**THIS FORM MUST BE SUBMITTED WITHIN 30 DAYS FROM THE DATE OF INSPECTION TO THE OCEAN CITY FIRE
MARSHALS OFFICE **
Rev. 10/7/2008
TOWN OF OCEAN CITY - OFFICE OF THE FIRE MARSHAL
P.O. Box 158 Ocean City, MD 21843
Phone # 410-289-8780 Fax # 410-289-8767
CERTIFICATE OF INSPECTION
Smoke Control / Smoke Management System
Annual Certificate of Inspection in Accordance with NFPA 92A
Annual Certificate of Inspection in Accordance with NFPA 92B
Non-Annual Certificate of Inspection in Accordance with NFPA 92A
Non-Annual Certificate of Inspection in Accordance with NFPA 92B
Deficiencies: YES NO
Protected Property:
Building Name:________________________________ Exact Physical Address:__________________________________________
Contact Person:________________________________ Bill To:_______________________________________________________
Contact Phone #:_______________________________ Billing Address:________________________________________________
Smoke Control Testing Company:
Inspector/Technician:___________________________ Company:_______________________________________________
Phone Number:________________________________ Address:_________________________________________________
Date System Tested:____________________________ _________________________________________________
Smoke Control System Owner’s Notification:
The owner and/or the owner’s representative of the system was notified on
of all deficiencies.
PRIOR TO TESTING, OCEAN CITY COMMUNICATIONS SHALL BE NOTIFIED!
PHONE # 410-723-6620
(Failure to do so will result in the full provisions of the Town of Ocean City Fire Prevention and Protection Code to be invoked.)
Dispatcher Name/Number:_____________________________ Time:__________________
Smoke Control System Information:
System Type: Dedicated Non-Dedicated Zoned Smoke Control Smoke Exhaust Stair Pressurization
Deficiencies Identified During Inspection:
System out of Service Stairway Fans Failed to Activate
System Failed to Activate Automatically Verification of System Components Failed
System Fans Failed to Operate Within 60 Seconds After Testing System Failed to Return to Normal
System Dampers Failed to Complete Travel within 75 Seconds Across Door Pressures too High / Low (Circle One)
System Failed to Operate When Transferred to Stand-by Power System Failed to Manual, Activate, or Shut Down
Smoke Detector in the Supply Failed to Shut Fan Off Other: List Below
Comments / Deficiency Description:
(Attach an “Additional Information Form” if more room is needed.)
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________
FOR INTERNAL USE ONLY:
Data Entry Date:__________ FM Assigned:__________ Date FM Assigned:__________ Date Inspected/Contacted:__________
No Deficiencies Found Deficiencies Verified
QV #:__________ Date of Violation:__________ Date of Compliance:__________
