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FIRE ALARM INSPECTION AND TEST REPORT
METRO ALARM
"WE SAVE LIVES & PROTECT PROPERTY"
SERVICE (952) 890-6684 FAX (952) 707-6881 LIC#CC01031
ACCr.NO lJ~ JI"ll!1 SERVICECALLNO,4.M5,~5
CUSTOMER N rSI: f},...J I J..r
ADDRESS Jf)t7:l,'7( Il-l.rL (/?, ,'L~ f{j, ~~$'
CITY PJ'\.-b.,..., Lu..
CONTROL PANEL
MANlJFACfURE fI1YliJ MODEL NO, j I " /1 Yi?
TYPE OF SIGNALING
GENERAL ALARM SELECTIVE SIGNALS CODED PRE-SIGNAL
METRO ALARM CONTRACTORS, INC
P.O. BOX 1775
BURNSVILLE, MN 55337
I COpy TO:LCLIENT_FIRE DEPT. I
U.L. CERTIFICATE NO,
CONTACT lh'''nl lIru /If
PHONE q!!fA <lil:) L' -1/11
STATE I'/\N I ZIP ,I);~ 71 'J..
I DATE I/lJi/O-::J.
I TITLE
I_BI-MONTHLY _SEMI-ANNUAL
I ~~~~:LY ~%~~AL
POWER elR. BRKR. LOCATION
SOURCE I J/
LOCATION III I1.J /'" JO. ~", d i. /...,d I
DEDICATED CIR
YES -""NO
'6
NO,
LOCKED CIR BRKR,
YES ~O
BAITERIES VOLT WITH CHARGER~OTE # l--I..-r- TROUBLE RESPONSE TO ZONE TROUBLE SIGNAL TROUBLE AClOP POWER LOSS EARTH GROUND
VOLTWITHOUTCHARGER~ NEvt~ CONDITIONS ~ORMAL NOTE -"'NORMAL NOTE..d'ORMAL NOTE NORMAL NOTE
COMMUNICATOR
MANUFACTURE ~/.J,.".b MODEL NO, '?L
BATTERIES VOLT WITH CHARGER AOTE #
VOLT WITHOUT CHARGER7"" NEW
CENTRAL MONITORING
STATION
RESPONSE TO ALARM
~ORM, NOTE #
COMMUNICATOR PRIMARY # '?I)'? _ 17 L/ II &-~
AUXILIARY FUNCTIONS
I MOD~L / tfn
AHNUNUAIOR (Mrrm..p
LOCATION <; A~_ ,.. ;;it
POWER CIR, BRKR LOCATION' NO,
SOURCE
LOCKED CIR BRKR,
YES NO
DEDICATED CIR
YES NO
TROUBLE RESPONSE TO ZONE TROUBLE SIGNAL TROUBLE AC/OP POWER LOSS EARTH GROUND
CONDITIONS ~NORMAL _NOTE LNORMAL _NOTE ....NORMAL _NOTE _NORMAL _NOTE
COMMUNICATOR SECONDARY # 'l41- J 'J. t- / / f{
TYPE
INCAU
_LED
_GRAPHIC
_DROP
ELEVATOR RECALL TO PRIMARY FLOOR RECALL TO ALTERNATE FLOOR
FIRE RECALL NORMAL ....NOTE t,LN/A NORMAL NOTE ~/A
SPRINKLER SYSTEM: METRO ALARM'S INSPECfION ~~y INCLUDES A FUNCfIQNAL TEST.
ACTUAL FIRE SPRINKLER TEST WAS DONE BY, /111 s::...... ..../" J,/,
~,
PERIPHERAL FUNCTION TEST
DEVICE
Manual Stations
R of R Heat Detectors
Fixed Heat Detec::tors
Photo Smoke
Ion Smoke
Duct Smoke
WaterDow j
GVT 'L
P)V
Low Air
Horns Only I
Strobes Only
Horn I Strobes I
Speaker I Strobes
Door Holders
NOTATIONS AND COMMENTS
FLOOR
jlJil Jcs :7MI
/ '
CUSTOMER SIGNATURE:
/:
,;::~~~I"UL}7~/Yl NU OF LONES
ELEVATOR RESTART
FROM FIRE SUe. AUTOMATICALLY
I uNUSED 1''1'.s.
YES
NO
TESTED .,?h2//);7
VOLTS
MFG & MODEL # NOTE
~51.- .5;;~",....-
\JicJ~t.r.1;,*_
fLrNJ' fN{J.v..r
t1.",
1~UL1./",ytl
_.JJ
/'-;;? ......-/
SE~~,
eY./ .~
FEB
.,.. .-'
.J. V
2007