(COMPANY HEADING / LOGO)
FIRE SAFETY MAINTENANCE REPORT
A. SHORT DESCRIPTION OF THE BUILDING
I.BUILDING NAME
II.COMPLETE ADDRESS
III.CONTACT NUMBER
IV.CONTACT PERSON
V.EMAIL ADDRESS
VI.GROSS FLOOR AREA
VII.NUMBER OF FLOORS
VIII.TYPE OF USE
B. STATEMENT OF TESTING AND MAINTENANCE STANDARDS USED
C. DISCUSSIONS OF FIRE PROTECTION AND LIFE SAFETY ISSUES
1. The building is equiped with fire safety equipment as follows:
I. FIRE PUMP SYSTEM
BRAND
TYPE
QUANTITY
CAPACITY
CUT-OUT
CUT- IN
II. FIRE DETECTION AND ALARM
SYSTEM
BRAND
TYPE
QUANTITY
CAPACITY
III. FIRE EXTINGUISHERS
BRAND
TYPE
QUANTITY
STATUS
III. EMERGENCY LIGHTS
BRAND
TYPE
QUANTITY
STATUS
III. SMOKE EXTRACTION FAN
BRAND
TYPE
QUANTITY
STATUS
2. Life Safety Activities
NR
TYPE OF TRAININGS / SEMINARS
RESOURCE
FREQUENCY
DATE CONDUCTED
D. EXITS AND MEANS OF EGRESS
a. Number of active Exits
NR
LOCATION
TYPE
QUANTITY
MAKE
LOCK TYPE
b. Maintenance records done on egress component such as doors ans eclosed
stairways;
NR
LOCATION
TYPE
QUANTITY
MAKE
LOCK TYPE
E. FIRE SUPPRESSION
a. Maintenance and testing records done on fire pumps, sprinkler system,
portable fire extinguishers, standpipes and other fire suppression systems;
NR
EQUIPMENT
FREQUENCY OF
INSPECTION
FREQUENCY OF
TESTING
PMS FREQUENCY
DATE LAST
TESTED
b. Result of Annual fire pump tests, annual main drain tests, and water flow test
for standpipe, submit other test results as appropriate;
NR
DESCRIPTION
TEST FLOW IN
GPM
TEST
PRESSURE IN
PSI
TESTING
FREQUENCY
DATE LAST
TESTED
F. FIRE DETECTION, ALARM, COMMUNICATION AND EVALUATION SYSTEM
a. Testing and maintenance records done on components of the Detection and
Alarm system including the fire alarm control panel;
NR
EQUIPMENT
FREQUNECY OF
INSPECTION
TESTING
FREQUENCY
PMS FREQUENCY
DATE LAST
TESTED
G. SMOKE CONTROL MANAGEMENT
a. Maintenance and testing records of the various component of the smoke
management system. Including test records for pressurization fans for flows
and fan controls.
NR
EQUIPMENT
FREQUNECY OF
INSPECTION
TESTING
FREQUENCY
PMS FREQUENCY
DATE LAST
TESTED
H. EMERGENCY POWER SUPPLY
a. Maintenance and testing records of the system components of the emergency
power supply.
NR
I.
TYPE
QUANTITY
TOTAL
CAPACITY (KVA)
TESTING
FREQUENCY
DATE LAST
TESTED
OTHER TESTING AND MAINTENANCE RECORDS, INCLUDING TEST RESULTS OF
ELEVATOR RECALL SYSTEM.
NR
TYPE
QUANTITY
CAPACITY IN
PAX
TESTING
FREQUENCY
DATE LAST
TESTED
Prepared by:
Noted by:
_____________________________
_____________________________
( Safety Officer )
(Owner / Representative)
**Kindly attach pictures and other records of actual testing and PMS conducted on fire fighting
equipments.