TE-11-11_NOTIFICATION AND INITIATING APPLIANCE SUPPLEMENT.pdf
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- W9127S21Q0057
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63rd Readiness Division Fire Alarm Record of Inspection and Testing
Initiating and Supervisory Device Tests and Inspections Zone Device
Type Address Location Notes Last Tested Test Results Comments
NOTIFCATION & INTIATING APPLIANCE
SUPPLIMENTARY RECORD OF INSPECTION AND TESTING
This form is a supplement to the Fire Alarm Inspection & Test Report.
It includes a notification appliance 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
CoD - Carbon Monoxide Detector DD - Duct Detector HORN - Horns/Horn-Strobes
LA - Low Air MM - Monitor Module (Ansul, temp, CO, etc) PS - Pull Station SD - Smoke Detector
SPKR - Speakers Strobe - Strobes TS - Tamper Switch WF - Waterflow Switch
HD - Heat Detector
Initiating and Supervisory Device Tests and Inspections (cont.)
Zone Device
Initiating and Supervisory Device Tests and Inspections (cont.)
Zone Device
Comments
Inspector's Information I state that the information on this form is correct at the time and place of my inspection, and that all equipment tested at this time was left in operating condition upon completion of this inspection except as noted in the Comments.
Inspected By: Inspector License:
Signature of Inspector: Date:
Number of Devices Tested
Number of Devices the Failed
Results
File details come from the government source that posted it. Updated .