide detector is plugged in to a wall outlet, is that outlet labeled 'CO Detector' in circuit panel?
Fire Extinguishers
Item No. Observation Yes No N/A
13 If a fire extinguisher present?
14 Is the fire extinguisher properly mounted and secured?
15 Does fire extinguisher appear to be free of physical damage?
16 Does fire extinguisher gauge show in the green?
If there is an attached garage, is a separate fire extinguisher installed in the garage?
Fire Sprinkler System
Item No. Observation Yes No N/A
Visually inspected all accessible sprinklers to ensure they are not blocked, being used to support decorations or wiring, and are not leaking or damaged?
Are all valves controlling water supply to the fire sprinkler system open and secured in the open position?
Verify designed static pressure (from hydraulic design placard, if available), and record static water pressure on riser gauge?
Record Static Pressure
Did system water flow switch activate local notification appliance (bell or horn), when water was flowed?
Is circuit powering the fire sprinkler system notification appliance (bell or horn), identified as 'Fire Sprinkler Bell/Horn' in circuit panel?
Self-contained System: Verify and record water level of any on-site water tank which solely supports the fire sprinkler system?
Record Tank Volume
Self-contained Systems: Verify and record fire sprinkler pump (if applicable, is fully operational and does not trip circuit breakers in operation?
Self-contained Systems: Is circuit powering the sprinkler system water pump identified as 'Fire Sprinkler Water Pump' in circuit panel?
Deficiency Comments
Annual Inspection and Testing Form (Form RFP-1)
Location No: Location Description :
Park: Site No and Park Name:
Sq. Ft.: Occupancy Type: Tenant Type:
Historic: Year Built:
Work Order History Summary
Annual Inspection and Testing Form (Form RFP-1)
Instructions: Inspection must be completed annually, and the results uploaded to the NPS Structural Fire Data Management System (SFDMS). Where a violation is discovered, and cannot be immediately corrected to the inspector ’s satisfaction, a check mark shall be placed in the 'No’ column. The inspector shall provide comment on all 'No' observations; describing the deficiency identified and recommended corrective action.
Smoke Alarms
Item No. Observation Yes No N/A
1 Does each bedroom have a smoke alarm installed on the ceiling/wall?
Does the common corridor leading to each bedroom have a smoke alarm installed on the ceiling/wall?
Are all smoke alarms in place and properly connected to the device base and the ceiling/wall?
Where smoke alarms are hard-wired to unit AC power, is circuit powering the fire sprinkler bell or horn identified as 'Fire Sprinkler Bell/Horn' in circuit panel
Have all smoke alarms been tested for proper operation:
1. Single Station: Activation of one device does not activate others
2. Interconnected: All devices sound simultaneously when any one device is activated
6 Are smoke alarms free of physical damage?
Carbon Monoxide Detectors (Required for attached garages, or where fuel-fired appliances are installed)
Item No. Observation Yes No N/A
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