HomeMy WebLinkAboutInspection - MB Properties - 06-16-2014Phone: 763-595-4300
7625 Boone Avenue North Service Fax: 763-595-4346
Brooklyn Park, MN 55428 www.eganco.com
INSPECTION AND TESTING FORM
Date:6/16/2014
SERVICE ORGANIZATION PROPERTY NAME (user)
Name:Egan Company Name:M.B. Properties
Address:7625 Boone Ave N, Brooklyn Park, MN 55428 Address:8251 Main St NE & 100 83rd Ave NE Fridley, MN
Representative:Blong Vang Owner Contact:
License No. :Telephone :763-786-4779
Telephone:
MONITORING ENTITY SPECIAL PROCEDURES
Contact:USA Central Station Place both Accounts on test
Telephone:(866) 914-1966
Monitoring Acct Ref No. :49-1276-1, 49-1276
PANEL INFORMATION INSPECTION
Control Unit Manufacturer:Silent Knight Weekly
Model No. :5207 Monthly
Circuit Styles:B Quarterly
No.of Circuits:6 Semi Annually
Software Rev:X Annually
Other (Specify)
SYSTEM POWER SUPPLIES
(a)Primary (main):Nominal Voltage:120 Amps Amps
Overcurrent Protection Type:Breaker 20 Amps
Location (of primary Suppy Panelboard):Mechanical Room
Diconnecting Means Location:House Panel #2 / Circuit Breaker #9
(b)Secondary (Standby)
2 @ 12Vdc Storage Battery Amp - Hr Rating 7 Ah
Calculated capacity to operate system, in hours:
Engine-driven generator dedicated for fire alarm system
Location of fuel storage:
(c)Battery Type:Sealed Leaad Acid
ALARM-INITIATING DEVICES AND CIRCUIT INFORMATION ALARM NOTIFICATION APPLIANCES AND CIRCUIT INFORMATION
Quantity Quantity
Manual Fire Alarm Boxes Horns
Ion Detectors Horn/Strobes
Photo Detectors Chimes/Strobes
Duct Detectors Strobes Only
Heat Detectors Speakers / Strobes
2 Waterflow Switches Door Holders
2 Supervisory Switches
Low Air
Dry Flow
Beam Detectors Are circuits monitored for integrity?:Yes
2 Low Temp No. of alarm notification appliance circuits:
Alarm verification feature is Enabled
MODIFIED 05/06/2013
Phone: 763-595-4300
7625 Boone Avenue North Service Fax: 763-595-4346
Brooklyn Park, MN 55428 www.eganco.com
INSPECTION AND TESTING FORM
SUPERVISORY SIGNAL-INITIATING DEVICES AND CIRCUIT INFORMATION
Quantity Circuit Style
Site Water Temp
Site Water Level
Fire Pump Power
Fire Pump Running
Fire Pump Auto Position
Fire Pump or Pump Controller Trouble
Other
SIGNALING LINE CIRCUITS
Quantity and style of signaling line circuits connected to system (see NFPA 72, Table 6.6.1):
Quantity:Style(s):
PRIOR TO ANY TESTING
NOTIFICATIONS ARE MADE Who Time
Monitoring Entity :Yes
Building Occupants :Yes
Building Management :Yes
Other (Specify) :
AHJ Notified of Any Impairments :
SYSTEM TESTS AND INSPECTIONS
Type Visual / Functional Comments
Control Unit Functional
Interface Equipment
Lamps/LEDS Functional
Fuses
Primary Power Supply Functional
Trouble Signals Functional
Disconnect Switches Functional
Ground-Fault Monitoring Functional
SECONDARY POWER
Type Visual / Functional Comments
Battery Condition Visual Date 06-2012
Load Voltage Functional
Discharge Test Functional
Charger Test Functional
Specific Gravity
TRANSIENT SUPPRESSORS
REMOTE ANNUNCIATORS
NOTIFICATION APPLIANCES
Audible
Visible
Speakers
Voice Clarity
MODIFIED 05/06/2013
Phone: 763-595-4300
7625 Boone Avenue North Service Fax: 763-595-4346
Brooklyn Park, MN 55428 www.eganco.com
INSPECTION AND TESTING FORM
SUPERVISORY SIGNAL-INITIATING DEVICES AND CIRCUIT INFORMATION
Please use U.L. Device List / Initial Signal Test Form
EMERGENCY COMMUNICATIONS EQUIPMENT COMMENTS
Phone Set
Phone Jacks
Off-Hook Indicator
Amplifier(s)
Tone Generator(s)
Call-in Signal
System Performance
Comments:
SUPERVISING STATION MONITORING Time Comment
Alarm Signal Yes
Alarm Restoration Yes
Trouble Signal Yes
Supervisory Signal Yes
Supervisory Restoration Yes
NOTIFICATIONS THAT TESTING IS COMPLETE Time Who
Building Management X
Monitoring Agency X
Building Occupants X
Other (Specify)
The following did not operate correctly:
System restored to normal operation:
6/16/2014 Date Time:10:00:00
THIS TESTING WAS PERFORMED IN ACCORDANCE WITH APPLICABLE NFPA STANDARDS.
Egan Technician Name:Blong Vang Date:6/16/2014
Signature:
Owner/Representative Name:Date:
Signature:
Fire Dept Representative Name:Date:
MODIFIED 05/06/2013