HomeMy WebLinkAbout2021-02-11 Fire Alarm Inspection & Testing Report
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FIRE ALARM INSPECTION AND TESTING
Service Order Number: Work Site #:
Date In: Time In: Date Out: Time Out:
1. PROPERTY INFORMATION
Name of property:
Address:
Description of property:
Name of property representative:
Address:
Phone: Fax: E-mail:
2. TESTING AND MONITORING INFORMATION
Testing organization:
Address:
Phone: Fax: E-mail:
Monitoring organization:
Address:
Phone: Fax: E-mail:
Means of transmission:
Account number: Phone line 1/IP address: Phone line 2/IP address:
Entity to which alarms are retransmitted: Phone:
3. DOCUMENTATION
On-site location of the required record documents and site-specific software:
4. DESCRIPTION OF SYSTEM OR SERVICE
4.1 Control Unit
Manufacturer: Model number:
4.1.1 Circuit Styles:
4.1.2 Number of Circuits:
4.1.3 Panel Locations:
Firmware revision number:
4.1.4 Was Firmware Updated? Yes No
Comments:
Does Alarm Panel Have Most Updated Firmware? Yes No
Comments:
4.3.1 Primary (Main) Power
Nominal voltage: Amps: Location:
Overcurrent protection type: Amps: Disconnecting means location:
4.3.2 Secondary Power
Type: Location:
Battery type (if applicable):
Calculated capacity of batteries to drive the system: In standby mode (hours): In alarm mode (minutes):
FACP
AMERICINN BY WYNDHAM
39053
2/11/2021
OAK PARK HEIGHTS, MN 55082
651-483-6631
SLC
Circuit breaker
OAK PARK HEIGHTS, MN 55082
3pm
ST00182945
13025 60TH STREET N
7100-2D
Nardini Fire Equipment
12:30pm
Sealed lead acid
PATEL, ROSHNI
St. Paul, MN
2/11/2021
651-275-1230
13025 60TH STREET N
1
PP11 ckt #43
2 12v5ah 09/2019
405 Cty Rd E west St Paul MN 55126
651-275-4027
FCI
POTS
Front entry
sales@nardinifire.com
20
651-275-0980
Hotel
120VAC
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FIRE ALARM INSPECTION AND TESTING
5. NOTIFICATIONS MADE PRIOR TO TESTING
Monitoring organization Contact: Time:
Building management Contact: Time:
Building occupants Contact: Time:
Authority having jurisdiction Contact: Time:
Other, if required Contact: Time:
6. TESTING RESULTS
6.1 Control Unit and Related Equipment
Description
Visual
Inspection
Functional
Test Comments
Control Unit
Lamps/LEDs/LCDs
Fuses
Trouble Signals
Disconnect Switches
Ground-Fault Monitoring
Supervision
Local Annunciator
Remote Annunciators
Remote Power Panels
Elevator Recall
Shunt Trip
Door Holder
Area of Refuge
Silent knight
Management
12:30pm
12:30pm
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FIRE ALARM INSPECTION AND TESTING
6.2 Power Supplies
Power
Supply Location
Battery
Condition
Discharge
Test
Charger
Test Comments
6.3 Secondary Power Location:
Description
Visual
Inspection
Functional
Test Comments
Battery Condition
Discharge Test
Charger Test
FCI FC-5495 Good (2) 12v7ah dated 2/2020GoodElectrical room Good
In facp
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FIRE ALARM INSPECTION AND TESTING
6.4 Alarm and Supervisory Initiating Device
Description Quantity
Functional
Test Comments
Manual Pulls
Smoke Detectors
Heat Detectors
Flame Detectors
Beam Detectors
Wet Water Flow
Dry Water Flow
Aspirating Smoke Detection
Duct Detector
Sprinkler Tamper (Supervisory)
Sprinkler Low/High (Supervisory)
CO Detector
Building Temperature
Fire Pump Running
Fire Pump Phase Fail
Fire Pump Phase Reversal
Fire Pump Trouble
Kitchen System
Gas Detectors
Other
6.4.1 Aspirating Smoke Detection
NAME MFG MODEL
FILTER
DATE
AMBIENT
% ACTION ALERT
ALARM
1
ALARM
2
TRANSPORT
TIME
3
Escape tested
Visual inspection only
1
1
Escape tested
Escape tested
20
2
Escape tested
6
1
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FIRE ALARM INSPECTION AND TESTING
6.5 Notification Appliances
Description Quantity
Functional
Test Comments
Horn/Strobe
Horn
Strobe
Speaker
Chime
Other
6.5.1 Number of Alarm Notification Circuits___________
6.6 Supervising Station Monitoring
Description Yes No Time Comments
Alarm Signal
Alarm Restoration
Trouble Signal
Trouble Restoration
Supervisory Signal
Supervisory Restoration
7. COMMENTS
8. NOTIFICATIONS THAT TESTING IS COMPLETE
Monitoring organization Contact: Time:
Building management Contact: Time:
Building occupants Contact: Time:
Authority having jurisdiction Contact: Time:
Other, if required Contact: Time:
9. SYSTEM RESTORED TO NORMAL OPERATION
Date: Time:
10. NARDINI FIRE TECHNICIAN
Printed Name: Printed Name:
11. CUSTOMER SIGNATURE
Printed Name: Signature:
50
3pm
3pm
12:30pm
16
Piezo
Management
4
6
12:30pm
Silent knight
Red tag system, smoke detector in south lobby not working
John Lo
3pm
2/11/2021
3pm
3pm
3pm
12:30pm