Potter Releasing Systems - Manual (Page 47)

47
AUTOMATIC SPRINKLER SYSTEMS
FORM 2-C
Monthly Inspection
YEAR
_______________________________
1. Date of inspection
2. Inspector’s name, initials or badge number.
3. If fire department connections are unobstructed and in good condition,
note “OK” in block. If not, see that corrections are made and briefly
describe under “notes”.
4. If valves are locked note “yes” in this block. If any are not locked, relock
and note “relocked” in this block.
5. Waterflow alarms should be tested by opening the inspector’s test
valve, allowing the water to flow.
6. Record any notes about the system which the inspector believes
to be significant. Place a number in this block and number the
corresponding note at the end of the inspection form.
DATE INSPECTOR
1 2 3 4 5 6
NOTES _________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
________________________________________________________________________________________________________________________
FIRE DEPARTMENT
CONNECTIONS
VALVES
LOCKED
WATERFLOW ALARMS
TESTED
NOTES