Contractors Material And Test Certificate - Fire Alarm And Fire Detection Systems Page 2

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Audio Devices:
_____ of _____
Make / Model: ______________________________________________
Visual Devices:
_____ of _____
Make / Model: ______________________________________________
Door Releases:
_____ of _____
Make / Model: ______________________________________________
Trouble indicators:_____ of _____
Make / Model: ______________________________________________
Batteries:
_____ of _____
Make / Model: ______________________________________________
Battery Readings: ____________ Full load ______________ Charge
Generator:
_____ of _____
Make / Model: ______________________________________________
HVAC Controls: _____ of _____
Make / Model: ______________________________________________
Alarm Dialer:
_____ of _____
Make /Model: _______________________________________________
Annunciator:
_____ of _____
Make / Model: ______________________________________________
SPRINKLER SYSTEM: (FIRE ALARM CONNECTIONS ONLY)
Water Flow Sw: _____ of _____
Make / Model: ______________________________________________
Tamper Sw:
_____ of _____
Make / Model: _______________________________________________
PIV:
_____ of _____
Make / Model: _______________________________________________
Alarm Bell:
_____ of _____
Make / Model: _______________________________________________
W/P Strobe:
_____ of _____
Make / Model: _______________________________________________
Automatic Time Delay of General Alarm: _______ minutes: _______ None installed.
Do you meet audible / visible requirements of WAC 51-44 and NFPA 72? _____ Yes _____ No
Test of Alarm System on emergency power, satisfactory? _____ Yes _____ No
Comments:____________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
COMPLETELY FILL OUT THIS TEST CERTIFICATE AND FAX TO:
Valley Regional Fire Authority
Fire Marshal’s Office
253-288-5870
Fax 253-288-5970

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