Fire sprinkler inspection report checklist
Form for inspection, testing and maintenance of fire sprinkler systems
What does this form include?
This form contains 58 sections:
Owner's Name and Phone Number:
Owner's Address:
Property Being Inspected:
Property Address:
Date of Inspection: Date
This inspection is:
All responses refer to the current inspection performed on this date.
Notes: 1) All questions are to be answered Yes, No, or Not Applicable. All NO answers are to be expla
Part I - Owner's Section
- A. Is the building occupied?
- B. Has the occupancy classification and hazard or contents remained the same since the last inspection?
- C. Are all fire protection systems in service?
- D. Has the system remained in service without modification since the last inspection?
- E. Was the system free of actuation of devices or alarms since the last inspection?
Owner or Representative Printed Name:
Signature and Date:
1. Daily and Weekly Items
- A. Control valves supervised with seals in correct (open or closed) position?
B. Backflow preventers:
2. Monthly Inspection Items (in addition to the above items):
- A. Control valves with locks or electrical supervision in correct (open or closed) position?
- B. Sprinkler wrench with spare sprinklers?
- C. Gauges on wet-pipe system in good condition and showing normal water perssure?
- D. Alarm Valves: Gauges show normal supply water pressure, free from physical damage, valves in correct (open or closed) position and no leakage from retarding chamber or drains?
A. Pressure Reducing Valves:
3. Quarterly Inspection Items (in addition to the above items).
- 1. In open position and not leaking?
- 2. Maintaining downstream pressure per design criteria?
- 3. In good condition with hand wheels not broken?
- B. Hydraulic nameplate, if provided, securely attached to riser and legible?
C. Fire Department Connections:
(If plugs or caps are not in place, inspect interior for obstructions).
4. Annual Inspection Items (in addition to above items):
- A. Proper number and type of spare sprinklers?
B. Visible sprinklers:
C. Visible Pipe:
(If the answer was "NO," conduct an internal inspection).
5. Fifth Year Inspection Items (in addition to the above items):
- A. Alarm valves and their associated strainers, filters and restriction orifices passed internal inspection?
- B. Check vavles internally inspected and all parts operate properly, move freely and are in good condition?
The following tests are to be performed at the noted intervals. Report any failures on Part III of th
1. Quarterly Test:
- A. Mechanical waterflow alarm devices passed tests by opening the inspector's test connection or bypass connection with alarms actuating and flow observed?
- B. Post indicating valves opened until spring or torsion is felt in teh rod, then closed back one-quarter turn?
C. Main drain test for system downstream of backflow or pressure reducing valve:
1. Record static pressure and residual pressure. (PSI)
2. Semiannual Test (in addition to previous items):
- A. Valve supervisory switches indicate movement?
- B. Electrical waterflow alarm devices passed tests by opening the inspector's test connection or bypass connection with alarms actuating and flow observed?
A. Main drain test:
1. Record Static Pressure and Residual Pressure (PSI).
3. Annual Tests (in addition to previous items):
- 2. Was flow observed?
- 3. Are results comparable to previous test?
- B. Are all sprinklers in service dated 1920 or later?
- C. Fast response sprinklers 20 or more years old replaced or successfully sample tested within the last 10 years?
- D. Standard response sprinklers 50 or more years old replaced or successfully sample tested within last 10 years?
- E. Standard response sprinklers 75 or more years old replaced or successfully sample tested within the last 5 years?
- F. Dry-type sprinklers replaced or successfully sample tested within last 10 years?
- G. Specific gravity of antifreeze correct?
- H. All control valves operated through full range and returned to normal position?
- I. Backflow devices passed backflow test?
- J. Backflow devices passed full flow test?
- K. Pressure reducing valves passed partial flow test?
4. Test to be done every third year:
- A. Hose (more than 5 years old) connected to the system has been service tested in accordance with NFPA 1962. Water discharged and water flow alarms operated?
5. Test to be done every fifth year.
- A. Extra high, very extra high and ultra high temperature sprinklers tested?
- B. Gauges checked against calibrated gauge or replaced?
- C. Pressure reducing valves passed full flow test?
1. Regular Maintenance Items:
- A. If sprinklers have been replaced. Were they properly replaced?
- B. Used hose was cleaned, drained and dried before being placed back in service? hose exposed to hazardous materials was disposed of or decontaminated in an approved manner?
- C. Systems normally filled with fresh water were drained and refilled twice if raw water got into the system?
- D. If any of the following were discovered, was an obstruction investigation conducted and the system flushed?
Explain reason(s) and obstruction investigation findings in Part III.
1. Defective intake screen for pumps taking suction from open sources.
2. Obstructive material discharged during waterlfow tests.
3. Foreign materials found in dry-pipe valves, check valves or pumps.
4. Foreign material in water during drain test or plugging of inspector's test connection.
5. Plugging of pipe or sprinklers found during activation or alteration.
6. Failure to flush yard piping or surrounding public mains following new installation or repairs.
7. Record of broken mains in the vicinity.
8. Abnormally frequents false-tripping of dry-pipe valves.
9. System is returned to service after an extended period out of service (greater than one year).
10. There is reason to believe the system contains sodium silicate or its derivatives or highly corro
2. Annual maintenance items:
- A. Operating system of all OS&Y valves lubricated, completely closed, and reopened?
- B. Sprinklers and spray nozzles protecting commercial cooking equipment and ventilation systems replaced except for buld-type which show no signs of grease buildup?
Notes:
Inspector (Print Name):
Company:
Company Address:
Signature of Inspector and Date:
LIcense or certification number (if applicable):
I state that the information on this form is correct at the time and place of inspection, and that al
Tested for NFPA 25 Requirements ONLY. Certification DOES NOT fall within the scope of this inspection
Inspection & Certification is to be performed by an Alarm Contractor.
Inspection & Certification is to be performed by Others.
The property owner or occupant shall not make changes in the occupancey, the use or the material used
Where changes in the occupancy, hazard, water supply, storage commodity, storage arrangement, buildin
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