Certificate Of Inspection - Standpipe System - Town Of Ocean City - Office Of The Fire Marshal
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1TOWN OF OCEAN CITY - OFFICE OF THE FIRE MARSHAL
P.O. Box 158 Ocean City, MD 21843
Phone # 410-289-8780 Fax # 410-289-8767
CERTIFICATE OF INSPECTION
Standpipe System
Annual Certificate of Inspection in Accordance with NFPA 25
Non-Annual Certificate of Inspection in Accordance with NFPA 25
Deficiencies:
YES
NO
Protected Property:
Building Name:________________________________
Exact Physical Address:__________________________________________
Contact Person:________________________________
Bill To:_______________________________________________________
Contact Phone #:_______________________________
Billing Address:________________________________________________
Standpipe System Testing Company:
Inspector/Technician:___________________________
Company:_______________________________________________
Phone Number:________________________________
Address:_________________________________________________
Date System Tested:____________________________
_________________________________________________
Standpipe System Owner’s Notification:
The owner and/or the owner’s representative of the system was notified on
of all deficiencies?
PRIOR TO TESTING, OCEAN CITY COMMUNICATIONS SHALL BE NOTIFIED!
PHONE # 410-723-6620
(Failure to do so will result in the full provisions of the Town of Ocean City Fire Prevention and Protection Code to be invoked.)
Dispatcher Name/Number:_____________________________
Time:__________________
System Type:
Wet Standpipe
Dry Standpipe
Manual
Semi-Automatic
Automatic
Other
Pressure Restricting Devices / Valves (PRV’s): Are PRV’s provided?
Yes
No
Deficiencies Identified During Inspection:
System Out Service
FDC Obstructed
Fire Hose Connection Damaged
Cap(s) Missing on FDC
Valve Handle Missing
Valves Do Not Operate Smoothly
Hose Connections / Valve Leaking
Pressure Restricting Device Not Functioning Properly
Damaged Pipe
Control Valve(s) Damaged
FDC Sign Missing / Obstructed
Fire Hose Connection Obstructed
Control Valves Not Supervised
Horizontal and/or Vertical Pipes Not Supported Properly
Other: List Below
Comments / Deficiency Description: (Attach an “Additional Information Form” if more room is needed.)
___________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
FOR INTERNAL USE ONLY:
Data Entry Date:__________
FM Assigned:__________
Date FM Assigned:__________
Date Inspected/Contacted:__________
No Deficiencies Found
Deficiencies Verified
QV #:__________
Date of Violation:__________
Date of Compliance:__________
**THIS FORM MUST BE SUBMITTED WITHIN 30 DAYS FROM THE DATE OF INSPECTION TO THE OCEAN CITY FIRE
MARSHALS OFFICE **
Rev. 10/7/2008
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