Specifications 02/25/2008 MON 8:39 FAX 3608160482 GB Manchester 2005 /010
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J II
r: M:NC . .HE .
CORPORATION
6000 NE 88 Street
Vancouver, WA 98665
503 287 -1112 503 287 -1863 fax
FIRE ALARM INSPECTION AND TESTING FORM
CCB # 60178
Site: Brightwaters 0 Redhawk Date of Testing: 1/8/08
Address: 16142 SW 108 Ave Contact: Terry Ann
Address: Tigard, OR 97224 Phone: 503.684.8000
Fax: 503.598.9479
INSPECTION PERFORMED
Quarterly ❑ Semi - Annual ❑ Annual
MONITORING ENTITY
Name: _ Type of Dialer:
Phone: Make:
Account #: Model #:
FIRE PANEL
Manufacturer: Radionics Model #: D7022
Circuit Styles: Class B # of initiating circuits or zones: 2
# of signaling circuits: 2
Primary Power: Nominal Voltage: 120V Amps: 1_5
Over Current Protection: Type: Breaker Amps: 15
Power Location (Panel Number): Building 16136- Circuit #5
Secondary / Standby: Battery Voltage: 12v Amp -Hr Rating: 7
Date Battery Installed: 5/23/07 Battery Condition: Good
Fire Alarm Inspection and Testing
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02/25/2008 MON 8:39 FAX 3608160482 GB Manchester a006/010
PANEL CONDITION
Good Bad N/A Comments
Lamps /LEDs ® ❑ ❑
Fuses ® ❑ ❑
Trouble Signal ® ❑ ❑
Disconnect Switches ❑ ❑
Ground -Fault Sup. ® ❑ ❑
Remote Annun. ❑ ❑
Additional Comments:
ALARM INITIATING DEVICES AND CIRCUIT INFORMATION
Device Qnty #Tested Pass Fail
Manual Station 4 4 ® ❑
Ion Detector _
-
❑ ❑
Photo Detector _ ❑ ❑
Duct Detector _ ❑ ❑
Heat Detector _ ❑ ❑
Waterflow Switch _ ❑ ❑
Supervisory Switch _ _ ❑ ❑
Other ❑ ❑
Other ❑ ❑
Other ❑ ❑
Fire Alarm Inspection and Testing
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02/25/2008 MON 8:39 FAX 3608160482 GB Manchester CJ007/010
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ALARM INDICATING DEVICES
Device Qnty # Tested Pass Fail
Hom /Strobe _ _ ❑ ❑
Strobe - - ❑ ❑
Speaker _ ❑ ❑
Speaker /Strobe _ ❑ ❑
Heat Detector _ ❑ ❑
Comments: (2) Exterior Bells.. (8) Interior Piezo's- All Work. NAC Panel is a
Bosch D7038.
ON / OFF PREMISES MONITORING
Signal Sent Yes No Comments
Alarm Signal ❑ ❑ NA
Alarm Restore ❑ ❑
Trouble Signal ❑ ❑
Trouble Restore ❑ ❑
Supervisory Signal ❑ ❑
Supervisory Restore ❑ ❑
SPECIAL PROCEDURES:
SYSTEM DEFICIENCIES / NOTES: None
Did system return to normal operation ? Yes ® No ❑
Comments:
This test was performed in accordance with NFPA standards.
Name of inspector Steve Urban
Signature: Date:
Name of owner or contact:
Signature: Date:
Fire Alarm Inspection and Testing
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