Title Page

  • Document No.

  • Conducted on

  • Area

  • Prepared by


  • Rated walls are properly labeled

  • All penetrations are sealed

  • Fire caulking installed

Fire Sprinkler

  • Piping is properly supported

  • Sprinkler piping not supported any wires, conduits, cabling, etc.

  • Drains installed where required

Plumbing / HVAC Piping

  • Piping is properly labeled

  • Valve tags are installed

  • Pipe insulation correct and complete

  • Insulation shields installed

  • Graded piping properly sloped

  • Piping properly supported

  • Seal pipes through floors and walls

  • Valves are operable and accessible

  • Med gas piping isolated from other materials

  • Framing for access doors

  • Roof drain bodies are properly insulated

  • High point vents and low point drains installed

  • Drain pans installed and piped where required

  • All piping tested and inspected


  • Service clearance for equipment

  • Fire and fire / smoke damper access doors installed and labeled

  • Wall angles installed around dampers

  • Insulation properly terminated at fire and fire / smoke dampers

  • Breakaway connection at damper correct

  • Duct insulation correct and complete

  • Duct is properly supported

  • Damper quadrants installed and marked

  • Equipment identification installed

  • All systems tested and inspected


  • Equipment and boxes properly labeled

  • Box knockout seals installed

  • Covers installed on boxes

  • Conduit bushings installed

  • Conduit, boxes, and fixtures installed and supported

  • Ground wire installed in boxes

  • Boxes are accessible

Low Voltage

  • Wiring is properly supported

  • Wiring is not touching sprinkler piping

  • Wiring has been properly terminated

  • Photos

  • Add media


  • NRMC Engineering Department

  • Painter

  • Life Safety for Sprinkler Piping

  • HVAC for Piping

  • Electrician

  • Phone/Data

Failed Items / Action Plan

  • Painter

  • Life Safety

  • HVAC

  • Electrician

  • Phone/Data

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. You should independently determine whether the template is suitable for your circumstances.