FORM B

Bomba Fail : JBPM / JH / BKK: 700-2 / 1 / 10 / 174-JBU

APPLICATION AND CERTIFICATION FORM
FOR FIXED INSTALLATIONS AND FIRE ALARM SYSTEMS
(as prescribed in By Laws 245(3), 246)
Date : 20/3/2017

To the Local Authority,

JABATAN BOMBA DAN PENYELAMAT, MALAYSIA
I (name of submitting person) : IR. LEONG PENG SENG

I/C No : 561108-10-6377 of SAFETY SERVICES & LOGISTICS SDN. BHD

Hereby apply for approval to *install/supervise the installation of the *fixed installations/fire alarm
system as described hereunder and as shown on the drawings endorsed for this application which I have
designed in accordance with the current British Standard / BSCP / Malaysia Standards:-

Name of Owner : TRINITY BLISS SDN. BHD.

Address of Premises of Installation/s : PLOT D40 DAN 44, SEBAHAGIAN PTD 2426,

MUKIM TANJUNG KUPANG, DAERAH JOHOR BAHRU, JOHOR DARUL TAKZIM

Type and Nature of Installation/s : Fire Alarm System *

Wet Riser *
Dry Riser *
Hose Reel *
Hydrant System
Other Fixed Installations * CO2 SYSTEM

Building Protected : WAREHOUSE BLOCK A,B & C

Number of Risers (*Wet/Dry) :

Number of pumping inlets :

Number of landing valves :

Number of Fire Alarm call points : 372 NOS.

Number of indicator panels : 2 NOS.

Location : GUARD HOUSE & GROUND FLOOR OFFICE

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Fire Station link to : FIRE ALARM PANEL (VIA CMS)

Secondary Power Supply : RECHARGEABLE BATTERY SET

Water Supplies : The following water supplies have been provided :-

Number of Fire Hydrant : 29 NOS. Minimum : 1.365 m³/min

Flow

Position / Location : ABOVE GROUND

JBA Main / Ring Main : TAP IN-PORT TANJUNG Diameter : 150 mm

PELEPAS

Private Reservoir (Type) : HOT DIPPED Capacity : 207 Cubic meter (m³)
GALVANIZED PRESSED
STEEL TANK

Rate of discharge/replenishment by Water Works Main :

Pump Motive power : 75hp Nominal Rating : 3000 lpm

Nominal Head : 6.638bar Drawing : HYDRANT TANK

Water from

Comments (if any) and departures from British Standard / Malaysian Standard / NFPA / BSCP / CIFS
Regulation:-

Signature of submitting person

FOR OFFICIAL USE ONLY :-

Date Received : Date Approved:

I, hereby certify that the *Fixed Installations/Fire Alarm System as described in the form of Application
and as shown on the approved drawings have been completed under my personal supervision and have
been tested to my satisfaction and as such, I would like to apply for your department endorsement for
issue of a completion certificate.

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Date :
Signature of submitting person

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