VEHICLE SYSTEM FIRE SUPPRESSION SYSTEM INSPECTION
System Type
WET
DATE:
DRY
WORK ORDER #:
COMBINATION
:
CUSTOMER
Inspection frequency ADDRESS
SEMI-ANNUAL OTHER
Inspector's name
CONTACT
EMAIL
DATE OF PREVIOUS SERVICE
PHONE
HAZARD DESCRIPTION
1. Machine Model 4. Fire system manufacturer?
2. Machine serial number 5. Fire system model?
3. Machine hours 6. Bottle dates? 6-year service: 12-year hydrotest:
Inspect and service all fire systesm to manufacturer's specifications and insert a check mark in the appropriate column. OK=acceptable or pass, NO=additional repairs required, N/A=not applicable
REMOTE ACTUATOR QUANTITY OK NO N/A TUBING / NOZZLES OK NO N/A
1.Remote/ground actuator 25. Physical Conditon
2. Safety seal/ Pull pin 26. Bracket / Fittings
3. Push Knob/ Manual Push Rod 27. Balance Ratios
4. Dust boot 28. Nozzles
5. Cartridge Seal 29. Nozzle Caps
6. Cartridge Condition/ Weight 30. Nozzle Locations
WEIGHTS:
HOSES / FITTINGS OK NO N/A
7. Electric Actuator 31. Physical Condition
INSIDE ACTUATOR / MONITOR OK NO N/A
32. Tight / Securely Mounted
8.Remote/ground actuator 33. Hoses Blown Clear
9. Safety seal/ Pull pin 34. Actuation Line Pressure Tested
10. Push Knob/ Manual Push Rod 35. Meets Specifications / Balanced
11.Dust boot
WIRING / SENSORS OK NO N/A
12. Cartridge Seal 36. Sensor Condition
13. Cartridge Condition/ Weight 37. Sensor Wiring
WEIGHTS: 38. Sensor Heat Check
14. Circuit Monitor lights 39. Connections / Routing
15. Backup Battery 40. Battery Connections
16. Electric Actuator 41. Linear Fire Wire
SYSTEM TANK / BOTTLES OK NO N/A
42. Engine Shutdown
17. Physical condition 43. Fuses / Connections
18. Outlet Assembly 44. Line Resistor
19. Bursting Disc 45. Modules
20. Gauge / Pressure Reading
21. Cap, O-Ring, and Washer
22. Bracket / Strap
23. Gas Tube Assembly
24. Pneumatic Control Heads
46. GENERAL COMMENTS:
888-462-7642
47. RECOMMENDATIONS: N/A
48. LIST OF CHANGES MADE AND/OR EQUIPMENT REPLACED OR ADDED: N/A
49. SYSTEM STATUS UPON
DEPARTURE?
OPERATIONAL OPERATIONAL WITH DEFICIENCIES INOPERABLE
SYSTEM ARMED? YES NO
SAFTEY SEALS IN PLACE? YES NO
SYSTEM TAG/STICKERS UPDATED? YES NO
Owner / designated rep name
Date
Owner / deisgnated rep signature
I state that the information on this form has been explained at my
request and a copy provided to me regarding this inspection,and
that all equipment tested at this time was left in operational
condition upon completion of this inspection except as noted.
inspector's name
LICENSE
inspector's signature
I state 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 operational condition upon completion of this inspection except
as noted.
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