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Fire Alarm and Emergency Communication System Inspection and Testing Form

  1. Insert N/A in all unused lines.

  2. 1. Property Information

  3. 2. Installation, Service, and Testing Contractor Information

  4. 3. Type of System or Service

  5. If Combination System, with which components

  6. 3.1 Control Unit

  7. 3.2 Mass Notification System

  8. 3.2.1 System Type

  9. 3.2.2 System Features

  10. 3.3 System Documentation

  11. 3.4 System Software

  12. 4. Control Unit

  13. 4.1.1 Primary Power

  14. 4.1.2 Engine-Driven Generator

  15. 4.1.3 Uninterruptible Power System

  16. Calculated Capacity of UPS Batteries to Drive the System Components Connected to it:

  17. 4.1.4 Batteries

  18. Calculated Capacity of Batteries to Drive the System:

  19. 4.2 In-Building Fire Emergency Voice Alarm Communication System or Mass Notification System

  20. 4.2.1 Primary Power

  21. 4.2.2 Engine-Driven Generator

  22. 4.2.3 Uninterruptible Power System

  23. Calculated Capacity of UPS Batteries to Drive the System Components Connected to it:

  24. 4.2.4 Batteries

  25. Calculated Capacity of Batteries to Drive the System:

  26. 4.3 Notification Appliance Power Extender Panels

  27. 4.3.1 Primary Power

  28. 4.3.2 Engine-Driven Generator

  29. 4.3.3 Uninterruptible Power System

  30. Calculated Capacity of UPS Batteries to Drive the System Components Connected to it

  31. 4.3.4 Batteries

  32. Calculated Capacity of Batteries to Drive the System

  33. 5. Annunciators

  34. 5.1 Location and Description of Annunciators

  35. 6. Notifications Made Prior to Testing

  36. Monitoring Organization

  37. Building Management

  38. Building Occupants

  39. Authority having Jurisdiction

  40. Other, if Required

  41. 7. Testing Results

  42. 7.1 Control Unit and Related Equipment

  43. Control Unit

  44. Lamps/LEDs/LCDs

  45. Fuses

  46. Trouble Signals

  47. Disconnect Switches

  48. Ground-fault Monitoring

  49. Supervision

  50. Local Annunciator

  51. Remote Annunciators

  52. Power Extender Panels

  53. Isolation Modules

  54. Other

  55. 7.2 Control Unit Power Supplies

  56. 120-Volt Power

  57. Generator or UPS

  58. Battery Condition

  59. Load Voltage

  60. Discharge Test

  61. Charger Test

  62. Other

  63. 7.3 In-Building Fire Emergency Voice Alarm Communications Equipment

  64. Control Unit

  65. Lamps/LEDs/LCDs

  66. Fuses

  67. Primary Power Supply

  68. Secondary Power Supply

  69. Trouble Signals

  70. Disconnect Switches

  71. Ground-fault Monitoring

  72. Panel Supervision

  73. System Performance

  74. Sound Pressure Levels

  75. Occupied

  76. System Intelligibility

  77. Type

  78. Other

  79. 7.4 Notification Appliance Power Extender Panels

  80. Lamps/LEDs/LCDs

  81. Fuses

  82. Primary Power Supply

  83. Secondary Power Supply

  84. Trouble Signals

  85. Ground-Fault Monitoring

  86. Panel Supervision

  87. Other

  88. 7.5 Mass Notification Equipment

  89. Functional Test

  90. Reset/Power Down Test

  91. Fuses

  92. Primary Power Supply

  93. UPS Power Test

  94. Trouble Signals

  95. Disconnect Switches

  96. Ground-Fault Monitoring

  97. CCU Security Mechanism

  98. Prerecorded Message Content

  99. Prerecorded Message Activation

  100. Software Back Up Performed

  101. Test Backup Software

  102. Fire Alarm to MNS Interface

  103. MNS to Fire Alarm Interface

  104. In-Building MNS to Wide-Area MNS

  105. MNS to Direct Recipient MNS

  106. Sound Pressure Levels

  107. Occupied

  108. System Intelligibility

  109. Type

  110. Other

  111. 7.6 Two-Way Communications Equipment

  112. Phone Handsets

  113. Phone Jacks

  114. Off-hook Indicator

  115. Call-in Signal

  116. System Performance

  117. System Audibility

  118. System Intelligibility

  119. Radio Communications Enhancement System

  120. Area of Refuge Communication System

  121. Elevator Emergency Communications System

  122. Other

  123. 7.7 Combination Systems

  124. Fire Extinguishing Monitoring Devices/System

  125. Carbon Monoxide Detector/System

  126. Combination Fire/Security System

  127. Other

  128. 7.8 Special Hazard Systems

  129. Specify in Comments

  130. Specify in Comments

  131. Specify in Comments

  132. 7.10 Monitored Systems

  133. Engine-Driven Generator

  134. Fire Pump

  135. Special Suppression Systems

  136. Other

  137. 7.11 Auxiliary Functions

  138. Door-Releasing Devices

  139. Fan Shutdown

  140. Smoke Management/Smoke Control

  141. Smoke Damper Operation

  142. Smoke Shutter Release

  143. Door Unlocking

  144. Elevator Recall

  145. Elevator Shunt Trip

  146. MNS Override of FA Signals

  147. Other

  148. Device test results sheet attached listing all devices tested and the results of the testing

  149. Device test results sheet attached listing all devices tested and the results of the testing

  150. Appliance test results sheet attached listing all appliances tested and the results of the testing

  151. 7.15 Supervisory Station Monitoring

  152. 8. Notifications that Testing is Complete

  153. Monitoring Organization

  154. Building Management

  155. Building Occupants

  156. Authority having Jurisdiction

  157. Other, if Required

  158. 9. System Restored to Normal Operation

  159. 10. Certification

  160. 10.1 Inspector Certification

    This system, as specified herein, has been inspected and tested according to all NFPA standards cited herein.

  161. By typing your name and date below, you attest that the information contained herein is true and accurate.

  162. 10.2 Acceptance by Owner or Owner's Representative

    The undersigned has a service contract for this system in effect as of the date shown below.

  163. By typing your name and date below, you attest that the information contained herein is true and accurate.

  164. Leave This Blank:

  165. This field is not part of the form submission.