General Information

  • Information on this form covers the minimum requirements of NFPA 25 (2014) Chapter 13, for visual inspections of fire sprinkler and standpipe components. Separate forms are available to inspect, test and maintain the rest of the fire protection system of which the fire alarm is a part.

  • Building Name

  • Add location
  • Date of Inspection:

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

  • Fire sprinkler service vendor:

Monthly Inspection

  • Valves

  • 1) Control valves are in their normal open position?

  • 2) Alarm valves and test valves are in their normal closed position?

  • 3) Control valves are locked in the open position or are electronically supervised?

  • 4) Valves are free of leaks or damage?

  • 5) Valves are marked with appropriate identification sign?

  • 6) Fire department connection is accessible, properly marked, with caps in place.

  • Gauges

  • 1) Gauges show normal water pressures?at

  • 2) Gauges are free of leaks or damage?

  • Record notes here.

  • Add photos here if necessary.

Inspector's Information

  • Company: MacKenzie Services

  • 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

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. Any ratings or scores displayed in our Public Library have not been verified by SafetyCulture for accuracy. Users of our platform may provide a rating or score that is incorrect or misleading. You should independently determine whether the template is suitable for your circumstances. You can use our Public Library to search based on criteria such as industry and subject matter. Search results are based on their relevance to your search and other criteria. We may feature checklists based on subject matters we think may be of interest to our customers.