Report t, OI I 0
FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 -
FIRE ALARM SYSTEM
RECORD OF COMPLETION
Name of protected .roperty: • • • ' •
Address: _ _ • - i :e . _ . 0
Representative of protected property (name /phone):
Authority having jurisdiction: C bA 0 d-1 Ot (CJ` •
Address/telephone number: . ! .c • , ;.. r • U A• ' , ' -(40/
>
Organization name /phone Representative name /phone
Installer 5C,L ' .& A _• G [ • '44 360- ( Q -2/ ?Q
Supplier TIM . . 1 _ B it 3 , - -9 - e /3 C)
Service organization
Location of record (as- built) drawings:
Location of operation and maintenance manuals:
Location of test reports:
•
A contract for test and inspection in accordance with NFPA standard(s)
Contract No(s): Effective date: Expiration date:
System Software
(a) Operating system (executive) software revision level(s):
(b) Site - specific software revision date:
(c) Revision completed by:
(name) (firm)
1. Type(s) of System or Service
NFPA 72, Chapter 6 — Local
If alarm is transmitted to location(s) -off premises, list where received:
•
NFPA 72, Chapter 8 — Remote Station
Telephone numbers of the organization receiving alarm:
Alarm:
Supervisory:
Trouble:
If alarms are retransmitted to public fire service communications centers or others, indicate location and telephone
numbers of the organization receiving alarm:
Indicate how alarm is retransmitted:
NFPA 72, Chapter 8 — Proprietary
Telephone numbers of the organization receiving alarm:
Alarm:
Supervisory:
Trouble:
If alarms are retransmitted to public fire service communications centers or others, indicate location and telephone
numbers of the organization receiving alarm:
Indicate how alarm is retransmitted:
NFPA 72, Chapter 8 — Central Station
Prime contractor:
Central station location:
(NFPA 72, 1 of 4)
FIGURE 4.5.2.1 Record of Completion.
2002 Edition
•
72 -32 ` NATIONAL FIRE ALARM CODE , . ,
•
Means of transmission of signals from the protected premises to the central station: _ - •
McCulloh - - Multiplex One -way radio
Digital alarm communicator Two -way radio Others
Means of transmission of alarms to the .public _fire service communications center:. _
(a) _ .
(b) "
System location: .
' - NFPA 72, Chapter 9 — Auxiliary ' . '
' Indicate: type of connection: v ' • Local energy Shunt ' `Parallel telephone
Location of telephone number for receipt of signals:
2.' Record of System. Installation - _ -
(Fill out after installation is complete and wiring is checked for opens, shorts, ground faults, and improper branching,
but prior to conducting operational acceptance tests.) '
This system has been installed in accordance with the NFPA standards as show n below, was inspected by
on , includes the devices shown
' in 5 and 6, and has been in service since v •
r'' NFPA 72 ; Chapters 1 2. - 3 4 5 b --r 7 K 9 11 - (circle all thatapply):
NFPA 70, National Electrical.Code, Article.760 ,
Manufacturer's instructions
Other (specify): - ' •
•
Signed: .. Date /L' 7& -) O
S .! o E Gfca(i
Organization: 5 � �6nhG� _ � - ,
3. Record of System" Operation •. JJ
Documentation in accordance with Inspection Testing Form, 'Figure, - 10.6.2.3,1s attached
All .operational features and functions'of this system were tested by date
and fou to be operating properly in accordance with the requirements: of: -
' ('NFPA 72, Chapters 1, , 2 3� 4 . '6 7 .,, 9 . 10 11. (circle all that apply) .i
NFPA 70, National Electrical Code, Article 760 -
Manufacturer's instructions , • -
Other .(specify):- - - '•
Signed: -... i Date / L� /� `/
Organization.
• (A , � rci i 4.10
4. Signaling Line Circuits - ,
Quantity and class of signalin line circuits connected'to system (see NFPA 72, Table 6.6.1): . ' '
' • Quantity: - • Style: - Class:
- (NFPA 72, 2 of 4) - •
- FIGURE 4.5.2:1 Continued
•
•
2002 Edition
•
FUNDAMENTALS OF FIRE ALARM SYSTEMS 72 -
•
5. Alarm- Initiating Devices and Circuits •
Quantity and class of initiating device circuits (see NFPA 72, Table 6.5):
Quantity: Style: Class:
MANUAL
(a) Manual stations Noncoded Transmitters Coded Addressable
(b) Combination manual fire alarm and guard's tour coded stations
AUTOMATIC
•
Coverage: Complete Partial
Selective Nonrequired
(a) Smoke detectors Ion Photo Addressable.
(b) Duct detectors Ion Photo Addressable
(c) Heat detectors FT RR FT/RR RC Addressable
(d) Sprinkler waterflow indicators: Transmitters Noncoded Coded Addressable
(e) The alarm verification feature is disabled or enabled , changed from seconds to seconds.
(f) Other (list):
6. Supervisory Signal- Initiating Devices and Circuits (use blanks to indicate quantity of devices)
GUARD'S TOUR
(a) Coded stations
(b) Noncoded stations
(c) Compulsory guard's tour system comprised of transmitter stations and intermediate stations
Note: Combination devices are recorded under 5(b), Manual, and 6(a), Guard's Tour.
SPRINKLER SYSTEM
Check if provided V
(a) Valve supervisory switches
(b) Building temperature points
(c) Site water temperature points
(d) Site water supply level points V
Electric fire pump:
(e) Fire pump power
(f) Fire pump running
(g) Phase reversal
Engine - driven fire pump:
•
(h) Selector in auto position
(i) Engine or control panel trouble •
(j) Fire pump running
ENGINE - DRIVEN GENERATOR:
•
(a) Selector in auto position
(b) Control panel trouble
(c) Transfer switches
(d) Engine running
Other supervisory function(s) (specify):
(NFPA 72, 3 of 4)
FIGURE 4.5.2.1 Continued
•
• 2002 Edition
•
•
i
• 72 - NATIONAL FIRE ALARM CODE - .
- 7. Annunciator(s) • . ' •
Number: Type: - Location: • - • •
•
8. Alarm Notification Appliances and Circuits
NFPA 72, Chapter. 6 — Emergency Voice/Alarm Service
- Quantity of voice/alarm channels: ` Single: Multiple: ,
' Quantity. of speakers installed: • Quantity of speaker zones: •
Quantity of telephones•or telephone jacks included in system:
Quantity and the class of notification appliance circuits connected to system (see NFPA 72, Table 6.7):
• Quantity: Style: Class: - - -
•r
Types and quantities of notification appliances installed:
(a) Bells With Visible
- (b) Speakers With Visible
(c) Horns With Visible ki
. ' (d) Chimes With Visible -
(e) Other: - With Visible
• (f) Visible appliances without; audible: •
9: System Power Supplies
(a) Fire Alarm Control Panel: Nominal voltage: 12— U Current rating: Z 0
Overcurrent protection: Type: `. erti(t L( - Current rating: 7.0
Location: _.
(b) Secondary (standby):
Storage- battery: Z - Amp -hour rating: •
• Calculated capacity to drive system, in hours: . 2 •
Engine- driven generator dedicated to fire alarm system: •
- Location of fuel storage; -
(c) Emergency system used as backup to primary power supply:
Emergency system described in NFPA 70, Article. 700: -
10: Comments •
Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s):
System deviations from the referenced NFPA standard(s) are: -
e i� Z— (G
or o v -
(sign- on contractor /supplier (title) '(date)
(signed) for alarm service company (title) (date) -
- • (sig ) for central station - • , (title) - - (date) .
U ompletio f the system(s) satisfactory test(s) witnessed (if re uired by the authority having jurisdiction): - -
c 1 Z . 1 6. - -
. (signed) repre e authority having jurisdiction (title) - (date) '
(NFPA 72, 4of4) • ' • •
FIGURE 4.5.2.1 , Continued . •
2002 Edition" •