Fillable Fire Alarm Inspection Report (City of Oakland)

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Fire Alarm Inspection Report (City of Oakland)

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Country of origin: US
File type: PDF

U.S.A. forms for City of Oakland

BROWSE CITY OF OAKLAND (CA) FORMS

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Fire Alarm Inspection Report
Customer Name
Supervising Station Monitoring
Deciencies, Comments, and Recommendations
Notes:
Monitoring Notied
Pass
Type TypeVoltage Voltage
Fail
Pass Pass
N/A
Fail Fail
Time
Time Inspection Begin Time Inspection End
Inspection Company
Final Result / Tag Color
Customer Phone
Management Notied
Inspection Date
Point of Contact
Email Address
Occupants Notied
Other
Inspectors Name
Service Interval
Customer Address
Inspection Company
Address
Alarm Signal
Alarm Restoration
Trouble Signal
Supervisory Signal
Trouble Signal Restoration
Supervisory Signal Restoration
Primary Power Secondary Power
Nominal Voltage
Amp-Hr Rating
N/A N/A
N/A
Over-current Protection Amps Engine-Driven Generator
Over-current Protection Disconnection
Amps
Calculated Capacity
Over-current Protection Type
Amp-Hrs to operate
Hrs
Over-current Protection Location
Location of fuel storage
Battery Location Battery Location
Monitoring Company
Monitoring Information
Transmission Type
Transmission Type
Number of Circuits
Building Occupant Contact
Circuit Styles
Last Software Revision
Communicator Brand
Monitoring Phone
Cntrl Unit Manufacturer
Software Rev
Building Management Contact
AHJ notied of impairments
Monitoring Account #
Model Number
Date of Last Service
Communicator Type
AHJ Contact
N/A
N/A
ARMY NATIONAL GUARD BLDG 27-2
ST. LOUIS MO 63111
573-690-6274
DARREN / RICH
GREEN / PASS
MARMIC FIRE & SAFETY
ST. LOUIS MO. 63146
06/04/2020
M. REINKEMEYER
ANNUAL
FRONT GATE
YES
YES
YES
8:45
11:00
DACT
SIMPLEX
4010 ES
B
2
DACT
SIMPLEX
9:00
120
12V12
20
CB
24
20
SAME RM AS FACP
PANEL P1 #46
FACP
12V12
13.01
FACP
12V12
13.01
BATTERYS FAILED LOAD TEST WITH AMPERAGE BELOW 5AH
24 DAVIS ST.
11694 LACKLAND RD.
Initiating Devices
Combination Systems
Special Hazard System
System Tests
Signaling Line Circuits
Notication Appliance Circuits
Manual Alarm Boxes
Fire Ext. Monitoring Visual
Visual
Control Unit
Quantity of Signaling Line Circuits
Installed
Pass
Pass
Visual
Tested
Fail
Fail
N/A
N/A
Functional
N/A
N/A
N/A
N/A Notes
Duct Detectors
CO2 System Operation
Fuses
CO2 Detectors
Ground Fault Monitoring
Waterow Switches
Trouble Signals
Other:
Other:
Ion Detectors
Fire Ext. Monitor Operation
Device Operation
Interface Equipment
Style of Signaling Line Circuits
Photo Detectors
CO2 System Visual
Special Procedures
Lamps/LED’s
Supervisory Switches
Disconnect Switches
Heat Detectors
Other:
Primary Power Supply
Kitchen Hood
Building Temperature
Fire Pump Power
Other:
Fire Pump / Controller Trouble
Other:
Site Water Temperature
Site Water Level
Generator in Auto Position
Fire Pump Running
Other:
Notication Devices
Device Notes
Customer Signature Inspectors SignatureDate Date
Bells
Installed
Tested
N/A
Chimes
Speakers
NAC Expanders
Number of Alarm Circuits
Door Holders
Other:
Other:
NACs Monitored for Integrity
Horns
Horn Strobes
Strobes
Aux Relays
Devices and Circuit Information
Emergency Communication
Phone Set
PassQty
Fail N/A
Ampliers
Call-In Signal
Phone Jacks
O-Hook Indicator
Tone Generators
This system has been inspected and tested according to NFPA 72
2
Y
8
8
41
41
2
YES
14
14
7
7
06/04/2020
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Zone Device Type Device Location Visual Functional Model Sensitivity Range Sensitivity Result Notes Pass Fail
MPS
FRONT EXIT
✔
✔
1-51
✔
MPS
WEST HALL EXIT
✔
✔
1-63
✔
MPS
1ST FL SOUTH EXIT
✔
✔
1-65
✔
MPS
1ST CENTER EXIT
✔
✔
1-27
✔
MPS
1ST EAST STAIR EXIT
✔
✔
1-20
✔
MPS
BASEMENT CENTER MITA EXIT
✔
✔
1-8
✔
MPS
BASEMENT MULTIPURPOSE TRAINING EXIT
✔
✔
1-9
✔
MPS
1ST WEST HALL EXIT
✔
✔
1-35
✔
✔
PHOTO
BY CENTER EAST RR'S
✔
✔
1-51
✔
PHOTO
1ST PROD. RMWEST
✔
✔
1-52
✔
PHOTO
1ST PROD RM EAST
✔
✔
1-53
✔
PHOTO
1ST EAST TRAINING RM
✔
✔
1-55
✔
PHOTO
1ST CENTER HALL BY LOBBY
✔
✔
1-42
✔
PHOTO
1ST FRONT WEST HALL BY S
✔
✔
1-61
✔
PHOTO
1ST FRONT WEST HALL BY O
✔
✔
1-62
✔
PHOTO
1ST WEST O RM
✔
✔
1-64
✔
PHOTO
1ST CENTER MECH. RM
✔
✔
1-66
✔
PHOTO
1ST CENTER STAIR/WOMENS
✔
✔
1-50
✔
PHOTO
1ST FL. CORRIDOR
✔
✔
1-26
✔
PHOTO
1ST TACTICAL TRAINING
✔
✔
1-25
✔
PHOTO
1ST TACTICAL TRAINING
✔
✔
1-23
✔
PHOTO
1ST FL. CORRIDOR
✔
✔
1-24
✔
PHOTO
1ST HUMINT TRAINING
✔
✔
1-22
✔
PHOTO
1ST HUMINT TRAINING
✔
✔
1-18
✔
PHOTO
1ST INTERVIEW RM.
✔
✔
1-19
✔
PHOTO
1ST EAST STAIRS
✔
✔
1-21
✔
PHOTO
BASE BY EAST STAIR
✔
✔
1-4
✔
PHOTO
BASE FAC. MAINT.
✔
✔
1-3
✔
PHOTO
BASE MECH.
✔
✔
1-1
✔
PHOTO
BASE EAST MITA
✔
✔
1-5
✔
PHOTO
BASE EAST MITA
✔
✔
1-2
✔
PHOTO
BASE CENTER MITA
✔
✔
1-6
✔
PHOTO
BASE CENTER MITA
✔
✔
1-7
✔
PHOTO
BASE MULTIPURPOSE TRAINING
✔
✔
1-10
✔
Zone Device Type Device Location Visual Functional Model Sensitivity Range Sensitivity Result Notes Pass Fail
PHOTO
BASE MULTIPURPOSE TRAINING
1-11
PHOTO
BASE BY WEST STAIRS
1-12
PHOTO
BASE SERVER RM
1-13
PHOTO
BASE CADRE
1-14
PHOTO
BASE CADRE
1-15
PHOTO
1ST WEST STAIRS
1-34
PHOTO
1ST SIGNT TRAINING
1-33
PHOTO
1ST FACILITY STORAGE
1-36
PHOTO
1ST SIGNT TRAINING
1-37
PHOTO
1ST SIGNT TRAINING
1-32
PHOTO
1ST SIGNT TRAINING
1-33
PHOTO
1ST GEOINT TRAINING
1-31
PHOTO
1ST GEOINT TRAINING
1-29
PHOTO
1ST FL CORRIDOR
1-30
PHOTO
1ST FL. CORRIDOR
1-28
Zone Device Type Device Location Visual Functional Model Sensitivity Range Sensitivity Result Notes Pass Fail
Zone Device Type Device Location Visual Functional Model Sensitivity Range Sensitivity Result Notes Pass Fail
Zone Device Type Device Location Visual Functional Model Sensitivity Range Sensitivity Result Notes Pass Fail
Zone Device Type Device Location Visual Functional Model Sensitivity Range Sensitivity Result Notes Pass Fail
Zone Device Type Device Location Visual Functional Model Sensitivity Range Sensitivity Result Notes Pass Fail
Zone Device Type Device Location Visual Functional Model Sensitivity Range Sensitivity Result Notes Pass Fail
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Fire Alarm Inspection Report (City of Oakland)

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Completed 2 March 2021

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