Report •
RS 2o /Z — 0000 �
FUNDAMENTALS OF FIRE ALAF ;M SYSTEMS 72 -31
FIRE ALARM SYSTEM
RECORD OF COMPLETION
Lc I,
Name of protected prope : _4 1 IN i / I
Address: Y WAMME
Representative of protected property ( mme, phone):
° .': . hall; � drw .:Oil: C 1 , r: 1 � 4 ,,rn4;o
_ 'ce_.iKit
Address/ telephone number:
Organization name / phone " Representative name /phone
Installer: f T2 1i GV/y1/J/ ( CC ' 2'vv 6 r . ; 7
Supplier: r ,4- ‹
Service organization: C '9 ri'✓f '"€-
Location of record (as- built) drawings:
•
Location of operation and maintenance manuals: G / ' �' : ,
Location of test reports: , r ..
A contract for test and inspection in accorda ce with NFPA standard(s):
Contract no(s): / / 1 11.----0 6,67 Effective Date 7^ ' J - f 2. Expiration date:
System Software L �- L
(a) Operating system (executive software revision level(s): iS I l /7 4/- (J� ('0 j )
(b) Site - specific software revision date: `~1- '2— t' 7- 2-- ' / — z--
(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 communication center 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 communication center 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: t.5 Yr
Central Station Location: S <6.Cyt Lf
(NFPA 72, 1 of 4)
FIGURE 4.5.2.1 Record of Completion
72 -32 NATIONAL FiRE ALARM CODE
Means of transmission of signals from the protected premises to the central station:
McCulloh Mutiplex One -way radio
Digital alarm communicator Two -way radio Others
Meads of transmission of alarms to the public fire service communications center:
(a)
System Location:
NFPA 72, Chapter 9 - Auxiliary
Indicate type of connection: 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 accprdance with the NFPA standards as shown below, was inspected by
1_- ej c� �f i jf Am ( q ✓' o ...-1 — ,includes the devices shown
in 5 and 6, and has been in service since Q , — 1— i Z .
NFPA 72, Chapters (check all that apply) R1 R12 p 3 '44 ❑ 5 ❑ 6 4 7 N8 X92,10 ❑ 11
NFPA 70, National Electrical Code, Article 760
Manufacturer's instructions
Other (specify)
Signed: i cv / Date: r -� . 2
Organizat lj/ _- GY! kki 44 14 vi 1 (jc?1 --(7t i
3. Record of System Operation
Documentation in accordance with Inspection Testing Form, Figure 10.6.2.3, is attached
All operational features and functions of this system were tested by: - ..f ff /11`it Date: x.44—/Z
and found to be operating properly in accordance with the requirements of:
K NFPA 72 , Chapter (check all that apply) . r 1 Z3 2 3 4_4 ❑ 5 ❑ 6 Z 7 [r8 X9,4A10 ❑ 11
NFPA 70, National Electrical Code, Article 760
Manufacturer's instructions
/// Other (specify)
Signed: Date: -41?
Organization: 6 A LL GQf i jh G{//)I ('ci4z.VN 5
4. Signaling Line Circuits
Quantity and class of signali� . line circuits connected to system (see NFPA 72 table 6.6.1):
Quantity: ti 5 Style: Class:
(NFPA 72 , 2 of 4)
FIGURE 4.5.2.1 Continued
FUNDAMENTALS OF FIRE ALARM SYSTEM 72 -33
5. Alarm- Initiating Devices and Circuits
Quantity and class of initiating device circuits (see NFPA 72, Table 6.5)
Quantity: Style: Class:
- - MANUAL -
(a) Manua: -.._ (p I S ".aloof -
stations Noncoded Transmitters Coded Addressable
(b) Combination manual fire alarm and guard's tour coded stations:
AUTOMATIC
Coverage: Complete Partial
Selective Nonrequired
p
(a) Smoke Detectors i 1 / d aP on Photo Addressable
(b) Duct Detectors Ion Photo Addressable
(c) Heat Detectors (7_1)— FT RR FT /RR RC Addressable
(d) Sprinkler Waterflow indicators: Transmitters /V/ Noncoded Coded Addressable
(e) The alarm verification feature is disabled t 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 f�
(a) Coded stations / J
(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
(a) Valve supervisory switches ❑
(b) Building temperature points ❑
(c) Site water temperature points ❑
(d) Site water supply level points ❑
Electric Fire Pump:
) 1 ❑ I
(e) Fire pump power 1
(f) Fire pump running ❑
(g) Phase reversal ❑
Engine- driven Fire pump:
(h) Selector in auto position ❑
(i) Engine or control panel trouble ❑
Q) 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):
FIGURE 4.5.2.1 Continued (NFPA 72 , 3 of 4)
•
72 -34 NATIONAL FIRE ALARM CODE
7.Annunciator(s)
Number: () ji Type: Location:
8. Alarm Notification Appliances and Circuits
NFPA 72, Chapter 6 - Emergency Voice/Alarm Service ,/� [/�
Quant �y of voice /alarm channels: 2 la - Sings: / / , I .' Multiple, r:• .-- - , - -
Quantity of speakers installed: j )-9- 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): Q
Quantity: Style: Q Class: ■
Types and quantities of notification appliances installed:
(a) Bells With Visible
(b) Speakers With Visible
(c) Horns 'WPM/ " 'v With Visible igliferaW • $
(d) Chimes With Visible
(e) Other: Visible
(f) Visible appliances without audible: 3 "` - H a -N P1c V
0
9. System Power Supplies
(a) Fire Alarm Control Panel: Nominal Voltage: 0 Current rating:
Overcurrent protection: Type: Current rating:
Location: _44 /
(b) Secondary (standby): 1 /� , / l/
Storage Battery: t `J V Amp -hour rating: s
Calculated capacity to drive system , in hours: a y
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:
•_ I d -94 -1?
(signe• -•r installation contracto supplier (title) (date)
- - i k ± I Sgl2e37( ) i5 2` -((0-
(signed) for alarm service comp y (title) (date)
X � 6z ves-6,/ 1 -- )---<1 . -1 'L
(signed) for central station (title) (date)
Upon completion of the system(s) satisfactory test(s) witnessed (if required by the authority having jurisdiction):
I I
(signed) representative of the authority having jurisdiction (title) (date)
FIGURE 4.5.2.1 Continued (NFPA 72 , 4 of 4)
02/22/2012 7:29:29 Event History Page 1 of 3
2/21/2012 00:00:00 TO 2/2212012 23:59:59
CS# 37 - 2066 To 37 - 2066 Site# To Sery Co# To Primary Sort
Name To City To State To Secondary Sort
Date Operator Zone State Event Zone Comment User Name User ID
37- 2066 - ESSENTIAL PLANNING
02/21/2012 16:48:15 LAR ONTEST- Placed On Test 'Test
Cat: TECH DAVE Expires: Feb 22 2012 5:00PM All Zones
02/21/2012 16:47:51 LAR WA- Critical Data Warning 'Test Missing agency.
02/21/2012 15:53:20 LAR CLTEST -Clear Test 'Test
Cat: CUST
02/21/2012 15:51:00 001 R 2000 - RESTORE 'Test
02/21/2012 15:50:27 001 A 7110 -FIRE 'Test
02/21/2012 15:50:25 002 R 2000 - RESTORE 'Test
02/21/2012 15:50:00 002 A 7110 -FIRE 'Test
02/21/2012 15:48:51 002 R 2000 - RESTORE 'Test
02/21/2012 15:48:49 002 A 7110 -FIRE 'Test
02/21/2012 15:48:16 002 R 2000 - RESTORE 'Test
02/21/2012 15:48:12 002 A 7110 -FIRE 'Test
02/21/2012 15:47:15 002 R 2000 - RESTORE 'Test
02/21/2012 15:47:13 002 A 7110 -FIRE 'Test
02/21/2012 15:46:22 002 R 2000 - RESTORE 'Test
02/21/2012 15:46:18 002 A 7110 -FIRE 'Test
02/21/2012 15:45:48 002 R 2000 - RESTORE 'Test
02/21/2012 15:45:46 002 A 7110 -FIRE 'Test
02/21/2012 15:45:13 002 R 2000 - RESTORE 'Test
02/21/2012 15:44:49 002 A 7110 -FIRE 'Test
02/21/2012 15:44:16 002 R 2000 - RESTORE 'Test
02/21/2012 15:44:12 002 A 7110 -FIRE 'Test
02/21/2012 15:43:39 002 R 2000 - RESTORE 'Test
02/21/2012 15:43:37 002 A 7110 -FIRE 'Test
02/21/2012 15:42:58 002 R 2000- RESTORE `Test
02/21/2012 15:42:54 002 A 7110 -FIRE 'Test
02/21/2012 15:42:07 002 R 2000 - RESTORE 'Test
02/21/2012 15:42:05 002 A 7110 -FIRE 'Test
02/21/2012 15:41:08 002 R 2000 - RESTORE 'Test
02/21/2012 15:41:03 002 A 7110 -FIRE 'Test
02/21/2012 15:40:37 R351 R CIR351- RESTORE Telco 1 Fault 'Test
02/21/2012 15:39:52 002 R 2000 - RESTORE 'Test
02/21/2012 15:39:48 002 A 7110 -FIRE - ' : 'Test
02/21/2012 15:38:36 E351 T 7351 -PHONE LINE 1 TBL/WAIT 3 MINUTE..:: : ..!Test'
02/21/2012 15:36:18 R352 R CIR352- RESTORE Telco 2 Fault 'Test
02/21/2012 15:35:07 E352 T 7352 -PHONE LINE 2 TROUBLE 'Test
02/21/2012 15:33:08 AS HISTRY
DONNY CALLED GAVE CSID CHECKING HIST
02/21/2012 15:31:47 001 R 2000 - RESTORE 'Test
Page 1 of 3
_ 02/22/2012 7:29:29 Event History Page 2 of 3
• 2121/2012 00:00:00 TO 2/22/2012 23:59:59
CS# 37 - 2066 To 37 - 2066 Site# To Sery Co# To Primary Sort
Name To City To State To Secondary Sort
Date Operator Zone State Event Zone Comment User Name User ID
37- 2066 - ESSENTIAL PLANNING
02/21/2012 15:31:44 001 A 7110 -FIRE 'Test
02/21/2012 15:28:24 001 R 2000 - RESTORE `Test
02/21/2012 15:27:54 001 A 7110 -FIRE 'Test
02/21/2012 15:26:55 001 R 2000 - RESTORE - 'Test
02/21/2012 15:26:06 001 A 7110 -FIRE 'Test
02/21/2012 15:25:37 001 R 2000 - RESTORE 'Test
02/21/2012 15:25:33 001 A 7110 -FIRE 'Test
02/21/2012 15:24:34 001 R 2000- RESTORE 'Test
02/21/2012 15:24:30 001 A 7110 -FIRE 'Test
02/21/2012 15:22:54 001 R 2000- RESTORE 'Test
02/21/2012 15:22:52 001 A 7110 -FIRE 'Test
02/21/2012 15:21:57 001 R 2000 - RESTORE 'Test
02/21/2012 15:21:55 001 A 7110 -FIRE 'Test
02/21/2012 15:20:52 001 R 2000 - RESTORE 'Test
02/21/2012 15:20:48 001 A 7110 -FIRE 'Test
02/21/2012 15:19:48 001 R 2000 - RESTORE 'Test
02/21/2012 15:19:46 001 A 7110 -FIRE 'Test
02/21/2012 15:18:33 001 R 2000 - RESTORE 'Test
02/21/2012 15:18:31 001 A 7110 -FIRE 'Test
02/21/2012 15:17:30 001 R 2000 - RESTORE 'Test
02/21/2012 15:16:42 001 A 7110 -FIRE 'Test
02/21/2012 15:15:55 001 R 2000 - RESTORE 'Test
02/21/2012 15:15:31 001 A 7110 -FIRE 'Test
02/21/2012 15:14:38 001 R 2000 - RESTORE 'Test
02/21/2012 15:13:57 001 A 7110 -FIRE 'Test
02/21/2012 15:13:55 001 R 2000 - RESTORE 'Test
02/21/2012 15:13:24 001 A 7110 -FIRE 'Test
02/21/2012 15:12:19 0. A 7604 -FIRE TEST 'Test 7
02/21/2012 15:11:43 BJL HISTRY
ROSS CHECKING HIST
02/21/2012 15:06:29 BJL HISTRY
DONNIE CHECKING HIST
02/21/2012 15:03:53 0. A 7604 -FIRE TEST 'Test 7
02/21/2012 15:03:48 0. A 7604 -FIRE TEST . - ' 'Test 7
02/21/2012 15:03:46 0. A 7604 -FIRE TEST ' " 'Test 7
02/21/2012 15:00:56 002 R 2000 - RESTORE 'Test
02/21/2012 15:00:13 002 T 7373 -FIRE TROUBLE 'Test
02/21/2012 14:59:34 000 R 2000 - RESTORE 'Test
02/21/2012 14:58:19 E302 T 7302 -LOW SYSTEM BATTERY 'Test
Page 2 of 3
02/22/2012 7:29:29 Event History Page 3 of 3
2/21/2012 00:00:00 TO 2/22/2012 23:59:59
CS# 37 - 2066 To 37 - 2066 Sited To Sery Co# To Primary Sort
Name To City To State To Secondary Sort
Date Operator Zone State Event Zone Comment User Name User ID
37- 2066 - ESSENTIAL PLANNING
02/21/2012 14:53:46 AS ONTEST- Placed On Test 'Test
Cat: OUST ROSS GAVE CSID Expires: Feb 21 2012 6:00PM All Zones
02/21/2012 14:53:35 AS WA- Critical Data Warning 'Test Missing agency.
02/21/2012 13:06:14 RS NOTT - Timer Test Reset Auto TT Feb 22, 2012 13:36
02/21/2012 13:06:06 RS IS - Service In Service
Page 3 of 3