MONTHLY FIRE PREVENTION INSPECTION Location INSPECTED BY: [DaTE: FIRE PROTECTION CONTROL VALVES (INSIDE & OUTSIDE) Tate] area Conmalied | Open] Stat | Supervised] Locked | Valve | Valve] diy _| Operating Mamber Condition | Readily | Evidence of| Wrench it Satisfactory| Accessible | Leakage | Place AUTOMATIC SPRINKLER SYSTEMS System # Air Dry Pipe | Pressure Systems Water Pressure Wet Pipe | System Systems |" Water Pressure Physicalcondition of all sprinkler system gauges satisfactory Yes ONo Physical condition of all sprinkler system alarm devices satisfactory Ores No “Alarm valves/dry pipe valves found to be in a good condition and free of any physical defects CYes Co PUBLIC WATER Public water supply in service Ges ONo Pressure: psi STANDPIPE & HOSE STATIONS “Are all standpipe or hose stations accessible Yes ONo Hose attached to outlet. Q¥es ONo Nozzle attached to hose QYes CNo Hose properly racked Yes No Protective caps in place (Yes CNo Paysical condition of all standpipe, hose stations, hose, noz les, valves and cabinets satisfactory O Yes ONoSMOKING ‘No Smoking Signs Posted in Restricted Areas C\YES C\NO Evidence of Unauthorized Smoking QYES ONO Proper Type of Butt Receptacles Porvided in Authorized Areas _O¥ES ONO FIRE EXTINGUISHERS All extinguishers accessible and clearly visible QYES ONO All tamper seals in place QYes ONO Was there any physical damage, corrosion, leakage, or clogged nozzles noted C1¥ES ONO Were all extinguishers checked to determine if full (check gauge) OyYes Ono FIRE ALARM SYSTEMS All fire alarm devices in service OYES ONO Physical condition of all fire alarm devices satisfactory YES ONO Are there any obstructions to smoke or heat detectors that would hamper operation CYES ONO Are all pull stations unobstructed and readily accessible YES ONO ELECTRICAL EQUIPMENT “re ail panel box cabinets clean OES ONO ‘Are all junction box covers in place OYES ONO Are all cabinet doors latched shut YES ONO Is there any temporary wiring ayes Ono Adequate clearance around electrical panels and transformers (minimum 36") ares Ono FLAMMABLE & COMBUSTIBLE LIQUIDS (including aerosols) ‘ll flammables properly stored in an approved cabinet or flammable liquids storage room Oyes ONO Quanities outside of aproved storsge area limited to one days use OYES ONO All flamables properly stored in approved containers __ Q¥YES_QNO ‘MISCELLANEOUS. ITEM ‘SATISFACTORY UNSATISFACTORY COMMENTS Housekeeping Proper storage of compressed gases Cutting/Welding controited| Missing ceiling tiles Accumulation of trash beneath dumpsters COMMENTS Comment on any unsatisfactory conditions:FIRE PREVENTION INSPECTION REPORT FIRE PROTECTION VALVES (List all insice and outside) VALVE ROMOER ‘VALVE LOGATIOW/AREA CONTROLS | _ { Were any sprinkler valves operated since last inspection? YES NO ws pws ut as mange ce? aoa anion npn iT OEE OTS 7 5 2 ae cece LE RES { EEF Ee eS wen | eee Za =— I = —— Wengine driven pump, is fuel supply atleast % ful? OQ YES ONO SPRINKLER SYSTEMS (wet, dy, deuge, pre-2etor) NoneeR —_|Tatane |nowna ronan] vave | acceumsvon | ves [vo | ves | vo COMMENTS ‘Storage within 18 inches of sprinkler heads? 1 YES) NO Sorinkler heads painied/loaded/covaded? __—. YES_) NO Adaiional comments:FIRE PREVENTION INSPECTION REPORT SPECIAL EXTINGUISHING SYSTEM (Halon, Ory Chemical, ofc) ‘ee system Cones LocaTion emus FIRE EXTINGUISHERS, INSIDE HOSE STATIONS, AND STANOPIPES: wweennce | accessiur [Pnoren TYP |aasiSeh fa] Comments vs [wo | wes [0] eS [no [ves [wo HYDRANT, HOSE HOUSES ve [ves | 80. YORANT LOCATION 'SMORETHEAT DETECTORS ANO MANUAL PULL STATIONS == i ‘Comments ee [se [| FIRE DOORS SHORING Signs posted in Evidence of smoking resticted areas? YES ONO _____| inresticted areas?_Q YES ONO FLANMABLE/COMBUSTIBLE LIQUIDS (holding aerosol) Stored in proper area? =. YES. NO Stored at proper height? C1 YES ONO Handling adequate? yes No TWSCELLANEOUS re SATISFACTORY | UNSATISFACTORY Comment Housekeeping oot Drainage. Bectical Wiing/Devices ‘Cating Weicing Controls Watch Service CommentsELECTRIC FIRE PUMP INSPECTION CHECKLIST INSTRUCTIONS: Alle pumps should be run and tested week. During plmp operation, record reauls for each weekly test tie appropiate column for at tom ited. fa need fo repairs or adjustments is covered during ihe weakly testing, they snould be made ‘mmediaioy, tollowing the manufacturer tineucions. Aways operate pumps or inutos ater repairs ta insur proper pump operation TMPORTANT Any pump aris noi lel inthe automatic sar mode al the endo eatels consdeved impaired, Reports condition o management and begin repairs immediatly. ‘CORRECT USE SPACES BELOW TO RECORD TEST RESULTS ITEMS USTED FOR TESTING READINGS | 1STWEEK | 2NOWEEK | aROWEEK | «THWEEK | STH WEEK | eTHWEEK 1_OATEFIRE PUMP TESTED [oayioater | | 2, TESTEDBY WHOM Youre 3.” MOTOR AUNNING TIME(S MINUTES engin of Ron [LE WecKUy MINIMUM ELECTRICAL inMirates ia, ain. min mmo. | ain ai | “_ SUCTION PRESSURE PSH I 5. OISCHARGE PRESSURE (PSI) 6_RPM(ATMAXMUM SPEED) 7._ PUMP ROOM TEMPERATURE Min. F * © F = = 6. FIRE PUMP AUTOMATICSTAAT PRESSURE SETTING PSI) | 10, JOCKEY PUMP SHUTS OFF AT(PSi I Ti. ARE STUFFING BOXGLANOS AT ‘stow [ves PROPER TIGHTNESS? AIP T i V2. START PUMP BY DROPPING PRESSURE ON | No lyes| nol ves| nol ves no|vesT no|ves| no i ot PRESSURE SENSING LINE (OPEN PET COCK ‘AND FLOW WATER). O10 PUMP START AUTO- MATICALLY ON PRESSURE OROP? 73. ID YOU ACTUALLY OBSERVE SUCTION ‘TANK OVERFLOW TOOETERMINE IF FULL? Va) WAS THE RUNNING AND POWER OFF PUMP ALARMS TESTED SATISFACTORY TO. (CENTRAL MONITORING STATION? I 15._WAS PUMP LEFT INFULLY AUTOMATIC ‘STARTING MODE ATENO OF TESTING ANOIS GAEEN“ONUGHT BURNING? I COMMENTS: Describe the nature of any protlama arcauntaed for ‘NO answers above and what was dane for carractin. Also stata ie and date tapas were completed and pump was cetures to complete operating sentces: The jockey pump shoud be sat to maniain pressure equal the tre pump ating plus Hale sucion pressure DS 10 pal The Wwe puma Smad Oe 501 start 10 pst less than she jockey pumo stan pressure, Reler ‘0 NEPA 20, Arto for guidance, INSPECTOR'S SIGNATURE ____ SUPER VIsUn Ss SIGNATURE eesesmsmeseesumer: * FILE FOR REVIEW : ¢ ATTACH TO FIRE PREVENTION INSPECTION REPORT *WEEKLY DIESEL FIRE PUMP INSPECTION CHECKLIST Date: yt. INSTRUCTIONS, All Ge pomp should be run and terted wecky. During pump operation, record results (or each weekly testi the appropriate column fr allitems listed. If need (or repairs o adjustments is decovered during the weekly testing, they should be made immediately, following the manutacture'riantrctions. Alvays operate pumps (or 5 minvtes alee repairs to insure proper pump operation. BPORTANT ‘Any pomp thats aot ef ia the automate start mode atthe ead of testis considered impared. 7 Report this condition to management and begia repairs immediately. ae ee ee ee CORRECT | RECORDED OPERATOR FTEMS LisTED FoR TESTING reapincs | resutts | _weme | namiats TLENGINE RUNTIME. OPERATE ALL INTERNAL COMBUSTION 30M ENGINES FOR ATLEAST 0 MINUTES WEERLY. weaty PUMP SUCTION PRESSURE CPS!) ! 2. PUMP DISCHARGE PRESSURE PSI) I “RPS (AT MAXINEMSPEED ) 1.01 PRESSURE - (SHOULD CONFORMTO MFO SPECS) RN Fs INVESTIGATE PROOLEM AND MAKE REPAIRS IF NECESSARY {COOLING WATER SUPPLY FOR THE HEAT EXCHANGER wacrban | YES RO Oneret [TAS (REGORO ENGINE GUAGE READING) AMP READING wtnon | + SHOULD BE 420 +5 AMPS AFTER 5 MINUTES RENO TME tien | — {CONDITION OF BATTERY CHARGER cucas | YES NO SEE ITEM 7 FORGUIDANCE) sucy FUEL TANKLEVEL (REED TANEFULL AF ALL TOMES TO sara | YES NO PREVENT CONDENSATION: Tera Te HECK OW. SICK TO DETERMINE LEVEL /CONDTHONOF ousue | YES NO CRANKCASE OX. ADD OW. WHENLEVEL AT ADD" MARIE onrurt TLPUMP ROOM (AMIENT) TEMPERATURE |_Mewoa® | IZ WATER AND OW: HEATER FOR ENGINE [5 OPERATING [Mia 70DeuF | _YES_NO a.cOOLING SYSTEM TENPERATU [ws bee | "M4 FIRE PUMP AUTOMATIC START PRESSURE SETTING (PSt), I T1SJOCKEY PUMP CONES OW AT( PSU) [ S16 JOCKEY PUMP SHUTS OFF AT PSE ! { WARE STUFFING DO GLANGS AT PROPER HONEST [som [ves No. {DID PUMP START AUTOMATICALY ON PRESSURE DROP? (OPEN PETCOCKAND FLOW WATER TO OROP PRESSURE SENSING UNE) W.ARE BATTERY COSNECTIONS FREE OFCORRONON@TIONT | zal 29.010 DIESEL START AUTOMATICALY ON a 8 BATTERIES WHEN Teste sereRATELY? 72LANTIFREEZE ADEQUATE IN COOUNG SYSTEM HEAT EXCHANGER? | I IL [O10 YOU ACTUALLY OBSERVE SUCTION TANKOVERALOW TO | aa |DIESEL FIRE PUMP INSPECTION CHECKLIST CONTINUED S-RONGING FO AND PORGP OFF ALARUG TESTED ATISTACTORLY TO CENTRAL MONTTDRING STATION? Tuas PUM EFT IN FULLY AUTOMATIC STARTING RODE END OTEST AND IS CREEN 09 (IGHT BURNING? The Jockey um shouldbe eo main restr Gul the We pomp ng lar a eon prs le 10 PL ‘he pp ond be rips ie an heey uy psi, Rl NAPA Acid ee COMMENTS: DESCRIBE THE NAUTREOF ANY PROBLEMS ENCOUNTERED FOR NO" ANSWERS ABOVE AND WHAT WAS DONE FOR ‘CORRECTION SUPERVISOR: