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SAFETY INSPECTION CHECKLIST BACK UP EQUIPMEN

Date: Time Checking: 1 Month

STANDARD ACTUAL CONDITION


A. WATER SUPPLY
Ground Water Tank Full Full Not Full
Jockey Pump Stand by Auto Auto Manual
Electrical Fire Pump Stand by Auto Auto Manual
Diesel Fire Pump Stand by Auto Auto Manual
Fire Pump Fuel Tank Full Full Not Full
Fire Pump Pressure Gauge Good Good Not Good
Valve supply From GWT to the Fire Pump Open Open Close
Power supply Main panel Fire Pump On On Off

B. MCFA PANEL
Indicator Lamp On On Off
Buzzer Function Function Trouble
Address Function Function Trouble
Back Up Battery Function Function Trouble

C. EMERGENCY POWER SUPPLY


Stand By Generator Auto Auto Not Auto
Daily Fuel Tank (min : 50%) Full Full Not Full

D. RESTRICTION
"No Smoking" Sign Available Available Not Available
Flammable Sign Available Available Not Available
Exit Sign Available Available Not Available

E. UPS
Indicator Lamp Function Function Not Function
Alarm Buzzer Function Function Trouble
Back Up (30 Minutes) Function Function Not Function

Inspect By Aknowledge By Approved

Fire Life Safety Supervisor Loss Prevention Manager Director Of Loss Prevention

Note :
- The "ACTUAL CONDITION" Coloumn fill by marks ( √ )
- If there is damage to the tool/material make a damage report by attaching this form.
ACK UP EQUIPMENT FORM
Checking: 1 Month

NDITION REMARKS

Approved By

Loss Prevention Director Of Engineering

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