FIRE ALARM SYSTEM TEST REPORT

(05/2020)

FIRE ALARM STATUS

Confidence Test Deficiency Repair Test Red Yellow White
Occupancy Information
Premises Name: Premises Address:
Contact Name: Contact Phone:
Contact Address: Contact Email:
Central Station Monitoring: Yes No Monitoring Required: Yes No
Monitoring Company Name: Internal Dialer? Yes No
Monitoring Company Phone: AES/Radio? Yes No
Fire Alarm Inventory (M-mandatory)
Fire Alarm Panel Unit ID (TCE will assign one per system) (M):
Smoke Detector Sensitivity (required every 5 yrs, after passing 1st annual calibration test) –
Last Test Date (month/year):
Smoke Detector Sensitivity – Test Due Date (month/year):
FACP & Annunciators
Fire Alarm Control Panel/Unit Location (M):
Fire Alarm Panel Brand: Fire Alarm Panel Model:
FACP – location of key (M): Annunciator location (M): N/A
Notification Power Notification Power
Yes No
Expander(s) Installed? Expander(s) Location:
Note: This section is optional except at time of new system acceptance. Please enter number of devices or items in the
system. Should match U.L. label.
Initiating Devices # of devices/items # of devices/items
Beam detectors Smoke detectors - Regular
Duct detectors Smokes – above ceiling
Heat tape supervisory signals Smokes – under floor
Heats – above ceiling Sprinkler flow switches
Heats – regular Sprinkler valve tamper switches
Heats – under floor High/low air switches
Pull stations (manual stations) Other supervisory switches
Notification Devices
Bells, chimes Horn/strobe combo
Exterior sprinkler alarm bell Horns only
Auxiliary Equipment
Auto door release Fire/smoke dampers
Auto door unlock Generators
Elevator recall Ventilation controls
Fire doors Other (DAS/Vesda…)
Fire fighter phone jacks Other (DAS/Vesda…)
Fire fighter phone sets Other (DAS/Vesda…)
Stairway Door Locks
Electric bolt Other locking devices
Electric strike Stairwell egress devices
Battery Info
Date Installed (month/year): Date due for next testing (month/year):
Number of batteries: Battery Size (AH):
Inspection & Testing Agency Information
Company Name: Phone:
Address: Emergency Phone:
Email:
Inspector/Tester Information
Inspector Name:
Certification No.:
Test Information
Date of Test:
Test Type: Annual Quarterly Semi-annual Monthly
Area of building tested and general description of testing performed on this report (text field)
This is the final report for the testing year, indicating completion of 100% of the mandatory
Yes No
tests. (Reports confirming tests of 100% of devices must be submitted annually.)
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 CURRENT FIRE CODE AND REFERENCED NFPA 72 STANDARD and
the MANUFACTURER'S INSTRUCTIONS for weekly, monthly, and quarterly inspecting and testing requirements. ONLY
SELECT N/A FOR ITEMS THAT DO NOT EXIST AT THE BUILDING, DO NOT USE N/A TO INDICATE THAT A TEST OR RESULT IS
NOT AVAILABLE.
PRE-TEST CHECKS
AVOID UNNECESSARY ALARMS BY PUTTING THE FIRE ALARM SYSTEM IN TEST MODE. Failure to place the Fire Alarm System
(FAS) into test mode and/or taking other precautions to may cause preventable alarms.
1 The building occupants were notified. Yes No N/A
2 The onsite supervisory station was notified. Yes No N/A
3 The Central Station Monitoring Service was notified to place FAS in test
Yes No N/A
mode.
GENERAL
4 The key to the panel is available at the FACP. Yes No N/A
5 The operating instructions are available at the FACP. Yes No
6 Materials and equipment needed to restore pull stations are available at the
Yes No N/A
main panel, e.g. glass rods, and plates; keys and allen wrenches, etc.
ALARM PANEL
7 The FACP operates on AC power. Yes No
8 If the system has batteries, the FACP operates on Battery power. Yes No N/A
9 If the system has emergency generator/standby power, the FACP operates
Yes No N/A
on emergency generator/standby power.
10 If the system has battery or standby power, the trouble indicators function
Yes No N/A
properly and a trouble signal comes on with AC power off.
INITIATING DEVICES AND NOTIFICATION APPLIANCES
11 Initiating & notification appliances tested operate properly on AC power. Yes No
12 If system has generator/standby power, initiating and notification appliances
Yes No N/A
tested operate properly on generator/standby power.
13 If system has batteries, initiating and notification appliances tested operate
Yes No N/A
properly on battery power.
14 100% of the INITIATING DEVICES per circuit that were tested and included as
part of this report were in accordance with the NFPA 72 Chapter 14 Yes No
standards referenced by the current fire code.
Note: 2 or 20%, whichever is greater, of restorable fixed-temperature, spot-type heat detectors need to be tested annually.
Records shall be kept to ensure that every detector is tested every five years.
15
The sensitivity test for smoke detectors is up-to-date in accordance with
NFPA 72. (After passing the 2nd required calibration test, sensitivity may be Yes No N/A
calibrated once every 5 years [2016 NFPA 72 Sec 14.4.4.3]).

Date most recent smoke detector sensitivity test was passed:

16 100% of the AUDIBLE NOTIFICATION APPLIANCES per circuit that were tested
and included as part of this report were in accordance with 2016 NFPA 72 Yes No
Chapter 14.
17 The audible notification appliances tested operate at the levels required by
Yes No
NFPA 72.
18 The audible notification appliances tested in residential units generate a
Yes No N/A
minimum of 60DBA at the pillow in the sleeping areas.
19 100% of the VISUAL NOTIFICATION APPLIANCES per circuit that were tested
and included as part of this report were in accordance with 2016 NFPA 72 Yes No N/A
Chapter 14. Only select N/A if no such devices in building.
BATTERIES
20 Battery voltage (no load):
21 Battery voltage (full load):
22 New batteries installed? Battery installation date: [current month/year]:
23 Charge circuit voltage:
INTERFACE DEVICES
The FACP received signals from the following Interface devices:
Simulation Operation
Tested by:
24 Emergency Generator(s) Yes No N/A
25 Flow Switch(es) Yes No N/A
26 Supervisory Switch(es) Yes No N/A
27 Range Hood Suppression System(s) Yes No N/A
28 Dry Chemical System(s) Yes No N/A
29 Clean Agent System(s) Yes No N/A
30 Pre-action Systems(s) Yes No N/A
31 Pull Stations Yes No N/A
OTHER EQUIPMENT CONTROLLED BY FACP
The following Fire Safety Functions responded to signals from the FACP:
Simulation Operation
Tested by:
Note: This section replaces the Sequence Test Form. The checks in this section are only required during one of the
quarterly tests. The functions in this section require testing during the annual confidence test for all other buildings.
32 Fan controls Yes No N/A
33 Smoke Dampers Yes No N/A
34 Elevator Recall system Yes No N/A
35 Elevator Shunt Switch(es) Yes No N/A
36 Magnetic Door Holders Yes No N/A
37 Door Lock devices Yes No N/A
38 Fire Pump(s) Yes No N/A
39 General alarm automatic time delay (minutes) Yes No N/A
40 Remote Annunciator Panels Yes No N/A
COMMUNICATION EQUIPMENT
41 All phone sets function properly. Yes No N/A
42 All phone jacks function properly. Yes No N/A
43 All phone indicating signals at the FACP work properly. Yes No N/A
44 The public address equipment at the FACP works properly. Yes No N/A
ALARM PANEL MONITORING
45 A signal was received at the Central Station monitoring company. Yes No N/A
STAIRWAY DOOR LOCKS [if no stairways in building, skip this section and proceed to final checks]
This building has stairways: Yes N/A
46
All stairway door locking devices release simultaneously, without unlatching,
Yes No N/A
upon activation of the fire alarm system from anywhere in the building.

47 All stairway door locking devices release simultaneously, without unlatching,

Yes No N/A
upon activation from the fire command center.
48 The door(s) to the roof unlocks upon activation of the fire alarm system. Yes No N/A
49 There is an access key at the control panel for doors that fail to unlock. Yes No N/A
50 All of the doors open, close, and latch properly. Yes No N/A
FINAL CHECKS, MANDATORY TAGGING, AND REPORTS
Put the Fire Alarm back into service and/or other precautionary measures that were made to restore fire alarm system to
normal operation (includes removal of protective coverings.)
51 A current red, yellow or white tag was placed at the fire alarm control panel
indicating the system’s status consistent with my inspection today and SFD Yes No
Administrative Rule 9.02.
The color of the tag is: Red Yellow White
52 I will provide a copy of the confidence test report to the owner. Yes No
53 I will submit this test report to the fire department through TCE. Yes No
By accepting this statement I, the certified technician shown on this form, certify that this fire protection system(s) has
been properly inspected for functional operation in accordance with the current Fire Code (FC) used by the department
that has jurisdiction and NFPA Standards adopted by the FC for this system. Any deficiencies found are noted in the report
and have been reported to the building Owner/Manager for corrective action.
I am authorized to submit this report for the certified (Initials of Employee)
I accept.
technician who has accepted this statement.
SIGNATURE (OPTIONAL)

Signature of Technician
Signature of Building Representative

System Testing Reports Must Be Submitted Online

Submit reports to http://www.thecomplianceengine.com/