Next Protection REV 4.5.18

SITE INFORMATION

• Conducted on

  Date

• Site Name

• Site Address
  Address

• Property Management Company

• Contact Name and Number

• Contact email

• Approximate square footage? Is the building more than one floor? If so, how many stories tall? Are there elevators?

TECHNICIAN INFORMATION

• Prepared by

• Did you speak with the contact?

  Yes

  No

• Type of Property

  Select Medical Multi-Family Industrial Self Storage Office Other

  • Medical
  • Multi-Family
  • Industrial
  • Self Storage
  • Office
  • Other

• Other

SPRINKLER SYSTEM INFORMATION

• Does the building have a fire sprinkler system?

  Yes

  No

• How many risers are there?

  1

  2

  3

  4

  +

• Quantity:

• Do the risers have inspection tags?

  Yes

  No

• Last Inspected on:

  Date

• Inspection Company:

• Estimated time for annual Fire Sprinkler Inspection:

• Notes:

FIRE ALARM SYSTEM INFORMATION

• Does the building have a fire alarm system?

  Yes

  No

• Current Dealer / Service Company:

• Current Central Station:

• What type of system?

  Conv.

  Addr.

  Other

• Other: Please specify.

• Panel type Manufacturer and Model Number

• FACP Location and Access Information:

• Does the panel have inspection tags?

  Yes

  No

• Date of last Inspection:

  Date

• Inspection Company:

• Estimated time for annual Fire Alarm Inspection.

• How does the system communicate?

  AES

  GSM - Cellular

  Phonelines

  Other

• Other: Please specify.

• What is the Zone List?

• Notes:

SECURITY SYSTEM INFORMATION

• Is there a security system at this site?

  Yes

  No

• What is the Panel Type / Location?

• How does the system communicate?

  AES

  GSM - Cellular

  Phonelines

  Other

• Other: Please specify.

• Current Dealer / Service Company:

• Current Central Station:

• Does the system have remote management / interaction?

  Yes

  No

• Does this system have multiple partitions?

  Yes

  No

• How many?

• Notes:

ACCESS CONTROL SYSTEM INFORMATION

• Is there an access control system?

  Yes

  No

• What is the Panel Type / Model / Location?

• How is the system currently managed?

• How many doors does the system have? (are there multiple panels?)

• Notes:

SURVEILLANCE SYSTEM INFORMATION

• Is there a surveillance system?

  Yes

  No

• What type of system is it?

  Analog

  IP

  Other

• Other: Please specify.

• DVR / NVR Model and Location?

• Is the system viewed on site or off site?

  On Site

  Off Site

  Both

• Is it Monitored off site? If so, where?

• How many cameras?

• Is there more than one DVR / NVR on site?

• Notes:

OTHER SERVICES TO PURSUE

• Select other items to pursue.

  Select Extinguishers E-Lights Backflows Hood Systems Hydrants

  • Extinguishers
  • E-Lights
  • Backflows
  • Hood Systems
  • Hydrants

• List applicable device counts:

• Please upload any photos that will be helpful.

  Media

NOTES

• Please add any notes that will be helpful.

• Please export, review and email this document to surveys@nextprotection.net