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Fire - Verification Survey & Takeover Checklist
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19
Questions
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1
Call Number
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2
Fire Branch Location
*
This field is required.
Fire Durham
Fire Glasgow
Fire Leeds
Fire Manchester
Fire Birmingham
Pointer Security
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3
Premises
*
This field is required.
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4
Address
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5
Contract No
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6
Date
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7
Category
*
This field is required.
If the category of system is not documented please insert a category which closely matches the level of cover as determined by BS 5839:2017
L1
L2
L3
L4
P1
P2
M
Unknown
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8
Variations to BS 5839:2017
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9
System Description - Control Panel
*
This field is required.
Detail
Number of Panels
Row 0, Column 0
Manufacturer
Row 1, Column 0
Type
Row 2, Column 0
AA/NA
Row 3, Column 0
Number of Zones
Row 4, Column 0
Number of Panels
Manufacturer
Type
AA/NA
Number of Zones
Detail
Row 0, Column 0
Detail
Row 1, Column 0
Detail
Row 2, Column 0
Detail
Row 3, Column 0
Detail
Row 4, Column 0
1
of 5
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10
System Description - Field Devices
*
This field is required.
Detail
Manufacturer
Row 0, Column 0
No of Smoke
Row 1, Column 0
No of Heat
Row 2, Column 0
No of MCP
Row 3, Column 0
Other
Row 4, Column 0
Manufacturer
No of Smoke
No of Heat
No of MCP
Other
Detail
Row 0, Column 0
Detail
Row 1, Column 0
Detail
Row 2, Column 0
Detail
Row 3, Column 0
Detail
Row 4, Column 0
1
of 5
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11
System Description - Alarm Devices
*
This field is required.
Detail
Type of Sounders
Row 0, Column 0
No of Sounders
Row 1, Column 0
No of Beacons
Row 2, Column 0
Type of Sounders
No of Sounders
No of Beacons
Detail
Row 0, Column 0
Detail
Row 1, Column 0
Detail
Row 2, Column 0
1
of 3
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12
System Description - Signalling
*
This field is required.
Detail
Type of Transmitter
Row 0, Column 0
Primary Path Type
Row 1, Column 0
Secondary Path Type
Row 2, Column 0
ARC connected to
Row 3, Column 0
Reference
Row 4, Column 0
Use of Shared Signalling
Row 5, Column 0
Type of Transmitter
Primary Path Type
Secondary Path Type
ARC connected to
Reference
Use of Shared Signalling
Detail
Row 0, Column 0
Detail
Row 1, Column 0
Detail
Row 2, Column 0
Detail
Row 3, Column 0
Detail
Row 4, Column 0
Detail
Row 5, Column 0
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of 6
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13
Inspection
*
This field is required.
Yes
No
N/A
Is there an adequate number of call points?
Row 0, Column 0
Row 0, Column 1
Row 0, Column 2
Is the provision of fire detection adequate to comply with the recommendations of the standard for the Category of system it was designed to meet
Row 1, Column 0
Row 1, Column 1
Row 1, Column 2
Do the sound pressure levels comply and is there sufficient beacons etc for DDA Compliance
Row 2, Column 0
Row 2, Column 1
Row 2, Column 2
Does the system have a standby power supply NOTE: The absence of any standby power supply for the fire alarm system is in breach of the Health and Safety (Safety Signs and Signals) Regulations
Row 3, Column 0
Row 3, Column 1
Row 3, Column 2
Does the standby power supply comply?
Row 4, Column 0
Row 4, Column 1
Row 4, Column 2
Does the fire resistance of the interconnecting cabling (including fixings) comply?
Row 5, Column 0
Row 5, Column 1
Row 5, Column 2
Does the monitoring of the circuits comply?
Row 6, Column 0
Row 6, Column 1
Row 6, Column 2
Does the standard of electrical safety comply?
Row 7, Column 0
Row 7, Column 1
Row 7, Column 2
Does the exposure to, or experience of, false alarms remain within the recommendations of section three of the standard?
Row 8, Column 0
Row 8, Column 1
Row 8, Column 2
Does the building layout appear to be unchanged since the fire alarm system was designed and installed?
Row 9, Column 0
Row 9, Column 1
Row 9, Column 2
Is a suitable log book provided?
Row 10, Column 0
Row 10, Column 1
Row 10, Column 2
Is there suitable “Zone Diagram” & “As fitted”drawings provided?
Row 11, Column 0
Row 11, Column 1
Row 11, Column 2
Is there an adequate number of call points?
Is the provision of fire detection adequate to comply with the recommendations of the standard for the Category of system it was designed to meet
Do the sound pressure levels comply and is there sufficient beacons etc for DDA Compliance
Does the system have a standby power supply NOTE: The absence of any standby power supply for the fire alarm system is in breach of the Health and Safety (Safety Signs and Signals) Regulations
Does the standby power supply comply?
Does the fire resistance of the interconnecting cabling (including fixings) comply?
Does the monitoring of the circuits comply?
Does the standard of electrical safety comply?
Does the exposure to, or experience of, false alarms remain within the recommendations of section three of the standard?
Does the building layout appear to be unchanged since the fire alarm system was designed and installed?
Is a suitable log book provided?
Is there suitable “Zone Diagram” & “As fitted”drawings provided?
Yes
Row 0, Column 0
No
Row 0, Column 1
N/A
Row 0, Column 2
Yes
Row 1, Column 0
No
Row 1, Column 1
N/A
Row 1, Column 2
Yes
Row 2, Column 0
No
Row 2, Column 1
N/A
Row 2, Column 2
Yes
Row 3, Column 0
No
Row 3, Column 1
N/A
Row 3, Column 2
Yes
Row 4, Column 0
No
Row 4, Column 1
N/A
Row 4, Column 2
Yes
Row 5, Column 0
No
Row 5, Column 1
N/A
Row 5, Column 2
Yes
Row 6, Column 0
No
Row 6, Column 1
N/A
Row 6, Column 2
Yes
Row 7, Column 0
No
Row 7, Column 1
N/A
Row 7, Column 2
Yes
Row 8, Column 0
No
Row 8, Column 1
N/A
Row 8, Column 2
Yes
Row 9, Column 0
No
Row 9, Column 1
N/A
Row 9, Column 2
Yes
Row 10, Column 0
No
Row 10, Column 1
N/A
Row 10, Column 2
Yes
Row 11, Column 0
No
Row 11, Column 1
N/A
Row 11, Column 2
1
of 12
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14
Comments
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15
Engineer Name
*
This field is required.
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16
Engineer Signature
*
This field is required.
Clear
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17
Responsible Person Signature
*
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Clear
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18
Responsible Person
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19
Position
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20
CP1
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21
CP2
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22
CP3
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23
CP4
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24
CP5
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25
AD1
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26
AD2
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27
AD3
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28
FD1
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29
FD2
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30
FD3
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31
FD4
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32
FD5
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33
SG1
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34
SG2
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35
SG3
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36
SG4
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37
SG5
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38
SG6
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39
IN1
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40
IN2
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41
IN3
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42
IN4
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43
IN5
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44
IN6
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45
IN7
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46
IN8
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47
IN9
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48
IN10
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49
IN11
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50
IN12
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51
Your Email Address to send copy of report
example@example.com
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