FIRE ALARM SYSTEM INSPECTION

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Mercy Lindsey
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1 13555 Wellington Center Circle Suite 123 Gainesville, VA T: F: FIRE ALARM SYSTEM INSPECTION Upon arrival, contact Vector Security Service to be logged on site & placed on test Job Number Date Store # Panel Brand/Model Firmware Rev # Fire Panel-Line 1 Verified as working? Security Panel # Fire Panel Line-2 Verified as working Verified as working? Is the Fire Panel communicating via the Network? What time is the Daily Test Timer being received? Does the store have keys to the Pull Stations? Does the Store have a Knox Box? Does the Store have an elevator? Is it tied into the System? Does the Store have a Water Tank? If yes, ensure each fire point is tested! Duct Detector Information-Check all that apply: Above or Below roofline? Return Side: Installed? Alarm Supv? Shtdwn Only? Trble Supv? HVAC Supply Side: Installed? Alarm Supv by FACP? Trble Supv by FACP? HVAC Shtdwn Only? RTS Switches Installed? Do RTS require keys? Are RTS keys on site? Powered By: RTU Unit Vector Power Supply VSI Technician Co. Name Fire Lic. # 1. After performing the inspection, complete the Fire Inspection Report, and affix the Fire Tag to the Fire Can. 2. Place a copy of the completed Report in the Fire Can. 3. Take a photograph the Fire Can showing the Report and the Fire Tag affixed. 4. Submit the completed Report and the photograph of the tagged system to VSI Inspection Department. Reports must be ed (nadinspections@vectorsecurity.com)/faxed from site to: same day as inspection Vector Security is a registered trademark of Vector Security, Inc. Licenses: AK ; AL AESBL , 44814; AR E ; AZ ROC218982; CA ACO 6152, ; DE ; FL EF , EF , EF , EF , EF ; HI C 27082; LA F 317, 54974; MA 1594 C; NC 2313-CSA; ND 37153; NJ, 13VH , Fire Alarm, Burglar Alarm and Locksmith Business Lic. # 34AL ; NV F 437, ; NY ; OH ; OK 559; PA PA004997; RI 30394, AFC-0449; TN 0444, 1341, 1551, 1552; TX B11645; UT ; VA DCJS # ; WA VECTOSI957PE; WV WV Additional license information available at

2 SYSTEM RECORD OF INSPECTION AND TESTING This form is to be completed by the system inspection and testing contractor at the time of a system test. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Attach additional sheets, data, or calculations as necessary to provide a complete record. Inspection/Test Start Date/Time: Supplemental Form(s) Attached: (yes/no) Inspection/Test Completion Date/Time: 1. PROPERTY INFORMATION Name of property: property: Name of property representative: Fax: of 2. TESTING AND MONITORING INFORMATION Testing organization: Fax: Monitoring organization: Fax: Account number: Phone line 1: Phone line 2: Means of transmission: Entity to which alarms are retransmitted: 3. DOCUMENTATION On-site location of the required record documents and site-specific software: 4. DESCRIPTION OF SYSTEM OR SERVICE 4.1 Control Unit Manufacturer: Model number: 4.2 Software and Firmware Firmware revision number: 4.3 System Power Primary (Main) Power Nominal voltage: Amps: Location: Overcurrent protection type: Amps: Disconnecting means location: (p. 1 of 4)

3 4. DESCRIPTION OF SYSTEM OR SERVICE (continued) Secondary Power Type: Location: Battery type (if applicable): Calculated capacity of batteries to drive the system: In standby mode (hours): In alarm mode (minutes): 5. NOTIFICATIONS MADE PRIOR TO TESTING Monitoring organization Contact: Time: Building management Contact: Time: Building occupants Contact: Time: Authority having jurisdiction Contact: Time: Other, if required Contact: Time: 6. TESTING RESULTS 6.1 Control Unit and Related Equipment Visual Inspection Functional Test Comments Control unit Lamps/LEDs/LCDs Fuses Trouble signals Disconnect switches Ground-fault monitoring Supervision Local annunciator Remote annunciators Remote power panels 6.2 Secondary Power Visual Inspection Functional Test Comments Battery condition Load voltage Discharge test Charger test Remote panel batteries (p. 2 of 4)

4 6. TESTING RESULTS (continued) 6.3 Alarm and Supervisory Alarm Initiating Device Attach supplementary device test sheets for all initiating devices. 6.4 Notification Appliances Attach supplementary appliance test sheets for all notification appliances. 6.5 Interface Equipment Attach supplementary interface component test sheets for all interface components. Circuit Interface / Signaling Line Circuit Interface / Fire Alarm Control Interface 6.6 Supervising Station Monitoring Yes No Time Comments Alarm signal Alarm restoration Trouble signal Trouble restoration Supervisory signal Supervisory restoration 6.7 Public Emergency Alarm Reporting System Yes No Time Comments Alarm signal Alarm restoration Trouble signal Trouble restoration Supervisory signal Supervisory restoration (p. 3 of 4)

5 7. NOTIFICATIONS THAT TESTING IS COMPLETE Monitoring organization Contact: Time: Building management Contact: Time: Building occupants Contact: Time: Authority having jurisdiction Contact: Time: Other, if required Contact: Time: 8. SYSTEM RESTORED TO NORMAL OPERATION Date: 9. CERTIFICATION Time: This system as specified herein has been inspected and tested according to NFPA 72, 2013 edition, Chapter 14. A copy of this report is to be left in the panel can at the conclusion of this inspection. Signed: Printed name: Date: Organization: Title: Qualifications (refer to ): 10. LIST ALL DEFECTS OR MALFUNCTIONS NOT CORRECTED AT CONCLUSION OF SYSTEM INSPECTION, TESTING, OR MAINTENANCE 10.1 Acceptance by Owner or Owner s Representative: The undersigned accepted the test report for the system as specified herein: Signed: Printed name: Date: Organization: Title: (p. 4 of 4)

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