Self Inspection Form Page 2

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IFC/NFPA
Y/N/NA
EXPLAIN
Fire Doors
703
Fire Doors/closing devices operating properly
703.2
Improper holding (open) devices used or obstructions
107.1,
Any unapproved or inappropriate sealing or openings in fire resistance rated
703.1
construction
NFPA80
Fire Protection Systems
107.1,
Fire Hydrants clear and in good condition
508.5.4,
508.5.5
502
Fire lanes clearly accessible, no obstructions
107.1
Access to standpipes, sprinkler valves, fire department connections and
508.5.4,
other fire protection equipment
508.5.5
107.1
Fire Protection equipment in good working order-protective covers on fire
508.5.4
department connections
508.5.5
912.3.1
907.2.6.3.3
102.8
Smoke detectors are in good operating condition
107.1
NFPA 72
913
Fire Pump Annual Inspection
NFPA 20 &
25
Chapter 9
Annual Sprinkler Certification
NFPA 13
Spare heads and wrench in cabinet
Ordinance
Annual backflow test provided
912.5
907.4.1
Pull Stations accessible, placed appropriately
901.4
Alarm Panel must be accurately labeled
901.7
Alarm system in good working order
Other
506
Knox Box present & in good condition and keys current & functional
1004.3
Occupancy Load sign posted
********
Emergency contact sheet provided
********
Preplan forms/file available/completed
Address present & visible from roadway (at least 4” in height)
505.1
Ordinance
603.9
Gas Meter and piping protected from damage
2703.4
MDSD Sheets on file
CONFIDENTIAL
2 of 5
6/1/2015

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