Fire Alarm Testing and Inspection Report
Fire Alarm Testing and Inspection Report Property Name:
PELICAN ISLE II
Fire Dept:
Property Address:
435 DOCKSIDE RD. NAPLES, FLORIDA 34110
Property Manager:
BILL WALLICK
Contact:
one)
(select
Result:
NORTH NAPLES FIRE DEPT
Inspector:
PABLO AGUERO
Phone Number:
239-287-6608
Contract No.:
Central Station:
SIMPLEXGRINNELL
Date:
07-06-16
Phone Number:
1-888-746-7539
Account #:
103-1701
Service Period:
Monthly
Quarterly
Semi-Annual
✔
Annual
Five-Year
Comments
1)SMOKE DET M1-55 4TH FL IN SE MECHANICAL RM DID NOT GO INTO ALARM WHEN TESTED. NEEDS TO BE REPLACED.
Date: 07-06-16
Inspector Signature: PABLO AGUERO
Customer Name:
Customer Sigature:
Rev #7 10-08-14
1 of 5
Rotation & Communicator Service Period
Communication Type
Weekly
McCulloh
Monthly
Multiplex
Quarterly
✔ Digital
Semi-Annual
Reverse Polarity
✔ Annual
RF
Other (specify)
Manufacturer: Model:
Other (specify)
Control Panel
Circuit Style:
SIMPLEX
Number of Circuits:
4100-8201
Software Rev:
4&Y
Last Date of Service:
09-02-20
Last Date Software or Configuration Changed:
2 MAPNET 27 NACS 06/2016
10-11-15
Alarm Notification Appliances and Circuit Information Quantity
Circuit Style
Bells Horns Strobe
2
Y
Horn Strobe
67
Y
125
Y
Chime Speakers Other Number of NAC Circuits:
27
Are Circuits Monitored for Integrity?:
YES
Alarm-Initiating Devices and Circuit Information Quantity
Circuit Style
51
4
Photo Detectors
48
4
Duct Detectors
20
4
Heat Detectors
2
4
Water Flow Switches
15
4
Supervisory Switches
18
4
Pull Stations Ion Detectors
Other (Specify):
Signaling Line Circuits Quantity and Style (See NFPA 72, Table 3-6) of Signaling Line Circuits connected to System: Quantity:
Rev #7 10-08-14
2
Style:
4
2 of 5
Alarm Notification Appliances and Circuit Information Quantity
Circuit Style
Still Water Temp Site Water Level Fire Pump Power Fire Pump Running Fire Pump Auto Position Fire Pump or Pump Controller Trouble Generator in Auto Position Generator or Controller Trouble Generator Engine Running Transfer Switch Other (Specify):
System Power Supplies A. Primary (Main): Nominal Voltage: Over Current Protection Type:
120
BREAKER
Location of Primary Supply Board: Disconnection Means Location:
20
Amps:
20
2ND FLOOR MECH RM PANEL EM2
CRKT #8
2X12VDC 33AH BATTERIES
24
✔
60
✖✐
Calculated Capacity to Operate System, In Hours:
✒✔
B. Secondary, Standby:
Amps:
Engine Driven Generator Dedicated to Fire Alarm System:
✔
Lead-Acid
Other
✯▼❈❅❒
Nickel-Cadmium
✬❅❁❄✍✡❃❉❄
Dry Cell
✤❒❙✿✣❅●●
Sealed Lead-Acid
✳❅❁●❅❄✿✬❅❁❄✍✡❃❉❄
Battery Type:
✮❉❃❋❅●✍✣❁❄❍❉◆❍
Location of Fuel Storage:
C. Emergency or Standby System Used as a Backup to Primary Power Supply, Instead of using a Secondary Power Supply Emergency System Described in NFPA 70, Article 700 Legally Required Standby Described in NFPA 70, Article 701 Optional Standby System Described in NFPA 70, Article 702, Which also Meets the Performance Requirements of Article 700 or 701
Prior to any Testing
Rev #7 10-08-14
Who
When
✮✏✡
✮❏
SIMPLEXGRINNELL
8:00 AM
RESIDENTS
8:00 AM
BILL WALLICK
8:00 AM
✮✏✡
✮❏ ✮❏
✮✏✡
✹❅▲
✮✏✡
✔
✮✏✡
✔ ✮❏
AHJ (Notified) of Any Impairments
✔
✮❏
Other (Specify)
✔
✔ ✹❅▲
Building Management
✔
N/A
✹❅▲
Building Occupants
No
✹❅▲
Monitoring Entity
✹❅▲
Yes
3 of 5
Initiating and Supervisory Device Tests and Inspections
Y
2 OF 2
HEAT DET
Y
Y
✮❏
Y
Y
✮❏
Y
DUCT DET
✔ ✮❏
PSD
20 OF 20
✔ ✮❏
48 OF 48
✔
✔
✹❅▲ ✹❅▲
✮❏
Y
✮❏
Y
Fail
✮❏
P/S
✹❅▲
51 OF 51
Pass ✹❅▲
Functional Test Factory Settings Meas. Settings
✹❅▲
Visual Test
✹❅▲
Device Type
✹❅▲
Local & S/N
Comments:
System Tests and Inspections
Disconnect Switches Ground Fault Monitoring
✦◆■❃▼❉❏■❁● ✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
✔ ✔ ✦◆■❃▼❉❏■❁●
✔
✔ ✦◆■❃▼❉❏■❁●
✔ ✔
✔ ✦◆■❃▼❉❏■❁●
Trouble Signals
✔
✔
✔ ✦◆■❃▼❉❏■❁●
Primary Power Supply
✔
✶❉▲❉❂●❅
Fuses
✔
✶❉▲❉❂●❅
Lamps/Leds
Comments
✔
✶❉▲❉❂●❅
Interface Eq.
Functional
✔
✶❉▲❉❂●❅
Control Unit
✶❉▲❉❂●❅
Visible
✔
✔
Secondary Power Functional
Comments
✦◆■❃▼❉❏■❁●
Battery Condition
✶❉▲❉❂●❅
Visible ✔
✔
Load Voltage Discharge Test Charger Test
✦◆■❃▼❉❏■❁● ✦◆■❃▼❉❏■❁●
Remote Annunciators
✶❉▲❉❂●❅
Transient Suppressors
✶❉▲❉❂●❅
Specific Gravity
Notification Appliances
Voice Clarity
Rev #7 10-08-14
✦◆■❃▼❉❏■❁● ✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
✦◆■❃▼❉❏■❁●
✔
✔
✔ ✦◆■❃▼❉❏■❁●
Speakers
Comments
✔
✔ ✶❉▲❉❂●❅
Visual
Functional
✔
✶❉▲❉❂●❅
Audible
✶❉▲❉❂●❅
Visible
✔
✔
4 of 5
✶❉▲❉❂●❅
Phone Set
✦◆■❃▼❉❏■❁●
Emergency Communications Equipment ✶❉▲❉❂●❅
Phone Jacks
✔ ✦◆■❃▼❉❏■❁●
✔
✶❉▲❉❂●❅
Off-hook Indicator
✔ ✦◆■❃▼❉❏■❁●
✔
✶❉▲❉❂●❅
Amplifier
✔ ✦◆■❃▼❉❏■❁●
✔
✶❉▲❉❂●❅
Tone Generator
✔ ✦◆■❃▼❉❏■❁●
✔
✶❉▲❉❂●❅
Call-In Signal
✔ ✦◆■❃▼❉❏■❁●
✔
✶❉▲❉❂●❅
System Performance
✔ ✦◆■❃▼❉❏■❁●
✔ ✔
✔
ELEV RECALL
Specify:
AHU SHUTDOWN
✶❉▲❉❂●❅
Specify:
✦◆■❃▼❉❏■❁●
Interface Equipment ✦◆■❃▼❉❏■❁●
✔ ✦◆■❃▼❉❏■❁●
✔ ✶❉▲❉❂●❅
Specify:
✔
✶❉▲❉❂●❅
✔
✶❉▲❉❂●❅
Specify:
✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
Specify:
✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
Specify:
✦◆■❃▼❉❏■❁●
Special Hazard Systems
Special Procedures: Comments:
Supervising Station Monitoring Yes
✔
8:00 AM
✔
8:00 AM
✔
8:00 AM
✔
8:00 AM
✮❏ ✹❅▲
Supervisory Restoration
✮❏
✹❅▲
Supervisory Trouble
✮❏
✹❅▲
Trouble Signal
✮❏
✮❏
8:00 AM
✹❅▲
Alarm Restoration
Time
✔
✹❅▲
Alarm Signal
No
Comment
Notification That Testing Is Complete Yes
Rev #7 10-08-14
✮✏✡ ✮✏✡ ✮✏✡
✮✏✡
✮❏ ✮❏
✹❅▲
✮✏✡
4:30 PM
✮❏
✔
✹❅▲
4:30 PM
✮❏
AHJ (Notified) of Any Impairments
✔
✮❏
Other (Specify)
4:30 PM
✹❅▲
Building Management
Time
✔
✹❅▲
Building Occupants
N/A
✹❅▲
Monitoring Entity
No
Comment
5 of 5
PELICAN ISLE II
Fire Dept:
Property Address:
435 DOCKSIDE RD. NAPLES, FLORIDA 34110
Property Manager:
BILL WALLICK
Contact:
one)
(select
Result:
NORTH NAPLES FIRE DEPT
Inspector:
PABLO AGUERO
Phone Number:
239-287-6608
Contract No.:
Central Station:
SIMPLEXGRINNELL
Date:
07-06-16
Phone Number:
1-888-746-7539
Account #:
103-1701
Service Period:
Monthly
Quarterly
Semi-Annual
✔
Annual
Five-Year
Comments
1)SMOKE DET M1-55 4TH FL IN SE MECHANICAL RM DID NOT GO INTO ALARM WHEN TESTED. NEEDS TO BE REPLACED.
Date: 07-06-16
Inspector Signature: PABLO AGUERO
Customer Name:
Customer Sigature:
Rev #7 10-08-14
1 of 5
Rotation & Communicator Service Period
Communication Type
Weekly
McCulloh
Monthly
Multiplex
Quarterly
✔ Digital
Semi-Annual
Reverse Polarity
✔ Annual
RF
Other (specify)
Manufacturer: Model:
Other (specify)
Control Panel
Circuit Style:
SIMPLEX
Number of Circuits:
4100-8201
Software Rev:
4&Y
Last Date of Service:
09-02-20
Last Date Software or Configuration Changed:
2 MAPNET 27 NACS 06/2016
10-11-15
Alarm Notification Appliances and Circuit Information Quantity
Circuit Style
Bells Horns Strobe
2
Y
Horn Strobe
67
Y
125
Y
Chime Speakers Other Number of NAC Circuits:
27
Are Circuits Monitored for Integrity?:
YES
Alarm-Initiating Devices and Circuit Information Quantity
Circuit Style
51
4
Photo Detectors
48
4
Duct Detectors
20
4
Heat Detectors
2
4
Water Flow Switches
15
4
Supervisory Switches
18
4
Pull Stations Ion Detectors
Other (Specify):
Signaling Line Circuits Quantity and Style (See NFPA 72, Table 3-6) of Signaling Line Circuits connected to System: Quantity:
Rev #7 10-08-14
2
Style:
4
2 of 5
Alarm Notification Appliances and Circuit Information Quantity
Circuit Style
Still Water Temp Site Water Level Fire Pump Power Fire Pump Running Fire Pump Auto Position Fire Pump or Pump Controller Trouble Generator in Auto Position Generator or Controller Trouble Generator Engine Running Transfer Switch Other (Specify):
System Power Supplies A. Primary (Main): Nominal Voltage: Over Current Protection Type:
120
BREAKER
Location of Primary Supply Board: Disconnection Means Location:
20
Amps:
20
2ND FLOOR MECH RM PANEL EM2
CRKT #8
2X12VDC 33AH BATTERIES
24
✔
60
✖✐
Calculated Capacity to Operate System, In Hours:
✒✔
B. Secondary, Standby:
Amps:
Engine Driven Generator Dedicated to Fire Alarm System:
✔
Lead-Acid
Other
✯▼❈❅❒
Nickel-Cadmium
✬❅❁❄✍✡❃❉❄
Dry Cell
✤❒❙✿✣❅●●
Sealed Lead-Acid
✳❅❁●❅❄✿✬❅❁❄✍✡❃❉❄
Battery Type:
✮❉❃❋❅●✍✣❁❄❍❉◆❍
Location of Fuel Storage:
C. Emergency or Standby System Used as a Backup to Primary Power Supply, Instead of using a Secondary Power Supply Emergency System Described in NFPA 70, Article 700 Legally Required Standby Described in NFPA 70, Article 701 Optional Standby System Described in NFPA 70, Article 702, Which also Meets the Performance Requirements of Article 700 or 701
Prior to any Testing
Rev #7 10-08-14
Who
When
✮✏✡
✮❏
SIMPLEXGRINNELL
8:00 AM
RESIDENTS
8:00 AM
BILL WALLICK
8:00 AM
✮✏✡
✮❏ ✮❏
✮✏✡
✹❅▲
✮✏✡
✔
✮✏✡
✔ ✮❏
AHJ (Notified) of Any Impairments
✔
✮❏
Other (Specify)
✔
✔ ✹❅▲
Building Management
✔
N/A
✹❅▲
Building Occupants
No
✹❅▲
Monitoring Entity
✹❅▲
Yes
3 of 5
Initiating and Supervisory Device Tests and Inspections
Y
2 OF 2
HEAT DET
Y
Y
✮❏
Y
Y
✮❏
Y
DUCT DET
✔ ✮❏
PSD
20 OF 20
✔ ✮❏
48 OF 48
✔
✔
✹❅▲ ✹❅▲
✮❏
Y
✮❏
Y
Fail
✮❏
P/S
✹❅▲
51 OF 51
Pass ✹❅▲
Functional Test Factory Settings Meas. Settings
✹❅▲
Visual Test
✹❅▲
Device Type
✹❅▲
Local & S/N
Comments:
System Tests and Inspections
Disconnect Switches Ground Fault Monitoring
✦◆■❃▼❉❏■❁● ✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
✔ ✔ ✦◆■❃▼❉❏■❁●
✔
✔ ✦◆■❃▼❉❏■❁●
✔ ✔
✔ ✦◆■❃▼❉❏■❁●
Trouble Signals
✔
✔
✔ ✦◆■❃▼❉❏■❁●
Primary Power Supply
✔
✶❉▲❉❂●❅
Fuses
✔
✶❉▲❉❂●❅
Lamps/Leds
Comments
✔
✶❉▲❉❂●❅
Interface Eq.
Functional
✔
✶❉▲❉❂●❅
Control Unit
✶❉▲❉❂●❅
Visible
✔
✔
Secondary Power Functional
Comments
✦◆■❃▼❉❏■❁●
Battery Condition
✶❉▲❉❂●❅
Visible ✔
✔
Load Voltage Discharge Test Charger Test
✦◆■❃▼❉❏■❁● ✦◆■❃▼❉❏■❁●
Remote Annunciators
✶❉▲❉❂●❅
Transient Suppressors
✶❉▲❉❂●❅
Specific Gravity
Notification Appliances
Voice Clarity
Rev #7 10-08-14
✦◆■❃▼❉❏■❁● ✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
✦◆■❃▼❉❏■❁●
✔
✔
✔ ✦◆■❃▼❉❏■❁●
Speakers
Comments
✔
✔ ✶❉▲❉❂●❅
Visual
Functional
✔
✶❉▲❉❂●❅
Audible
✶❉▲❉❂●❅
Visible
✔
✔
4 of 5
✶❉▲❉❂●❅
Phone Set
✦◆■❃▼❉❏■❁●
Emergency Communications Equipment ✶❉▲❉❂●❅
Phone Jacks
✔ ✦◆■❃▼❉❏■❁●
✔
✶❉▲❉❂●❅
Off-hook Indicator
✔ ✦◆■❃▼❉❏■❁●
✔
✶❉▲❉❂●❅
Amplifier
✔ ✦◆■❃▼❉❏■❁●
✔
✶❉▲❉❂●❅
Tone Generator
✔ ✦◆■❃▼❉❏■❁●
✔
✶❉▲❉❂●❅
Call-In Signal
✔ ✦◆■❃▼❉❏■❁●
✔
✶❉▲❉❂●❅
System Performance
✔ ✦◆■❃▼❉❏■❁●
✔ ✔
✔
ELEV RECALL
Specify:
AHU SHUTDOWN
✶❉▲❉❂●❅
Specify:
✦◆■❃▼❉❏■❁●
Interface Equipment ✦◆■❃▼❉❏■❁●
✔ ✦◆■❃▼❉❏■❁●
✔ ✶❉▲❉❂●❅
Specify:
✔
✶❉▲❉❂●❅
✔
✶❉▲❉❂●❅
Specify:
✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
Specify:
✦◆■❃▼❉❏■❁●
✶❉▲❉❂●❅
Specify:
✦◆■❃▼❉❏■❁●
Special Hazard Systems
Special Procedures: Comments:
Supervising Station Monitoring Yes
✔
8:00 AM
✔
8:00 AM
✔
8:00 AM
✔
8:00 AM
✮❏ ✹❅▲
Supervisory Restoration
✮❏
✹❅▲
Supervisory Trouble
✮❏
✹❅▲
Trouble Signal
✮❏
✮❏
8:00 AM
✹❅▲
Alarm Restoration
Time
✔
✹❅▲
Alarm Signal
No
Comment
Notification That Testing Is Complete Yes
Rev #7 10-08-14
✮✏✡ ✮✏✡ ✮✏✡
✮✏✡
✮❏ ✮❏
✹❅▲
✮✏✡
4:30 PM
✮❏
✔
✹❅▲
4:30 PM
✮❏
AHJ (Notified) of Any Impairments
✔
✮❏
Other (Specify)
4:30 PM
✹❅▲
Building Management
Time
✔
✹❅▲
Building Occupants
N/A
✹❅▲
Monitoring Entity
No
Comment
5 of 5
