T&C Form – CO2/Clean Agent 1/1

JKR/CKM/T & C :______________________

CAWANGAN KEJURUTERAAN MEKANIKAL

JABATAN KERJA RAYA

TESTING AND COMMISSIONING FOR FIRE FIGHTING SYSTEM

CARBON DIOXIDE / CLEAN AGENT SYSTEM

Project : ........................................................................................................................................................
.......................................................................................................................................................
Date : ............................................................................
Time :..............................................................................
Equipment/System :……………………………………….
Make / Model :……………………………………….
Capacity : ……………………………………………………
Location : ……………………………………………………

Solenoid Valve
Item Indication Light LED Indication Alarm Bell
Actuation Signal
Green Red Volt Second
Zone 1 Intermediate
Zone 1 & 2 Continue
Manual Key Continue

Test & Check : Results Test & Check : Results

1. Operation of Reset Switch 5. Labeling

2. Power On Indicator 6. Proper Connections
3. AC Fail Indicator And Alarm 9. Proper Mounting And Painting
4. Battery Voltage
Remarks :
a. Fire Curtain ………….. Volt Signal
b. Roller Shutter ………….. Volt Signal
c. Ventilation Fan ………….. Volt Signal
d. High Temperature “Heat Detector” ………….. Volt Signal
e. High Temperature “Heat Detector” ………….. Volt Signal

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Test By : Witness By :

……………………………………………………. …………………………………………………….
Name : Name :
Company Chop : Company Chop :

All test forms to be attached together with this inspection forms.

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