Smoke Detector Inspection Checklist

• Location
  Address

• Conducted on

  Date

• Prepared by

Room/Unit

• Location

• Serial Number

• Is the smoke detector securely fastened to the wall or ceiling?

  Yes

  No

  N/A

• Does the smoke detector show no evidence of physical damage, paint application, or excessive grease and dirt accumulations?

  Yes

  No

  N/A

• What is the expiration date of the smoke detector's battery?

  Date

• Does the battery need replacement?

  Yes

  No

  N/A

• Date Replaced

  Date

• Who performed the replacement?

Testing of Detectors

• Have all Smoke Detectors in the installation been tested?

  Yes

  No

  N/A

• How many Smoke Detectors were tested?

• Have all detectors that were tested passed the operational test procedures?

  Yes

  No

  N/A

• How many Smoke Detectors were tested?

• Have all Smoke Detectors that failed the tests been replaced?

  Yes

  No

  N/A

• Is any further action required to meet compliance of these installations

  Yes

  No

  N/A

Next Due Date for Smoke Detector Inspection

• Your next test is due on:

  Date

Confirmation

• Further to the installation of smoke detectors at the listed address above, this compliance certificate is to confirm the installation of smoke detectors and state their installation and operational compliance, and that they have been hard wired to the electrical system in accordance with the above standards.

• Full Name and Signature of Inspector

  Sign