Fire System Sales Survey

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Contact Information:

  Sign

Fire Sprinkler Systems

• Is this facility sprinklered?

  Yes

  No

• Enter inventory for the following:

• Wet sprinkler risers

• Dry sprinkler risers

• Floor Control valve assembly (not counted in riser count)

• Antifreeze loops

• Pre action systems

• Deluge systems

• Hose valves (outlet count including those on standpipes)

• Standpipe riser count

• Fire department connections (FDC)

• Other Fire Sprinkler Information:

• Last Annual Test Date

  Date

• Photo

  Media

• Has the facility conducted 5 year inspections?

  Yes

  No

• Date of Last 5 Year Inspection:

Fire Pumps

• Is the facility provided with a fire pump?

  Yes

  No

• How many fire pumps are present?

• Type of fire pump(s)

• Size of fire pump(s)

• Are any of the fire pumps located not at grade and /or require special provisions to test?

  Yes

  No

• Please describe testing arrangements required

• Other Fire Pump Information:

• Last Annual Test Date

  Date

• Photo

  Media

Water Storage Tanks

• Is a fire water storage tank present at this site?<br>

  Yes

  No

• Enter size and type of water storage tank

• Last 5 Year Inspection

  Date

• Photo

  Media

Fire Alarm System

• Is a fire alarm system installed in this facility?

  Yes

  No

• Panel Make / Model

• Enter inventory for the following:

• Manual Pull Stations

• Smoke detectors

• Heat Detectors

• Heat detectors

• Beam detectors

• Duct detectors

• Water flow switches (include all including riser)

• Tamper switches (include all including riser, floor control and pump tampers)

• Pressure switches (ie dry riser flows)

• Horn

• Horn / Strobe

• Strobe

• Bell

• Other (list and describe)

• Are all of the above devices accessible from the floor level or with maximum 20 ft test pole?

  Yes

  No

• Describe what is not accessible from floor or with test pole:

• Can sensitivity testing of smoke detectors be done by the panel or must it be manually tested?

  Tested via Panel

  Manually Tested

• Other fire alarm system information:

• Last Annual Inspection

  Date

• Photo

  Media

Portable Fire Extinguishers

• Is client responsible for testing and inspection of portable extinguishers?

  Yes

  No

• Enter number of portable extinguishers at facility:

• Last Annual Inspection Date:

  Date

• Photo

  Media

Backflow Preventors

• Is client responsible for testing and inspection of Backflow preventers?

  Yes

  No

• Enter number of Backflow preventers at facility:

• Last Annual Inspection Date:

  Date

• Photo

  Media

Kitchen Hood Systems

• Are kitchen hood suppression systems installed at this facility?

  Yes

  No

• Is client responsible for testing and inspection of kitchen hood suppression systems?

  Yes

  No

• Enter number of kitchen extinguishing systems (control heads) at facility:

• Enter total number agent bottles:

• Enter total number links (if known):

• Last Semi-Annual Inspection Date:

  Date

• Photo

  Media

Emergency Lighting

• Is client responsible for testing and inspection of emergency lighting?

  Yes

  No

• Is the emergency lighting supplied by battery back up units or generator?

  Battery Units Only

  Generator Only

  Battery Units with Generator

  Rectifier System

• Enter number of battery lighting units at facility:

• Are the lighting units in individual circuits (ie one or more dedicated breakers serve the emergency lighting) or mixed so each light is tested at the unit?

  Dedicated Breaker

  On Common Circuit

  Mixed Arrangement

  Unknown

• Enter number of generators at facility:

• Last Annual Inspection Date:

  Date

• Photo

  Media

Special Agent Suppression Systems

• Is client responsible for testing and inspection of any clean / special agent systems?

  Yes

  No

• Enter description of systems present:

• Enter system configuration, number tanks, tank size etc.

• Do any of these systems have a dedicated releasing panel?

  Yes

  No

• Enter summary of devices on releasing panel:

• Last Semi-Annual Inspection Date:

  Date

• Photo

  Media

Facility Summary

• Enter description of facility and operations:

• How many buildings are included at this location under this report? Include proximity if multiple buildings are covered in this report.

• What are operating hours of facility?

• When can inspections be conducted and are there any restrictions?

• Are there any security restrictions or access control features that can delay inspections?

  No

  Yes

• Is any special training required for inspectors before entering this site?

  No

  Yes

• Describe training required:

• Enter facility drawing if available.

  Media

• Site Photo

  Media