RECEIVING INSPECTION FORM

LEVEL 2A
LEVEL 2A COMMISSIONING FORM
Record the equipment tag, manufacturer, ratings, attributes and note any additional arrangement details or spare parts received in the comments section C.
Complete the checklist below once the equipment is fixed in its final position.

RECEIVING SUPERVISOR: CLIENT:

BUILDING ID: COUNTRY:

PURCHASE ORDER NO: EQUIPMENT CATEGORY: Clean agent system- FM 200

EQUIPMENT TAG:

Manufacturer Model Number Serial Number

Reference Dwg Revision or Date

Voltage Rating - Volts Current Rating - Amps

Power Rating kW

A: VERIFICATION OF EQUIPMENT AND ACCESSORIES - DOCUMENTATION

Item Description YES NO N/A Comments

1 As built drawings are provided

B INSPECTION / VERIFICATION OF EQUIPMENT AND ACCESSORIES - VISUAL ISPECTION

Item Description YES NO N/A Comments
Confirm the correct equipment has been delivered as per design specification and record
1 name plate information (check serial numbers, other identification, appropriate warning labels
are in place, integral pump packages, any loose items)

2 Ensure that installation activities of the system have been completed.

Ensure that the discharge nozzle and orifice unit have been installed in the accordance with
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calculation and node diagram.
5 Actuation hose and discharge hose are rigidly fitted.
Check the cylinder guage to confirm that the pressure in the cylinder are in the acceptable
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range.
7 The leak test of the piping has been complete and accepted

8 All the idendification and warning sign shall be done.

9 Check the cable termination of the all fire alarm and detection system.

10 Ensure the electromagnetic release device is removed from the cylinder.

11 Cabling interfacing connection to the panels are completed and approved.

12 Ensure that each solenoid valve is connected with respective cylinders.

Confirm all necessary cabling is correctly glanded to ensure the characteristics of the
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enclosure (e.g. IP56) which the cable enters can be maintained adequately.
15 Confirm all cabling has appropriate strain relief in place
Confirm system and equipment grounding installation is per approved Equinix grounding
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installation drawing
17 Equipment ready to be offered to CxA for Red tag inspection

L2A.RIF.50 Clean agent system

©JONES ENGINEERING 2022 Page 1 of 2 Rev 00
2022-07-25
 RECEIVING INSPECTION FORM
LEVEL 2A

C COMMENTS, DEFICIENCIES

Record any defect or deficiency of the equipment below to be notified to the manufacturer, GC coordinator or Construction Manager
Record any issues and resolutions on the construction snag list for tracking and close out
Additional Comments Below:

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D DOCUMENT SIGN OFF

Signature below shall be considered confirmation that the above checks have been carried out effectively.

Equipment Vendor Signature Date (DD-MM-YYYY)

MEP Sub Contractor Signature Date (DD-MM-YYYY)

General Contractor Signature Date (DD-MM-YYYY)

QA/QC Inspector Signature Date (DD-MM-YYYY)

CxA Signature Date (DD-MM-YYYY)

L2A.RIF.50 Clean agent system

©JONES ENGINEERING 2022 Page 2 of 2 Rev 00
2022-07-25