Fillable Fire Alarm System Confidence Test Report (City of Lacey)

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Fire Alarm System Confidence Test Report (City of Lacey)

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File type: PDF

U.S.A. forms for City of Lacey

BROWSE CITY OF LACEY (WA) FORMS

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Mail to: Confidence Testing
City of Lacey Community Development Dept.
420 College Street SE
Lacey, WA 98503
FORM: ALARM-TEST-1-05 © 2005 City of Lacey, Washington, USA
Fire Alarm System
Confidence Test Report
Date of Inspection: Technician (print):
Fire Alarm Company:
Occupancy Name:
Occupancy Contact:
Telephone:
Occupancy Address:
City:
Central Station:
Acct. #:
Alarm Panel Make:
Model #:
System #:
Results Satisfactory. No Corrections Noted at the Time of Inspection.
Comments, Explanation of Unsatisfactory Results, Action Taken, Etc.:
CORRECTIONS/REPAIRS PERFORMED:
DATE OF CORRECTIONS:
WORK ORDER #:
Page 1 of 2
CITY OF LACEY
Community Development Dept.
420 College Street SE
Lacey, WA 98503
(360) 491-5642
EQUIPMENT TESTED
This is to certify that this fire alarm system has been properly inspected for reliability covering the items listed in this
report
and is consistent with NFPA Fire Alarm Maintenance Standards.
Fire Alarm Technician (signature) Date:
License Number & Company
Owner Representative (signature)
Date:
Owner Representative (print)
FORM: ALARM-TEST-1-05 © 2005 City of Lacey, Washington, USA
SATISFACTORY
CHECK
TYPE OF EQUIPMENT
# OF UNITS
MANUFACTURER
MODEL
YES
NO
N/A
1. CONTROL PANEL
2. MANUAL STATION
3. HEAT DETECTORS
4. SMOKE DETECTORS
5. AUDIBLE DEVICES
6. VISUAL DEVICES
7. DOOR RELEASE
8. TROUBLE INDICATORS
9. BATTERIES
10. CHARGER
11. GENERATOR
12. VENTILATION CONTROL
13. CENTRAL STATION
TRANSMITTER
14. SPRINKLER WATER FLOW
SWITCH
15. SPRINKLER GATE VALVE
SUPERVISORY SWITCH
16. ANNUNCIATORS
17. ELEVATORS
18. QUICK-RELEASE DEVICES
19. OTHER
Page 2 of 2
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Fire Alarm System Confidence Test Report (City of Lacey)

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Completed 3 August 2020

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