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  • Checklist Heat

    Uploaded by

    Riza Mahendra
    11 views12 pages
    This document contains multiple forms checking the status of heat detectors across different floors of a building. Each form checks the wiring, connection to the main control panel, indicator lights, and physical condition of up to 35 individual heat detectors or zones. Staff members sign off after inspecting each floor to confirm all heat detectors are functioning properly.

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    Form Checklist Heat Detector

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    This document contains multiple forms checking the status of heat detectors across different floors of a building. Each form checks the wiring, connection to the main control panel, indicator lights, and physical condition of up to 35 individual heat detectors or zones. Staff members sign off after inspecting each floor to confirm all heat detectors are functioning properly.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    11 views12 pages

    Checklist Heat

    Uploaded by

    Riza Mahendra
    This document contains multiple forms checking the status of heat detectors across different floors of a building. Each form checks the wiring, connection to the main control panel, indicator lights, and physical condition of up to 35 individual heat detectors or zones. Staff members sign off after inspecting each floor to confirm all heat detectors are functioning properly.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 12

    Form Checklist Heat Detector

    Bulan :
    Lantai : Basement

    Koneksi ke MCFA
    Lampu Indikator

    Kondisi Fisik
    No Uraian Keterangan

    Wiring
    √ X √ X √ X √ X
    1 Modul Heat Detector Zona 3
    2 Modul Heat Detector Zona 4
    3 Heat Detector 1
    4 Heat Detector 2
    5 Heat Detector 3
    6 Heat Detector 4
    7 Heat Detector 5
    8 Heat Detector 6
    9 Heat Detector 7
    10 Heat Detector 8
    11 Heat Detector 9
    12 Heat Detector 10
    13 Heat Detector 11
    14 Heat Detector 12
    15 Heat Detector 13
    16 Heat Detector 14
    17 Heat Detector 15
    18 Heat Detector 16
    19 Heat Detector 17
    20 Heat Detector 18
    21 Heat Detector 19
    22 Heat Detector 20
    23 Heat Detector 21
    24 Heat Detector 22
    25 Heat Detector 23
    26 Heat Detector 24
    27 Heat Detector 25
    28 Heat Detector 26
    29 Heat Detector 27
    30 Heat Detector 28
    31 Heat Detector 29
    32 Heat Detector 30
    33 Heat Detector 31
    34 Heat Detector 32
    35 Heat Detector 33
    36 Heat Detector 34
    37 Heat Detector 35
    38 Heat Detector 36
    39 Heat Detector 37
    40 Heat Detector 38

    Catatan :

    dicek oleh

    (_________________)
    NIK.
    Form Checklist Heat Detector
    Bulan :
    Lantai : Ground

    Koneksi ke MCFA
    Lampu Indikator

    Kondisi Fisik
    No Uraian Keterangan

    Wiring
    √ X √ X √ X √ X
    1 Modul Heat Detector Zona 3
    2 Modul Heat Detector Zona 4
    3 Heat Detector 1
    4 Heat Detector 2
    5 Heat Detector 3
    6 Heat Detector 4
    7 Heat Detector 5
    8 Heat Detector 6
    9 Heat Detector 7
    10 Heat Detector 8
    11 Heat Detector 9
    12 Heat Detector 10
    13 Heat Detector 11
    14 Heat Detector 12
    15 Heat Detector 13
    16 Heat Detector 14
    17 Heat Detector 15
    18 Heat Detector 16
    19 Heat Detector 17
    20 Heat Detector 18
    21 Heat Detector 19
    22 Heat Detector 20
    23 Heat Detector 21
    24 Heat Detector 22
    25 Heat Detector 23
    26 Heat Detector 24
    27 Heat Detector 25
    28 Heat Detector 26

    Catatan :

    dicek oleh

    (_________________)
    NIK.
    Form Checklist Heat Detector
    Bulan :
    Lantai : 2

    Koneksi ke MCFA
    Lampu Indikator

    Kondisi Fisik
    No Uraian Keterangan

    Wiring
    √ X √ X √ X √ X
    1 Modul Heat Detector Zona 3
    2 Modul Heat Detector Zona 4
    3 Heat Detector 1
    4 Heat Detector 2
    5 Heat Detector 3
    6 Heat Detector 4
    7 Heat Detector 5
    8 Heat Detector 6
    9 Heat Detector 7
    10 Heat Detector 8
    11 Heat Detector 9
    12 Heat Detector 10
    13 Heat Detector 11
    14 Heat Detector 12
    15 Heat Detector 13
    16 Heat Detector 14
    17 Heat Detector 15
    18 Heat Detector 16
    19 Heat Detector 17
    20 Heat Detector 18
    21 Heat Detector 19
    22 Heat Detector 20
    23 Heat Detector 21
    24 Heat Detector 22
    25 Heat Detector 23
    26 Heat Detector 24
    27 Heat Detector 25
    28 Heat Detector 26
    29 Heat Detector 27
    30 Heat Detector 28

    Catatan :

    dicek oleh

    (_________________)
    NIK.
    Form Checklist Heat Detector
    Bulan :
    Lantai : 3

    Koneksi ke MCFA
    Lampu Indikator

    Kondisi Fisik
    No Uraian Keterangan

    Wiring
    √ X √ X √ X √ X
    1 Modul Heat Detector Zona 3
    2 Modul Heat Detector Zona 4
    3 Heat Detector 1
    4 Heat Detector 2
    5 Heat Detector 3
    6 Heat Detector 4
    7 Heat Detector 5
    8 Heat Detector 6
    9 Heat Detector 7
    10 Heat Detector 8
    11 Heat Detector 9
    12 Heat Detector 10
    13 Heat Detector 11
    14 Heat Detector 12
    15 Heat Detector 13
    16 Heat Detector 14
    17 Heat Detector 15
    18 Heat Detector 16
    19 Heat Detector 17
    20 Heat Detector 18
    21 Heat Detector 19
    22 Heat Detector 20
    23 Heat Detector 21
    24 Heat Detector 22
    25 Heat Detector 23
    26 Heat Detector 24
    27 Heat Detector 25
    28 Heat Detector 26
    29 Heat Detector 27
    30 Heat Detector 28
    31 Heat Detector 29
    32 Heat Detector 30
    33 Heat Detector 31
    34 Heat Detector 32
    35 Heat Detector 33
    36 Heat Detector 34
    37 Heat Detector 35
    Catatan :

    dicek oleh

    (_________________)
    NIK.
    Form Checklist Heat Detector
    Bulan :
    Lantai : 5

    Koneksi ke MCFA
    Lampu Indikator

    Kondisi Fisik
    No Uraian Keterangan

    Wiring
    √ X √ X √ X √ X
    1 Modul Heat Detector Zona 3
    2 Modul Heat Detector Zona 4
    3 Heat Detector 1
    4 Heat Detector 2
    5 Heat Detector 3
    6 Heat Detector 4
    7 Heat Detector 5
    8 Heat Detector 6
    9 Heat Detector 7
    10 Heat Detector 8
    11 Heat Detector 9
    12 Heat Detector 10
    13 Heat Detector 11
    14 Heat Detector 12
    15 Heat Detector 13
    16 Heat Detector 14
    17 Heat Detector 15
    18 Heat Detector 16
    19 Heat Detector 17
    20 Heat Detector 18
    21 Heat Detector 19
    22 Heat Detector 20
    23 Heat Detector 21
    24 Heat Detector 22
    25 Heat Detector 23
    26 Heat Detector 24
    27 Heat Detector 25
    28 Heat Detector 26

    Catatan :

    dicek oleh

    (_________________)
    NIK.
    Form Checklist Heat Detector
    Bulan :
    Lantai : 6

    Koneksi ke MCFA
    Lampu Indikator

    Kondisi Fisik
    No Uraian Keterangan

    Wiring
    √ X √ X √ X √ X
    1 Modul Heat Detector Zona 3
    2 Modul Heat Detector Zona 4
    3 Heat Detector 1
    4 Heat Detector 2
    5 Heat Detector 3
    6 Heat Detector 4
    7 Heat Detector 5
    8 Heat Detector 6
    9 Heat Detector 7
    10 Heat Detector 8
    11 Heat Detector 9
    12 Heat Detector 10
    13 Heat Detector 11
    14 Heat Detector 12
    15 Heat Detector 13

    Catatan :

    dicek oleh

    (_________________)
    NIK.
    Form Checklist Heat Detector
    Bulan :
    Lantai : 7

    Koneksi ke MCFA
    Lampu Indikator

    Kondisi Fisik
    No Uraian Keterangan

    Wiring
    √ X √ X √ X √ X
    1 Modul Heat Detector Zona 3
    2 Modul Heat Detector Zona 4
    3 Heat Detector 1
    4 Heat Detector 2
    5 Heat Detector 3
    6 Heat Detector 4
    7 Heat Detector 5
    8 Heat Detector 6
    9 Heat Detector 7
    10 Heat Detector 8
    11 Heat Detector 9
    12 Heat Detector 10
    13 Heat Detector 11
    14 Heat Detector 12
    15 Heat Detector 13

    Catatan :

    dicek oleh

    (_________________)
    NIK.
    Form Checklist Heat Detector
    Bulan :
    Lantai : 8

    Koneksi ke MCFA
    Lampu Indikator

    Kondisi Fisik
    No Uraian Keterangan

    Wiring
    √ X √ X √ X √ X
    1 Modul Heat Detector Zona 3
    2 Modul Heat Detector Zona 4
    3 Heat Detector 1
    4 Heat Detector 2
    5 Heat Detector 3
    6 Heat Detector 4
    7 Heat Detector 5
    8 Heat Detector 6
    9 Heat Detector 7
    10 Heat Detector 8
    11 Heat Detector 9
    12 Heat Detector 10
    13 Heat Detector 11
    14 Heat Detector 12
    15 Heat Detector 13

    Catatan :

    dicek oleh

    (_________________)
    NIK.
    Form Checklist Heat Detector
    Bulan :
    Lantai : 9

    Koneksi ke MCFA
    Lampu Indikator

    Kondisi Fisik
    No Uraian Keterangan

    Wiring
    √ X √ X √ X √ X
    1 Modul Heat Detector Zona 3
    2 Modul Heat Detector Zona 4
    3 Heat Detector 1
    4 Heat Detector 2
    5 Heat Detector 3
    6 Heat Detector 4
    7 Heat Detector 5
    8 Heat Detector 6
    9 Heat Detector 7
    10 Heat Detector 8
    11 Heat Detector 9
    12 Heat Detector 10

    Catatan :

    dicek oleh

    (_________________)
    NIK.

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