Fire Alarm Test & Inspection Certificate

• Document No:

• PO

• Customer

• Site Address

• Date

  Date

• Arrival Time

• Control Panel (Make, Model & QTY)

• System Device (Make, Model & QTY)

• Last Service Visit

  Date

• Next Service Visit

  Date

• % of system tested

  25%

  50%

  100%

• False Alarms over last 12 months

• No of False Alarms per 100 Automatic Fire Detectors per annum (Category M systems show N/A)

System Tested & Inspected

• Control Panel

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Not Inspected Reason

• Failed Action Required

• Passed Quantity

• Repeater Panel

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Not Inspected Reason

• Failed actions required

• Passed Quantity

• Check Fault Indication

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Not Inspected Reason

• Actions Required

• Battery

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Not Inspected Reason

• Failed Quantity

• Passed Quantity

• Battery Date Installed

• Area's Tested

• Call Point / Check Break Glass

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Failed Quantity

• Not Inspected Reason

• Smoke Detector

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Failed Quantity

• Not Inspected Reason

• Heat Detector

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Failed Quantity

• Not Inspected Reason

• Beam Detector

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Not Inspected Reason

• Failed Quantity

• Air Sampling

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Not Inspected Reason

• Failed Quantity

• Sounder Test

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Not Inspected Reason

• Failed Quantity

• Beacons

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Not Inspected Reason

• Failed Quantity

• Door Magnets

  Select Pass Fail Not Inspected N/A

  • Pass
  • Fail
  • Not Inspected
  • N/A

• Not Inspected Reason

• Failed Quantity

Remote Signalling

• Site Connected to ARC

  Yes

  No

• Linked to Fire Brigade

  Yes

  No

• Automatic Transmission of Alarm system to ARC

  Pass

  Fail

  Not Inspected

  N/A

• Not Inspected Reason

Documentation for Site / System

• Log book checked & updated

  Yes

  No

• Reason

• All Recorded Faults Rectified

  Yes

  No

  N/A

• Outstanding Faults

• Zone Chart Present & up to Date

  Yes

  No

• Reason

Battery Functions

• System Standby Period - Hrs

• System Quiescent - mA

• System Current in Full Alarm - mA

• Battery Size Required - Ah

• Battery Size - Ah

Remedial

• Parts used on site at time of visit

• Recommendations

• I being the competent person(s) responsible for the servicing of the Fire Detection & Fire Alarm Systems of the type identified above, certify that the maintenance work identified above complies with the recommendations of BS 5839 except for the variations if any stated in this certificate.

• Variations from the recommendations of clause 45 of BS 5839-1 for periodic or annual inspection and test

Signature

• Engineers Signature

  Sign

• Customer Signature

  Sign

• Position