Confidence Test Report Form - Fire Pump - Seattle Fire Department Page 2
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This is a Federal Building
The items on the checklists below shall be inspected and tested. This list may not constitute all of the required inspecting and
testing of the fire and life safety system. Refer to the Seattle Fire Department Fire Code and adopted NFPA standards
for inspecting and testing requirements.
P
-T
C
RE
EST
HECKS
1. The Fire Alarm was put into test mode and/or other precautions were taken to avoid
Yes
No
preventable alarms.
Yes
No
2. This is the only Fire Pump at this address.
a. If “No” What is the unique ID number? (See SFC Ad Rule 9.02.09)_________
Yes
No
3. Routine maintenance is being performed (including weekly pump tests w/0 flow) and
records are being kept in accordance with NFPA 20 and NFPA 25
N/A
Yes
No
4. The suction screens were inspected and cleared.
Yes
No
5. All signs, placards, and labels are provided on doors and system controls.
Electrical based on NFPA 20 test procedures
E
P
LECTRIC
UMP
Flow
0 gpm (churn)
100% gpm
150% gpm
6. Amperage
Ph 1____ Ph2____ Ph3____
Ph 1____ Ph2____ Ph3____
Ph 1____ Ph2____ Ph3____
7. Voltage
Ph 1____ Ph2____ Ph3____
Ph 1____ Ph2____ Ph3____
Ph 1____ Ph2____ Ph3____
Yes
No
8. The electric pump ran properly for a minimum 10 minutes.
D
P
IESEL
UMP
Yes
No
9. Oil level is OK.
Yes
No
10. Coolant level is full.
Yes
No
11. The hydrometer reading indicates that the antifreeze protection is adequate.
Yes
No
12. The fuel filter/strainer was serviced.
Yes
No
13. The diesel engine/pump operated properly for a minimum 30 minutes.
P
C
(
)
UMP
ONTROLLER
S
Yes
No
14. The fire pump controller is listed and operates according to NFPA 20 standards
N/A
Yes
No
15. The controller regulates the jockey pump as required by 2005 NFPA 20
Yes
No
16. The controller regulates the fire pump as required by 2005 NFPA 20
P
T
- R
C
(RC) ________ R
RPM_________ R
PSI/FT______/_____
UMP
EST
ATED
APACITY
ATED
ATED
17. When the Pump starts from pressure drop the start pressure is 5 psi below
N/A
Yes
No
the start point of the jockey pump.
18. The pump runs smoothly without unusual noise or vibration. (For standards regarding
Yes
No
pump vibration see Hydraulics Institute Standards for Centrifugal, Rotary and
Reciprocating Pumps – Ref. NFPA 20 6.5.2 and 14.2.6)
19. The gauges passed a 5-year pressure gauge comparison test with a calibrated gauge.
Yes
No
Date for next test:______________
N/A
Yes
No
20. Defective gauges were replaced or recalibrated.
21. The pump performs at its rated capacity (RC) and at 150% of its RC (or the capacity
Yes
No
that the supply will accommodate above the RC if it is less than 150%.)
22. Actual Test RPM:
Churn:____
100% RC_____
150% RC______
23. Pitot or Flowmeter Reading: Test Capacity (100%)_______ Test Peak Flow (150% ): _____ gpm
24. PSI reading on Discharge Gauge:
Pre-test_____ psi Churn (0 flow) _____ psi RC _____ psi 150% RC _____ psi
25. PSI reading on Suction Gauge:
Pre-test_____ psi Churn (0 flow) _____ psi RC _____ psi 150% RC _____ psi
26. Hose size:
_____ in.
Tip size:
_____ in.
Hose length:
________ ft.
Yes
No
27. The shaft seals are dripping water properly.
N/A
Yes
No
28. The System pressure relief valve operates properly
N/A
Yes
No
29. The Casing relief valve operates properly
Yes
No
30. The fire alarm panel monitors the fire pump
Fire Pump
Page 2 of 4
9-2012 Ver.1.3
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