Test Forms - Water Based Fire Suppression System

TEST CERTIFICATE
Client/CMS CONSTRACTOR'S
LOGO LOGO
FIRE PROTECTION SYSTEM
Site : Location :
Project Area Served :
Description :
Equipment Mark :
Project Code : System ID :
ELECTRIC DRIVEN FIRE PUMP

PRE-COMMISSIONING CHECKLIST
Item Compliance
Description
No. Y N
1 Check if pump and motor are complying with the specifications.
Check if accessories such as suction and discharge guages, automatic air

2
release valve, casing relief valve are complying with the specifications.
3 Check if OS & Y shut-off valve is provided with supervisory tamper switch.
4 Check if the Pump controller is complying with the specifications.
5 Check if pump, motor, accessories and controller are installed correctly.
6 Check the pump and motor alignment.
7 Check the wire termination from supply to controller of motor.
Check if the pressure sensing line is installed correctly from the system and
8
the controller.
Perform visual inspection inside the component of the controller if there is
9
some loose connections or contacts.
10 Make to set the parameter required by the controller.
11 Check if the equipment is ready for functional test.
LEGEND : (P) Yes (X) No (N/A) Not Applicable
Inspection carried out by

Contractors Representative Signature Date
Inspection witnessed by :
CMS Representative Signature Date
Inspection witnessed and

approved by: Clients Representave Signature Date
REMARKS :
TEST CERTIFICATE
CONTRACTOR'S
Client/CMS Logo
LOGO
Site : Location :
Project : Area Served :
Description :
Equipment Mark :
ELECTRIC DRIVEN FIRE PUMP

PRE-START UP CHECKLIST
Conforme
Item No. Description Comments
Y N
1 Check tapping of power supply wires to control.
2 Check tapping of wires from control to motor.
3 Check tapping of pressure sensing line.
4 Check Fire Pump controller components installed are complete.
a. Circuit Breaker
b. Locked rotor protector
c. Start and stop push buttons
d. Control terminal board
e. Running period timer
f. Power availability and starting relays
g. Accelarating timer
h. Control transformer
i. Wiring diagram and sequence description inside door
j. Pressure transducer
k. Isolation switch
l. Current sensors & Sensing Line
m. Motor contactor
n. Emergency start handle
o. Grounding lug
5 Check Fire Pump accessories are installed.
a. Suction and discharge pressure gauges
b. Pump casing relief valve
c. Automatic air release valve
6 Check pump & motor properly bolted to steel base
7 Check vibration isolators are properly installed.
8 Check discharge and suction gate valve are installed properly.
9 Check that valve is installed at the discharge line.
10 Check suction strainer is installed and clean and free of clog.
11 Check that name plate for pump, motor & controller is provided.
12 Pump casing dismantled and checked for possible foreign object.
13 Check pump & motor alignment.
14 Check pump, motor, controller properly labeled with tag number.
Test carried out by :

Contractor Representative Signature Date
Test witnessed by :
Test witnessed and

approved by : Clients Representative Signature Date
REMARKS :
TEST CERTIFICATE
CONTRACTOR'S
LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark :
ELECTRIC DRIVEN FIRE PUMP PERFORMANCE TEST

PUMP SPECIFICATION
Brand / Manufacturer : Type :
Model Series / Size : Serial No. :
No. of Stages : Rotation :
Capacity : TDH :
MOTOR SPECIFICATION
Brand / Manufacturer : Type :
Model No. : FLC :
Electrical Supply : Speed :
Output Power : Phase / Frequency :
Frame number :
STARTER
Manufacturer : Type :
O/L Setting : O/L Range :
Timer Setting : CB Rating :
DRIVE COUPLING
Coupling Manufacturer : Type :
Model No. : Size :
FIRE PUMP FLOW TEST

DESCRIPTION REMARKS
0% 50% 100% 150%
Water Flow Rate Gpm

Pump Suction Pressure Psi
Pump Discharged Pressure Psi
Pump Speed Rpm
Voltage Volt
Current Ampere
Pump Cut-in Pressure Psi
Manual Stop and Reset
Verify the Test Results based on the NFPA Requirements YES NO

1. Shut-off head : no flow exceeding 140 % of the rated head.
2. Pump deliver not less than 150% of rated capacity at not less than 65% of total head.
3. Performance curve ploted base on test result and compare to pump performance curve as per specifications.
Cut-in Pressure Setting

1. Pump start awhen cut-in pressure of psi is reached.
2. Pump stop when manually press the stop button in the controller.

Test witnessed by :
Test witnessed and

REMARKS :
TEST CERTIFICATE
CONTRACTOR'S
LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark :
ELECTRIC DRIVEN JOCKEY PUMP

Compliance
Item No. Description
Y N
1 Check if pump and motor are complying with the specifications.
Check if accessories such as suction and discharge guages, automatic air

2
release valve, casing relief valve are complying with the specifications.
3 Check if OS & Y shut-off valve is provided with supervisory tamper switch.
4 Check if the Pump controller is complying with the specifications.
5 Check if pump, motor, accessories and controller are installed correctly.
6 Check the pump and motor alignment.
7 Check the wire termination from supply to controller of motor.
Check if the pressure sensing line is installed correctly from the system and
8
the controller.
Perform visual inspection inside the component of the controller if there is
9
some loose connections or contacts.
10 Make to set the parameter required by the controller.

Test witnessed by :
Test witnessed and

REMARKS :
TEST CERTIFICATE
CONTRACTOR'S
LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark :
Project Code: System ID :
JOCKEY PUMP PERFORMANCE TEST
PUMP SPECIFICATION MOTOR

Brand / Manufacturer : Manufacturer :
Model Series / Size : Model No. :
Serial No. : Electrical Supply (V/Ph/Hz):
No. of Stages : Output Kw :
Capacity : Frame No. :
Rated Head : Type :
Type : Serial No. :
Size : FLC :
Rotation : Speed :
STARTER DRIVE
Manufacturer : Coupling Manufacturer :
O/L Setting : Model No. :
O/L Range : Type :
Type : Size :
Fuse Rating :
Timer Setting :
SITE TEST DESIGN DATA ACTUAL DATA COMMENTS

Water Flow Rate Gpm
Voltage V
Current A
Pump Cut-In Pressure Psig
Pump Cut-Out Pressure Psig
Pump Speed
Jockey Pump Cut-In & Cut-Out Pressure Setting YES NO
1. Jockey pump cut-in when pressure setting at ____ psig is reached.

2. Jockey pump cut-out when pressure setting at ____ psig is reached.
3. Pump performance curve attached and plotted result of test.

Test witnessed by :
Signature Date
CMS Representative
Test witnessed and

Signature Date
approved by : Clients Representative
REMARKS :
TEST CERTIFICATE
CONTRACTOR'S
LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark : :
VISUAL INSPECTION OF FIRE STORAGE AND APPURTENANCES
Conforme
Pre-Commissioning Checklist Comments
Yes No
Check if fire storage tank installation is in accordance with the approved
1
drawings and water leak testing has been completed.
Check if the cleaning, flushing and sterilization of fire storage tank is
2
completed.
Check if the float level control valve for the inlet pipe is functioning properly
3
and float valve setting is correct.
Check if the following fire storage tank appurtenances are provided and
4
installed properly.
4.1 Tank Manhole Door Opening
4.2 Air vent with insect screen (Air release valve)
4.3 Overflow pipe
4.4 Drain pipe with shut-off valve
4.5 Inlet pipe with float control valve
4.6 Internal and external tank ladders
4.7 Water level indicator
4.8 Return pipe for fire pump is installed properly and completed

Test witnessed by :
Test witnessed and

REMARKS:
TEST CERTIFICATE
CONTRACTOR'S LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark :

VISUAL & FUNCTIONAL TEST
SPRINKLER ALARM CHECK VALVE ASSEMBLY
ALARM CHECK VALVE WATER-MOTOR ALARM BELL
Manufacturer : Manufacturer :
Model No. : Model No. :
Max Working Pressure : Max Working Pressure :
Required Accessories :
Size :
DESCRIPTION Y N REMARKS
1. The alarm check valve is installed in accordance with the approve drawing.
2. The pressure gauges are installed at the inlet and outlet side of the alarm valve.
3. The alarm valve trim such as valves, fittings and nipples are properly connected.
4. Check if main drain discharge line is connected to open site drain or nearest drain.
5. Check if flow switch is correctly installed in the supply line and wired for FDAS.
6. Check if the entire piping system had been hydrostatically & flushed.
7. Check if water-motor alarm going piping connection is complete and strainer cleaned.
8. Check if supervisory tamper switch for riser shut-off valve is installed and wired to FDAS.
9. Check if correct valve tag number is installed.
FUNCTIONAL TEST
Procedure Result Pass Fail Remarks
To simulate the test operation of alarm check valve and The water motor alarm bell should activate. The alarm sound
1. alarm equipment open the alarm test module of one floor 1 should be clear and steady. If not make the necessary
control valve equivalent to one sprinkler flow. adjustment and repeat the test.
To simulate the test operation of alarm bell only, close the This should activate the water motor alarm bell. The alarm
2. ball valve in the alarm line and open the valve in the alarm 2 sound should be clear and steady. If not make the necessary
test line. adjustment and repeat the test.
A full flow of water indicates a clear supply line & also verifies
To test main water supply piping for unobstructed flow,
3 3 that alarm valve clappers has lifted form its normal seated
close ball valve in the alarm line & open main drain valve.
position.
Check operation of the tamper switch by closing the main

Alarm signal should be send to FACP indicating valve has
4 OS & Y valve to approximately closed position (three 4
been closed.
turns).
Check operation of the tamper switch by setting back the Alarm signal in the FACP should disappear indicating valve
5 5
main OS & Y valve to normally open position. has been put back to its normally open position.

Contractors Representative Signature Date
Test witnessed by :
Test witnessed and
REMARKS :
TEST CERTIFICATE
CONTRACTOR'S
LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark :
VISUAL AND FUNCTIONAL TEST

SPRINKLER SYSTEM
Functional Conforme
Visual Conforme
Item Description Quantity Notes
Yes No Yes No
Type of sprinkler heads
To conforme with the following:
1. Check if the Sprinkler Heads installed are correct as per approved drawings and/or specifications.
2. Check if the item installed is mounted or fixed properly.
3. Check if the sprinkler heads installed are in correct temperature rating with regards on the area it serves.
4. Check or test if the item indicated is functioning properly.
LEGEND: (P) Yes (X) No (N/A) Not Applicable

Test witnessed by :
Test witnessed and

REMARKS:
TEST CERTIFICATE
CONTRACTOR'S LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark :
Project code: System ID :
VISUAL INSPECTION CHECKLIST
WET STAND PIPE
Pipe Manufacturer / Brand : Pipe Diameter :

Floor Servicing : Type :
Conforme
Item Description Comments
Yes No
Are materials and Installation in accordance with the approved
1.
shopdrawings/submittals (RFA), plans and specifications.
2. Are all the pipes and fittings properly supported.
3. Are all the pipes and valves properly labeled / tag.
4. Hydrostatic pressure test completed.
5. Temporary piping used during construction are removed.
6. Are pipe sleeves are properly installed.
7. Are required seismic anchoring / supports installed.
8. Are fire sealant correctly applied as per manufacturer recommendations.
9. Are all piping properly cleaned.
10. Are the Isolation Valves / Supervisory Valves installed as specified.
11. Is the Check Valve installed as specified.
12. Are the Flexible Connectors installed as specified.
13. Pressure gauges installed as required.
14. Flanges installed as specified.
15. Victaulic Connector installed as specified.
16. Drain pipe installed for Riser.
17. Is the system ready for functional test?

Test witnessed by :
Test witnessed and

REMARKS :
TEST CERTIFICATE
CONTRACTOR'S LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark :
VISUAL INSPECTION CHECKLIST

DRY STAND PIPE
DRY STAND PIPE MANIFOLD
Manufacturer : Pipe Diameter :

Floor Servicing : Type :
Item Conforme
Inspection Description Remarks
No. Yes No
A. Dry Stand Pipe
Check that Dry Stand Pipe Roof Manifold Hose Valve is

1
installed according to drawing.
Check if the Dry Stand Pipe Fire Hose Valve installed is as per
2
approved brand.
Check if the size of Dry Stand Pipe is correct according to the
3
drawing plan.
4 Is labelling provided?
5 Check if the entire piping system has no water leak.
B. Roof Manifold Hose Valve
1 Check if the Roof Manifold Hose Valve is installed according to

drawing.
2 Check if the Roof Manifold Hose Valve is installed is as per
approved brand
3 Check if the size of Roof Manifold Hose Valve is correct
according to the drawing plan.
4
Check if the roof manifold opening has cap with chain.
5
Is labelling provided?
6 Check if the fire hose valve connection has no water leak.
Inspection carried out by :

Inspection witnessed by :
CMSRepresentative Signature Date
Inspection witnessed and

approved by : Client Representative Signature Date
REMARKS :
TEST CERTIFICATE
CONTRACTOR'S
LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark :

VISUAL INSPECTION CHECKLIST OF FIRE HOSE HOUSE
FIRE HOSE HOUSE FIRE HOSE

Dimensions : Dimensions :
BRASS ANGLE VALVE ADJUSTABLE FOG NOZZLE

Material Construction : Material Construction :
Dimension : Dimension :
HOSE RACK FIRE EXTINGUISHER

Dimension : Capacity/ Rating :
Type :
(Yes) for Conformance & (No) for Non-conformance

Item
Description FIRE HOSE CABINET (FHC)
No Remarks
Yes No
1 Check that fire hose cabinet is installed according to the
drawing.
2 Check that fire hose cabinet is provided with the following
a. Brass Angle Valve
b. 65 mm diameter X 50 meter Hose
c. Adjustable Fog Nozzle
d. Hose Rack
e. 4.5 kg ABC Dry Chemical Fire Extinguisher
3 Check that fire extinguisher safety pin seal is not broken &
pressure reading is full charge.
4 Check that fire hose cabinet is provided with proper labeling
approved by authority having jurisdiction
5 Check angle hose valve is in close position.
6 FHC Connected To Sprinkler Floor Control Valve.
7 Check if the system is ready for functional test.

Signature Date
Contractor Representative
Test witnessed by :
Signature Date
CMS Representative
Test witnessed and

REMARKS :
TEST CERTIFICATE
CONTRACTOR'S
LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark :
VISUAL INSPECTION CHECKLIST FOR PORTABLE FIRE EXTINGUISHER
Installed Portable Fire Extinguisher

Item Conforme
Location Cap. UL Fire Extinguisher Type Serial No. Remarks
No. Qty
(lbs) Rating CO2 Dry Chem Foam Y N
The following item should be satisfied: Yes No
1. Check if the installed fire extinguisher safety seal is not broken.

2. Check if the installed fire extinguisher pressure reading is full charge.
3. Check if the installed fire extinguisher is of the approved manufacturer.

Test witnessed by :
Test witnessed and

approved by : Client Representative Signature Date
Remarks:
TEST CERTIFICATE
CONTRACTOR'S LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark :
Project No.: System ID :
VISUAL & FUNCTIONAL TEST OF FLOOR CONTROL VALVE ASSEMBLY
EQUIPMENT TAG NO. :
FLOOR CONTROL VALVE
Model No. : Size :
Operating Pressure :
WATER FLOW SWITCH

Model No. : Size :
PRE-COMMISSIONING CHECKLIST Yes No Remarks

1. Check if floor control valve assembly is installed in accordance with approved drawing.
2. Check if tamper switch & flow switch are correctly installed and wired to FDAS.
3. Check if OS&Y valve is in open position (e.g. valve stem fully raised)
4. Check if alarm test module valve (atm) and drain valve are closed.
5. Check if installation of (atm) sight glass is facing against the operator.
6. Check if correct valve tag number are installed.
7. Check if entire piping system served by this floor control valve had been hydro tested &
flushed.
8. Floor control valve assembly concealed above ceiling is provided with access panel.
9. Check if the system is ready for functional test.
FUNCTIONAL TEST
Procedure Desired Result Pass Fail Remarks
Check operation of tamper switch by closing the Alarm signal should be send to FACP
1. 1.
OS&Y valve. indicating valve has been closed.
Check operation of tamper switch by setting back Alarm signal indicated in the FACP should
2. the OS&Y valve to normally open position. 2. disappear indicating valve is put back to its
normally open position.
Check operation of water flow switch by opening Water flow switch should be activated and fire
3. the test valve to simulate water flow equivalent to 3. alarm signal is send to FACP indicating the
one sprinkler. affected zone area.
Water flow switch will be de-activate and the fire

Check operation of flow switch by closing the test
4. 4. alarm signal should be able to reset in in the FACP
valve to stop water flow. indicating normal condition.

Test witnessed by :
Test witnessed and

REMARKS :
TEST CERTIFICATE
CONTRACTOR'S LOGO
Client/CMS Logo
Site : Location :
Description :
Equipment Mark :
Project No.: System ID :
VISUAL & FUNCTIONAL TEST OF FIRE HYDRANT
EQUIPMENT TAG NO. :
FIRE HYDRANT
Model No. : Size :
ISOLATION VALVE
Model No. : Size :
PRE-COMMISSIONING CHECKLIST Yes No Remarks

1. Check if Fire Hydrant assembly is installed in accordance with approved drawing.
3. Check if OS&Y valve (Isolation Valave) is in open position (e.g. valve stem fully raised)
5. Check if installation of angle valve w/ cap and chain are in correct position.
6. Check if correct valve tag number are installed.
7. Check if entire piping system served by this fire hydrant had been hydro tested &
flushed.
8. Check fire hydrant barrier post is correct.
9. Check if the system is ready for functional test.
FUNCTIONAL TEST
Procedure Desired Result Pass Fail Remarks
Closing of OS&Y valve result no passing of
Check operation of OS&Y valve (isolation valve) by
1. 1. water thru system and by opening of OS&Y
closing and opening of the valve.
valve result continous flowing of water
Check operation of Angle valve by closing and Closing of Angle valve result no passing of
2. opening of the valve. 2. water thru system and by opening of Angle
valve result continous flowing of water
Check operation of water flow switch by opening Water flow switch should be activated and fire
3. the test valve to simulate water flow equivalent to 3. alarm signal is send to FACP indicating the
one sprinkler. affected zone area.

Test witnessed by :
Test witnessed and

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TEST CERTIFICATE

Project Area Served :

Project Code : System ID :

ELECTRIC DRIVEN FIRE PUMP

1 Check if pump and motor are complying with the specifications.

Check if accessories such as suction and discharge guages, automatic air

3 Check if OS & Y shut-off valve is provided with supervisory tamper switch.

4 Check if the Pump controller is complying with the specifications.

5 Check if pump, motor, accessories and controller are installed correctly.

6 Check the pump and motor alignment.

7 Check the wire termination from supply to controller of motor.

10 Make to set the parameter required by the controller.

11 Check if the equipment is ready for functional test.

LEGEND : (P) Yes (X) No (N/A) Not Applicable

Inspection carried out by

Inspection witnessed and

Project : Area Served :

Project Code : System ID :

ELECTRIC DRIVEN FIRE PUMP

Test carried out by :

Test witnessed and

Project : Area Served :

Project Code : System ID :

ELECTRIC DRIVEN FIRE PUMP PERFORMANCE TEST

FIRE PUMP FLOW TEST

Water Flow Rate Gpm

Verify the Test Results based on the NFPA Requirements YES NO

Cut-in Pressure Setting

LEGEND : (P) Yes (X) No (N/A) Not Applicable

Test carried out by :

Test witnessed and

Project : Area Served :

Project Code : System ID :

ELECTRIC DRIVEN JOCKEY PUMP

1 Check if pump and motor are complying with the specifications.

Check if accessories such as suction and discharge guages, automatic air

3 Check if OS & Y shut-off valve is provided with supervisory tamper switch.

4 Check if the Pump controller is complying with the specifications.

5 Check if pump, motor, accessories and controller are installed correctly.

6 Check the pump and motor alignment.

7 Check the wire termination from supply to controller of motor.

10 Make to set the parameter required by the controller.

11 Check if the equipment is ready for functional test.

LEGEND : (P) Yes (X) No (N/A) Not Applicable

Test carried out by :

Test witnessed and

Project : Area Served :

Project Code: System ID :

JOCKEY PUMP PERFORMANCE TEST

PUMP SPECIFICATION MOTOR

SITE TEST DESIGN DATA ACTUAL DATA COMMENTS

Jockey Pump Cut-In & Cut-Out Pressure Setting YES NO

1. Jockey pump cut-in when pressure setting at ____ psig is reached.

LEGEND : (P) Yes (X) No (N/A) Not Applicable

Test carried out by :

Test witnessed and

Project : Area Served :

Project Code: System ID :