TE-11-10_MASS NOTIFICATION SYSTEM SUPP RECORD OF INSP AND TEST.pdf
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63rd Readiness Division MNS Supplementary Record of Inspection and Testing
MASS NOTIFICATION SYSTEM
SUPPLIMENTARY RECORD OF INSPECTION AND TESTING
This form is a supplement to the Fire Alarm Inspection & Test Report.
It includes a mass notification system test record.
This form is to be completed by the system inspection and testing contractor at the time of the inspection and/or test.
Insert N/A in all unused lines.
FACID
Building Number
Date of Inspection
Complete the remainder of this page once inspection is complete.
Mass Notification System Assessment Green Yellow Red
Fire Alarm system appears to operate as designed—Color Code (Color code is based on the following criteria: Green = No deficiencies or only noncritical
Comments/Deficiencies
Mass Notification System Information (if MNS is combination, enter “Combination” under Manufacturer)
Control Unit Manufacturer: Model Number: Location: Software Revision:
Primary Power
Voltage: Amps: Overcurrent Protection Type: Amps: Disconnecting Means Location:
Battery 1 Voltage: Amps: Mfr Year: Load Test
Battery 1 VDC: Ah: Temp (F):
Result of Battery 1 & 2
Battery 2 Voltage: Amps: Mfr Year: Load Test
Battery 2 VDC: Ah: Temp (F):
Pass Fail Replaced
Secondary Power
Other Power Present Description Yes No
MNS Power Supplies (for combination MNS panels where all tests are previously conducted, enter N/A for the tests below)
Type Visual Functional N/A Results
120-volt Power Pass Fail N/A
Generator or UPS
Battery Condition
Load Voltage
Discharge Test
Charger Test
Mass Notification System Type In-building MNS— combination
In-building MNS— stand alone
Wide Area
MNS
Indicate the MNS System Type
Mass Notification Equipment Tests Type Visual Functional N/A Results
Functional Test
Reset/Power Down test
Fuses
Primary Power Supply
UPS Power Test
Trouble Signals
Disconnect Switches
Ground Fault Monitoring
CCU Security Mechanism
Prerecorded Message Content
Prerecorded Message Activation
Software Backup Performed
Test Backup Software
Fire Alarm to MNS Interface
MNS to Fire Alarm Interface
Sound Pressure Levels Ambient dBA ______ Alarm DBA ______
System Intelligibility Test Method ______ Score ______ CIS Value ______
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