APPENDIX D (FIRE PUMP SYSTEM INSPECTION CHECK LIST)

To be completed by the Inspector at the time of Inspection

Attach additional sheets, data or calculation as necessary to provide a complete
record

FACTORY INFORMATION

Factory Name: _____________________________________________________

Address: _________________________________________________________

Representative Name: ________________________________________________

Designation: ______________________________________________________

Phone: _________________ Fax: _______________

E-mail:_________________

INSTALLATION, SERVICE AND TESTING CONTRACTOR INFORMATION

Contractor Name: ___________________________________________________

Address: _________________________________________________________

Inspector or Tester Name: _____________________________________________

Qualification of Inspector or Tester: ______________________________________

Phone: _________________ Fax: _______________

E-mail:_________________

A Contract for Inspection & testing in accordance with NFPA is in effect as of: __________

The Contract Expires: ________________Frequency of Test: ___________________

WITNESS BY

Company Name: ____________________________________________________

Address: _________________________________________________________

Representative Name: ________________________________________________

Designation: ______________________________________________________

Phone: _________________ Fax: _______________

E-mail:_________________

27|43
 Inspection, Testing & Scope Action Taken
Maintenance: Weekly

Tank level Visual Inspection YES / NO

Checking

Tank float switch Visual Inspection YES / NO

Testing

Solenoid valve operation Visual Inspection YES / NO

Testing

Water in system Checking YES / NO

Cleaning

Flexible hoses and connectors Visual Inspection YES / NO

Oil level Visual Inspection YES / NO

Checking

Lube oil heater Checking YES / NO

Level (Cooling system) Visual Inspection YES / NO

Checking

Diesel Adequate cooling water to heat Checking YES / NO

Engine exchanger
System
Water pump(s) Visual Inspection YES / NO

Condition of flexible hoses and Visual Inspection YES / NO

connections Checking

Jacket water heater Checking YES / NO

Leakage (Exhaust system) Visual Inspection YES / NO

Checking

Drain condensate trap Checking YES / NO

Electrolyte level (Battery system) Checking YES / NO

General inspection Visual Inspection YES / NO

Pump house, heating ventilating Visual Inspection YES / NO

louvers Checking

Inspection, Testing & Scope Action Taken

Maintenance: Monthly
Electrical
System Exercise isolating switch and circuit Visual Inspection YES / NO
breaker Checking

28|43
 Case exterior clean and dry (Battery Testing YES / NO
system)

4QFDJůD
HSBWJUZ
PS
TUBUF
PG
DIBSHF
Visual Inspection YES / NO

Diesel (Battery system)
Engine
System Charger and charge rate (Battery Checking YES / NO
system)

Equalize charge (Battery system) Checking YES / NO

Circuit breakers or fuses (Electrical Visual Inspection YES / NO

system)

Inspection, Testing & Scope Action Taken

Maintenance: Quarterly

4USBJOFS
ůMUFS
PS
EJSU
MFH
PS
Cleaning YES / NO

combination thereof

Crankcase breather (Lubrication Visual Inspection YES / NO

system) Changing
Cleaning

Diesel Water strainer (Cooling system) Cleaning YES / NO

Engine
System *OTVMBUJPO
BOE
ůSF
IB[BSET
&YIBVTU
Visual Inspection YES / NO
system)

Terminals clean and tight (Battery Visual Inspection YES / NO

system) Checking

8JSF
DIBůOH
XIFSF
TVCKFDU
UP
Visual Inspection YES / NO

movement (Electrical system) Checking

Inspection, Testing & Scope Action Taken

Maintenance: Semiannually
Electrical
System Operate manual starting means Testing YES / NO
(electrical)

Antifreeze protection level (Cooling Testing YES / NO

system)

Diesel Flexible exhaust section (Exhaust Visual Inspection YES / NO

Engine system)
System
Operation of safeties and alarms Checking YES / NO
(Electrical system) Testing

Boxes, panels, and cabinets Cleaning YES / NO

(Electrical system)

29|43
 Inspection, Testing & Scope Action Taken
Maintenance: Annually

Lubricate pump bearings Changing YES / NO

Pump Check pump shaft end play Checking YES / NO

System
Check accuracy of pressure Checking YES / NO
gauges and sensors Changing

Check pump coupling alignment Checking YES / NO

Mechanical Lubricate coupling Changing YES / NO

Transmission
Lubricate right-angle gear drive Changing YES / NO

Trip circuit breaker (if mechanism Testing YES / NO

provided)

Inspect and operate emergency Visual Inspection YES / NO

manual starting means (without Testing
power)

Electrical Tighten electrical connections as Checking YES / NO

System necessary

Lubricate mechanical moving parts Checking YES / NO

(excluding starters and relays)

Calibrate pressure switch settings Checking YES / NO

Grease motor bearings Changing YES / NO

Water and foreign material in tank Cleaning YES / NO

Tank vents and overflow piping Checking YES / NO

unobstructed Testing

Piping Visual Inspection YES / NO

Rod out heat exchanger Cleaning YES / NO

Inspect duct work, clean louvers Visual Inspection YES / NO

(combustion air) (Cooling system) Checking
Diesel Changing
Engine
System Excessive back pressure (Exhaust Testing YES / NO
system)

Exhaust system hangers and Visual Inspection YES / NO

supports (Exhaust system)

Clean terminals (Battery system) Cleaning YES / NO

Tighten control and power wiring Checking YES / NO

connections (Battery system)

30|43
 Inspection, Testing & Scope Action Taken
Diesel Maintenance: Annually
Engine
System Oil change Changing YES / NO

0JM
ůMUFS T
Changing YES / NO

31|43