Form Cms-2786u - Fire Safety Survey Report - Asc & Esrd 2012 Life Safety Code Page 15
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39Name of Facility
2012 LIFE SAFETY CODE
ID
NOT
MET
N/A
REMARKS
PREFIX
MET
Fire Alarm Systems – Testing and Maintenance
K345
A fire alarm system is tested and maintained in accordance with an
approved program complying with the requirements of NFPA 70, National
Electric Code, and NFPA 72, National Fire Alarm and Signaling Code.
Records of system acceptance, maintenance and testing are readily
available.
9.6.1.3, 9.6.1.5
Fire Alarm – Out of Service
K346
Fire alarms that are out of service for 4 hours in a 24 hour period, the
authority having jurisdiction shall be notified, and the building shall be
evacuated or an approved fire watch shall be provided for all parties left
unprotected by the shutdown until the fire alarm system has been returned
to service.
9.6.1.6
Sprinkler System – Installation
K351
Sprinkler systems (if installed) are installed per NFPA 13.
Where more than two sprinklers are installed in a single area for protection,
waterflow devices shall be provided to sound the building fire alarm system
or to notify a constantly attended location such as a PBX, security office, or
emergency room.
20.3.5.1, 20.3.5.2, 21.3.5.1, 21.3.5.2, 9.7.1.2, 9.7, NFPA 13
Sprinkler System – Maintenance and Testing
K353
Automatic sprinkler and standpipe systems are inspected, tested, and
maintained in accordance with NFPA 25, Standard for the Inspection,
Testing, and Maintaining of Water-based Fire Protection Systems. Records
of system design, maintenance, inspection and testing are maintained in a
secure location and readily available.
a) Date sprinkler system last checked. _____________________
b) Who provided system test. ____________________________
c) Water system supply source. __________________________
Provide in REMARKS information on coverage for any non-required or
partial automatic sprinkler system.
9.7.5, 9.7.7, 9.7.8, and NFPA 25
Form CMS-2786U (10/2016)
Page 15
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