• Owner's Name and Phone Number:

  • Building

  • Date of Inspection:

  • Notes: 1) All questions are to be answered Yes, No, or Not Applicable. All NO answers are to be explained in Part III of this form. 2) Inspection, Testing and Maintenance are to be performed with water supplies (including fire pumps) in service, unless the impairment procedures of Chapter 11 of NFPA 25 are followed.

Part I - Owner's Section

  • A. Is the building occupied?

  • B. Has the occupancy classification and hazard or contents remained the same since the last inspection?

  • C. Are all fire protection systems in service?

  • D. Has the system remained in service without modification since the last inspection?

Part II - Inspector's Section

A. Inspections

1. Weekly Items

  • A. Control valves supervised with seals in correct (open or closed) position?

  • B. Backflow preventers:

  • 1. Valves in correct (open or closed) position?

  • 2. Sealed, locked or supervised and accessible?

  • 3. Any Leaks

  • C. Gauges in Good Condition?

  • D. All pipes in good condition?

C. Maintenance

Part III- Comments (Any "No" answers, test failures or other problems found with the sprinkler system must be explained here. Also, note here any products noticed on the system that have been the subject of a recall or a replacement program.)

  • Notes:

  • Pictures of any issues.

Part IV - Inspector's Information

  • Inspector's Name

  • Signature of Inspector and Date:

Backflow Preventer

  • Tested for NFPA 25 Requirements ONLY. Certification DOES NOT fall within the scope of this inspection.

Fire Alarm

  • Inspection & Certification is to be performed by an Alarm Contractor.

Fire Extinguisher(s)

  • Inspection & Certification is to be performed by Others.

NFPA 25 2008:4.1.5 "changes in Occupancy, Use, Process, or Materials"

  • The property owner or occupant shall not make changes in the occupancey, the use or the material used or stored in the building without evaluation of the fire protection systems for their capability to protect the new occupancy, use or materials.

NFPA 25 2008:4.1.6 "Addressing Changes in Hazard"

  • Where changes in the occupancy, hazard, water supply, storage commodity, storage arrangement, building modification, or other condition that affects the installation criteria of the system are identified, the property owner or occupant shall promptly take steps such as contacting a qualified contractor, consultant or engineer, and the authority having jurisdiction, to evaluate the adequacy of the installed system in order to protect the building or hazard in question.

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