CHERRY HILL FIRE MARSHAL’S OFFICE

FIRE PUMP TEST REPORT

**Only this document will be accepted by the Cherry Hill Fire Prevention Division for annual testing
purposes as required by the New Jersey Uniform Fire Safety Code and applicable N.F.P.A. standards.

PROPERTY NAME: DATE OF INSPECTION: / /

PROPERTY ADDRESS: INSPECTOR:

TESTING AGENCY NAME:

NJ-DFS BUSINESS PERMIT # PHONE #

TESTING AGENCY ADDRESS

ALL FIRE PUMPS SUPPLYING WATER TO SUPPRESSION AND STANDPIPE SYSTEMS SHALL BE OPERATED AT LEAST ONCE
EVERY THIRTY DAYS, UNTIL WATER IS DISCHARGED FREELY FROM THE RELIEF VALVE.

1. TEST INTERVAL THIRTY DAYS? ! YES ! NO IF NO, WHAT TEST INTERVAL IS USED?

* THIS TEST SHALL NOT DRAW THE RESIDUAL SUCTION PRESSURE BELOW 20 P.S.I. WHERE THE SYSTEM IS FED BY
A PUBLIC WATER MAIN.

2. MANUFACTURER: PUMP TYPE: ! HORIZONTAL SHAFT ! VERTICAL SHAFT

3. RATED G.P.M.: @ R.P.M. RATED HEAD PRESSURE: P.S.I.

4. PUMP TYPE: ! ELECTRIC VOLTS AMPS PHASE

! DIESEL ! GASOLINE ! OTHER

5. BATTERY CONDITION: BATTERY CHARGER WORKS: ! YES ! NO CHARGE RATE?

6. WEEKLY TEST RUN RECORDS CURRENT? ! YES ! NO MONTHLY? ! YES ! NO

7. PUMP IN SERVICE ON INSPECTION? ! YES ! NO FIRE PUMP CONTROLLER POWER “ON”: ! YES ! NO

8. TRANSFER SWITCH NORMAL PILOT LIGHT “ON”: ! YES ! NO JOCKEY PUMP OPERATIONAL? ! YES ! NO

9. JOCKEY PUMP CONTROLLER SET ON “AUTO”: ! YES ! NO

10. TEST HEADER CONTROL VALVE CLOSED? ! YES ! NO

11. TEST HEADER VALVES, CAPS, HANDLES, SWIVELS - IN GOOD CONDITION? ! YES ! NO

12. DOES PUMP START MANUALLY: ! YES ! NO AUTOMATICALLY? ! YES ! NO

13. DOES JOCKEY PUMP OPERATE PROPERLY: ! YES ! NO ! N/A

14. FLOW TEST OF PRIVATE HYDRANTS FED BY FIRE PUMP: ! YES ! NO ! N/A FLOW: GPM

15. DATE OF LAST ENGINE MAINTENANCE? / / RECORDS ON SITE: ! YES ! NO ! N/A

16. DATE OF LAST PUMP TEST: / /

CHERRY HILLFIRE PREVENTION DIVISION 98FPDT/04

301 Burnt Mill Road (856) 795-1340

Cherry Hill, NJ 08003 (856) 795-8432 FAX