HomeMy WebLinkAbout2022-10-28 Metro Alarm Fire Alarm Inspection & Test Form FIRE ALARM INSPECTION AND TEST REPORT
0Underwriters Laboratories Inc.®ALARM SERVICE#58526-1
3921 West 6Metroq farm & Lock 952-890-668414•3RD Dispatch 952-346-9 52 55378Street•Savage,MN #TS00401
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ACCT.NO. 4 1550 SERVICE CALL NO. r„'C D CO.'S U.L.CERTIFICATE NO. DATE iG/as/��
CUSTOMER j l .9L. )/1- C CONTACT' .i _C�,,,:,,,,1/ TITLE
ADDRESS )3)i�/ — /3177 _ j)/ ' . 'j1, PHONE ��' _BI-MONTHLY SEMI-ANNUAL
CITY C Ca (C P-t.k I-I.u'1 4 N STATF,/�� ZIP s5C8Z _QUARTERLY _FINAL_ N �
CONTROL PANEL 1/
MANUFACTURE ().m}) MODEL NO.Xe,5"-v f LOCATION dC .. i2
'[)WE OF SIGNALING POWER CIR.BRK LOCATION NO. LOCKED CIR.BRKR. DEDICATED CIR.
ENERALALARM_SELECTIVE SIGNALS_CODED—PRE-SIGNAL SOURCE `S 3 FES _NO � _NO
BATTERIES-LOAD TEST 'NOl'�� TROUBLE REST=T"O ZONE TROUBLE SIGNAL TROUBLE AC/OP POWER LOSS
PASS _FAIL DATED r CONDITIONS y5ORMAL_NOTE _),NORMAL_NOTE _]NORMAL_NOTE
COMMUNICATOR / T
MANUFACTURE„5"4/4--((2 MdJ .NO. LOCATION SA-i4—I(` 7O..‘
BATTERIES-LOAD TEST . / NOTE# POWER CIR.BRKR.LOCATION NO. CKED CIR.BRKR. DEDICATED CIR.
_PASS _FAIL ATED SOURCE _YES _NO _YES _NO
CENTRAL MONITORING RESPONSE TO ALARM TROUBLE RESPONSE TO ZONE TROUBLE SIGNAL TROUBLE AC/OP POWER LOSS
STATION _NORM _NOTE CONDITIONS_NORMAL_NOTE _NORMAL_NOTE _NORMAL_NOTE
COMMUNICATOR PRIMARY# �jA COMMUNICATOR SECONDARY# HA)
FIRE RADIO ANTENNA CUT CELLULAR INTERNET
_PASS _FAIL A .ASS _FAIL _NA _PASS _FAIL>>4IA NOTE#
AUXILIARY FUNCTIONS
ANNU FG) MODEL(y-' �-- .1—,/..-7.7— TYPE _INCAD_GRAPHIC _CRT VPL!AGi,c NO.OF ZONES UNUSED PTS.
_LED VROP ' CD /7C,/
ELEVATOR RECALL TO PRIMARY FLOOR RECALL TO ALTERNATE FLOOR ELEVATOR RESTART
FIRE RECALL _NORMAL_NOTEI/A _NORMAL_NOTE_N/A FROM FIRE SUC.AUTOMATICALLY _YES _NO
SPRINKLER SYSTEM:METRO ALARM'S INSPECTIOVILVNCLUDES A FUNCTIONAL TEST.0 �j
ACTUAL FIRE SPRINKLER TEST WAS DONE BY: i IT-4 w DATE: 7/..,).7/),,)—
PERIPHERAL FUNCTION TEST
DEVICE FLOOR VOLTS MFG&MODEL# NOTE
Manual Stations (
Hem Detectors
Smoke Detectors 1
Duct Detector
Weterllow
CVT
PIY
Low Air
Low Tmper.ture
Horn Only
Strobes Only
Horn/Strobes 3
Mini Sounders
Door Holders
Ansul
BPS
NOT TIONS AND COAXMENTS
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CUSTOMER PRINT: SERVICE TECH PRINT: iL./k
CUSTOMER SIGNATURE: SERVICE TECH SIGNATURE: /,'
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