5 Year Fire Sprinkler Inspection Template

5 Year Fire Sprinkler Inspection Template

The 5 Year Fire Sprinkler Inspection form is a crucial document used to ensure the proper inspection, testing, and maintenance of fire sprinkler systems in compliance with California regulations. This form helps property owners and contractors keep track of necessary checks and repairs, ensuring safety and functionality. For a seamless experience, consider filling out the form by clicking the button below.

Table of Contents

The 5 Year Fire Sprinkler Inspection form is a crucial document that ensures the safety and reliability of fire sprinkler systems in buildings. This form captures essential property and contractor information, including the building name, address, and contact details for the licensed owner or contractor responsible for the inspection. It outlines a comprehensive checklist for inspection, testing, and maintenance of the fire sprinkler system, adhering to the California Code of Regulations - Title 19. Key components include details about control valves, waterflow alarm devices, and pressure readings, all critical for assessing system functionality. Each item is marked with a pass, fail, or not applicable status, making it easy to identify areas needing attention. Additionally, the form includes sections for annual inspections, which cover all quarterly inspections, ensuring that every aspect of the fire sprinkler system is thoroughly evaluated. The final section allows for the documentation of any deficiencies or comments, ensuring that all repairs and maintenance actions are recorded. Overall, this form serves as a vital tool for maintaining fire safety standards in buildings.

5 Year Fire Sprinkler Inspection Sample

Wet Pipe
Fire Sprinkler System
California Code of Regulations - Title 19
Inspection, Testing, and Maintenance
5-Year
Report
1 of 3
Property Information Contractor or Licensed Owner Information
Building Name
Name
Address
Address City St. Zip
City
License #
Phone
Contact Person
SFM Job #
CSLB Misc.
Riser Information Main Drain Test (ANNUAL)
Riser
No.
Location
Riser
Diameter
Main Drain
Diameter
Initial Static
Pressure
Residual
Pressure
Final Static
Pressure
P, F, N/A
This building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached:
5-Year INSPECTION, TESTING AND MAINTENANCE
Includes ALL Quarterly and Annual Inspections, Tests, and Maintenance items
I = Inspection T = Test M = Maintenance
P = Pass F = Fail N/A = Not Applicable
Item Description
NFPA 25 CA
ed.
Reference
Date Comments Only P, F, N/A
1.1 I Control Valves – Identification Sign 13.3.1
1.2 I Control Valves – Inspection 13.3.2
1.3 I Waterflow Alarm Devices 5.2.5
1.4 I Supervisory Devices 5.2.5
1.5 I Gauges (Wet Pipe Systems) 5.2.4.1
1.6 I
Hydraulic Design Information Sign
(For hydraulically designed systems)
5.2.6
1.7 I
Enter Water Supply Pressure Below Riser Check
5.2.4.1 psi
1.8 I
Enter Water Supply Pr
essure Above Riser Check 5.2.4.1 psi
1.9 I
Pressure Readings Acceptable
5.2.4.1
1.10 I
General Information Sign
(not required for system prior to 2007 Edition NFPA 13)
5.2.8
1.11 I Heat Tape 5.2.7
1.12 I Spare Sprinklers 5.2.1.4
1.13 I Fire Department Connections 13.7
1.14 I Alarm Valves – Exterior Inspection 13.4.1
1.15 I Pressure Reducing Valves 13.5.1.1
1.16 I Backflow Preventers 13.6.1
Form AES 2.
2
Se
p
t. 3, 2013
Wet Pipe
Fire Sprinkler System
California Code of Regulations - Title 19
Inspection, Testing, and Maintenance
5 Year
Report
2 of 3
Property Information Contractor or Licensed Owner Information
Building Name Name
Address Job #
City
ANNUAL INSPECTION, TESTING, AND MAINTENANCE
Include ALL Quarterly Inspections (See AES 2.1)
I = Inspection T = Test M = Maintenance
P = Pass F = Fail N/A = Not Applicabl
e
Item Description
NFPA 25 CA ed.
Reference
Date Comments Only P,F,N/A
1.17 I Small Hose Connections - Hose Valve*
5.1.6, 13.5.2
13.5.5.1
1.18 I PRV – Fire Sprinkler Systems 13.5.1.1
1.19 I Buildings (Freeze Protection) 4.1.1.1 Owner’s Responsibilit
y
1.20 I Sprinklers 5.2.1
1.21
I Sprinklers - Accessible Concealed Space 5.2.1.1.6
1.22
I Pipe and Fittings 5.2.2
1.23
I Pipe and Fittings - Accessible Concealed Space 5.2.2.3
1.24 I Hangers 5.2.3
1.25 I Hangers - Accessible Concealed Space 5.2.3.3
1.26 I Seismic Braces 5.2.3
1.27 I Seismic Braces - Accessible Concealed Space 5.2.3.3
1.28 I Unsprinklered Areas CFC 901.4 Yes No
2.1 T
Field Service Test Required
Send Report to Fire Code Official
5.3.1
If REQUIRED, Enter 'F' until
results are returned from Lab
2.2 T
Recalled Sprinklers
If not present = Pass; If present = Fail
Title 19
904.1(c)
2.3 T
Water Flow Alarm Devices
90 secs max. Enter time
5.3.3
13.2.6
sec.
2.4 T
Main Drain Test
(Enter data on Page 1 of this form)
13.2.5
13.3.3.4
2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1
2.7 T Supervisory Devices 13.3.3.5
2.8 T Backflow Preventer Assemblies 13.6.2
2.9 T
Small Hose Connections*
w/PRV Hose Valves – Partial Flow Test
13.5.2.3
13.5.3.3
2.10 T PRV – Fire Sprinkler Systems 13.5.1.3
2.11 T Pressure Gauges - Calibration 5.3.2
2.12 T
Small Hose Connections
*
13.5.6.2.2
* Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III
standpipe systems.
Form AES 2.
2
Se
p
t. 3, 2013
Wet Pipe
Fire Sprinkler System
California Code of Regulations - Title 19
Inspection, Testing, and Maintenance
Property Information Contractor or Licensed Owner Information
Building Name Name
Address Job #
City
ANNUAL INSPECTION, TESTING, AND MAINTENANCE
include ALL Quarterly Inspections (See AES 2.1)
I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable
Item Description
NFPA 25 CA ed.
Reference
Date Comments Only P,F,N/A
3.1 M Check Valves - Internal inspection 13.4.2
3.2 M Control Valves 13.3.4
3.3 M FDC - Backflush
14.3.2.3
14.3.2.4
3.4 M
Internal Pipe Inspection - See Deficiencies and
Comments Section for Results.
14.2
Yes
No
3.5 M
Obstruction Inv
estigation Required. If "Yes", see
Deficiencies and Comments Section for Results
14.3
3.6 M System Returned to Service 4.5.3
Yes
No
D = Deficiency C = Comment (Indicate type )
Item Date Riser D C
Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced
Check here if additional Deficiencies and Comments are listed on Form AES 9
See Correction Form AES 10 for corrected deficiencies.
Number attached:
Number attached:
I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by
the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable
except as noted in the “Deficiencies and Comments” section of this form.
Print Name
Signature Date
Form AES 2.
2
Se
p
t. 3, 2013
5
Year
Report
3 of 3

Document Attributes

Fact Name Description
Governing Law The 5-Year Fire Sprinkler Inspection form is governed by the California Code of Regulations, Title 19.
Inspection Frequency This form is used for comprehensive inspections, testing, and maintenance every five years, including quarterly and annual checks.
Required Information Property and contractor details, including building name, address, and license number, must be provided to ensure compliance and accountability.
Documentation of Results Inspectors must document results for each item inspected, indicating pass, fail, or not applicable status, along with relevant comments.

5 Year Fire Sprinkler Inspection: Usage Instruction

Completing the 5 Year Fire Sprinkler Inspection form is a crucial step in ensuring the safety and compliance of fire protection systems. This form gathers essential information about the inspection, testing, and maintenance of fire sprinkler systems. After filling out the form, it is important to submit it to the appropriate fire code official for review and record-keeping.

  1. Begin by entering the Property Information section. Fill in the building name, address, city, state, and zip code.
  2. Next, provide the Contractor or Licensed Owner Information. Include the name, address, city, license number, phone number, and the contact person's name.
  3. In the Misc. Riser Information section, indicate the riser location and the details for the main drain test, including initial static pressure, residual pressure, and final static pressure.
  4. If the building has more than five risers, note the number of additional AES 2.9 forms that are attached.
  5. Proceed to the 5-Year Inspection, Testing, and Maintenance section. For each item listed, mark whether it was inspected (I), tested (T), or maintained (M), and indicate if the result was a pass (P), fail (F), or not applicable (N/A).
  6. For each item, provide the NFPA 25 Reference and the date of the inspection, testing, or maintenance. Include any relevant comments.
  7. Continue to the Annual Inspection, Testing, and Maintenance section and repeat the process for each item listed. Ensure to indicate the same details as above.
  8. In the Deficiencies and Comments section, indicate any equipment, devices, or parts that were repaired or replaced. Check the box if additional comments are listed on Form AES 9.
  9. Finally, certify the form by printing your name, signing it, and entering the date. This confirms that the inspection, testing, and maintenance were conducted in accordance with the applicable regulations.

Frequently Asked Questions

  1. What is the purpose of the 5 Year Fire Sprinkler Inspection form?

    The 5 Year Fire Sprinkler Inspection form is designed to ensure that fire sprinkler systems are regularly inspected, tested, and maintained in accordance with California regulations. It helps verify that all components of the sprinkler system are functioning properly, which is crucial for fire safety in buildings.

  2. Who is responsible for completing the inspection form?

    The responsibility for completing the inspection form typically falls on a licensed contractor or a qualified owner of the property. This person must ensure that the inspection is conducted by trained professionals who understand the requirements set forth by the California Code of Regulations.

  3. What types of inspections are included in the 5 Year inspection?

    The 5 Year inspection includes a comprehensive review of all quarterly and annual inspections, tests, and maintenance items. This encompasses a variety of components, such as control valves, alarm devices, gauges, and sprinklers. Each item is evaluated to determine if it passes, fails, or is not applicable.

  4. What should I do if a component fails the inspection?

    If any component fails the inspection, it is crucial to address the issue immediately. The form includes a section for documenting deficiencies and comments, which should be filled out to specify what needs to be repaired or replaced. Following this, the necessary repairs should be made, and a follow-up inspection may be required to ensure compliance.

  5. How often should the fire sprinkler system be inspected?

    Fire sprinkler systems must be inspected annually, with additional quarterly checks for certain components. The 5 Year Fire Sprinkler Inspection form consolidates these requirements to ensure that all necessary inspections and maintenance are conducted on schedule.

  6. What information is required on the inspection form?

    The form requires various details, including property information, contractor or licensed owner information, and specific inspection results for each component of the fire sprinkler system. This includes the condition of control valves, water flow alarms, and more. Accurate data ensures compliance and enhances safety.

  7. What happens if there are deficiencies noted on the form?

    When deficiencies are noted, they must be addressed promptly. The form allows for documentation of any repairs or replacements made. Additionally, if more significant issues arise, a detailed follow-up inspection may be necessary to confirm that all deficiencies have been resolved.

  8. Is there a certification process for the inspection?

    Yes, at the end of the inspection, the responsible party must certify that the fire protection equipment has been fully inspected, tested, and maintained. This certification is crucial for compliance with California regulations and ensures that the fire sprinkler system is operable, except where deficiencies have been noted.

Common mistakes

Completing the 5 Year Fire Sprinkler Inspection form can be a straightforward task, but several common mistakes can lead to complications. One frequent error is failing to provide complete property information. When the building name, address, or contractor details are missing, it can create confusion about which property the inspection pertains to. This oversight can delay necessary actions and may lead to compliance issues.

Another common mistake involves the misinterpretation of the inspection categories. Individuals often confuse the terms "Inspection," "Test," and "Maintenance." Each category has specific requirements, and mislabeling an item can result in incomplete records. For instance, marking a test as a maintenance item could mislead the review process, potentially affecting the safety of the fire sprinkler system.

Inaccurate data entry is also a prevalent issue. When entering pressure readings or other numerical values, even a small typo can lead to significant misunderstandings. For example, entering a static pressure of 50 psi instead of 15 psi could imply that the system is functioning well when, in reality, it may not be. Such errors can have serious implications for safety and compliance.

Omitting comments or explanations can be another mistake. Each item on the form includes a comments section, which is crucial for clarifying any issues encountered during the inspection. Leaving this section blank may prevent the next inspector from understanding the context of previous findings. Providing detailed comments helps ensure that any follow-up actions are clearly communicated.

Failing to attach necessary additional forms can create further complications. If a building has more than five risers, for instance, the appropriate AES 2.9 form must be included. Neglecting to attach this form can lead to incomplete documentation and may result in regulatory penalties.

Another mistake is not adhering to the specified codes and references. Each item on the form is linked to specific regulations, and ignoring these references can lead to non-compliance. Ensuring that all inspections align with the latest codes is essential for maintaining safety standards.

People sometimes forget to sign and date the form. This step is crucial as it certifies that the inspection was completed and that the information provided is accurate. Without a signature, the form may be considered invalid, which can complicate compliance and enforcement actions.

In some cases, individuals may overlook the requirement for annual inspections. While the 5 Year Fire Sprinkler Inspection form encompasses various inspections, failing to conduct and document annual checks can lead to gaps in safety. Regular inspections are essential for identifying potential issues before they escalate.

Lastly, misunderstanding the definitions of "Pass," "Fail," and "Not Applicable" can lead to incorrect assessments. Each designation has specific implications for the fire sprinkler system's status. Misclassifying an item can result in a false sense of security regarding the system's readiness.

By being aware of these common mistakes, individuals can ensure that they complete the 5 Year Fire Sprinkler Inspection form accurately and thoroughly. Attention to detail in this process is vital for maintaining safety and compliance with fire protection regulations.

Documents used along the form

When conducting a 5 Year Fire Sprinkler Inspection, several other documents and forms are typically required to ensure compliance and thoroughness. These documents help in tracking maintenance, inspections, and any necessary repairs. Below is a list of commonly used forms that complement the 5 Year Fire Sprinkler Inspection form.

  • AES 2.1 Quarterly Inspection Form: This form records the results of quarterly inspections, which are essential for maintaining the functionality of the fire sprinkler system. It includes details about inspections, tests, and any maintenance performed.
  • AES 2.9 Riser Information Form: Used when a building has more than five risers, this form provides detailed information about each riser, including location and performance metrics. It ensures that all risers are accounted for during inspections.
  • AES 9 Deficiencies and Comments Form: This form documents any deficiencies found during inspections. It allows contractors to note repairs or replacements needed, ensuring that all issues are addressed promptly.
  • AES 10 Correction Form: Following the identification of deficiencies, this form is used to report on the corrections made. It provides a clear record of how issues were resolved, which is crucial for compliance.
  • Annual Maintenance Report: This report summarizes the annual maintenance performed on the fire sprinkler system. It includes details of inspections and tests conducted throughout the year, ensuring that the system is always in good working order.
  • Fire Department Connection Inspection Form: This document focuses specifically on the inspection of fire department connections. It ensures that these vital connections are accessible and functional, which is crucial for emergency response.

Using these forms together with the 5 Year Fire Sprinkler Inspection form helps maintain a comprehensive record of the fire sprinkler system's condition and compliance with regulations. Keeping these documents organized and up-to-date is essential for safety and legal adherence.

Similar forms

  • Annual Fire Alarm Inspection Report: This document outlines the annual inspection, testing, and maintenance of fire alarm systems. Similar to the 5 Year Fire Sprinkler Inspection form, it includes details on system components, inspection dates, and compliance with applicable codes.
  • Fire Extinguisher Inspection Report: This report is used to document the inspection of fire extinguishers. It shares similarities in format and detail, including inspection dates, findings, and compliance with safety standards.
  • Emergency Lighting Inspection Report: This document records the testing and maintenance of emergency lighting systems. Like the sprinkler inspection form, it includes information about the system's operational status and compliance with safety regulations.
  • Backflow Prevention Device Test Report: This report verifies the functionality of backflow prevention devices. It is similar in that it requires detailed testing information and compliance with local codes, ensuring the protection of the water supply.
  • Smoke Detector Inspection Report: This document is used to track the inspection and maintenance of smoke detectors. It parallels the sprinkler inspection form in its need for thorough documentation of testing results and compliance with safety standards.
  • Fire Pump Test Report: This report details the performance testing of fire pumps. It is similar in structure, requiring specific performance metrics and compliance with relevant codes to ensure the pump's effectiveness in emergencies.
  • Building Fire Safety Inspection Report: This document provides a comprehensive assessment of a building's fire safety features. It shares a similar purpose of ensuring compliance with fire safety regulations and includes detailed findings and recommendations.
  • Fire Safety Plan Review Document: This document outlines the evaluation of a building's fire safety plan. It resembles the sprinkler inspection form by requiring detailed assessments and compliance checks to ensure safety measures are in place.

Dos and Don'ts

When filling out the 5 Year Fire Sprinkler Inspection form, attention to detail is crucial. Here are five things you should do, as well as five things you should avoid.

  • Double-check all information before submitting the form. Ensure that the property and contractor details are accurate.
  • Use clear and concise language in the comments section. This will help anyone reviewing the form understand any issues or observations.
  • Follow the format specified in the form. Use the correct abbreviations for inspections, tests, and maintenance to avoid confusion.
  • Document all findings thoroughly. Every inspection, test, and maintenance item should be noted with appropriate results.
  • Keep a copy of the completed form for your records. This can be important for future inspections or audits.
  • Do not leave any fields blank. If a section does not apply, mark it as N/A rather than skipping it.
  • Avoid using technical jargon that may not be understood by everyone. Clear communication is key.
  • Do not rush through the process. Take the time to ensure all measurements and observations are accurate.
  • Do not forget to sign and date the form. An unsigned form may not be considered valid.
  • Refrain from altering the form in any unauthorized way. Use the official format to ensure compliance.

Misconceptions

Misconception 1: The 5-Year Fire Sprinkler Inspection form is only for new installations.

This form is required for all fire sprinkler systems, regardless of age. It ensures that both new and existing systems meet safety standards and function properly.

Misconception 2: Completing the form is optional if the system has passed previous inspections.

Every five years, a comprehensive inspection is mandatory. Previous approvals do not exempt a system from this critical assessment.

Misconception 3: The form is only about visual inspections.

The inspection involves various tests, including water flow tests and pressure readings. It ensures that all components are functional and meet regulatory standards.

Misconception 4: Only licensed contractors can fill out the form.

While a licensed contractor must perform the inspection, anyone can assist in completing the form as long as the final certification is done by the licensed professional.

Misconception 5: The form does not need to be submitted to any authority.

After completion, the form must be submitted to the local fire code official. This ensures compliance with safety regulations and helps maintain public safety standards.

Key takeaways

  • Accurate Information: Ensure all property and contractor details are filled out completely. This includes the building name, address, and contact information.

  • Inspection Types: Understand the difference between inspections, tests, and maintenance. Each has specific requirements and must be documented appropriately.

  • Pressure Readings: Record initial static, residual, and final static pressure accurately. These readings are crucial for assessing system performance.

  • Deficiencies and Comments: Use the designated section to note any issues found during inspections. This helps in tracking repairs and ensuring compliance.

  • Signatures: Obtain the necessary signatures to certify that the inspection has been completed. This includes the name and date of the inspector.

  • Compliance with Regulations: Familiarize yourself with California Code of Regulations, Title 19. The form must comply with these standards to be valid.

  • Attachments: If there are additional forms, such as the AES 2.9, ensure they are attached and referenced properly on the main form.

  • Regular Updates: Maintain the form regularly to reflect any changes or updates in the fire sprinkler system. This ensures ongoing compliance and safety.