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Report (18) SYSTEM RECORD OF COMPLETION (continued) 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: t'4(, Control panel amps: Overcurrent protection: Type: L I-ces„l/- (;,t- ...ke ' Amps: Branch circuit disconnecting means location: Number: 5.1.2 Secondary Power Type of secondary power: 6 434_4_ $ . Q Qc Location,if remote from the plant: Calculated capacity of secondary power to drive the system: In standby mode(hours): In alarm mode(minutes): 5.2 Control Unit ❑ This system does not have power extender panels Ig Power extender panels are listed on supplementary sheet A 6. CIRCUITS AND PATHWAYS Pathway Type Dual Media Pathway Separate Pathway Class Survivability Level Signaling Line Device Power Initiating Device Notification Appliance Other(specify): 7. REMOTE ANNUNCIATORS .0/4 Type Location 8. INITIATING DEVICES pip,. Addressable or Type Quantity Conventional Alarm or Supervisory Sensing Technology Manual Pull Stations Smoke Detectors Duct Smoke Detectors Heat Detectors Gas Detectors Waterflow Switches Tamper Switches Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. SYSTEM RECORD OF COMPLETION (continued) 9. NOTIFICATION APPLIANCES Type Quantity Description Audible Visible 5/To S C w4(( / ;I i' Combination Audible and Visible g5t3 1-4-of s 'fie. W.c-I /t 10. SYSTEM CONTROL FUNCTIONS Type Quantity Hold-Open Door Releasing Devices HVAC Shutdown Fire/Smoke Dampers Door Unlocking Elevator Recall Elevator Shunt Trip 11. INTERCONNECTED SYSTEMS This system does not have interconnected systems. 0 Interconnected systems are listed on supplementary sheet 12. CERTIFICATION AND APPROVALS 12.1 System Installation Contractor This system as specified herein has been installed according to all NFPA standards cited herein. Signed: Printed name: .fryt, Date: I(LS-/it Organization: pb.;4,f /4`endt-}I Title: rt.(,h,:(yl*M Phone: S)erpoli)3 82SS- 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed: Printed name: ' rot.c.1-+f Date: y2,5- Organization: 2,sOrganization: Ver-s. It..tiJ-,r Title: Tt at it-: A.+1 Phone: se 3 • y d •6 Z33" 12.3 Acceptance Test Date and time of acceptance test: V2-5-/1 S Installing contractor representative: Testing contractor representative: 4•*—R- (` 41 'I Property representative: (qt..K' A,✓ vise AHJ representative: Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.