Harris Security Fire Alarm System Test and Inspection

• Document No.

• Customer Name

• Inspection Address
  Address

• Inspection Conducted on

  Date

• Prepared by

• Personnel Assisting with Inspection/Test

• This form is to be completed by the system inspection and testing contractor at the time of a system test.
  
  It shall be permitted to modify this form as needed to provide a more complete and/or clear record.
  
  Insert N/A in all unused lines. Attach additional sheets, data, or calculations as necessary to provide a complete record.

• Inspection/Test Start Date/Time:

  Date

Property Information

• Name of Property:

• Address:
  Address

• Description of Property:

• Example: "40-story high-rise building with an adjacent 1-story parking structure."

• Name of Property Representative:

• Is Property Representative address the same as property address?

  Yes

  No

  N/A
• Property Representative Address:
  Address

• Phone:

• Email:

Testing Organization

• Harris Security Systems, Inc
  2780 US Hwy 231 S
  Ozark, AL 36360
  1-800-240-1717

• License Information:
  AESBL Number: AL-190
  Georgia: LVA205039
  Florida: EF20000473
  Alabama: GC 27363

Monitoring Information:

• Is system monitored off-site?

  Yes

  No

  N/A

• Monitoring Organization:

• Address:

• Phone:

• Account Number:

• Means of Transmission:

  Dual POTS Lines

  Sole-Path Cellular

  Cellular/POTS

  IP Dialer

• Phone Line 1:

• Phone Line 2:

• POTS Line Phone Number:

• Entity to which alarms are retransmitted (Dispatcher):

• Phone Number:

Documentation

• On-site location of the required record documents and site-specific software:

Description of System or Service

Control Unit

• Manufacturer:

• Model Number:

• Firmware revision number:

System Power

Primary Power:

• Nominal Voltage:

• Amps:

• Breaker Location:

• Circuit Number:

Secondary Power:

• Type:

  Sealed Lead Acid Battery

  Generator

  UPS

  Other

• Calculated capacity of batteries to drive the system:

• In standby mode (hours):

• In alarm mode (minutes)

• Specify:

Notifications Made Prior to Testing?

• Monitoring Organization

• Contact:

• Time:

• Building Management

• Contact:

• Time:

• Building Occupants

• Contact:

• Time:

• Authority Having Jurisdiction

• Contact:

• Time:

• Other

• Contact:

• Time:

Testing Results

Control Unit and Related Equipment

Control Unit

• Generate an alarm condition on the panel.

• Did panel properly display alarm condition?

  Yes

  No

  N/A

• Did NAC (Notification Appliance Circuits) operate on alarm condition?

  Yes

  No

  N/A

• Generate a supervisory condition on the panel.

• Did panel properly display supervisory information?

  Yes

  No

  N/A

• Generate a trouble condition on the panel.

• Did panel properly display trouble information?

  Yes

  No

  N/A

• Create an open on a NAC circuit, introduce a ground fault, and remove an initiating device to verify each.

• Are circuits properly supervised for opens, ground faults, and missing devices?

  Yes

  No

  N/A

• Turn off AC power at the circuit breaker to verify that panel reports the trouble. After restoring AC power, disconnect the batteries to verify supervision of secondary power. Reconnect batteries and ensure trouble clears.

• Is incoming power properly supervised?

  Yes

  No

  N/A

• Passed (Can only pass if all functions responded properly)

Lamps/LEDs/LCDs

• Perform a lamp test on the system.

• Do all lamps, LEDs, LCD displays, etc. function?

  Yes

  No

  N/A

• Passed (Can only pass if all lamps, LEDs, LCDs, etc. worked)

Fuses

• Verify rating of all fuses to ensure they match manufacturers recommendation.

• Passed (Fuses must comply with manufacturer's recommendation)

Annunciators

• How many remote annunciators are on the system? (If there are 4 or more, select 4)

• Location of remote annunciator 1:

• Did remote annunciator 1 properly display panel status?

  Yes

  No

  N/A

• Location of remote annunciator 2:

• Did remote annunciator 2 properly display panel status?

  Yes

  No

  N/A

• Location of remote annunciator 3:

• Did remote annunciator 3 properly display panel status?

  Yes

  No

  N/A

• Include notes about locations and testing of additional annunciators.

• Passed (Can only pass if all annunciators functioned properly)

• All functions of the Control Unit and Related Equipment met performance requirements.

• Documented deficiencies

Secondary Power

• Main Control Panel

• Nominal Amp-Hours

• Charger Test: With batteries fully charged and connected to the panel, check voltage across the batteries with a voltmeter. Voltage SHALL be between 27.36 and 27.84 VDC, or as specified by equipment manufacturer. If using equipment manufacturer specifications, list reference documentation in comments.

• Was voltage within acceptable range?

  Yes

  No

  N/A

• Test each battery with the company-provided ELK battery tester. Result SHALL be greater than 71% of original Reference Reading (Current reading/Reference reading). If this is a new installation, record Mhos result on the battery label as the Reference Reading.

• Voltage of battery 1:

• 1. Recorded reference Mhos of battery 1:

• 2. Mhos of battery 1:

• Divide Box 2. by Box 1. Multiply result by 100.

• Result is greater than 71%

• Voltage of battery 2:

• 1. Recorded reference Mhos of battery 2:

• 2. Mhos of battery 2:

• Divide Box 2. by Box 1. Multiply result by 100.

• Result is greater than 71%

• Remote Power Panel(s)

• How many remote power panels are on the system?

• Remote Power Panel 1

• Location of Remote Power Panel 1

• Nominal Amp-Hours

• Charger Test: With batteries fully charged and connected to the panel, check voltage across the batteries with a voltmeter. Voltage SHALL be between 27.36 and 27.84 VDC, or as specified by equipment manufacturer. If using equipment manufacturer specifications, list reference documentation in comments.

• Was voltage within acceptable range?

  Yes

  No

  N/A

• Test each battery with the company-provided ELK battery tester. Result SHALL be greater than 71% of original Reference Reading (Current reading/Reference reading). If this is a new installation, record Mhos result on the battery label as the Reference Reading.

• Voltage of battery 1:

• 1. Recorded reference Mhos of battery 1:

• 2. Mhos of battery 1:

• Divide Box 2. by Box 1. Multiply result by 100.

• Result is greater than 71%

• Voltage of battery 2:

• 1. Recorded reference Mhos of battery 2:

• 2. Mhos of battery 2:

• Divide Box 2. by Box 1. Multiply result by 100.

• Result is greater than 71%

• Remote Power Panel 2

• Location of Remote Power Panel 2

• Nominal Amp-Hours

• Charger Test: With batteries fully charged and connected to the panel, check voltage across the batteries with a voltmeter. Voltage SHALL be between 27.36 and 27.84 VDC, or as specified by equipment manufacturer. If using equipment manufacturer specifications, list reference documentation in comments.

• Was voltage within acceptable range?

  Yes

  No

  N/A

• Test each battery with the company-provided ELK battery tester. Result SHALL be greater than 71% of original Reference Reading (Current reading/Reference reading). If this is a new installation, record Mhos result on the battery label as the Reference Reading.

• Voltage of battery 1:

• 1. Recorded reference Mhos of battery 1:

• 2. Mhos of battery 1:

• Divide Box 2. by Box 1. Multiply result by 100.

• Result is greater than 71%

• Voltage of battery 2:

• 1. Recorded reference Mhos of battery 2:

• 2. Mhos of battery 2:

• Divide Box 2. by Box 1. Multiply result by 100.

• Result is greater than 71%

• Remote Power Panel 3

• Location or Remote Power Panel 3

• Nominal Amp-Hours

• Charger Test: With batteries fully charged and connected to the panel, check voltage across the batteries with a voltmeter. Voltage SHALL be between 27.36 and 27.84 VDC, or as specified by equipment manufacturer. If using equipment manufacturer specifications, list reference documentation in comments.

• Was voltage within acceptable range?

  Yes

  No

  N/A

• Test each battery with the company-provided ELK battery tester. Result SHALL be greater than 71% of original Reference Reading (Current reading/Reference reading). If this is a new installation, record Mhos result on the battery label as the Reference Reading.

• Voltage of battery 1:

• 1. Recorded reference Mhos of battery 1:

• 2. Mhos of battery 1:

• Divide Box 2. by Box 1. Multiply result by 100.

• Result is greater than 71%

• Voltage of battery 2:

• Recorded reference Mhos of battery 2:

• 2. Mhos of battery 2:

• Divide Box 2. by Box 1. Multiply result by 100.

• Result is greater than 71%

• Additional remote power panels

• Attach photo of supplemental forms documenting additional remote power panels.

  Media

• All Secondary Power Sources met inspection criteria.

• Documented deficiencies:

Alarm and Supervisory Alarm Initiating Device

• Test all initiating devices. While performing this portion of the inspection, verify all required life safety functions (i.e. air handler shutdown, door holder release, elevator recall, magnetic locks release, etc.).

• All Alarm and Supervisory Alarm Initiating Devices performed as required.

• Documented deficiencies:

• All life safety functions (Interface Components) functioned as required.

• Documented deficiencies:

• Attach photo of supplementary device test sheets for all initiating devices.

  Media

Notification Appliances

• While the system is in an alarm condition, and NOT silenced, check operation of all notification appliances.

• All Notification Appliances functioned as required.

• Documented deficiencies:

Supervising Station Monitoring

• Is the system monitored off-site?

• Alarm signal received?

  Yes

  No

  N/A

• Time received:

• Alarm Restoration received?

  Yes

  No

  N/A

• Time received:

• Trouble signal received?

  Yes

  No

  N/A

• Time received:

• Trouble restoration received?

  Yes

  No

  N/A

• Time:

• Supervisory signal received?

  Yes

  No

  N/A

• Time:

• Supervisory restoration received?

  Yes

  No

  N/A

• Time:

Notifications that testing is complete

• Monitoring Organization

• Contact:

• Time:

• Building Management

• Contact:

• Time:

• Building Occupants

• Contact:

• Time:

• Authority Having Jurisdiction

• Contact:

• Time:

• Other

• Contact:

• Time:

System Restored To Normal Operation

• System Restored to Normal Operation at:

  Date

Certification

• This system as specified herein has been inspected and tested according to NFPA 72, 2013 edition, Chapter 14.

• Inspector's Signature

  Sign

• Date:

  Date

• Organization:

• Title:

• Phone:

• Inspector Qualifications (refer to NFPA 72, Section 10.5.3)

Defects or Malfunctions Not Corrected at Conclusion of System Inspection, Testing, or Maintenance

• Were there any deficiencies not already documented?

  Yes

  No

  N/A

• Deficiencies not noted elsewhere:

Acceptance by Owner or Owner's Representative:

• Is the Owner or his/her designated representative available for signature?

  Yes

  No

  N/A

• The undersigned accepted the test report for the system as specified herein:

  Sign

• Date:

  Date

• Organization:

• Title:

• Phone:

Photos

• Take photo of panel displaying System Normal at conclusion of inspection (ensure that Inspection sticker is visible in photo). Attach photos documenting any deficiencies.

  Media