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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.