Klepps, Inc. - Klepps Fire Alarm Testing Report - Bellevue Seattle Fire Alarm Systems Security CCTV Audio/Video Automation

Fire Alarm Testing

Fire Alarm Testing Info*
- Confidence Test
- Repair
Certification Given*
- Red
- Yellow
- White
Job Number:*
Occupancy Name:*
Occupancy Address:*

Street Address

City

State

ZIP Code
Responsible Person:
Phone Number:
E–Mail Address:
Date of Inspection:*

Date Format: MM slash DD slash YYYY
Inspection Frequency/Type:
- Quarterly (High-rise Only)
- Annual
If Quartely
Testers Name:
SFD Certification Number:
Central station monitoring?*
- Yes
- No
Monitoring Required?*
- Yes
- No
Monitoring Company Name:*
System Make:*
System Model:*
System Location*
Identification Number:
Problems Found
Comments
Corrections Made:
Comments
Date Corrected:

Date Format: MM slash DD slash YYYY
Corrected By:
Alarm System Functionality:

The items on the checklists below shall be inspected and tested. This list does not constitute all of the required inspecting and testing of the fire and life safety system. Refer to the Seattle Fire Department Fire Code for inspecting and testing requirements.
Trouble signal with AC power off?
- Yes
- No
System operates properly on battery backup?
- Yes
- No
Battery Voltage (no load)
Battery voltage (full load) 5 min Test
Charge circuit voltage
System operates properly on standby power?
- Yes
- No
All signals operate on AC power?
- Yes
- No
Number of initiating circuits
Number of signal circuits
Does alarm system meet audibility standards as accepted?
- Yes
- No
All circuits checked for electrical supervision?
- Yes
- No
All auxiliary equipment operates (Elevators, fans, dampers)?
- N/A
- Yes
- No
Ventilation controls operate?
- N/A
- Yes
- No
Key to panel available?
- Yes
- No
Operating instructions at panel?
- Yes
- No
Trouble indicators function properly?
- Yes
- No
Remote Annunciator Panels function properly?
- N/A
- Yes
- No
Elevator Call Down functions properly?
- N/A
- Yes
- No
Test record posted at panel?
- N/A
- Yes
- No
General alarm automatic time delay
- N/A
Was a signal received at the Central Station monitoring company?
- N/A
- Yes
- No
Other Devices (Specify)
- Yes
- No
System Devices:
Bells, Horns, Chimes
- Bells
- Horns
- Chimes
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Voice Speakers (Voice Clarity)
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Smoke Detectors
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Heat Detectors
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Duct Detectors
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Sprinkler Flow Switches
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Sprinkler Supervisory Switches
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Visual Notification
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Manual Pull Stations
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Annunciator(s)
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Beam Detectors
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Automatic Door Unlocks
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Automatic Door Release
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Fire Dampers, every 4 yrs.
Total Number of Units in Building:
Total Number Units Inspected:
Test Results Acceptable:
- N/A
- Yes
- No
Communication Equipment:
Phone Sets
Total Number of Units in Building:
Total Number Units Tested:
Test Results Acceptable:
- N/A
- Yes
- No
Phone Jacks
Total Number of Units in Building:
Total Number Units Tested:
Test Results Acceptable:
- N/A
- Yes
- No
Call-in Signal
Total Number of Units in Building:
Total Number Units Tested:
Test Results Acceptable:
- N/A
- Yes
- No
Battery Readings:
NAC1

Battery Load Charging Voltage Drop
NAC2

Battery Load Charging Voltage Drop
NAC3

Battery Load Charging Voltage Drop
NAC4

Battery Load Charging Voltage Drop
NAC5

Battery Load Charging Voltage Drop
NAC6

Battery Load Charging Voltage Drop
This certifies that this fire and life safety system has been properly inspected for reliability to cover the
Items listed in this report and is consistent with Seattle Fire Department Fire Code standards, and that
discrepancies are noted and have been reported to the building Owner/Manager for corrective action.
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Service Info
Batteries replaced (qty)
Batteries Source:
- WH
- TS
- Other
List of Parts
Technician(s) Name:
Normal Hours (all techs):
After Hours or Saturday (all techs):
Emergency Calls or Sunday (all techs):
Mileage (all vehicles):
Technician Signature*
Date*

Date Format: MM slash DD slash YYYY
Technician Email
Customer Name*
Customer Signature*

Customer signature acknowledges that services were provided. Invoicing and testing report will be emailed/mailed separately.
- Customer not onsite
- Customer notified by phone/email
Miscellaneous Tech Comments:
Email

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Service Areas

Allyn, Arlington, Auburn, Bangor, Belfair, Bellevue, Bonney Lake, Bremerton, Brownsville, Burley, Chico, Clinton, Coupeville, Des Moines, Edmonds, Everett, Federal Way, Fox Island, Freeland, Gig Harbor, Gorst, Graham, Grapeview, Greenbank, Hansville, Holly, Indianola, Issaquah, Kent, Key Center, Keyport, Kingston, Kirkland, Lake Stevens, Langley, Little Boston, Lynnwood, Manchester, Marysville, Mill Creek, Mukilteo, Navy Yard City, Oak Harbor, Olalla, Olympia, Orting, Port Gamble, Port Orchard, Poulsbo, Purdy, Puyallup, Redmond, Renton, Seabeck, SeaTac, Seattle, Silverdale, Snohomish, South Colby, Southworth, Steilacoom, Suquamish, Tacoma, Tahuya, Tracyton, Tukwila, Tumwater, Yelm

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