Annual testing certification for sensor release door locks
Testing date
Facility name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Door location
Company service provider
Name of technician
Phone Number
Email
example@example.com
Fire alarm system interconnection: Activation of the building fire alarms system, if so equipped, shall automatically unlock the door. The door shall remain unlocked until the fire alarm system has been reset.
Yes
No
N/A
Fire sprinkler system interconnection: Activation of the building fire alarms system, if so equipped, shall automatically unlock the door. The door shall remain unlocked until the fire alarm system has been reset.
Yes
No
N/A
Loss of power: The door must lock upon loss of power to any of the following: 1) occupant sensor 2) the locking device 3)the locking control system
Yes
No
N/A
Listing: The door locking system units are listed in accordance with UL 294.
Yes
No
N/A
Notes
Should be Empty: