• Weekly/Monthly Fire Alarm Inspection Report

  • Document No.

  • UMMS Shore Medical Pavilion

  • 125 Shore Way Drive
  • Conducted on

  • Inspection Template Prepared by:

  • Personnel

General Information

  • Information on this form covers the minimum requirements of NFPA 72 (2013), Table 14.3.1 for visual inspections of fire alarms. Separate forms are available to inspect, test and maintain the rest of the fire protection system of which the fire alarm is a part.

  • UMMS Shore Medical Building

  • Ralph Lindner

  • Date of Inspection:

  • All responses refer to the current inspection performed on this date.

  • Fire alarm service vendor:

  • Fire alarm monitoring vendor:

Weekly Fire Alarm Inspection

  • Date of weekly inspection.

  • Control Equipment

  • 1) Fire alarm is powered?

  • 2) Fire alarm control panel and remote enunciator panels are unobstructed and accessible by emergency personnel?

  • 3) Lights and LEDs light when tested?

  • 4) Control panel is free of supervisory or trouble signals?

  • Record notes here.

  • Include photos here if necessary.

Monthly Fire Alarm Inspection

  • Date of monthly inspection.

  • 1) Batteries are free of corrosion and leakage?

  • 2) Battery connections are tight?

  • Date on battery is less than 5 years old?

  • Record notes here.

  • Include photos here if necessary.

Inspector's Information

  • Company: Colliers International

  • I state that the information on this form is correct at the time and place of inspection, and that all equipment tested at this time was left in operational condition upon completion of this inspection.

  • Add signature

  • Select date

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