Report (56) 2
SUPERVISORY SIGNAL INITIATING DEVICES AND CIRCUIT INFORMATION
QTY OF CIRCUIT STYLE
BUILDING TEMP.
SITE WATER TEMP.
SITE WATER LEVEL
FIRE PUMP POWER
FIRE PUMP RUNNING
FIRE PUMP AUTO POSITION
FIRE PUMP OR PUMP CONTROLLER
FIRE PUMP RUNNING
GENERATOR IN AUTO POSITION
GENERATOR OR CONTROLLER TBL
SWITCH TRANSFER
GENERATOR ENGINE RUNNING
OTHER:
SIGNALING LINE CIRCUITS
Quantity and style(See NFPA 72,Table 3-6)of signaling line circuits connected to system:
Quantity 1 Style(s)B
SYSTEM POWER SUPPLIES
a.Primary(Main):
Nominal Voltage 120 Amps 20
Over-current Protection: Type BREAKER Amps 20
Location(Panel Number): L2 CRKT 8
Disconnecting Means Location:ELECT RM BEHIND FACP RM
b. Secondary(Standby):
Storage Battery:2 Amp-Hr.Rating 7
Calculated capacity to operate system,in hours: ®24 ❑60
TYPE BATTERY
❑Dry Cell
❑Nickel-Cadmium
® Sealed Lead-Acid
❑Lead-Acid
❑Other(Specify)
c.Emergency or standby system used as a backup to primary power supply,instead of using a secondary
power supply consist of one of the following:
®Emergency system described in NFPA 70,Article 700
Legally required standby described in NFPA 70,Article 701
❑Optional standby system described in NFPA 70,Article 702,which also meets the performance
requirements of Article 700 or 701.
PRIOR TO ANY TESTING
NOTIFICATIONS ARE MADE: YES NO WHO TIME
MONITORING ENTITY ® ❑ CSM 7AM
BUILDING OCCUPANTS ® ❑
BUILDING MANAGEMENT ® ❑ CHRIS MORRIS 7AM
OTHER(SPECIFY) ❑ ❑
AHJ(NOTIFIED)OF ANY IMPAIRMENTS ❑ ❑
t
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SYSTEM TESTS AND INSPECTIONS
TYPE VISUAL FUNCTIONAL COMMENTS
CONTROL PANEL
INTERFACE EQ. ❑ ❑
LAMPS/LEDS
FUSES
PRIMARY POWER SUPPLY
TROUBLE SIGNALS
DISCONNECT SWITCHES
GROUND FAULT MONITORING El E
SECONDARY POWER
TYPE VISUAL FUNCTIONAL COMMENTS
BATTERY CONDITION
LOAD VOLTAGE
DISCHARGE TEST
CHARGER TEST
SPECIFIC GRAVITY ❑ ❑
TRANSIENT SUPPRESSORS ❑
REMOTE ANNUNCIATORS V ® FRONT DOOR
NOTIFICATION APPLIANCES
AUDIBLE
VISUAL
SPEAKERS ❑ ❑
VOICE CLARITY ❑ ❑
INITIATING AND SUPERVISORY DEVICE TESTS AND INSPECTIONS
DEVICE VISUAL FUNCTIONAL
LOC.&S/N TYPE CHECK TEST PASS FAIL
011-1ST FLR ELECT RM SMOKE E ® ® ❑
012-1ST FLR ATM RM SMOKE ® E ® ❑
013-1ST FLR VAULT SMOKE E E E ❑
014-1ST FLR STORAGE RM SMOKE ® ® ® ❑
015- 1ST FLR BREAK RM SMOKE ® ® ® ❑
021-2ND FLR ELECT RM SMOKE ® ® E ❑
022-2ND FLR FACP RM SMOKE E E ® ❑
023-2ND FLR W.BRK RM HEAT ® ® .1 ❑
024-2ND FLR E.BRK RM HEAT ® ® ® ❑
031-3RD FLR ELECT RM SMOKE ® ® ® ❑
032-3RD FLR BRK RM HEAT ® ® ® ❑
033-3RD FLR SERVER RM SMOKE ® ® ® ❑
036-1ST FLR N STAIR PULL ® ® ® ❑
037-1ST FLR MAIN ENT PULL ® ® ® ❑
038-1ST FLR S STAIR PULL ® ® ® ❑
039-2ND FLR N STAIR PULL ® ® ® ❑
040-2ND FLR S STAIR PULL ® ® ® ❑
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ON/OFF PREMISES MONITORING:
YES NO TIME COMMENTS
ALARM SIGNAL ® ❑
ALARM RESTORAL ® ❑
TROUBLE SIGNAL ® ❑
SUPERVISORY SIGNAL ® ❑
SUPERVISORY RESTORAL ® ❑
NOTIFICATIONS THAT TESTING IS COMPLETE:
YES NO TIME WHO
BUILDING MANAGEMENT ® ❑
MONITORING AGENCY ® ❑
BUILDING OCCUPANTS ® ❑
OTHER(SPECIFY) ❑ ❑
COMMENTS:
SYSTEM RESTORED TO NORMAL OPERATION:
YES NO DATE TIME
0 0 06-10-2016 12:00
TESTING WAS PERFORMED IN ACCORDANCE WITH APPLICABLE NFPA STANDARDS.
NAME OF INSPECTOR: DATE: TIME:
SIGNATURE:
OWNERS REPRESENTATIVE: DATE: TIME:
SIGNATURE:
WITNESSED BY THE AUTHORITY HAVING JURISDICTION YES ❑NO❑
NAME OF AUTHORITY HAVING JURISDICTION:
SIGNATURE: DATE: TIME:
Stoner Protective Systems
1904 S.E.Ochoco St Milwaukie,OR 97222
(503)462-5203 Fax(503)659-2824 Watts(800)548-2701
CCB#44823