Smoke Alarm Yearly Test

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

General Inspection

• Does the property contain the correct number of smoke alarms? (At least one alarm on each level)

  Yes

  No

  N/A

• Are the smoke alarms installed in the correct location?

  Yes

  No

  N/A

• Are the smoke alarms securely fixed in place?

  Yes

  No

  N/A

Smoke Alarm 1

• Smoke alarm location

• Smoke alarm expiry date

• Hard Wired or Battery

  Hard Wired

  Battery

• 9 Volt battery replaced?

  Yes

  No

  N/A

• Smoke alarm complies with AS3786-1993

  Yes

  No

  N/A

• Smoke alarm cleaned and vaccummed?

  Yes

  No

  N/A

• Audible Test (Mains Power)

  Pass

  Fail

  N/A

• Audible Test (Battery / Battery Backup)

  Pass

  Fail

• Visual Test (Mains Power)

  Pass

  Fail

  N/A

• Visual Test (Battery / Battery Backup)

  Pass

  Fail

• Full function test using artificial smoke

  Pass

  Fail

• Insect surface spray applied to alarm surround?

  Yes

  No

  N/A

Smoke Alarm 2

• Smoke alarm location

• Smoke alarm expiry date

• Hard Wired or Battery

  Hard Wired

  Battery

• 9 Volt battery replaced?

  Yes

  No

  N/A

• Smoke alarm complies with AS3786-1993

  Yes

  No

  N/A

• Smoke alarm cleaned and vaccummed?

  Yes

  No

  N/A

• Audible Test (Mains Power)

  Pass

  Fail

  N/A

• Audible Test (Battery / Battery Backup)

  Pass

  Fail

• Visual Test (Mains Power)

  Pass

  Fail

  N/A

• Visual Test (Battery / Battery Backup

  Pass

  Fail

• Full function test using artificial smoke

  Pass

  Fail

• Insect surface spray applied to alarm surround?

  Yes

  No

  N/A

Smoke Alarm 3

• Smoke alarm location

• Smoke alarm expiry date

• Hard wired or battery

  Hard Wired

  Battery

• Smoke alarm complies with AS3786-1993

  Yes

  No

  N/A

• Smoke alarm cleaned and vaccummed?

  Yes

  No

  N/A

• Audible Test (Mains Power)

  Pass

  Fail

  N/A

• Audible Test (Battery / Battery Backup)

  Pass

  Fail

• Visual (Mains Power)

  Pass

  Fail

  N/A

• Visual Test (Battery / Battery Backup)

  Pass

  Fail

• Full function test using artificial smoke

  Pass

  Fail

• Insect surface spray applied to alarm surround

  Yes

  No

  N/A

Notes and recommendations

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