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899 Atlantic Blvd NFPA-25 Inspection 613 N.W.MERCANTILE PLACE 3226 CHERRY PALM DRIVE r TAMPA,Fill 33619 772-378-3350-FAX:772478-5967 81 3.630-0303-FAX;813-630l PORT ST.LUCIE,134986 'm 113H DISTRIBUTION AVENUE WEST ""/W�AYNIE 4683 LAREDO AVENUE JACKSONVILLE,FLORIDA 32266-2745 Automatic Fire Spriniclers, Inct FORT MYERS,FLORIDA 33906 906-268-3030-I":904-268H()724 222 CAPITOL CT. 239433-3030-FAX 239431 4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 Nall 16TH TERRACE CONCORD.NORTH CAROLINA 28027 407-656-3030-407-656-8026 POMPANO BEACH,FLORIDA 33064 704-782-3032-fifil 704�796-6838 954417-3030-1":954-917-9424 NFPA-25 Inspection, Testing and Maintenance of Wet Pipe Fire Sprinkler Systems liberal an this form pointer 08 minimum rechannel of the current Supoptiod NITA 25 amps,for him Snunkler System conampand to datrituffloom symems and,pat supPlarnalmall Wks or fire Pumps.Sep"a"a am available to Innate.win And human fire Pumps."by Wks and other fire probaction Systems, Names ambneent metal mare,And mhwan�My be nexampary depending an Me opposed,orthe scoopful and Me water supply Omer: PANERA BREAD#1781 SITE#: CALI-irl 326744 Overper'sAddress: 899ATLANTIC BOULEVARDATILANTIC BEACH.132233 Omer.Phone Number (9N)249-9358 Property Being Evalwated: PMERABREAD#1781 Property Address: 899 ATLANTIC BOULEVARD ATLANTIC BEACH,FL.32233 DateofPsork: 2018-04-02 AJI responses refer to the current wark(Inspection,testing and Maintenance)performseed on III clate. 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ONO 3 Proulary ml old no indarm 1.�, ON. 87'1AA K Owner or hip.requensts WAFS to relearse information from D Visible pro manul manum be—red Fee ONO Inspections to the underwriters,of my Insurance company. Ormy ONO E H........upins;and randatimiumparaminnown,Annual AMANDA 2018-04-02 ami in a—mayme with Mi 1� ONIC I ONO &VA comeriandereemnalverymmourps) Sgroades Dem 0 Pad 11-Inspunctor's Spection Fourveravromp-houndayeame Me Meher,...ard on.ypn..r.—...AS b. A.l�l.. Am within.my,b y—, ONIC I ONO &PA tressinedylemahmeno plembrovermary-Nal—d..h Human mander.) X conel...avereamovereparm.noternandmays siii..ampardonomm.vin matimyeatunim..) Ayl Ones ONO ONIA A.morm�Smmy a.ams,....mmul firmem and a.. A ral harmay pass"makerall inspeadder? ONIC Oym ONO I I valves in oureact(am or down)�on? @Y- ON. ON. 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A eved.w... a- vs. —it.1 protest der thavreaream prelaure per made wwm,and in good ovivemn even 9 NN am led shmishoserm ad correction or ansays,—monal ven al�W�M humpinney n.Novi 0 P-gr=u-Savallable brommadmaymor eyes ONO Cay, *Hdral norepithe wv�vvmd symberm saybody memped So depar 3.Annual Time(in WdWm W Parmeres Here) and ads" (Ell.. ON. A,Man it..1. psi and FddmdmA C,Fee ouloaminvant oral 1 R�SWcPmss" GO preadure Se ,muser somearly,tiourincy and canes me damosse,arm r S..mnmnm-SpMAl Smoothly plugs or mays in Save and Underhill beery in plate mad 2 vions fla.man..' @y. ON. ().A In al oonders,..'ar,samp 1.0..ni'lle me d A.Am...par.,.to an.. eyes ON. OVA eal dampuse an 1.Arm tiparders prumed,Am minam.a.. va.mientiand.1.11housill Orr.. ONO OVA 8 Am Or sonvidem new moo or l�o 0...to deal. ...0yes ONO C per napprem Numbers 20 an mom years No repposed (I ONO OWA AshomandsmarrummuMvievers? Q)NSC Or" ONO CALLII: 326744 Pad an-Godrandand,In", andue",ad,daynon,On� "Mod,why"Men low stworearry di My any'laward ..a Met pards, Now dr,hade-Mad eyes Me It .P.111reperniterri D S�M�w�mW���oldmp�� appoodept deadquip suppead aured met 10 Preand? ONIC Order ONO E Standeard hadeparposse appereepart 75 Or show deade did wNwwd or @11 Otow ON. F wit," ormser P.or�,�..We ONIC Ordere ONO (DWA Seal 1310973 G speep,hip'twoodarded—proardess? Oynd ONO (BNVA Seal BACKIFLOW 131097`481175 A us, Othade ONO OVA I Maturity,...parowd readeptow try, ONIC Opera ONO eVA J ...... OWC oyare ONO 01"J", K Pw—randupprOwers"passed parmal flowass? 01try-dayea not prowdeadt ONIC Oyid ONO &VA 11yeattipleadonewhospreflol year. NFIPAI.yeadwousupperred ONO Ory. 0. SN. Tand re,be Mand,wher,On swur a,SWn..Myonspi hoppernatures andend ON,One. ON. *Gametes.0,pardomers go,.On pappappows Orred, ONO *prandemon dedused,...ped.Ne flow, ad ONIC Oyster Onto (DNA C.Mal�nce 1.Persons eatundemance Um at,It dropped have send request wide Mae prophyar madaymeards? Orion, ONO 8,owed sper,was opposed mandu end used perfory len, yesed Indeed SiAndayl be whyroy'residessuseptodusishow...1—d���.� d..I..n an prowd!manners Ohdat ONO Onhk C,Systand rotor fled awah Man water were derandsol and @chapportamparatermads, Oyes, ONO I'domrianstaryworgessardesproped whismarippearadead,swerlynatem ONIC Oy- ONO (DIVA 1,�reake arreen on pump with auction from pred thandeas 2 O���wmWenaidisoargedounngw�erflmtMan chadessappeamorware, 4 F~�hw�rdunngdmlnt@MWP�M��$%St�m pau"Motmeepreparryposoyfronsionard,�v�oi 7 prodays of tender many in the sudity 8 attyroarmally Mrstarent aws tripping Or phrose vorwas, Pan N-Cadeaddreadpand:says pand a Mat Ne"pai itheyeadider Me, "are"Lay,di Is 9 Systimmus onnermard to person,add an endampedl parad put Or Monday Q,dMer Man ords yeave. W��byaft�n�, 10 Thape a neetworn to psyseve the system me n.andisert eassayse...deadeadwaye per hi sonsesessayunnesempoppeopil.asparnme E if opersdaraw were Ishands and posquided flues,wary running 0 Sy� ONIC Oyeare ONO @mA L Annual MiMenan�Rms(a addepent ad praddhousatered) ,y nowhere...pow,ostly vskyrempardand spernment,..a.and, parmnsts' Othe ONO JWA d phn..e pard.,.1.M.,proundeardenal possan,adoaphysent und—teentiddards was.andri for toni whis.appow- onness ONO &VA 3.�ularMi�.mo�$ A Is-possay!dide? OY" @No C),A is Syned,and deasnither? (Dy- ONO OMA C lssy�m,mps,r�?(Impa�t��pWiMo�WNFP�aM Me-Alessi In.Sphiters Orion, 0. lasenter-M.".1.1matereamon I ands,Mad Met"—.a...1 Into and,1. M,ars,did Pi of rusprespeasphy .1 wouphatent shaded ad the time was afted opeoppeoned oppi upon somparson Or as y i naposmon trends a.parted an Pad 111.. mra suppay Or wor, pronompay,does not spent, w—OF Me sponamper or Me Olson system passed Date: 2[1 Signature of intspenclor: 54P Print Name: TAILSTOCK Lisomed, r Certification Number(if applicable): FPI-170DD027 Color of tag placed on system: Which systems am Red Tagged: F F r? Red Yellow, Green 613 K.W.MERCANTILE PEACE 3226 CHERRY PALM DRIVE PORT ST.LUCIE,FIL 34986 TAMPA,FIE 33619 772-878-330-FAX:772-878-5967 \"V"07A0MNE 813.630-0303-FA)E 81 3-6304312 11326 DISTRIBUTION AVENUE WEST 4683 LAREDO AVENUE JACKSONVILLE,FLORIDA 32256-2745 A.tometic Fire Sprinklers, Inc. FORT MYERS,FLORIDA 33905 9�268-3030-FAX;9N.26"7U 222 CAPITOL CT. 239�3-3030-1":239433-3263 4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW 16TH TERRACE CONCORD,NORTH CAROLINA U027 407-656-3030-407-656-8026 POMPANO BEACH,FLORIDA 330U 7N.7824032-FAX:704-795-6838 951-917-3030-FAX:SU-9174424 Backfiow Prevention Assembly Test Report CUSTOMER: PANERABREAD#1781 INSPECTOR: TAILSTOCK DATE: 2018-04-02 ADDRESS: SNATLANTICBOULEVAM LICENSEM T02-17-10120 TIME: CITY,ST,ZIP: ATLANTIC BEACH,FIL,32233 ISC#: JOBLOCATION: PANERABREAD#1781 ADDRESS: 899 ATLANTIC BOULEVARD ATLANTIC BEACH,FIE.32233 LOCATION(CHECK&DESCRIBE): C INSIDE G ABOVE GROUND r PIT USAGE(CHECK ONE): F-FIRE D? DOMESTIC REAR HE CORNER OF STORE NEXT TO DUMPSTERS (')DC r DOC r, DDC-BYPASS (*, RPZ C'RPZ-DET r RPZ-DET-BYPASS MFG MODEL E SERIAL# TYPE(CHEC,0: WILKIN I 975XL S21.ZO FIII132 REDUCED PRESSURE PRINCIPLE ASSEMBLY (q-, YES DATE RELIEF PORTS ON RPZ FREE OF CONTINOUS DISCHARGE?(CHECK ONE) (7 NO INSTALLED APPARENT PME.SSUR.E DROP A.Ro��"P� E. DAM DOUBLE CHECK VALVE ASSEMBLY REBUILT CHECK VALVE#1 CHECK VALVE 02 RELIEF VALVE PVB1SVB HELDAT PSID HELDAT 1.4 PSID OPENED AT 2.0 PSID AIR INLET - OPENED AT PSID 4 LEAKED LEAKED DID NOT OPEN r DID NOT OPEN F E CLOSED TIGHT CLOSED TIGHT CLEANED CLEANED CLEANED CLEANED r REPLACED REPLACED REPLACED REPLACED PSID PSID AIR INLET PSID PSID a CLOSED TIGHT CLOSED TIGHT I CHECK VALVE PSID (0)PASS 0 FAIL SUPPLY PRESSURE METERM READING#: BFPINSERVICE IN CERTIFICATION TAG ON BFP FSPECTOWSSI NATURE: 613 N.W.MERCANTILE PLACE 3226 CHERRY PALM DRIVE PORT ST.LUCIE,FL U906 TAMPA,FL 3MI9 77247843M-FAX:772478-5967 \VAVM�AYNE 01 3.63D.0303-FAX:81 3-630-0312 11326 DISTRIBUTION AVENUE WEST 4683 LAREDO AVENUE JACKSONVILLE,FLORIDA 32256-2145 Autoinstic Fkv SprWiiirst. bc. FORT MYERS,FLORIDA 33906 9M.268-3030-FAX:904-20-0724 222 CAPITOL CT. 239433-3030-FAX:239433-3263 4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NIN ISTH TERRACE CONCORD,NORTH CAROLINA 20027 407-656-3030-407-656-8026 POMPANO BEACH.FLORIDA 33N4 704-7824032�I":7N-796�838 9541-917-3030-FAX:SM-917-9424 Backflow Prevention Assembly Test Report CUSTOMER: PANERABREAD#1781 INSPECTOR: TAILSTOCK ADDRESS: 899ATLANTIC BOULEVARD LICENSE#: T02-17-10120 CITY,ST,ZIP: ATLANTIC BEACH,FL.32233 3ZI17" JOBLOCATION: PANERA BREAD#1781 ADDRESS: 899 ATLANTIC BOULEVARD ATLANTIC BEACH,FL.U233 LOCATION(CHECK&DESCRIBE): C.' INSIDE (t' ABOVE GROUND (' PIT USAGE(CHECK ONE): FIRE OZ DOMESTIC REAR NE CORNER OF STORE NEXT TO DUMPSTERS CDC (- DOC (, DDC-BYPASS re,RPZ (,RPZ.DET (,RPZ-DET-BYPASS MFG MODEL BIZE SERIAL# TYPE(CHECK): WILKIN I 975XL 1.0 3939885 REDUCED PRESSURE PRINCIPLE ASSEMBLY re, YES DATE RELIEF PORTS ON RPZ FREE OF CONTINOUS DISCHARGE?(CHECK ONE) (- NO INSTALLED PRE E�P ��ME�IRV E=V&� REBUILT DOUBLE CHECK VALVE ASSEMBLY DATE CHECK VALVE 91 CHECK VALVE 02 REUEF VALVE PVBISVB HELD AT 8.0 PSID HELD AT 2.6 PSID OPENED AT 2.0 PSID AIR INLET - OPENED AT PSI- LEAKED LEAKED DID NOT OPEN F DID NOT OPEN z CLOSED TIGHT CLOSED TIGHT CLEANED CLEANED CLEANED CLEANED F Q REPLACED F REPLACED REPLACED F REPLACED F PSID _PSID AIRINUET_ PSID PSID CHECKVALVE PSID CLOSED TIGHT CLOSED TIGHT re,PASS C)FAIL SUPPLY PRESSURE METERM READINGN BFP IN SERVICE CERTIFICATION TAG ON BFP F��I NATURE: �WAZ;z'-- I 613 N.W.MERCANTILE PLACE 3226 CHERRY PALM DRIVE PORT ST.LUCIE,FIL 34996 TAMPA,FIL 33619 7724784350-FAX:772-87M967 \"V'51mMYNE 8134304303-FAX:813.630-0312 11326 DISTRIBUTION AVENUE WEST 4683 LAREDO AVENUE JACKSONVILLE,FLORIDA 32256-2745 Automatic Fire Sprinklers, Inc. FORT MYERS,FLORIDA 33905 9W268-3030-FAX;904-2684724 222 CAPITOL CT. 239433-3030-FAX:239433-3263 4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW ISTH TERRACE CONCORD,NORTH CAROLINA 28027 407-656-3030-407-656-8026 POMPANO BEACH,FLORIDA 330U 7N.7824032-FAX:7W79548M 9�917-3030-FAX:964-917-94U Backflow Prevention Assembly Test Report CUSTOMER: PANERABREAD#1781 INSPECTOR: TAILSTOCK DATE: 2018��2 ADDRESS: 899 ATLANTIC BOULEVARD LICENSE* T02-17-10120 TIME: CITY,ST,ZIP: ATLAN nC BEACH.FL.32233 Ise# 3267� JOBLOCATION: PANERABREAD#1781 ADDRESS: 899ATLANTIC BOULEVARDATLANTIC BEACH.FL.32233 LOCATION(CHECK&DESCRIBE): (- INSIDE (a, ABOVEGROUND IF PIT USAGE(CHECK ONE): OZ FIRE r- DOMESTIC REAR NE CORNER OF STORE NEXT TO DUMPSTERS (-�)DC (,�DOG (P DDC-SYPASS r, RPZ (7 RPZ-DET ( ,RPZ-DET-BYPASS MFG MODEL SIZE SERIAL0 TYPE(CHECK): WILIKINI 950XL .750 1 3890282 REDUCED PRESSURE PRINCIPLE ASSEMBLY C, YES DATE RELIEF PORTS ON RPZ FREE OF CONTINOUS DISCHARGE?(CHECK ONE) (-; NO INSTALLED �PAR WPRES=DwP VALVE ASSEMBLY �"RST. VAL� DATE DOUBLE CHECK I I REBUILT CHECK VALVE#1 CHECK VALVE#2 REUEFVALVE PVfffsVB HELD AT 2.8 PSID HELD AT 2.4 PSID OPENEDAT PSID AIR INLET OPENEDAT PSID LEAKED LEAKED r DIONOTOPEN r CLOSECTIGHT CLOSED TIGHT R DID NOT OPEN F CLEANED CLEANED r CLEANED CLEANED r- r- F F REPLACED REPLACED REPLACED REPLACED PSID PSID AIR INLET PSID PSID CLOSED TIGHT CLOSED TIGHT F- CHECKVALVE PSID ro,PASS 0,FAIL SUPPLY PRESSURE METER#; READING#: BFPINSERVICE CERTIFICATION TAG ON BFP �WSPCTOR.SSI NATURE: 613 N.W.MERCANTILE PLACE 3226 CHERRY PALM DRIVE PORT ST.LUCIE,FIL U986 TAMPA,FIL 33619 71247843M-FAX:772-8784967 \"V* WOMYNE 8134130-0303-FAX:81 3 4304312 11326 DISTPJBUTION AVENUE WEST Automatic Fire Sprinklers. Inc. 4683 LAREDO AVENUE JACKSONVILLE.FLORIDA 32256-2746 FORT MYERS,FLORIDA 33905 904-2684030-FAX:904-2604724 222 CAPITOL CT. 239433-3030-FAX:239433-3263 4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW 16TH TERRACE CONCORD,NORTH CAROLINA 28027 407-656-3030-407-656-8026 POMPANO BEACH,FLORIDA 330" 704-782-3032-FAX:704-795-6838 954-917-3030.FAX:9�911-94U Backflow Prevention Assembly Test Report CUSTOMER: PANERABRFAD#1781 INSPECTOR TAJLSTOCK DATE*=2111-1"2,, TI ADDRESS: 8%ATLANTIC BOULEVARD LICENSE 0: T02-17-10120 TIME: CITY,ST,ZIP: ATLANTIC BEACH,FL.32233 ISC#: 326744 JOBLOCATION: PANERABREAD#1781 ADDRESS: 899 ATLANTIC BOULEVARD ATLANTIC BEACH.FL.32233 LOCATION(CHECK&DESCRIBE): (- INSIDE Q! ABOVE GROUND r PIT USAGE(CHECK ONE): OZ FIRE DOMESTIC REAR NE CORNER OF STORE NE)(TTO DUMPSTERS C',DO Ie DOC (-, DDC-BYPASS r RPZ r,RPZ-DET (' RPZ-DET-BYPASS MFG MODEL SIZE SERIAL# TYPE(CHI WILKIN I 350ADA 6.0 V39892 REDUCED PRESSURE PRINCIPLE ASSEMBLY C YES DATE RELIEF PORTS ON RPZ FREE OF CONTINOUS DISCHARGE?(CHECK ONE) (- NO INSTALLED I ArP-E-'RT..-URE.-I DAM DOUBLE CHECK VALVE ASSEMBLY �S'R. �.Kv�� I REBUILT CHECK VALVE 91 CHECK VALVE#2 RELIEF VALVE PVB/SVB HELD AT 3.8 PSID HELD AT 2.4 PSID OPENED AT PSID AIR INLET OPENEDAT PSO LEAKED LEAKED r DID NOT OPEN F DID NOT OPEN CLOSED TIGHT CLOSED TIGHT CLEANED CLEANED CLEANED CLEANED REPLACED REPLACED REPLACED REPLACED PSID PSID AIR INLET PSID PSID CLOSED TIGHT CLOSED TIGH1 CHECKVALVE PSID PASS C FAIL SUPPLY PRESSURE METER#: REAdDINCIP. CERTIFICATION TAG ON BFP NATURE; BFPINSERVICE 613 INK MERCANTILE PLACE 3226 CHERRY PALM DRIVE TAMPA,FL 33619 PORT ST.LUCIE,FIL U986 772-878�3350-FAX:772-078-5967 813430-0303-FAX:81 3 4304312 113H DISTRIBUTION AVENUE WEST ""AWMYNIE 4683"REDO AVENUE JACKSONVILLE,FLORIDA 32256-2745 Autmunatic Fire Sprinklers, Inc. FORT MYERS,FLORIDA 33905 904-268.3DW-FAX:904-2611-0724 222 CAPITOL CT. 239433�030-FAX:239433-3263 4370 MOTORSPORT DRIVE 3121 NVY 16M TERRACE OCOEE,FL 34761-3033 POMPANO BEACH,FLORIDA 33064 CONCORD,NORTH CAROLINA 28027 407-666-3030-407-656-8026 964-917-3030-FAX:9541-917-94Z4 71�182-3032-FAX:704-79540138 Fire Alarm System Inspection and Testing Report -ttils testing was performed in accordance Win applicable N.F.P.A.standards. ONtner: PANERA BREAD#1781 ISC st 326744 Date 2018-�02 O�.Address: 8%ATLANTIC BOULEVARD ATLANTIC BEACH,FL.32233 Property Being Einaluated: PANERA BREAD#1781 Property Address: 899 ATLANTIC BOULEVARD ATLANTIC BEACH.FL.S2233 Monitoring Entity Panel Manufactuner: FIRE LITE Model No. MS-gMUD Name: CONSOLIDATED FIRE CircuitStyles: STYLE B(CLASS B)STYLE Y(CLASS N) And l(SLC)1(NAC) Telephone: (800)662-1711 Last Date System Had Service Peribnmed: UNK Account Ref.No. A21-54M Last Date Solteeare or Configuration Was REARead: V13 B2 I OCTOBER 2013 Servica, All i An BCH DIR OF PUBLIC SAFETY Weekly Monthly AHJ phone# (904)247-6864 Quartedy (�' -Digital Senni-Annually (*7 -R.F. Other Specify Other(Spereft) Inspected by(pdnt) TAILSTOCK Date: 20l&-0"2 Time Signature ofAlann Agent: (Agent Mesets Requirement$Per Florida Statute 489.518) Nam of Omtner or repmetuartati" Amanda Signature Date: 2018-04-02 I�ld NO to have a�Of NIPPANTe I n O� ONO Cramer or esp.rectitude,WAFS to release hifienrualon frome inspections to the undenemitems Of MY Insurance company. OYOS ONO System restored to normal operabon:Tim: Notifications are made Yes No Me Time Monitoring Entity V r— — Building Occupants 15Z F- Building Management Other Specify) 1. ALARM NOTIFICATION APPLIANCES TEST AND INSPECTION Device Cieit Style/Quarafty Operational Test Approired Location Pas. Fall Bell. Quantity( I Size( 6 Type(Ac v r— Home A( B( I- F- Speakers A( B( F- F- r- Chimes A� S( I r- F- r- Strobes A( S( F- r- F- Other.(Specify) A( I Big v R F- HORNSTROSE No.ofluarmIndicatingetrouits: 1 AmCir.ufts,erwmadl? (,—Y.. (—No Page 2 11,INIT10111413 AND SUPERVISORY DEVICE TEST AND INSPEC TION ass Fail Device - Chwit StylaiQuentity, - Operational Test - Simulated Test P Manuel Stations A B( 3 1 F Ion Detectors A B( I r— Photo Detectors A B( I I F Dud Detectors A B( I F Heat Detective A I B( I F Waterhad Detectors A B( I I F Supervisory Switches A I B( 3 I F- Pressure Swit.1-ras A I B I I F F F Lovi,Air A I B I I F Other(spect A I B( I Ill. SUPERVISORY SIGNAL INITIATING DEVICES&CIRCUIT INFORMATION SifteWaterTernia. C Yes C,No (is NIA Site Water Level (-Yes No (9)NIA Fire Pump POviar r Yes No WA Fire Pump Running ryes (7 No r*WA Fire Pump Auto Position C Yes rNo N/A Fire Pump or Pump Control Trouble Yes No Ill Generator In Auto PoSition Yes No rl�'WA Gewrator or Centralist Trouble Yes r;No N/A SWtch Transfer Yes ONO NIA Generator Engine Running Yes ( ,No NIA Lock Box (,Yes r.No N/A A.SIGNALING LINE CIRCUITS Quantity and style(Be.NFPA 72,Table 3-6)0 signaling line CHWH5 connected to system Quantity I Style(S)� 4 IV.SYSTEM POWER SUPPLIES A.Pahmary(Main):Normal Voltage 120 Amiss 3 OvercarmudProuschon:Type: BREAKER Amps 20 Locationfidarvelli (PANELIGP) Disconnecting Mean Location: #29 B.Secondary(Standby): 24V ShmageBaftery:Ani Rating 7AH Calculated capacity to opera rs: DZ 24 r so Na Engine driven generator dedicated to fire alanand System: C.Location of Fuel Storage! No D.TYPE BATTERY SECONDARY POWER Type Visual F,mrWral Dry Cell Battery Condition VZ Nickel Cadmium Load Voltage Pass Seated Lead-Acid Discharge Test Min Offner Basely): Specific Gravity F E.Emergency or standby system used as a back-up to primary pomr supply,instead of using a ascondary covas'SUPply. NO Emergency system described In NTPA...Article 700. Page 3 V.SYSTEM TESTS&INSPECTIONS A.Type Visual Functional D.Notification Appliances Valued Functional Cormcl Pawl 0z Audible V F Interface Equipment r Visual ..E.D�III Lamps 9 Speakers Fuses/MicrOlInaakem F Voice Clancy Prinsm,P�r Supply Trouble Signals Disconnect Switches Ground Fault Monitoring E.ON I OFF pmorwass Monitoring Y. No NIA B.Emergency Cosmnunk-Umn Equipment Namn Signal ro (7 Type Visual Functional NIA Ala.Restonal rw Phone Set F Trouble Signal (0-1 Plume Jacks Trouble Reshral R, C Off Hook Indicators Supervisory Signal re Amptifier(s) Su,pervisory Restoral la`�, Tom Gerserator(s) Reasons Anuciator Call In signal System Performance C.broarlace Equipment DEVICE SIMULATED (SPECIFY) VISUAL OPERATION OPERATION F r r- Special Hatard System(Specify) F r V1.COMMENTS: Mi.DEFICIENCIES: Mass items are Me O."s weposequilly to be repalmardand"I be quoted SePAr8ta ftmo Inspection cost Trouble on panel upon arrival ground fault