TESTING COMMISIONING REPORT

FIRE ALARM
Project _______________________
FM/IK/ODR/MEP-005-02 Rev: 0 Halaman 1 dari 1

Location : _______________________________ Equipment No. : _____________________________

Level : _______________________________ Service : _____________________________
Test Date : _______________________________ Drawing Ref. : _____________________________

Fire Alarm Data :

Manufacture : ______________________ Smoke Detector : _______________________
Type : ______________________ Manual Push Button : _______________________
Serial no. : ______________________ Bell : _______________________
Head Detector : ______________________ Indicator Lamp : _______________________
Fix. Head Detector: ______________________ Jack Phone : _______________________
ROR Detector : ______________________ Annunciator : _______________________
Interface : _______________________

Test Result :

Unit Cleaning : Yes No

Bolt & Nut Tightening : Yes No

System Grounding : Yes No

Voltage Input : Phase-Nol V Phase-Gr V Nol-Gr V

Ambient Temperature : ______________________

Battery : ______________________

Function Test
Location Heat Fix. Heat ROR Smoke Manual Lamp Jack
Bell Interface
Detector Detector Detector Detector Push Button Indicator Phone

Test Result Equipment Test Comments

Approved

Not Approved

Re - Tested

Approved by, Checked by, Tested by,

_________________________ _________________________ _________________________

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