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Fire Pump 6 Monthly Routine Maintenance
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1
Person completing the testing
First Name
Last Name
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2
Site
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3
Date
-
Date
Year
Month
Day
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4
Testing to be completed on this visit
Monthly
6 Monthly
Yearly
5 Yearly
Fire Alarm
Yes
No
N/A
Yes
No
N/A
Row 0, Column 0
Yes
No
N/A
Yes
No
N/A
Row 0, Column 1
Yes
No
N/A
Yes
No
N/A
Row 0, Column 2
Yes
No
N/A
Yes
No
N/A
Row 0, Column 3
Fire Extinguishers
Yes
No
N/A
Yes
No
N/A
Row 1, Column 0
Yes
No
N/A
Yes
No
N/A
Row 1, Column 1
Yes
No
N/A
Yes
No
N/A
Row 1, Column 2
Yes
No
N/A
Yes
No
N/A
Row 1, Column 3
Fire Sprinklers
Yes
No
N/A
Yes
No
N/A
Row 2, Column 0
Yes
No
N/A
Yes
No
N/A
Row 2, Column 1
Yes
No
N/A
Yes
No
N/A
Row 2, Column 2
Yes
No
N/A
Yes
No
N/A
Row 2, Column 3
Hydrants
Yes
No
N/A
Yes
No
N/A
Row 3, Column 0
Yes
No
N/A
Yes
No
N/A
Row 3, Column 1
Yes
No
N/A
Yes
No
N/A
Row 3, Column 2
Yes
No
N/A
Yes
No
N/A
Row 3, Column 3
Pumps
Yes
No
N/A
Yes
No
N/A
Row 4, Column 0
Yes
No
N/A
Yes
No
N/A
Row 4, Column 1
Yes
No
N/A
Yes
No
N/A
Row 4, Column 2
Yes
No
N/A
Yes
No
N/A
Row 4, Column 3
Fire Hose Reels
Yes
No
N/A
Yes
No
N/A
Row 5, Column 0
Yes
No
N/A
Yes
No
N/A
Row 5, Column 1
Yes
No
N/A
Yes
No
N/A
Row 5, Column 2
Yes
No
N/A
Yes
No
N/A
Row 5, Column 3
Gas System
Yes
No
N/A
Yes
No
N/A
Row 6, Column 0
Yes
No
N/A
Yes
No
N/A
Row 6, Column 1
Yes
No
N/A
Yes
No
N/A
Row 6, Column 2
Yes
No
N/A
Yes
No
N/A
Row 6, Column 3
Fire Alarm
Fire Extinguishers
Fire Sprinklers
Hydrants
Pumps
Fire Hose Reels
Gas System
Monthly
Yes
No
N/A
Yes
No
N/A
Row 0, Column 0
6 Monthly
Yes
No
N/A
Yes
No
N/A
Row 0, Column 1
Yearly
Yes
No
N/A
Yes
No
N/A
Row 0, Column 2
5 Yearly
Yes
No
N/A
Yes
No
N/A
Row 0, Column 3
Monthly
Yes
No
N/A
Yes
No
N/A
Row 1, Column 0
6 Monthly
Yes
No
N/A
Yes
No
N/A
Row 1, Column 1
Yearly
Yes
No
N/A
Yes
No
N/A
Row 1, Column 2
5 Yearly
Yes
No
N/A
Yes
No
N/A
Row 1, Column 3
Monthly
Yes
No
N/A
Yes
No
N/A
Row 2, Column 0
6 Monthly
Yes
No
N/A
Yes
No
N/A
Row 2, Column 1
Yearly
Yes
No
N/A
Yes
No
N/A
Row 2, Column 2
5 Yearly
Yes
No
N/A
Yes
No
N/A
Row 2, Column 3
Monthly
Yes
No
N/A
Yes
No
N/A
Row 3, Column 0
6 Monthly
Yes
No
N/A
Yes
No
N/A
Row 3, Column 1
Yearly
Yes
No
N/A
Yes
No
N/A
Row 3, Column 2
5 Yearly
Yes
No
N/A
Yes
No
N/A
Row 3, Column 3
Monthly
Yes
No
N/A
Yes
No
N/A
Row 4, Column 0
6 Monthly
Yes
No
N/A
Yes
No
N/A
Row 4, Column 1
Yearly
Yes
No
N/A
Yes
No
N/A
Row 4, Column 2
5 Yearly
Yes
No
N/A
Yes
No
N/A
Row 4, Column 3
Monthly
Yes
No
N/A
Yes
No
N/A
Row 5, Column 0
6 Monthly
Yes
No
N/A
Yes
No
N/A
Row 5, Column 1
Yearly
Yes
No
N/A
Yes
No
N/A
Row 5, Column 2
5 Yearly
Yes
No
N/A
Yes
No
N/A
Row 5, Column 3
Monthly
Yes
No
N/A
Yes
No
N/A
Row 6, Column 0
6 Monthly
Yes
No
N/A
Yes
No
N/A
Row 6, Column 1
Yearly
Yes
No
N/A
Yes
No
N/A
Row 6, Column 2
5 Yearly
Yes
No
N/A
Yes
No
N/A
Row 6, Column 3
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5
2.1 Monthly Services
Complete all monthly service activities
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6
2.2 Alternative Power Supplies Electric Pumps
In addition to the requirement of Item 1.14 of monthly test, where alternative power supplies are provided, RUN the pump(s) continuously for not less than 3 minutes off the alternative supply.
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2.3 Hydro-Pneumatic Accumulator
................. kPa.
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8
Test Results of devices
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Testing comments/Suggestions/Defects
Huge
Large
Normal
Small
Ok
quote
Created with Sketch.
Ok
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Testing comments/Suggestions/Defects Photos
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