FORM B

Bomba Fail : JBPM : SL / 005 /110151

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. WONG SIEW SHENG

I/C No : 710421-04-5191 of FIG CONSULTANCY 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 : SPICES & SEASONINGS SPECIALITIES SDN.

BHD.

Address of Premises of Installation/s : LOT 1956, MUKIM SEMENYIH, DAERAH HULU

LANGAT, SELANGOR DARUL EHSAN.

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

Wet Riser *
Dry Riser *
Hose Reel *
Other Fixed Installations *

Building Protected : WAREHOUSE AREA

Number of Risers (*Wet/Dry) :

Number of pumping inlets :

Number of landing valves :

Number of Fire Alarm call points : 24 NOS.

Number of indicator panels : 1 NOS.

Location : IN FRONT 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 : Minimum : m³/min

Flow

Position / Location :

JBA Main / Ring Main : ) Diameter : mm

Private Reservoir (Type) : Capacity : Cubic meter (m³)

Rate of discharge/replenishment by Water Works Main :

Pump Motive power : Nominal Rating : lpm

Nominal Head : Drawing :

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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