NATIONAL FIRE PROTECTION ASSOCIATION

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NFPA® 25 eForms
Overview: Any form, whether produced commercially or developed independently, can be used to document inspection, testing, and maintenance
activities, provided it details the activity sufficiently to verify compliance with NFPA 25. Many people assume that NFPA 25 requires a specific
series of forms to be filled out; however, in reviewing the standard, it is completely devoid of forms. This absence of forms in the standard is not
intended to lessen the importance of recording ITM data, but rather it allows the owners and inspectors the flexibility to use their own
project management programs, software, and ITM forms to track their ITM work. This handbook contains several examples of sample forms that
can be used for recording system information or documenting completed ITM tasks.

The forms contained within are copyrighted by NFPA and are licensed to the end user on the basis of a non-exclusive, non-transferable license
to be filled in and used by you in business or professional activities concerning the information requested on the forms. These forms may not be
reproduced, given away, sold, or distributed for any other purpose, including, without thereby limiting, the commercial reproduction and distribu-
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Using NFPA eForms

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 TABLE OF CONTENTS
Wet Pipe Sprinkler Systems Inspection, Testing, and Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 3
Dry Pipe Sprinkler Systems Inspection, Testing, and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 8
Preaction/Deluge Sprinkler Systems Inspection, Testing, and Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 14
Standpipe and Hose Systems Inspection, Testing, and Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 21
Water Spray Systems Inspection, Testing, and Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 30
Water Mist Systems Inspection, Testing, and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 35
Foam-Water Sprinkler Systems Inspection, Testing, and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 43
Private Fire Service Mains Inspection, Testing, and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 52
Private Fire Service Mains Hydrant Flow Test Report. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 56
Water Storage Tanks Inspection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 59
Fire Sprinkler System Hazard Evaluation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 63
Contractor’s Material and Test Certificate for Aboveground Piping. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 67
Contractor’s Material and Test Certificate for Underground Piping. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 70
Fire Pump Weekly Inspection. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 72
Fire Pump Weekly Operating Tests. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 74
Fire Pump Monthly Inspection, Testing, and Maintenance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 76
Fire Pump Quarterly Inspection, Testing, and Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 78
Fire Pump Semiannual Inspection, Testing, and Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 79
Fire Pump Annual Inspection, Testing, and Maintenance. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 80
Fire Pump Annual Performance Test. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 83
Possible Causes of Pump Troubles. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Page 89
Learn
More

WET PIPE SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE

N

ES
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INSPEC

G
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AI N
T E NA NC

Property Name: Inspector:

Property Address: Contract No.:

Property Phone Number: Date:

Inspection Frequency:    Daily    Weekly    Monthly    Quarterly    Annually    Five Years

Inspections: Daily Valve (Cold Weather/Heating Season Only)

Yes       No N/A      Enclosure, not equipped with a low temperature alarm, is inspected during cold
weather to verify a minimum temperature of 40°F (4°C)

Inspections: Weekly Backflow

Yes No N/A       Isolation valves are in open position and locked or supervised
Yes No N/A       RPA and RPDA — differential-sensing relief valve operating correctly

Master Pressure-Regulating Device

Yes No N/A Downstream pressures are in accordance with design criteria psi
Yes No N/A Supply pressure is in accordance with design criteria psi
Yes No N/A Free of damage or leaks
Yes No N/A Trim in good operating condition

Control Valves
Yes No N/A In the correct (open or closed) position
Yes No N/A Sealed
Yes No N/A Accessible
Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches
Yes No N/A Free from damage or leaks
Yes No N/A Proper signage

Inspections: Monthly
Yes No N/A       Gauges are in good operating condition
Yes No N/A       Gauges — normal unsupervised air and nitrogen pressure maintained psi

Control Valves (Locked or Supervised)

Yes No N/A       In the correct (open or closed) position
Yes No N/A Locked or supervised
Yes No N/A       Post Indicator Valves (PIVs) are provided with correct wrenches
Yes No N/A       Accessible
Yes No N/A       Free from damage or leaks
Yes No N/A       Proper signage

NFPA 25 Handbook (p. 1 of 5)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WET PIPE SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Quarterly
Yes       No       N/A       Waterflow alarm and supervisory devices are free of damage
Yes       No       N/A      Gauges — normal air and nitrogen pressure that is supervised by a constantly
attended location is maintained psi
Yes       No       N/A       Gauges — normal water pressure is maintained psi

Alarm Valves/Riser Check

Yes       No       N/A       Gauges — normal water pressure maintained
Yes       No       N/A       Free of damage
Yes       No       N/A       In appropriate open or closed position
Yes       No       N/A       Retard chamber/alarm drains not leaking

Control Valves (Electronically Supervised)

Yes       No       N/A       In the correct (open or closed) position
Yes       No       N/A       Electronically supervised
Yes       No       N/A       Accessible
Yes       No       N/A       Post Indicator Valves (PIVs) are provided with correct wrenches
Yes       No       N/A       Free from damage or leaks
Yes       No       N/A       Proper signage

Fire Department Connections

Yes       No       N/A       Visible and accessible
Yes       No       N/A       Coupling/swivels operate correctly
Yes       No       N/A       Plugs/caps are in place
Yes       No       N/A       Gaskets are not damaged
Yes       No       N/A       Automatic Drain Valve in place and operating properly
Yes       No       N/A       Identification signs are in place
Yes       No       N/A       Interior is clear of obstructions (unless locked)
Yes       No       N/A       Clapper(s) operates correctly
Yes       No       N/A       Check valve is not leaking
Yes       No       N/A       Visible piping supplying the fire department connection is undamaged

Pressure-Reducing Valve
Yes       No       N/A       In the open position and not leaking
Yes       No       N/A       Maintaining downstream pressure
Yes       No       N/A       In good condition, with hand wheel installed and unbroken

Inspections: Annual
Yes       No       N/A       Hydraulic design information sign is securely attached to riser and legible

NFPA 25 Handbook (p. 2 of 5)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WET PIPE SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Annual Sprinklers (visible)

Yes       No       N/A       No damage or leaks
Yes       No       N/A       Free of corrosion, foreign material, or paint
Yes       No       N/A       Installed in proper orientation
Yes       No       N/A       Fluid in glass bulbs
Yes       No       N/A      Spare sprinklers — proper number and type, including installation wrench
Yes       No       N/A      No paint or coating other than that applied by the manufacturer
Yes       No       N/A       Loading — sprinklers are free of dust
Yes       No       N/A       Escutcheons/cover plates are present and installed correctly
Yes       No       N/A       Minimum clearance between sprinklers and storage

Hangers/Seismic Bracing
Yes       No       N/A       Not damaged or loose

Pipes and Fittings (visible)

Yes       No       N/A       In good condition and no external corrosion
Yes       No       N/A       No leaks or mechanical damage
Yes       No       N/A       Correct alignment — no external loads
Yes       No       N/A       Heat trace per manufacturer’s requirements

Building
Yes       No       N/A       Wet piping not exposed to freezing temperatures

Fire Department Connections

Yes       No       N/A       Interior of connection with locked plugs or caps is free of obstructions

Inspections: Five Years

Yes       No       N/A       Alarm valve interior including strainers, filters, and restriction orifice
Yes       No       N/A       Check valve — internal moves freely and in good condition
Yes       No       N/A       Obstruction inspection — no foreign or obstructing material found
Yes       No       N/A       Backflow — internal inspection

Test: Quarterly
Yes       No       N/A       Alarm devices — water motor gong
Yes       No       N/A      Main drain test — if the sole supply is through a backflow preventer or
pressure-reducing valve
Static psi Residual psi
Yes       No       N/A       Do main drain test results differ more than 10% from previous test?

Master Pressure-Regulating Device

Yes       No       N/A       Partial flow test performed to exercise valve

Test: Semiannual
Yes       No       N/A      Alarm device (vane, paddle, and pressure switch type) — inspector’s test or bypass
opened and observed flow
Yes       No       N/A       Valve supervisory switch(es) function

NFPA 25 Handbook (p. 3 of 5)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WET PIPE SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Test: Annual
Yes       No       N/A       All control valves operated through full range of motion and returned to normal position
Yes       No       N/A       Backflow — forward flow test at a minimum flow rate of the system demand
Yes       No       N/A       Valve status test performed
Yes       No       N/A       Antifreeze solution has been tested
Yes       No       N/A       Sprinkler pressure-reducing valve — partial flow test
Yes       No       N/A       Supervisory switch(es) function

Main Drain Test

Static psi Residual psi
Yes       No       N/A       Do main drain test results differ more than 10% from previous test?

Master Pressure-Regulating Device

Yes       No       N/A       Full flow test compared to previous test results

Test: Five Years

Yes       No       N/A       Gauges tested or replaced
Yes       No       N/A      Sprinkler pressure-reducing valve — full flow test compared to previous
test results

Fire Department Connections

Yes       No       N/A       P
 iping from fire department connection to fire department connection check valve
has been hydrostatically tested at 150 psi (10 bar) for at least 2 hours

Routine Maintenance
Yes       No       N/A       Sprinklers tested or replaced per appropriate testing schedule
Yes       No       N/A       OS&Y — stems lubricated annually

Comments

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:
NFPA 25 Handbook (p. 4 of 5)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WET PIPE SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

This form covers a 6-month period.

Year: System:

Location:

General
1. If valves are sealed, note “yes” in this block. If any are not sealed, reseal and note “resealed” in this block.
2. Gauges for dry, preaction, and deluge systems must be inspected for normal air and water pressures.
3–6. Record pressure readings in psi (bar). A loss of more than 10% should be investigated.
7. Record any notes about the system that the inspector believes to be significant. Place a number in the box and corresponding
note in space provided below.

Dry Pipe Valve Preaction Valve

(4) (5) Deluge
Alarm Valve
Valves Valve Water Air Water Water
Sealed Gauges OK Air Static Static Static Static Pressure Notes
Date Inspector (1) (2) (3) Press. Press. Press. Press. (6) (7)

Notes:

NFPA 25 Handbook (p. 5 of 5)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
Learn
More

N T
DRY PIPE SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE

ES
TIO

TIN
INSPEC

G
M E
AI N
T E NA NC

Property Name: Inspector:

Property Address: Contract No.:

Property Phone Number: Date:

Inspection Frequency:     Daily    Weekly    Monthly    Quarterly    Annual    Five-Year

Inspections: Daily Dry Pipe Valve (Cold Weather/Heating Season Only)

Enclosure, not equipped with a low temperature alarm, is inspected during cold weather
Yes No N/A
to verify a minimum temperature of 40°F (4°C)

Inspections: Weekly Backflow

Yes No N/A Isolation valves — open position and locked or supervised

Yes No N/A RPA and RPDA — differential-sensing relief valve operating correctly

Control Valves

Yes No N/A In the correct (open or closed) position

Yes No N/A Sealed

Yes No N/A Accessible

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper Signage

Dry Pipe Valve

Enclosure, where equipped with low temperature alarm, is inspected during cold weather
Yes No N/A
to verify a minimum temperature of 40°F (4°C)
Master Pressure-Regulating Device

Yes No N/A Downstream pressures are in accordance with design criteria        psi

Yes No N/A Supply pressure is in accordance with design criteria        psi

Yes No N/A Free of damage or leaks

Yes No N/A Trim in good operating condition

Inspections: Monthly

Yes No N/A Gauges are in good operating condition

Gauge on system side of dry valve reads proper ratio of air or nitrogen
Yes No N/A
(when not supervised) psi
Gauge on quick-opening device reads the same as system side dry valve gauge
Yes No N/A
(when not supervised) psi
Control Valves (Locked or Supervised)

Yes No N/A In the correct (open or closed) position

Yes No N/A Locked or supervised

Yes No N/A Accessible

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper signage

NFPA 25 Handbook (p. 1 of 6)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 DRY PIPE SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Monthly Dry Pipe Valves

Yes No N/A Exterior is free of damage

Yes No N/A Trim valves are in correct (open or closed) position

Yes No N/A Intermediate chamber is not leaking

Inspections: Quarterly

Yes No N/A Waterflow alarm and supervisory devices are free of damage

Yes No N/A Gauge on supply side of dry valve reads normal        psi

Gauge on system side of dry valve reads proper ratio of air or nitrogen when supervised
Yes No N/A
at a constantly attended location        psi
Gauge on quick-opening device reads the same as system side dry valve gauge when
Yes No N/A
supervised at a constantly attended location        psi

Fire Department Connections

Yes No N/A Visible and accessible

Yes No N/A Coupling/swivels operate correctly

Yes No N/A Plugs/caps are in place

Yes No N/A Gaskets are not damaged

Yes No N/A Identification signs are in place

Yes No N/A Automatic drain valve in place and operational

Yes No N/A Clapper operates correctly

Yes No N/A Interior is clear of obstructions (unless locked)

Yes No N/A Check valve is not leaking

Yes No N/A Visible piping supplying the fire department connection is undamaged

Pressure-Reducing Valve

Yes No N/A In the open position and not leaking

Yes No N/A Maintaining downstream pressure

Yes No N/A In good condition, with handwheel installed and unbroken

Control Valves (Electronically Supervised)

Yes No N/A In the correct (open or closed) position

Yes No N/A Electronically supervised

Yes No N/A Accessible

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper signage

NFPA 25 Handbook (p. 2 of 6)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 DRY PIPE SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Annual

Yes No N/A Hydraulic design information sign is securely attached to riser and legible

Sprinklers (visible)

Yes No N/A No damage or leaks

Yes No N/A Free of corrosion, foreign material, or paint

Yes No N/A Installed in proper orientation

Yes No N/A Fluid in glass bulbs

Yes No N/A Spare sprinklers — proper number and type, including installation wrench

Yes No N/A No paint or coating other than that applied by the manufacturer

Yes No N/A Loading — sprinklers are free of dust

Yes No N/A Escutcheons/cover plates are present and installed correctly

Yes No N/A Minimum clearance between sprinklers and storage

Hangers/Seismic Bracing

Yes No N/A Not damaged or loose

Pipes and Fittings

Yes No N/A In good condition and no external corrosion

Yes No N/A No leaks or mechanical damage

Yes No N/A Correct alignment and no external loads

Fire Department Connections

Yes No N/A Interior of connection with locked plugs or caps is free of obstructions

Dry Pipe Valve

Yes No N/A Interior inspection following trip test

Building
Yes No N/A Prior to onset of freezing weather, all openings are closed, and water-filled pipe is not
exposed to freezing temperatures
Yes No N/A Heat trace per manufacturer’s instructions

Yes No N/A Low temperature alarm is free of physical damage

Inspections: Five Year

Yes No N/A Obstruction inspection — no foreign or obstructing material is found

Yes No N/A Check valve — internal moves freely and in good condition

Yes No N/A Internal inspection of dry pipe valve strainers, filters, and orifices

Yes No N/A Internal inspection of backflow

Test: Quarterly
Yes No N/A Alarm devices — water motor gong
Yes No N/A Main drain test — if the sole supply is through a backflow preventer
or pressure-reducing valve
Static psi Residual psi

Yes No N/A Do results differ by more than 10% from previous test?
Yes No N/A Priming water — test level
Yes No N/A Quick-opening device tested
NFPA 25 Handbook (p. 3 of 6)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 DRY PIPE SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Test: Quarterly Master Pressure-Regulating Device

Yes No N/A Partial flow test performed to exercise valve

Test: Semiannual
Yes No N/A Valve supervisory switch(es) function

Yes No N/A Alarm devices — inspector’s test or bypass opened and observed waterflow

Test: Annual

Yes No N/A Supervisory switch functions

Yes No N/A Low temperature alarm (if installed) at the beginning of heating season

Yes No N/A Low air alarm — test per manufacturer’s instructions

Yes No N/A Automatic air pressure maintenance device

Yes No N/A All control valves operated through full range of motion and returned to normal position

Yes No N/A Backflow preventer — forward flow test at a minimum flow rate of the system demand

Yes No N/A Valve status test performed

Yes No N/A Pressure reducing valve partial flow test

Main Drain Test

Static psi Residual psi

Yes No N/A Do results differ by more than 10% from previous test?

Dry Pipe Valve Trip Test (Partial Flow)

Water pressure (psi) Air pressure (psi)

Tripping air pressure (psi) Trip time (sec)

Yes No N/A Results comparable to previous tests

Master Pressure-Regulating Device

Yes No N/A Full flow test performed and compared to previous test results

Test: Three Years

Dry Pipe Valve Trip Test (Full Flow)

Water pressure (psi) Air pressure (psi)

Tripping air pressure (psi) Trip time (sec)

Water delivery time (min.)

Yes No N/A Results comparable to previous years

Yes No N/A Dry pipe system tested for leakage

Test: Five Years

Yes No N/A Gauges tested or replaced

Yes No N/A Sprinkler pressure-reducing valve — flow test performed and compared to previous results

Fire Department Connections

Yes No N/A Piping from fire department connection to fire department connection check valve has been
hydrostatically tested at 150 psi (10 bar) for at least 2 hours
NFPA 25 Handbook (p. 4 of 6)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 DRY PIPE SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Routine Maintenance

Yes No N/A Sprinklers tested or replaced per appropriate testing schedule

Yes No N/A OS&Y — stems lubricated annually

Yes No N/A Operate all auxiliary drains after operation and before freezing conditions

Comments:

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

NFPA 25 Handbook (p. 5 of 6)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 DRY PIPE SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

This form covers a 6-month period.

Year: System:

Location:

General
1. If valves are sealed, note “yes” in this block. If any are not sealed, reseal and note “resealed” in this block.
2. Gauges for dry, preaction, and deluge systems must be inspected for normal air and water pressures.
3–6. Record pressure readings in psi (bar). A loss of more than 10% should be investigated.
7. Record any notes about the system that the inspector believes to be significant. Place a number in the box and corresponding
note in space provided below.

Dry Pipe Valve

(4) Preaction Valve (5) Deluge
Alarm Valve
Valves Valve Water Air Water Water
Sealed Gauges OK Air Static Static Static Static Pressure Notes
Date Inspector (1) (2) (3) Press. Press. Press. Press. (6) (7)

Notes:

NFPA 25 Handbook (p. 6 of 6)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
Learn
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PREACTION/DELUGE SPRINKLER SYSTEMS INSPECTION, TESTING, Your Logo

ES
TIO

TIN
INSPEC AND MAINTENANCE Here

G
M E
AI N
T E NA NC

Property Name: Inspector:

Property Address: Contract No.:

Property Phone Number: Date:

Inspection Frequency:     Daily    Weekly    Monthly    Quarterly    Annual    Five-Year

Inspections: Daily Preaction and Deluge Valve (Cold Weather/Heating Season Only)

Enclosure, not equipped with a low temperature alarm, is inspected during cold weather
Yes No N/A
to verify a minimum temperature of 40°F (4°C)

Inspections: Weekly

Backflow

Yes No N/A Isolation valves — open position and locked or supervised

Yes No N/A RPA and RPDA — differential-sensing relief valve operating correctly

Control Valves

Yes No N/A In the correct (open or closed) position

Yes No N/A Sealed

Yes No N/A Accessible

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper signage

Preaction and Deluge Valve

Enclosure, where equipped with low temperature alarm, is inspected during cold
Yes No N/A
weather to verify a minimum temperature of 40°F (4°C)

Master Pressure-Regulating Device

Yes No N/A Downstream pressures are in accordance with design criteria     psi

Yes No N/A Supply pressure is in accordance with design criteria     psi

Yes No N/A Free of damage or leaks

Yes No N/A Trim in good operating condition

Inspections: Monthly

Yes No N/A Gauges are operable and not physically damaged

Yes No N/A Gauges — normal air or nitrogen pressure maintained (not supervised)

Gauge on system side of dry valve reads proper ratio of air or nitrogen
Yes No N/A
(not supervised) psi
Gauge on quick-opening device reads the same as system side dry valve gauge
Yes No N/A
(not supervised) psi

NFPA 25 Handbook (p. 1 of 7)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 PREACTION/DELUGE SPRINKLER SYSTEMS INSPECTION, TESTING,
AND MAINTENANCE (Continued)

Inspections: Monthly Control Valves (Locked or Supervised)

Yes No N/A In the correct (open or closed) position

Yes No N/A Locked or supervised

Yes No N/A Accessible

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper signage

Preaction/Deluge Valve

Yes No N/A Free from physical damage or leaks

Yes No N/A Electrical components are in service

Yes No N/A Trim valves are in the correct (open or closed) position

Yes No N/A Valve seat is not leaking

Inspections: Quarterly
Gauges — normal air or nitrogen pressure maintained when supervised at a constantly
Yes No N/A
attended location psi
Gauge on system side of dry valve reads proper ratio of air or nitrogen when supervised
Yes No N/A
at a constantly attended location psi
Gauge on quick-opening device reads the same as system side dry valve gauge when
Yes No N/A
supervised at a constantly attended location psi

Yes No N/A Gauge on supply side of valve reads normal psi

Yes No N/A Waterflow alarm and supervisory devices are free of damage

Fire Department Connections

Yes No N/A Visible and accessible

Yes No N/A Coupling/swivels operate correctly

Yes No N/A Plugs/caps are in place

Yes No N/A Gaskets are not damaged

Yes No N/A Identification signs are in place

Yes No N/A Check valve is not leaking

Yes No N/A Automatic drain valve in place and operating correctly

Yes No N/A Clapper operates correctly

Yes No N/A Interior is clear of obstructions (unless locked)

Yes No N/A Visible piping supplying the fire department connection is undamaged

Pressure-Reducing Valve

Yes No N/A In the open position and not leaking

Yes No N/A Maintaining downstream pressure

Yes No N/A In good condition, with handwheel installed and unbroken

NFPA 25 Handbook (p. 2 of 7)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 PREACTION/DELUGE SPRINKLER SYSTEMS INSPECTION, TESTING,
AND MAINTENANCE (Continued)

Inspections: Quarterly Control Valves (Electronically Supervised)

Yes No N/A In the correct (open or closed) position

Yes No N/A Electronically supervised

Yes No N/A Accessible

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper signage

Inspections: Annual

Yes No N/A Hydraulic design information sign is securely attached to riser and legible
Sprinklers (visible)

Yes No N/A No damage or leaks

Yes No N/A Free of corrosion, foreign material, or paint

Yes No N/A Installed in proper orientation

Yes No N/A Fluid in glass bulbs

Yes No N/A Spare sprinklers — proper number and type, including installation wrench

Yes No N/A Loading — sprinklers are free of dust

Yes No N/A No paint or coating other than that applied by the manufacturer

Yes No N/A Escutcheons/cover plates are present and installed correctly

Yes No N/A Minimum clearance between sprinklers and storage

Hangers/Seismic Bracing
Yes No N/A Not damaged or loose

Pipes and Fittings

Yes No N/A In good condition and no external corrosion

Yes No N/A No leaks or mechanical damage

Yes No N/A Correct alignment and no external loads

Fire Department Connections

Yes No N/A Interior of connection with locked plugs or caps is free of obstructions

Preaction/Deluge Valve

Yes No N/A Interior inspection following trip test

Yes No N/A Detection device condition inspection

Building

Yes No N/A Prior to onset of freezing weather, all openings are closed and water-filled pipe is not
exposed to freezing temperatures
Yes No N/A Heat trace is per manufacturer’s instructions

Yes No N/A Low temp alarm is free of physical damage

NFPA 25 Handbook (p. 3 of 7)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 PREACTION/DELUGE SPRINKLER SYSTEMS INSPECTION, TESTING,
AND MAINTENANCE (Continued)

Inspections: Five Years

Yes No N/A Obstruction inspection — no foreign or obstructing material is found

Yes No N/A Check valve — internal moves freely and in good condition

Yes No N/A Internal inspection of preaction/deluge valve strainers, filters, restricted orifices, and
diaphragm chambers
Yes No N/A Internal inspection of valves that can be reset without removal of faceplate

Yes No N/A Internal inspection of backflow

Test: Quarterly
Yes No N/A Alarm devices — water motor gong

Yes No N/A Detection system low air pressure supervisory device

Yes No N/A Main drain test, if the sole supply is through a backflow preventer or pressure-reducing
valve
Static psi Residual psi

Yes No N/A Do results differ by more than 10% from previous test?

Yes No N/A Priming water — test level

Yes No N/A Low air alarm — test per manufacturer’s instructions

Master Pressure-Regulating Device

Yes No N/A Partial flow test performed to exercise valve

Test: Semiannual

Yes No N/A Valve supervisory switch(es) function

Yes No N/A Alarm devices — inspector’s test or bypass opened and observed waterflow

Test: Annual

Yes No N/A Valve supervisory switch(es) function

Yes No N/A Low temperature alarm (if installed) at the beginning of heating season

Yes No N/A All control valves operated through full range of motion and returned to normal position

Yes No N/A Pressure reducing valve partial flow test

Yes No N/A Automatic air maintenance device functional

Yes No N/A Valve status test performed

Yes No N/A Backflow preventer — forward flow test at a minimum flow rate of the system demand

Main Drain Test

Static psi Residual psi

Yes No N/A Do results differ by more than 10% from previous test?

NFPA 25 Handbook (p. 4 of 7)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 PREACTION/DELUGE SPRINKLER SYSTEMS INSPECTION, TESTING,
AND MAINTENANCE (Continued)

Test: Annual Full Flow Trip Test (Deluge Valve)

Yes No N/A Unobstructed discharge from all nozzles

Pressure reading at deluge valve psi

Yes No N/A Compare if pressure readings to hydraulic design/water supply meets requirements

Yes No N/A Manual release functions correctly

Yes No N/A Valve status test performed

Yes No N/A Pressure reading at most remote nozzle or sprinkler psi

Yes No N/A Air maintenance device functions correctly (if provided)

Preaction Partial Flow Trip Test

Yes No N/A Preaction valve — trip test with partially open control valve

Water pressure (psi) Air pressure (psi)

Tripping air pressure (psi) Trip time (sec)

Water delivery time (min.)

Yes No N/A Results compared to previous results

Test: Three Year Preaction Full Flow Trip Test

Preaction valve — trip test with open control valve

Water pressure (psi) Air pressure (psi)

Tripping air pressure (psi) Trip time (sec)

Water delivery time (min.)

Yes No N/A Results compared to previous results

Yes No N/A Preaction system tested for air leakage

Test: Five Years

Yes No N/A Gauges tested or replaced

Yes No N/A Sprinkler pressure-reducing valve — flow test and comparable to previous results

Fire Department Connections

Yes No N/A Piping from fire department connection to fire department connection check valve has
been hydrostatically tested at 150 psi (10 bar) for at least 2 hours
Routine Maintenance

Yes No N/A Sprinklers/pilot sprinklers tested or replaced per appropriate testing schedule

Yes No N/A OS&Y — stems lubricated annually

Yes No N/A Leaks causing drops in supervisory air pressure or electrical malfunctions causing
alarms fixed
Yes No N/A Interior of valve cleaned after trip test and internal inspection

Yes No N/A Operate axillary drains after system operation and before freezing conditions

NFPA 25 Handbook (p. 5 of 7)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 PREACTION/DELUGE SPRINKLER SYSTEMS INSPECTION, TESTING,
AND MAINTENANCE (Continued)

Comments

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

NFPA 25 Handbook (p. 6 of 7)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 PREACTION/DELUGE SPRINKLER SYSTEMS INSPECTION, TESTING,
AND MAINTENANCE (Continued)

This form covers a 6-month period.

Year: System:

Location:

General
1. If valves are sealed, note “yes” in this block. If any are not sealed, reseal and note “resealed” in this block.
2. Gauges for dry, preaction, and deluge systems must be inspected for normal air and water pressures.
3–6. Record pressure readings in psi (bar). A loss of more than 10% should be investigated.
7. Record any notes about the system that the inspector believes to be significant. Place a number in the box and corresponding
note in space provided below.

Dry Pipe Valve

(4) Preaction Valve (5) Deluge
Alarm Valve
Valves Valve Water Air Water Water
Sealed Gauges OK Air Static Static Static Static Pressure Notes
Date Inspector (1) (2) (3) Press. Press. Press. Press. (6) (7)

Notes:

NFPA 25 Handbook (p. 7 of 7)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
Learn
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STANDPIPE AND HOSE SYSTEMS INSPECTION, TESTING, AND MAINTENANCE Your Logo

ES
Here
TIO

TIN
INSPEC

G
M E
AI N
T E NA NC

Name of Property: Inspector:

Address: Contract No.:

Property Phone Number: Date:

Inspection Frequency: Daily      Weekly      Monthly      Quarterly      Annual     

Five-Year     

Inspections: Daily Dry/Deluge Valve (Cold Weather/Heating Season Only)

Yes No N/A Enclosure, not equipped with a low temperature alarm, is inspected during cold weather
to verify a minimum temperature of 40°F (4°C)

Inspection: Weekly Backflow

Yes No N/A Isolation valves — open position and locked or supervised

Yes No N/A RPA and RPDA — differential-sensing relief valve operating correctly

Control Valves

Yes No N/A In the correct (open or closed) position

Yes No N/A Sealed

Yes No N/A Accessible

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper signage

Dry/Deluge Valve

Yes No N/A Enclosure, where equipped with low temperature alarm, is inspected during cold weather
to verify a minimum temperature of 40°F (4°C)

Master Pressure-Regulating Device

Yes No N/A Downstream pressures are in accordance with design criteria               psi

Yes No N/A Supply pressure is in accordance with design criteria               psi

Yes No N/A Free of damage or leaks

Yes No N/A Trim in good operating condition

Inspections: Monthly

Yes No N/A Gauges are operable and not physically damaged

Yes No N/A Gauges — normal air or nitrogen pressure maintained (not supervised)

Gauge on system side of dry valve reads proper ratio of air or nitrogen
Yes No N/A
(not supervised) psi
Gauge on quick-opening device reads the same as system side dry valve gauge
Yes No N/A
(not supervised) psi

NFPA 25 Handbook (p. 1 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 STANDPIPE AND HOSE SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Monthly Control Valves (Locked or Supervised)

Yes No N/A In the correct (open or closed) position

Yes No N/A Locked or supervised

Yes No N/A Accessible

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper signage

Dry Pipe Valve (Automatic Dry Systems)

Yes No N/A Exterior is free of damage

Yes No N/A Trim valves are in correct (open or closed) position

Yes No N/A Intermediate chamber is not leaking

Deluge Valve (Semiautomatic Dry System)

Yes No N/A Free from physical damage or leaks

Yes No N/A Electrical components are in service

Yes No N/A Trim valves are in the correct (open or closed) position

Yes No N/A Valve seat is not leaking

Inspections: Quarterly
Yes No N/A Waterflow alarm and supervisory devices are free of damage

Yes No N/A Gauges — normal air or nitrogen pressure maintained when supervised at a constantly
attended location psi
Yes No N/A Gauge on system side of dry valve reads proper ratio of air or nitrogen when supervised
at a constantly attended location psi
Yes No N/A Gauge on quick-opening device reads the same as system side dry valve gauge when
supervised at a constantly attended location psi
Yes No N/A Gauge on supply side of valve reads normal psi

Control Valves (Electronically Supervised)

Yes No N/A In the correct (open or closed) position

Yes No N/A Electronically supervised

Yes No N/A Accessible

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper signage

NFPA 25 Handbook (p. 2 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 STANDPIPE AND HOSE SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Quarterly Hose Valves

Yes No N/A Caps are in place and not damaged

Yes No N/A Hose threads are not damaged

Yes No N/A Valve handles are present and not damaged

Yes No N/A Gaskets are not damaged or deteriorated

Yes No N/A Valves are not leaking

Yes No N/A Valves are not obstructed

Yes No N/A Valves are capable of normal operation

Fire Department Connections

Yes No N/A Visible and accessible

Yes No N/A Couplings/swivels operate correctly

Yes No N/A Plugs/caps are in place

Yes No N/A Gaskets are not damaged

Yes No N/A Identification signs are in place

Yes No N/A Check valve is not leaking

Yes No N/A Automatic drain valve in place and operating properly

Yes No N/A FDC clapper is functional

Yes No N/A Interior is clear of obstructions (unless locked)

Yes No N/A Visible piping supplying the fire department connection is undamaged

Inspections: Annual

Yes No N/A Dry pipe valve interior inspection following trip test

Yes No N/A Deluge valve interior inspection following trip test

Yes No N/A Hydraulic design information attached securely and legible

Hose Cabinet

Yes No N/A Visible and accessible

Yes No N/A No damaged or corroded components

Yes No N/A Cabinet door is not difficult to open and opens fully

Yes No N/A Glass is not broken

Yes No N/A Glass break device is present and attached

Yes No N/A Cabinet is properly identified

Yes No N/A Lock (in break-glass type) is functional

Yes No N/A Contents are present and accessible

Fire Department Connections

Yes No N/A Interior of connection with locked plugs or caps is free of obstructions

NFPA 25 Handbook (p. 2 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 STANDPIPE AND HOSE SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Annual Nozzle (Inspected per NFPA 1962)

Yes No N/A Hose nozzle is present

Yes No N/A Gasket is not missing or deteriorated

Yes No N/A Nozzle is not obstructed

Yes No N/A Nozzle operates smoothly

Hose (Inspected per NFPA 1962)

Yes No N/A No mildew, cuts, abrasions, and deterioration

Yes No N/A Gaskets are not missing or deteriorated

Yes No N/A Threads on coupling are not incompatible

Yes No N/A Hose connected to hose rack nipple or valve

Yes No N/A Hose test is to date

Yes No N/A Hose has been reracked, rereeled, or rerolled

Hose Storage Device

Yes No N/A Visible and accessible

Yes No N/A Not damaged and operates correctly

Yes No N/A Hose is properly racked or rolled

Yes No N/A Nozzle clip in place and nozzle correctly contained

Yes No N/A If installed in cabinet, will swing out at least 90 degrees

Hose Connections

Yes No N/A Valve cap(s) are not missing or damaged

Yes No N/A Fire hose connection is not damaged

Yes No N/A Valve handles are not missing or damaged

Yes No N/A Cap gaskets are not missing or deteriorated

Yes No N/A Valve is not leaking

Yes No N/A Valve does not have any visible or physical obstruction

Yes No N/A Pressure reducing device is not missing

Yes No N/A Manual, semiautomatic, or dry standpipe valves operate smoothly

Yes No N/A Valve is not damaged

NFPA 25 Handbook (p. 3 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 STANDPIPE AND HOSE SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Annual Pipe and Fittings

Yes No N/A In good condition with no external corrosion

Yes No N/A No leaks or mechanical damage

Yes No N/A Correct alignment with no external loads

Yes No N/A Control valves are not damaged

Yes No N/A No missing or damaged supporting devices

Building

Prior to onset of freezing weather, all openings are closed and water-filled pipe is not
Yes No N/A
exposed to freezing temperatures

Yes No N/A Heat trace is per manufacturer’s instructions

Yes No N/A Low temp alarm is free of physical damage

Inspection: Five Year

Yes No N/A Obstruction inspection — no foreign or obstructing material found

Yes No N/A Check valve — internal moves freely and in good condition

Yes No N/A Backflow — internal inspection

Yes No N/A Internal inspection of dry pipe and preaction/deluge valve strainers filters and orfices

Test: Quarterly

Yes No N/A Alarm devices — water motor gong

Main drain test — if the sole supply is through a backflow preventer or pressure-reducing
Yes No N/A
valve
Static psi: Residual psi:

Yes No N/A Do results differ by more than 10% from previous test?

Yes No N/A Priming water level tested

Yes No N/A Quick-opening device tested

Master Pressure-Regulating Device

Yes No N/A Partial flow test performed to exercise valve

Test: Semiannual

Yes No N/A Valve supervisory switch(es) functioning

Alarm devices (vane and pressure switch type) — inspector’s test or bypass opened and
Yes No N/A
observed waterflow

NFPA 25 Handbook (p. 4 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 STANDPIPE AND HOSE SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)
Test: Annual

Yes No N/A Supervisory switch functioning

Yes No N/A Automatic air pressure maintenance device functioning

Yes No N/A Backflow preventer — forward flow test at a minimum flow rate of the system demand

Yes No N/A Valve status test performed

Yes No N/A Low temperature alarm (if installed) at the beginning of heating season

Yes No N/A Low air alarm tested per manufacturer’s instructions

Yes No N/A Partial flow test for hose connection and hose rack assembly pressure regulating device

Yes No N/A Hose valves — Class I and Class III — fully open and close valves

Yes No N/A Hose nozzle — per NFPA 1962 (tested at same frequency as the hose it is attached)

Main Drain Test

Static psi Residual psi

Yes No N/A Do results differ by more than 10% from previous test?

Yes No N/A All control valves operated through full range of motion and returned to normal position

Dry Pipe Valve Trip Test (Partial Flow)

Water pressure (psi) Air pressure (psi)

Tripping air pressure (psi) Trip time (sec)

Yes No N/A Results compared to previous test

Deluge Valve Full Flow Trip Test

Pressure reading at deluge valve psi

Yes No N/A Compare if pressure readings to hydraulic design/water supply meets requirements

Yes No N/A Air maintenance device (if provided) works correctly

Master Pressure-Regulating Device

Yes No N/A Full flow test performed and compared to previous test

Tests: Three Years

Yes No N/A Hose hydrostatically tested in accordance with NFPA 1962 (for hose older than 5 years)
Yes No N/A Hose valves — Class II — fully open and close valves

Dry Pipe Valve Full Flow Trip Test

Water pressure (psi) Air pressure (psi)

Tripping air pressure (psi) Trip time (sec)

Water delivery time (min.) (sec)

Yes No N/A Results comparable to previous years

Yes No N/A Dry pipe system tested for leakage

NFPA 25 Handbook (p. 5 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 STANDPIPE AND HOSE SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Test: Five Years

Yes No N/A Gauges tested or replaced

Yes No N/A Hydrostatic test (manual and semiautomatic dry only)

Yes No N/A Flow test (all automatic systems)

Static pressure (psi)

Total flow (gpm)

Pressure at topmost outlet (psi)

Yes No N/A Hose connection pressure-reducing/restricting valves — flow test

Fire Department Connections

Piping from fire department connection to fire department connection check valve has
Yes No N/A
been hydrostatically tested at 150 psi (10 bar) for at least 2 hours
Routine Maintenance

Yes No N/A Re-rack hose with folds in different position annually

Yes No N/A Drain water from all low point drains in dry systems prior to freezing temperatures

Yes No N/A OS&Y — stems lubricated annually

Yes No N/A Lubricate, repair, or replace hose valves that do not open smoothly or fully

Comments

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

NFPA 25 Handbook (p. 6 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 STANDPIPE AND HOSE SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Hose Connection Reducing/Restricting Valves — Flow Test

Static Pressure Flowing Pressure

Location/Floor Model # Inlet Outlet Inlet Outlet Flow (gpm)

NFPA 25 Handbook (p. 7 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 STANDPIPE AND HOSE SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

This form covers weekly inspections over a 6-month period.

Year: System:

Location:

General
1. If valves are sealed, note “yes” in this block. If any are not sealed, reseal and note “resealed” in this block.

2. Record any notes about the system that the inspector believes to be significant.

Valves
Date Inspector Sealed (1) Notes (2)

NFPA 25 Handbook (p. 8 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
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WATER SPRAY SYSTEMS INSPECTION, TESTING, AND MAINTENANCE

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Name of Property: Inspector:

Address: Contract No.:

Property Phone Number: Date:

Inspection Frequency:     Daily     Weekly     Quarterly     Semiannual     Annual    

Inspections: Daily Deluge Valve (Cold Weather/Heating Season Only)

Yes       No       N/A      Enclosure, not equipped with a low temperature alarm, is inspected during cold
weather to verify a minimum temperature of 40°F (4°C)

Inspections Weekly Backflow

Yes       No       N/A       Isolation valves — open position and locked or supervised

Yes       No       N/A       RPA and RPDA — differential-sensing relief valve operating correctly

Control Valves

Yes       No       N/A       In the correct (open or closed) position

Yes       No       N/A       Sealed

Yes       No       N/A       Accessible

Yes       No       N/A       Post Indicator Valves (PIVs) are provided with correct wrenches

Yes       No       N/A       Free from damage or leaks

Yes       No       N/A       Proper signage

Deluge Valve

Yes       No       N/A      Enclosure, where equipped with low temperature alarm, is inspected during cold
weather to verify a minimum temperature of 40°F (4°C)

Inspections: Monthly

Yes       No       N/A       Gauges are operable and not physically damaged

Yes       No       N/A      Gauges — normal air or nitrogen pressure maintained (not supervised)    psi

Control Valves (Locked or Supervised)

Yes       No       N/A       In the correct (open or closed) position

Yes       No       N/A       Locked or supervised

Yes       No       N/A       Accessible

Yes       No       N/A       Post Indicator Valves (PIVs) are provided with correct wrenches

Yes       No       N/A       Free from damage or leaks

Yes       No       N/A       Proper signage

Deluge Valve

Yes       No       N/A       Free from physical damage or leaks

Yes       No       N/A       Electrical components are in service

Yes       No       N/A       Trim valves are in the correct (open or closed) position

Yes       No       N/A       Valve seat is not leaking

Yes       No       N/A       Detection system gauge (if provided) — normal pressure is being maintained
NFPA 25 Handbook (p. 1 of 5)
© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER SPRAY SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Monthly UHSWSS Detectors

Yes       No       N/A       Free of physical damage

Yes       No       N/A       Optical detectors (where used) — lenses clean

Inspections: Quarterly

Yes       No       N/A      Gauges — normal supply water pressure is being maintained psi

Yes       No       N/A      Gauges — normal air or nitrogen pressure maintained when supervised at a
constantly attended location psi

Control Valves (Electronically Supervised)

Yes       No       N/A       In the correct (open or closed) position

Yes       No       N/A       Electronically supervised

Yes       No       N/A       Accessible

Yes       No       N/A       Post Indicator Valves (PIVs) are provided with correct wrenches

Yes       No       N/A       Free from damage or leaks

Yes       No       N/A       Proper signage

Drainage

Yes       No       N/A       Method is in good operating condition

Yes       No       N/A       Retention embankments or dikes are in good condition

Inspections: Annual Support/Hangers

Yes       No       N/A       In good condition (no missing or damaged paint or coating, rust, or corrosion)

Yes       No       N/A       Securely attached to structure and piping

Yes       No       N/A       No damaged or missing hangers, braces, and support

Pipes and Fittings

Yes       No       N/A       In good condition with no external corrosion

Yes       No       N/A       No leaks or mechanical damage

Yes       No       N/A       Correct alignment with no external loads

Yes       No       N/A       Low point drains maintained and in proper working order

Yes       No       N/A       Rubber-gasketed fittings in good condition

Nozzles

Yes       No       N/A       In place, aimed, and pointed in the direction intended

Yes       No       N/A       Free from external loading and corrosion

Yes       No       N/A       Caps or plugs are in place (where required)

Note:
For fire pumps refer to NFPA 25, Chapter 8, and the appropriate inspection forms.
For water storage tanks refer to NFPA 25, Chapter 9, and the appropriate inspection forms.
For detection systems refer to NFPA 72® National Fire Alarm and Signaling Code, and the appropriate inspection forms.
NFPA 25 Handbook (p. 2 of 5)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER SPRAY SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Annual Deluge Valve

Yes       No       N/A       Inspection following trip test

Yes       No       N/A       Detection device in good condition

Building

Yes       No       N/A      Prior to onset of freezing weather, all openings are closed and water-filled pipe is
not exposed to freezing temperatures

Yes       No       N/A       Heat trace is per manufacturer’s instructions

Yes       No       N/A       Low Temp alarm is free of physical damage

Inspections: Five Years

Yes       No       N/A       Check valve — internal moves freely and in good condition

Yes       No       N/A       Backflow — internal inspection

Yes       No       N/A      Internal inspection of deluge valve strainers, filters, restricted orifices, and
diaphragm chambers

Test: Quarterly
Yes       No       N/A       Alarm devices — water motor gong
Yes       No       N/A      Main drain test, if sole supply is through a backflow preventer or pressure-
reducing valve

Static psi Residual psi

Yes       No       N/A       Do results differ by more than 10% from previous test?
Yes       No       N/A       Deluge valve priming water level tested
Yes       No       N/A       Low air alarm tested per manufacturer’s instructions (if provided)

Test: Semiannual
Yes       No       N/A       Valve supervisory switch(es) function
Yes       No       N/A       Alarm devices — inspector’s test or bypass opened and observed waterflow

Test: Annual
Yes       No       N/A       Supervisory switch(es) function
Yes       No       N/A       Low temp alarm (if installed) at the beginning of heating season

Main Drain Test

Static psi Residual psi
Yes       No       N/A       Do results differ by more than 10% from previous test?
Yes       No       N/A      All control valves operated through full range of motion and returned to
normal position

Full Flow Trip Test (Deluge Valve)

Yes       No       N/A       Unobstructed discharge from all nozzles
Pressure reading at most remote nozzle         psi
Pressure reading at deluge valve         psi

NFPA 25 Handbook (p. 3 of 5)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER SPRAY SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Test: Annual Full Flow Trip Test (Deluge Valve)

Yes       No       N/A      Compare pressure readings to hydraulic design and water supply
meets requirements
Yes       No       N/A      Manual release functions correctly
Yes       No       N/A      Valve status test performed
Yes       No       N/A       Nozzle spray patterns and direction verified
Yes       No       N/A      Air maintenance device functions correctly
Yes       No       N/A       Mainline strainer flushed after trip test
Yes       No       N/A      Backflow — forward flow test at a minimum flow rate of the system demand
Yes       No       N/A      Detection system tested in accordance with NFPA 72®

System Response Time

Yes       No       N/A       Heat detection responded in         sec

Yes       No       N/A      Flammable gas detection responded in         sec

Discharge Time

Yes       No       N/A      Time lapse between operation of detection systems and water delivery time to
protected area         sec

Yes       No       N/A       UHSWSS/response time does not exceed 100 milliseconds

Routine Maintenance
Yes       No       N/A       OS&Y — stems lubricated annually

Comments

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

NFPA 25 Handbook (p. 4 of 5)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER SPRAY SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

This form covers a 6-month period.

Year: System:

Location:

Inspection
Weekly

General

1. If valves are sealed, note “yes” in this block. If any are not sealed, reseal and note “resealed” in this block.
2. If all nozzles are in good condition and not blocked, note “yes” in block. If not, see that corrections are made and briefly describe under
“notes.”
3. Assure valve enclosure is maintained above 40ºF (4ºC).
4. Assure deluge or preaction valve is free of damage, trim valves are in proper position, and electrical components are operational.

5. Record any notes about the system that the inspector believes to be significant.

Deluge
Valves Nozzles Alarm Valve Valve
Date Inspector Sealed (1) OK (2) OK (3) OK (4) Notes (5)

NFPA 25 Handbook (p. 5 of 5)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
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Date: Inspector: System:

Location:

General

System designation

Building

Location of control valve

Has system been modified since last inspection? Yes No

What is hazard protected?

Valves

How are valves supervised? Sealed Locked Tamper switch

Are valves identified with signs? Yes No

Detection System (if any)

When was the detection system last inspected?

Operating Instructions

Are operating instructions present? Yes No

Notes

NFPA 25 Handbook (p. 1 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER MIST SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Name of Property: Inspector:

Address: Contract No.:

Property Phone Number: Date:

Inspection Frequency: Daily     Weekly     Monthly     Quarterly     Semiannual    

Annual     Five-Year

Inspections: Daily Valve (Cold Weather/Heating Season Only)

Yes No N/A Enclosure, not equipped with a low temperature alarm, is inspected during cold weather to verify
a minimum temperature of 40°F (4°C)

Inspections: Weekly
Backflow

Yes No N/A Isolation valves — open position and locked or supervised

Yes No N/A RPA and RPDA — differential-sensing relief valve operating correctly

Control Valves

Yes No N/A In the correct (open or closed) position

Yes No N/A Sealed

Yes No N/A Accessible

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper signage

Dry/Deluge Valve/Preaction
Yes No N/A Enclosure, where equipped with low temperature alarm, is inspected during cold weather to
verify a minimum temperature of 40°F (4°C)
Master Pressure-Regulating Device

Yes No N/A Downstream pressures are in accordance with design criteria psi

Yes No N/A Supply pressure is in accordance with design criteria psi

Yes No N/A Free of damage or leaks

Yes No N/A Trim in good operating condition

Inspections: Monthly

Yes No N/A Gauges are in good operating condition

Yes No N/A Gauges — normal air or nitrogen pressure maintained (unsupervised) psi

Yes No N/A Gauge on system side of dry valve reads proper ratio of air or nitrogen (unsupervised) psi
Gauge on quick-opening device reads the same as system side dry valve
Yes No N/A
gauge (unsupervised) psi
Yes No N/A Water circulation tank — water level is full (unsupervised)

Compressed Gas Cylinders

Yes No N/A Cylinder pressure (unsupervised) psi

NFPA 25 Handbook (p. 2 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER MIST SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Monthly Standby Pump

Yes No N/A Compressed gas supply inlet air pressure psi

Yes No N/A Outlet water pressure psi

Yes No N/A Inspect and empty the moisture trap, oil injection (pneumatic)

Yes No N/A Oil level on air regulator unit

System Control Valves (Locked or Supervised)

Yes No N/A In the correct (open or closed) position

Yes No N/A Locked or supervised

Yes No N/A Accessible

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper signage

Inspections: Quarterly

Gauges — normal air or nitrogen pressure maintained when supervised at a constantly

Yes No N/A
attended location psi
Gauge on system side of dry valve reads proper ratio of air or nitrogen when supervised
Yes No N/A
at a constantly attended location psi
Gauge on quick-opening device reads the same as system side dry valve gauge when
Yes No N/A
supervised at a constantly attended location psi

Yes No N/A Gauge on supply side of valve reads normal psi

Yes No N/A Water supply pressure psi

Yes No N/A Water storage cylinder (high pressure) water level is full (unsupervised)

Yes No N/A Additive storage cylinder in good condition

Yes No N/A Water recirculation tank — water level is full (supervised)

Yes No N/A Compressed gas cylinder properly secured

Yes No N/A Waterflow alarm and supervisory device is free of damage

Yes No N/A Hydraulic design information sign is securely attached to riser and legible

Alarm Valves/Riser Check

Yes No N/A Gauges — normal water pressure maintained

Yes No N/A Free of damage

Yes No N/A In appropriate open or closed position

Yes No N/A Accessible

Yes No N/A Retard chamber/alarm drains not leaking

Control Valves (Electronically Supervised)

Yes No N/A In the correct (open or closed) position

Yes No N/A Electronically Supervised

Yes No N/A Accessible

NFPA 25 Handbook (p. 3 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER MIST SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Quarterly Control Valves (Electronically Supervised)

Yes No N/A Post Indicator Valves (PIVs) are provided with correct wrenches

Yes No N/A Free from damage or leaks

Yes No N/A Proper signage

Pressure-Reducing Valve

Yes No N/A In the open position and not leaking

Yes No N/A Maintaining downstream pressure

Yes No N/A In good condition, with hand wheels installed and unbroken

Inspections: Semiannual

Yes No N/A Manually operated indicating valves are in proper position

Yes No N/A Pressure in electronically supervised and monitored gas cylinder psi (bar)

Yes No N/A Water storage cylinder (high pressure) water level is full (supervised)

Yes No N/A Pneumatically operated valves and tubing inspected

Yes No N/A Water quality checked (first year)

Yes No N/A Additive agent level is full

Yes No N/A Enclosure integrity verified

Inspections: Annual

Yes No N/A Hoses are not damaged

Yes No N/A Water quality checked (after first year)

Yes No N/A Low temperature alarm is in good condition

Nozzles

Yes No N/A No signs of physical damage, corrosion, or leaking

Yes No N/A No loss of fluid in glass bulb heat responsive element

Yes No N/A Loading — free of dust

Yes No N/A No paint or coating unless applied by the manufacturer

Yes No N/A Correct orientation

Yes No N/A Correct number and type of spare water mist nozzles

Hangers, Braces, and Support

Yes No N/A Not damaged, loose, or unattached

NFPA 25 Handbook (p. 4 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER MIST SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Annual High-Pressure Water Storage Cylinder

Yes No N/A Properly secured

Yes No N/A Vent plug is not ruptured or damaged

Yes No N/A Filters are clean

Yes No N/A Inspect cylinder capacity and pressure rating

Yes No N/A Check cylinder compliance specification

Yes No N/A Cylinder pressure on discharge psi (bar)

Yes No N/A Water recirculation tank supports and attachments in good condition

Yes No N/A Water recirculation tank clean filters, strainers, and cyclone separator

Piping, Tubing, and Fittings

Yes No N/A Free of mechanical damage

Yes No N/A Free of leakage

Yes No N/A Free of external loads

Yes No N/A Missing or damaged paint or coatings

Yes No N/A Free of corrosion or rust

Yes No N/A Misalignment or trapped sections

Yes No N/A Low point drains not damaged or corroded

Compressed Gas Cylinders

Yes No N/A Inspect cylinder capacity and pressure rating

Yes No N/A Check cylinder compliance specification

Yes No N/A Compressed gas meets specifications

Inspection: Five Years

Yes No N/A Alarm valve — interior including strainers, filters, and restricted orfices

Yes No N/A Obstruction inspection — no foreign or obstructing material found

Yes No N/A Check valve — internal moves freely and in good condition

Yes No N/A Backflow — internal inspection

Yes No N/A Compressed gas cylinder exterior inspection

Test: Quarterly

Yes No N/A Water mist system operated by pressurized gas cylinders or pressurized vessels,
nozzles flow upon operation
Test: Semiannual

Yes No N/A Alarm device — vane and pressure switch type

Yes No N/A Valve supervisory switch(es) function

Yes No N/A Pneumatic slave valve and cycle on off valve test
NFPA 25 Handbook (p. 5 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER MIST SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Test: Annual

Yes No N/A Supervisory switch(s) function

Yes No N/A Water supply tested

psi gpm minute duration

Yes No N/A Additive agent quality tested

Yes No N/A Additive agent injection — full discharge test

Yes No N/A Valve status test

Yes No N/A Standby pump operated

Yes No N/A All control valves operated through full range of motion and returned to normal position

Backflow

Yes No N/A Forward flow test at a minimum flow rate of the system demand

Master Pressure-Regulating Valve

Yes No N/A Full flow test compared to previous test results

Water Recirculation Tank

Yes No N/A Operational test per manufacturers instructions

Yes No N/A Float-operated valve functions

Yes No N/A Pressure at outlet during discharge psi

Yes No N/A Backflow preventer functions

Pneumatic Valves

Yes No N/A Solenoid release for electronic and manual release

Full Flow Trip Test

Yes No N/A Unobstructed discharge from all nozzles

Yes No N/A Pressure reading at control valve psi

Yes No N/A Detection system response time sec

Yes No N/A Detection system tested in accordance with NFPA 72®

Yes No N/A Ventilation system interlocks tested

Yes No N/A Fuel/lubrication system interlocks tested

Test: Five Years

Yes No N/A Gauges tested or replaced

Yes No N/A DOT, CTC, or similar compressed gas/water cylinder retesting

Yes No N/A Hose hydrostatic test

NFPA 25 Handbook (p. 6 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER MIST SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Routine Maintenance

Yes No N/A OS&Y — stems lubricated annually

Yes No N/A Flush mainline strainer after each test

Yes No N/A Evaluate additives per manufacturer

Yes No N/A Drain and refill water tank annually

Yes No N/A Rebuild pneumatically operated standby pump every 5 years

Yes No N/A Inspect representative sample of operated water mist nozzles after activation

Comments

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

NFPA 25 Handbook (p. 7 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER MIST SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Name of Property: Inspector:

Address: Contract No.:

Property Phone Number: Date:

Inspection Frequency: Weekly     Monthly     Quarterly     Annual     Other

This form covers weekly inspections over a 6-month period.

Year: System:

Location:

General:

1. Check that water tank is full if water level not supervised.

2. Check air pressure gauge to confirm that adequate air pressure is being maintained.
3. Check air pressure gauge to confirm that adequate air pressure is being maintained by the compressor.
4. Record any notes about the system that the inspector believes to be significant.

Y = Satisfactory N = Unsatisfactory (explain below)

Air Tank Air

Water Level Pressure Compressor
Date Inspector (1) (2) (3) Notes (4)

NFPA 25 Handbook (p. 8 of 8)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
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Learn
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FOAM-WATER SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE Your Logo

ES
TIO

TIN
INSPEC Here

G
M E
AI N
T E NA NC

Date: Inspector: System:

Location:

General

System designation

Building

Location of control valve

Has system been modified since last inspection? Yes No

What is hazard protected?

Valves

How are valves supervised? Sealed Locked Tamper switch

Are valves identified with signs? Yes No

Fire Department Connections

Location

Are identification signs provided? Yes No

Operating Instructions

Are operating instructions present? Yes No

Notes:

NFPA 25 Handbook (p. 1 of 9)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
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 N T
FOAM-WATER SPRINKLER SYSTEMS INSPECTION, TESTING,
AND MAINTENANCE (Continued)

ES
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Property Name: Inspector:

Property Address: Contract No.:

Property Phone Number: Date:

Inspection Frequency:      Daily      Weekly      Monthly      Quarterly     

Annual      Five-Year

Inspections: Daily Valve (Cold Weather/Heating Season Only)

Yes       No       N/A Enclosure, not equipped with a low temperature alarm, is inspected during cold
weather to verify a minimum temperature of 40°F (4°C)

Inspections: Weekly

Backflow

Yes       No       N/A Isolation valves — open position and locked or supervised
Yes       No       N/A RPA and RPDA — differential-sensing relief valve operating correctly

Control Valves

Yes       No       N/A In the correct (open or closed) position

Yes       No       N/A Sealed
Yes       No       N/A Accessible
Yes       No       N/A Post Indicator Valves (PIVs) are provided with correct wrenches
Yes       No       N/A Free from damage or leaks
Yes       No       N/A Proper signage

Deluge/Preaction Valve

Yes       No       N/A Enclosure, where equipped with low temperature alarm, is inspected during
cold weather to verify a minimum temperature of 40°F (4°C)

Master Pressure-Regulating Device

Yes       No       N/A Downstream pressures are in accordance with design criteria psi

Yes       No       N/A Supply pressure is in accordance with design criteria psi
Yes       No       N/A Free of damage or leaks
Yes       No       N/A Trim in good operating condition

Inspections: Monthly

Yes       No       N/A Gauges are in good operating condition

Yes       No       N/A Gauges — normal air or nitrogen pressure maintained when not supervised at
a constantly attended location psi
Yes       No       N/A Gauge on system side of dry valve reads proper ratio of air or nitrogen when
not supervised at a constantly attended location psi
Yes       No       N/A Gauge on quick-opening device reads the same as system side dry valve
gauge when not supervised at a constantly attended location psi

NFPA 25 Handbook (p. 2 of 9)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FOAM-WATER SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Monthly Control Valves (locked or supervised)

Yes       No       N/A In the correct (open or closed) position
Yes       No       N/A Locked or supervised
Yes       No       N/A Accessible
Yes       No       N/A Post Indicator Valves (PIVs) are provided with correct wrenches
Yes       No       N/A Free from damage or leaks
Yes       No       N/A Proper signage

Deluge/Preaction Valve

Yes       No       N/A Free from physical damage or leaks

Yes       No       N/A Electrical components are in service
Yes       No       N/A Valve seal not leaking
Yes       No       N/A Trim valves are in the correct (open or closed) position

Proportioning System(s)

Yes       No       N/A Foam concentrate quantity meets original design requirements
Yes       No       N/A Strainers inspected
Yes       No       N/A Pressure vacuum vent is operating freely
Yes       No       N/A Gauges are in good operating condition
Yes       No       N/A Sensing line valves are open
Yes       No       N/A Foam liquid pump provided with power
Yes       No       N/A Free of corrosion
Yes       No       N/A Automatic drain valves are free and opened
Yes       No       N/A Valves in correct position
Nozzles
Yes       No       N/A In place, aimed, and pointed in the direction intended
Yes       No       N/A Free from external loading and corrosion
Yes       No       N/A Caps or plugs are in place (where required)

Inspections: Quarterly
Yes       No       N/A Gauges — normal air or nitrogen pressure maintained when supervised at a
constantly attended location psi
Yes       No       N/A Gauge on system side of dry valve reads proper ratio of air or nitrogen when
supervised at a constantly attended location psi
Yes       No       N/A Gauge on quick-opening device reads the same as system side dry valve
gauge when supervised at a constantly attended location psi
Yes       No       N/A Gauge on supply side of valve reads normal psi
Yes       No       N/A Alarm devices — free of damage
Yes       No       N/A Hydraulic design information sign is securely attached to riser and legible

Alarm Valves/Riser Check

Yes       No       N/A In appropriate open or closed position

Yes       No       N/A Free of damage
Yes       No       N/A Accessible
Yes       No       N/A Retard chamber/alarm drains not leaking
NFPA 25 Handbook (p. 3 of 9)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FOAM-WATER SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Quarterly Pressure-Reducing Valve

Yes       No       N/A In the open position and not leaking
Yes       No       N/A Maintaining downstream pressure
Yes       No       N/A In good condition, with handwheels installed and unbroken
Foam Concentrate Strainer(s)
Yes       No       N/A Blow-down valve closed and plugged
Drainage
Yes       No       N/A Method — in good operating condition
Yes       No       N/A Retention embankments or dikes are in good condition

Control Valves (Electronically Supervised)

Yes       No       N/A In the correct (open or closed) position

Yes       No       N/A Electronically supervised
Yes       No       N/A Accessible
Yes       No       N/A Post Indicator Valves (PIVs) are provided with correct wrenches
Yes       No       N/A Free from damage or leaks
Yes       No       N/A Proper signage

Inspections: Annual

Yes       No       N/A Low temperature alarm free of damage

Support/Hangers

Yes       No       N/A In good condition (no missing or damaged paint or coating, rust, or corrosion

Yes       No       N/A No damaged or missing hangers bracing and support

Yes       No       N/A Securely attached to structure and piping

Pipes and Fittings

Yes       No       N/A In good condition and no external corrosion

Yes       No       N/A No leaks or mechanical damage
Yes       No       N/A Correct alignment — no external loads
Yes       No       N/A Low point drains maintained and in proper working order
Yes       No       N/A Rubber-gasketed fittings in good condition

Sprinklers (visible)

Yes       No       N/A No damage or leaks

Yes       No       N/A Free of corrosion, foreign material, or paint
Yes       No       N/A Fluid in glass bulbs
Yes       No       N/A Spare sprinklers — proper number and type, including installation wrench
Yes       No       N/A Loading — sprinklers are free of dust
Yes       No       N/A Escutcheons/cover plates are present and installed correctly
Yes       No       N/A Clearance — minimum clearance between sprinklers and storage

NFPA 25 Handbook (p. 4 of 9)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FOAM-WATER SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Annual Bladder Tank

Yes       No       N/A Presence of foam in water surrounding bladder

Deluge Valve

Yes       No       N/A Interior is in good working condition

Yes       No       N/A Detection device in good condition

Inspections: Five Years

Yes       No       N/A Strainers — per manufacturer’s instructions

Yes       No       N/A Alarm valve interior in good condition

Yes       No       N/A Check valve — internal moves freely and in good condition
Yes       No       N/A Obstruction inspection — no foreign or obstructing material found
Yes       No       N/A Backflow — internal inspection
Yes       No       N/A Internal inspection of deluge valve strainers, filters, restricted orfices, and
diaphragm chambers
Test: Quarterly

Yes       No       N/A Alarm devices — water motor gong

Yes       No       N/A Priming water level tested

Yes       No       N/A Low air alarm tested per manufacturer’s instructions

Yes       No       N/A Main drain tested if sole supply is through a backflow preventer or
pressure-reducing valve

Yes       No       N/A Static psi Residual psi

Yes       No       N/A Do main drain test results differ more than 10% from previous test?

Master Pressure-Regulating Device

Yes       No       N/A Partial flow test performed to exercise valve

Test: Semiannual

Yes       No       N/A Valve supervisory switch(es) function

Yes       No       N/A Alarm devices (vane and pressure switch type) tested and functioning correctly

Test: Annual

Yes       No       N/A All control valves operated through full range of motion and returned to normal
position

Yes       No       N/A Valve status test performed

Yes       No       N/A Supervisory switch(es) function

Yes       No       N/A Low temp alarm (if installed) at the beginning of heating season

Main Drain Test

Static psi Residual psi

Yes       No       N/A Do main drain test results differ more than 10% from previous test?

NFPA 25 Handbook (p. 5 of 9)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FOAM-WATER SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Test: Annual Backflow Preventer

Yes       No       N/A Forward flow test at a minimum flow rate of the system demand

Master Pressure-Regulating Device

Yes       No       N/A Full flow test compared to previous test results

Full Flow Test (Deluge Valve)

Yes       No       N/A Unobstructed discharge from all nozzles/position correctly

Yes       No       N/A Pressure reading at deluge valve psi
Yes       No       N/A Pressure reading at most remote nozzle of sprinkler psi
Yes       No       N/A Air maintenance functions correctly (if provided)

Preaction Partial Trip Test

Water pressure (psi) Air pressure (psi)

Tripping air pressure (psi) Trip time (sec)

Water delivery time (min.) (sec)

Foam Concentrate Strainer(s)

Yes       No       N/A In proper working condition

Operational Test

Yes       No       N/A Foam-water system(s) responded as designed

Discharge time (min.) (sec)

Yes       No       N/A Manual actuation device functions as intended

Concentration Test

Yes       No       N/A Foam sample measured

Yes       No       N/A Foam concertation within 10% of acceptance test results
Yes       No       N/A Foam concentrate not more than 10% below minimum design standard

Test: Three Years

Preaction Valve Trip Test Open Control Valve

Water pressure (psi) Air pressure (psi)

Tripping air pressure (psi) Trip time (sec)

Water delivery time (min.)

Yes       No       N/A Results compared to previous results

Yes       No       N/A Preaction system tested for air leakage

NFPA 25 Handbook (p. 6 of 9)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FOAM-WATER SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Test: Five Years

Yes       No       N/A Gauges tested or replaced

Routine Maintenance

Yes       No       N/A OS&Y — stems lubricated annually

Yes       No       N/A Proportioned ball drip disassembled, cleaned, and reassembled every five
years. Date:

Yes       No       N/A Foam concentrate tank drained and flushed every ten years. Date:

Yes       No       N/A Foam concentrate tank inspected internally and externally for corrosion every
ten years. Date:

Yes       No       N/A Foam concentrate tank hydrostatically tested every ten years. Date:

Yes       No       N/A Bladder tank proportioner sight glass cleaned every ten years. Date:

Yes       No       N/A Balancing valve diaphragm flushed every five years. Date:

Yes       No       N/A Pressure vacuum vents serviced every five years. Date:

Comments

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

NFPA 25 Handbook (p. 7 of 9)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FOAM-WATER SPRINKLER SYSTEMS INSPECTION, TESTING,
AND MAINTENANCE (Continued)

This form covers monthly inspections for a 1-year period.

Year: System:

Location:

General
1. If fire department connections are unobstructed and in good condition, note “OK” in block. If not, see that corrections are made and
briefly describe under “notes.”
2. If valves are locked, note “yes” in this block. If any are not locked, relock and note “relocked” in this block.
3. Assure alarm devices are free of physical damage and electrical connections are secure. If so, note “OK” in blank. If not, see that
corrections are made and briefly describe them under “notes.”
4. Record water pressure. If there is a difference of 10% or more, investigate cause, evaluate impact to system operation, and briefly
describe under “notes.”
5. Note “OK” if system operating instructions are posted. If not, see that corrections are made and briefly describe under “notes.”
6. Inspect nozzles for proper orientation, blockage, and caps (if provided) are in place.
7. Inspect all valves on portioning system for proper position.
8. Inspect foam concentrate tank to ensure it is full and there is no serious corrosion.
9. Record any notes about the system that the inspector believes to be significant.
Y = Satisfactory N = Unsatisfactory (explain below)

Fire Department Valves Alarm Water Instructions Concentrate

Connections Locked Devices Pressure Posted Nozzles Valves Tank
Date Inspector (1) (2) (3) (4) (5) (6) (7) (8)

NFPA 25 Handbook (p. 8 of 9)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FOAM-WATER SPRINKLER SYSTEMS INSPECTION, TESTING, AND MAINTENANCE (Continued)
Notes (9)

NFPA 25 Handbook (p. 9 of 9)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
Learn
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PRIVATE FIRE SERVICE MAINS INSPECTION, TESTING, AND MAINTENANCE

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Name of Property: Inspector:

Address: Contract No.:

Property Phone Number: Date:

Inspection Frequency:     Weekly       Monthly       Quarterly      Semiannual     

Annual       Five-Year

Inspections: Weekly Control Valves

Yes       No       N/A       In the correct (open or closed) position

Yes       No       N/A       Sealed

Yes       No       N/A       Accessible

Yes       No       N/A       Post Indicator Valves (PIVs) are provided with correct wrenches

Yes       No       N/A       Free from damage or leaks

Yes       No       N/A       Proper signage

Backflow

Yes       No       N/A       Isolation valves are in open position and locked or supervised

Yes       No       N/A       RPA and RPDA - differential-sensing relief valve operating correctly

Inspections: Monthly Control Valves (Locked or Supervised)

Yes       No       N/A       In the correct (open or closed) position

Yes       No       N/A       Locked or supervised

Yes       No       N/A       Accessible

Yes       No       N/A       Post Indicator Valves (PIVs) are provided with correct wrenches

Yes       No       N/A       Free from damage or leaks

Yes       No       N/A       Proper signage

Inspections: Quarterly Control Valves (Electronically Supervised)

Yes       No       N/A       In the correct (open or closed) position

Yes       No       N/A       Electronically supervised

Yes       No       N/A       Accessible

Yes       No       N/A       Post Indicator Valves (PIVs) are provided with correct wrenches

Yes       No       N/A       Free from damage or leaks

Yes       No       N/A       Proper signage

Fire Department Connections

Yes       No       N/A       Visible and accessible

Yes       No       N/A       Coupling/swivels operate correctly

Yes       No       N/A       Plugs/caps are in place

NFPA 25 Handbook (p. 1 of 4)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 PRIVATE FIRE SERVICE MAINS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Quarterly Fire Department Connections

Yes       No       N/A       Gaskets are not damaged

Yes       No       N/A       Automatic drain valve in place and operating properly

Yes       No       N/A       Identification signs are in place

Yes       No       N/A       Interior is clear of obstructions (unless locked)

Yes       No       N/A       Clapper(s) operates correctly

Yes       No       N/A       Check valve not leaking

Yes       No       N/A       Visible piping supplying the fire department connection is undamaged

Hose Houses

Yes       No       N/A       Accessible

Yes       No       N/A       Free from damage or leaks

Yes       No       N/A       No missing equipment

Dry Hydrant

Yes       No       N/A       Water supply is not deteriorated in pond, stream, or cistern.

Yes       No       N/A       Vegetation cleared 3 ft (0.9 m) radius from hydrant

Inspections: Semiannual Monitor Nozzles

Yes       No       N/A       Not leaking

Yes       No       N/A       Free of damage

Yes       No       N/A       Free of corrosion

Dry Hydrants

Yes       No       N/A      Reflective material marking and signage is in accordance with 8.4.7 of NFPA 1142

Inspections: Annual Hydrants (Dry Barrel and Wall Type)

Yes       No       N/A       Accessible

Yes       No       N/A       Barrel is free of water and ice

Yes       No       N/A       Barrel drains properly

Yes       No       N/A       Not leaking

Yes       No       N/A       Barrel is free of cracks

Yes       No       N/A       Outlets are not excessively tight and lubricated

Yes       No       N/A       Nozzle threads are not worn

Yes       No       N/A       Operating nut is not worn

Yes       No       N/A       Operating wrench is available

Yes       No       N/A       Free of detrimental corrosion

NFPA 25 Handbook (p. 2 of 4)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 PRIVATE FIRE SERVICE MAINS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Inspections: Annual Hydrants (Wet Barrel)

Yes       No       N/A       Accessible

Yes       No       N/A       Not leaking

Yes       No       N/A       Barrel is free of cracks

Yes       No       N/A       Outlets not excessively tight and lubricated

Yes       No       N/A       Nozzle threads are not worn

Yes       No       N/A       Operating nut is not worn

Yes       No       N/A       Operating wrench is available

Fire Department Connections

Yes       No       N/A       Interior of connection with locked plugs or caps is free of obstructions

Mainline Strainers

Yes       No       N/A       Not plugged or fouled

Yes       No       N/A       Free of corrosion

Yes       No       N/A       No damaged parts

Pipe and Fittings (exposed)

Yes       No       N/A       Not leaking

Yes       No       N/A       Free of damage and corrosion

Yes       No       N/A       Hangers intact and not damaged

Inspections: Five Years

Yes       No       N/A       Backflow - internal inspection

Yes       No       N/A       Check valve - internal moves freely and in good condition

Yes       No       N/A       Backflow - forward flow test at minimum flow rate of the system demand

Test: Annual Monitor Nozzles

Yes       No       N/A       Flow test until all foreign material has cleared (not less than one minute)

Yes       No       N/A       Operated through full range of motion

Dry Hydrant

Yes       No       N/A       Flow Test

Hydrants

Yes       No       N/A       Flow test until all foreign material has cleared (not less than one minute)

Yes       No       N/A       Barrel drains within 60 minutes

Hydrant Isolation Valve

Yes       No       N/A       Operated through full range of motion

Yes       No       N/A       Status test (verify valve is in the open position)

NFPA 25 Handbook (p. 3 of 4)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 PRIVATE FIRE SERVICE MAINS INSPECTION, TESTING, AND MAINTENANCE (Continued)

Test: Five Years Piping (Exposed and Underground)

Yes       No       N/A       Flow test piping at rate anticipated during a fire

Yes       No       N/A       Flow test results comparable to previous test

Fire Department Connections

Yes       No       N/A       P

 iping from fire department connection to fire department connection check valve
hydrostatically tested at 150 psi (10 bar) for at least 2 hours

Maintenance: Annual Mainline Strainers

Yes       No       N/A       Removed, inspected, and cleaned

Hydrants

Yes       No       N/A       Lubricate stems, caps, plugs, and threads

Yes       No       N/A       Accessible (no snow, ice, or other material)

Yes       No       N/A       Protected from damage

Monitor Nozzles

Yes       No       N/A       Lubricate per manufacturer’s recommendations

Comments

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

NFPA 25 Handbook (p. 4 of 4)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
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PRIVATE FIRE SERVICE MAINS HYDRANT FLOW TEST REPORT Your Logo
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Name of Property:

Address:

Tested by: Date:

Contract No.: Time:

Weather conditions:

Location of test:

Residual hydrant location: Elevation:

Flow hydrant(s) location: Elevation:

Static pressure (residual hydrant): psi

Residual pressure (residual hydrant): psi

Nozzle size (flow hydrant): in. (mm)

Nozzle coefficient (flow hydrant):

Pitot pressure(s): psi

Projected results: gpm (L/min) @ 20 psi

Remarks:

NFPA 25 Handbook (p. 1 of 3)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 PRIVATE FIRE SERVICE MAINS HYDRANT FLOW TEST REPORT (Continued)

Location Map (N.T.S.) — show line sizes and distances, show valves and hydrant branch sizes, indicate north, show flow
hydrants, and show location of static and residual hydrant.

NFPA 25 Handbook (p. 2 of 3)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 PRIVATE FIRE SERVICE MAINS HYDRANT FLOW TEST REPORT (Continued)

Hydraulic Graph Pressure vs. (Flow)1.85 Hydraulic Graph Pressure vs. (Flow)1.85
130
Location:
Static Pressure: Date:
120
Residual Pressure: Time:
Flow: By:
110
Elevation: Notes:

90
Pressure (pounds per square inch)
)

80

70
(Multiply scale by

60

50

40

30

20

10

0
0 200 300 400 500 600 700 800 900 1000

Flow — gallons per minure

(Multiply scale by )

NFPA 25 Handbook (p. 3 of 3)

© 2016 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution.
No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized use, contact [email protected].
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WATER STORAGE TANKS INSPECTION

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Name of Property: Inspector:

Address: Contract No.:

Property Phone Number: Date:

Inspection Frequency: Daily Weekly Monthly Quarterly

Annual Five-Year

Inspections: Daily (Cold Weather/Heating Season Only)

Yes       No       N/A       Heating system (when not supervised)

Inspectons: Weekly Control Valves

Yes       No       N/A       In the correct (open or closed) position

Yes       No       N/A       Sealed

Yes       No       N/A       Accessible

Yes       No       N/A       Post Indicator Valves (PIVs) are provided with correct wrenches

Yes       No       N/A       Free from damage or leaks

Yes       No       N/A       Proper signage

(Cold Weather/Heating Season Only)

Yes       No       N/A       Record Water temperature (when not supervised)

Yes       No       N/A       Record water temperature (supervised systems)

Inspections: Monthly

Yes       No       N/A       Gauges are in good operating condition

Control Valves (Locked or Supervised)

Yes       No       N/A       Water temperature (supervised systems)

Yes       No       N/A       In the correct (open or closed) position

Yes       No       N/A       Locked or supervised

Yes       No       N/A       Accessible

Yes       No       N/A       Post Indicator Valves (PIVs) are provided with correct wrenches

Yes       No       N/A       Free from damage or leaks

Yes       No       N/A       Proper signage

Water Level

Yes       No       N/A       Water level (unsupervised) full

Inspections: Quarterly

Yes       No       N/A       Gauges — normal water pressure maintained

Yes       No       N/A       Water level (supervised) full NFPA 25 Handbook (p. 1 of 4)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER STORAGE TANKS INSPECTION (Continued)

Inspections: Quarterly Tank Exterior Inspection

Yes       No       N/A      Exterior of tank, supporting structure, vents, foundation, and catwalks or ladders
are in good condition

Yes       No       N/A      Area is free of combustible storage, trash, debris, brush, or material that could
present a fire exposure hazard

Yes       No       N/A      Area is free of accumulation of material on or near parts that could result in
accelerated corrosion or rot

Yes       No       N/A      Tank and support are free of ice buildup

Yes       No       N/A      Exterior sides and top of embankments supporting coated fabric tanks are free of
erosion

(Cold Weather/Heating Season Only)

Yes       No       N/A       Heating system (supervised systems)

Control Valves (Electronically Supervised)

Yes       No       N/A       In the correct (open or closed) position

Yes       No       N/A       Electronically supervised

Yes       No       N/A       Accessible

Yes       No       N/A       Post Indicator Valves (PIVs) are provided with correct wrenches

Yes       No       N/A       Free from damage or leaks

Yes       No       N/A       Proper signage

Surrounding Area

Yes       No       N/A       Free of combustibles

Yes       No       N/A       Free of material that could accelerate corrosion or not

Yes       No       N/A      Free of ice buildup

Yes       No       N/A       Embankments (for coated fabric tank) free of erosion

Inspections: Annual

Yes       No       N/A       Hoops and grillage (wooden tanks) are in good condition

Yes       No       N/A       Painted/coated surfaces are in good condition

Yes       No       N/A       Expansion joints are not cracked or leaking

Inspections: Three Years Steel Tank Interior Inspection (Without Corrosion Protection)

Yes       No       N/A       Silt has been removed for underwater evaluation

Yes       No       N/A       Interior surfaces are free of pitting, corrosion, spalling, or other forms of deterioration

Yes       No       N/A       Interior is free of waste material, aquatic growth, and debris

Yes       No       N/A       Interior coating is intact

Yes       No       N/A       Tank floor is free of dents

Yes       No       N/A       Heating system and components are in good condition

Yes       No       N/A       Anti-vortex plate is in good condition and is not obstructed

NFPA 25 Handbook (p. 2 of 4)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER STORAGE TANKS INSPECTION (Continued)

Inspections: Five Years Interior Inspection (All Other Tank Types)

Yes       No       N/A       Silt has been removed for underwater evaluation

Yes       No       N/A       Interior surfaces are free of pitting, corrosion, spalling, or other forms of deterioration

Yes       No       N/A       Interior is free of waste material, aquatic growth, and debris

Yes       No       N/A       Interior coating is intact

Yes       No       N/A       Tank floor is free of dents

Yes       No       N/A       Heating system and components are in good condition

Yes       No       N/A       Anti-vortex plate is in good condition and is not obstructed

Check Valves

Yes       No       N/A       Check valve­— internal moves freely and in good condition

Test Prior to Heating Season Tank Heating System

Yes       No       N/A       In proper working order

Yes       No       N/A       Low water temperature signals

Yes       No       N/A       High water temperature signals

Test: Monthly Water Temperature

Yes       No       N/A       Low temperature alarm is working correctly

Yes       No       N/A       High temperature limit switch is working correctly

Test: Semiannual

Yes       No       N/A      High and low water level signals work correctly

Test: Annual Valve Status

Yes       No       N/A       Operated through its full range of motion

Yes       No       N/A       Status test to verify valve(s) is in the open position

Automatic Tank Fill Valve

Yes       No       N/A       Valve actuated by lowering water level

Yes       No       N/A       Measure and record refill rate

Test: Five Years

Yes       No       N/A       Level indicators are accurate and move freely

Yes       No       N/A       Gauges tested or replaced

Maintenance

Yes       No       N/A       Tank maintained full or at designated water level

Yes       No       N/A      Hatch covers in the roofs and the door at the top of frost-proof castings kept
securely fastened

Yes       No       N/A       Waste material in or on the tank

Yes       No       N/A       Clean strainers quarterly

NFPA 25 Handbook (p. 3 of 4)

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or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 WATER STORAGE TANKS INSPECTION (Continued)

Comments

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

NFPA 25 Handbook (p. 4 of 4)

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FIRE SPRINKLER SYSTEM HAZARD EVALUATION Your Logo

Here

Changes in building occupancy, use, or process, or material used or stored, create the need for evaluation of the installed fire protection
systems. This form is intended to identify and evaluate such changes and should be completed only by an individual properly qualified in
the area of system design.

Owner: Owner’s address:

Property being evaluated:

Property address:

Date of work:

(All responses refer to the current hazard evaluation performed on this date.)

Section 1. Identification of Sprinklered Occupancy and Storage Hazards

(Use additional pages as needed.)

Area of Property Hazard Protected

(List nonsprinklered Type of Design (Uses or storage Improvements
areas separately in System and Capability arrangements, Needed to
Section 3.) Sprinklers of System including commodity) Address Hazard
1.

2.

3.

4.

5.

NFPA 25 Handbook (p. 1 of 4)

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or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE SPRINKLER SYSTEM HAZARD EVALUATION (Continued)

Section 2. Evaluation of Protection

For each area of the property evaluated in Section 1, please answer the following questions with a “yes,” “no,” “N/A,” or “?” and explain all
“no” and “?” responses below by row and column identification:

Answer the following for each identified property area: 1 2 3 4 5

a. Are all sprinklers the correct type for their application?

b. Are the obstructions to sprinklers in all areas within acceptable limits for the specific types of
sprinklers used?
c. Are hazards associated with all occupancy areas consistent with hazards typical for that
occupancy hazard classification?
d. Are stockpiles of combustibles located within occupancy areas limited to appropriate
heights?
e. Are miscellaneous and dedicated storage areas properly identified and managed?
f. Are all dedicated storage areas protected in accordance with the proper storage configuration and
commodity classification?
g. Is the storage or use of flammable liquids, combustible liquids, or aerosol products in any area
properly addressed?
h. Is all idle pallet storage properly protected?
i. Is there any presence of nitrate film, pyroxylin plastic, compressed or liquefied gas cylin-
ders, liquid or solid oxidizers, or organic peroxide formulations except where specifically
addressed by appropriate protection measures?
j. Are all sprinklers spaced appropriately for the hazard and the type of sprinkler?
k. Do the available sources of heat and cooling appear adequate for the type of system and
temperature rating of sprinklers?

Explanation of “no” and “?” answers:

Examples:
b2 — no — Obstructions to ESFR sprinklers exceed currently accepted standards.
e3 — ? — Owner must provide information on type of plastic involved in product before evaluation can be finalized.

NFPA 25 Handbook (p. 2 of 4)

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or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE SPRINKLER SYSTEM HAZARD EVALUATION (Continued)

Section 3. Evaluation of Unsprinklered Areas

Area of Property for Which Basis of Lack of Protection Basis for Omission Under Current
Protection Is Not Provided (if known) Codes/Standards

1.

2.

3.

4.

5.

Section 4. Water Supply Evaluation

If this hazard evaluation is the result of a reduction in the residual pressure during routine inspections, explain the results of the
investigation made to determine the reasons for this change:

Explain the basis of continued acceptability of the water supply or proposed improvements:

NFPA 25 Handbook (p. 3 of 4)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE SPRINKLER SYSTEM HAZARD EVALUATION (Continued)
Section 5. Hazard Evaluator’s Information and Certification

Evaluator:

Company:

Company address:

I state that the information on this form is correct at the time and place of my review of my evaluation.

Is this hazard evaluation completed? (Note: All “?” must be resolved.) Yes No

Explain if answer is not “yes”:

Have deficiencies in protection been identified that should be improved or corrected? Yes No

Summarize improvements of corrections needed:

Signature of Evaluator: Date:

License or Certification Number (if applicable):

NFPA 25 Handbook (p. 4 of 4)

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CONTRACTOR’S MATERIAL AND TEST CERTIFICATE FOR ABOVEGROUND PIPING
PROCEDURE
Upon completion of work, inspection and tests shall be made by the contractor’s representative and witnessed by the property owner or their authorized agent. All
defects shall be corrected and system left in service before contractor’s personnel finally leave the job.
A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is understood
the owner’s representative’s signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving
authority’s requirements or local ordinances.
Property name Date
Property address
New installation? ❑ Yes    ❑ No
Modification? If yes, complete applicable portions of the form. ❑ Yes    ❑ No
Provide a description of the scope of work on page 3.
Plans Accepted by approving authorities (names)
Address
Installation conforms to accepted plans ❑ Yes    ❑ No
Equipment used is approved ❑ Yes    ❑ No
If no, explain deviations
Has person in charge of fire equipment been instructed as ❑ Yes    ❑ No
to location of control valves and care and maintenance
of this new equipment?
If no, explain
Instructions
Have copies of the following been left on the premises? ❑ Yes    ❑ No
   1. System components instructions ❑ Yes    ❑ No
   2. Care and maintenance instructions ❑ Yes    ❑ No
  3. NFPA 25 ❑ Yes    ❑ No
Location of
Supplies buildings
system

Make Model Year of manufacture Orifice size Quantity Temperature rating

Sprinklers

Pipe and Type of pipe                                                        

fittings Type of fittings                                                       

Alarm Alarm device Maximum time to operate through test connection

valve or
flow Type Make Model Minutes Seconds
indicator

Dry valve Q. O. D.
Make Model Serial no. Make Model Serial no.

Time to trip through Water Air Trip point air pressure Time waterreached Alarm operated
test connectiona,b pressure pressure test outleta,b properly
Dry pipe
operating Minutes Seconds psi psi psi Minutes Seconds Yes No
test
Without
Q.O.D.
With
Q.O.D.

NFPA 25 Handbook (p. 1 of 3)

a
Measured from time inspector’s test connection is opened.
b
NFPA 13 only requires the 60-second limitation in specific sections.

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 CONTRACTOR’S MATERIAL AND TEST CERTIFICATE FOR ABOVEGROUND PIPING (Continued)

Operation          ❑ Pneumatic         ❑ Electric         ❑ Hydraulic

Piping supervised       ❑ Yes   ❑ No Detecting media supervised        ❑ Yes   ❑ No

Does valve operate from the manual trip, remote, or both control stations?               ❑ Yes   ❑ No

Deluge and Is there an accessible facility in each circuit for testing? If no, explain
preaction
          ❑ Yes   ❑ No
valves
Does each circuit operate Does each circuit operate valve Maximum time to operate release
supervision loss alarm? release?
Make Model
Yes No Yes No Minutes Seconds

Location Make and

Setting Static pressure Residual pressure (flowing) Flow rate
and floor model
Pressure-
reducing valve Inlet (psi) Outlet (psi) Inlet (psi) Outlet (psi) Flow (gpm)
test

Backflow device Indicate means used for forward flow test of backflow device:                              
forward
flow test When means to test device was opened, was system flow demand created?   ❑ Yes    ❑    Yes    ❑ N/A

Hydrostatic: Hydrostatic tests shall be made at not less than 200 psi (13.8 bar) for 2 hours or 50 psi (3.4 bar) above static pressure in excess
of 150 psi (10.3 bar) for 2 hours. Differential dry pipe valve clappers shall be left open during the test to prevent damage. All
Test aboveground piping leakage shall be stopped.
description
Pneumatic: Establish 40 psi (2.7 bar) air pressure and measure drop, which shall not exceed 1¹⁄2 psi (0.1 bar) in 24 hours. Test pressure
tanks at normal water level and air pressure and measure air pressure drop, which shall not exceed 1¹⁄2 psi (0.1 bar) in 24 hours.

All piping hydrostatically tested at      psi (   bar) for     hours If no, state reason
Dry piping pneumatically tested        ❑ Yes   ❑ No
Equipment operates properly        ❑ Yes   ❑ No

Do you certify as the sprinkler contractor that additives and corrosive chemicals, sodium silicate or derivatives of sodium silicate, brine, or
other corrosive chemicals were not used for testing systems or stopping leaks?
  ❑ Yes   ❑ No

Drain Reading of gauge located near water Residual pressure with valve in test
test supply test connection:      psi (   bar) connection open wide:      psi (   bar)

Underground mains and lead-in connections to system risers flushed before connection made to sprinkler piping

Verified by copy of the Contractor’s Material and Test       ❑ Yes   ❑ No

Certificate for Underground Piping. Other       Explain
Flushed by installer of underground sprinkler piping        ❑ Yes   ❑ No

If powder-driven fasteners are used in concrete,         ❑ Yes   ❑ No

has representative sample testing been If no, explain
satisfactorily completed?

Blank testing Number used Locations Number removed

gaskets

Welding piping             ❑ Yes   ❑ No

Do you certify as the sprinkler contractor that welding procedures used complied with the minimum ❑ Yes   ❑ No
requirements of AWS B2.1, ASME Section IX Welding and Brazing Qualifications, or other applicable
qualification standard as required by the AHJ?
Do you certify that all welding was performed by welders or welding operators qualified in accordance with ❑ Yes   ❑ No
the minimum requirements of AWS B2.1, ASME Section IX Welding and Brazing Qualifications, or other
applicable qualification standard as required by the AHJ?
Do you certify that the welding was conducted in compliance with a documented quality control procedure ❑ Yes   ❑ No
to ensure that (1) all discs are retrieved; (2) that openings in piping are smooth, that slag and other welding
residue are removed; (3) the internal diameters of piping are not penetrated; (4) completed welds are free
from cracks, incomplete fusion, surface porosity greater than 116 in. (1.6 mm) diameter, undercut deeper
than the lesser of 25% of the wall thickness or 132 in. (0.8 mm); and (5) completed circumferential butt NFPA 25 Handbook (p. 2 of 4)
weld reinforcement does not exceed 3 32 in. (2.4 mm)?
NFPA 25 Handbook (p. 2 of 3)

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or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 CONTRACTOR’S MATERIAL AND TEST CERTIFICATE FOR ABOVEGROUND PIPING (Continued)

Cutouts Do you certify that you have a control feature to ensure that all cutouts (discs) are retrieved?
(discs)

Hydraulic Nameplate provided

data If no, explain
nameplate                  ❑ Yes   ❑ No

Sprinkler contractor removed all caps and straps?    ❑ Yes   ❑ No

Date left in service with all control valves open

Remarks

Name of sprinkler contractor

Tests witnessed by

Title Date

Signatures

The property owner or their authorized agent (signed) Title Date

Additional explanations and notes:

NFPA 25 Handbook (p. 3 of 3)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
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CONTRACTOR’S MATERIAL AND TEST CERTIFICATE FOR UNDERGROUND PIPING
M E
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PROCEDURE
Upon completion of work, inspection and tests shall be made by the contractor’s representative and witnessed by an owner’s representative. All defects shall be
corrected and system left in service before contractor’s personnel finally leave the job.
A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is
understood the owner’s representative’s signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure
to comply with approving authority’s requirements or local ordinances.

Property Name: SAUDI CHEMICAL CO. LTD. Date: 18/05/2021

Property Address: EXPLOSIVES MANUFACTURING AND STORAGE FACILITIES, ATSHANAH SITE (CENTRAL REGION), KSA

Accepted by approving authorities (names) AJECS

Address JEDDAH, KSA

Plans
Installation conforms to accepted plans ✔❑ Yes ❑ No
Equipment used is approved ✔❑ Yes ❑ No
If no, state deviations
Has person in charge of fire equipment been instructed as to location of control valves and care
❑ Yes ❑ No
✔
and maintenance of this new equipment?

Instructions If no, explain Partial UG HDPE Pipe hydrotesting has been done only. (from PIV-1 to PIV-2), Once the complete network is hydrotested accordingly will be instructed to the care & maintenance team.

Have copies of appropriate instructions and care and maintenance charts been left on premises? ❑ Yes ❑ No
If no, explain

Location Supplies buildings

Pipe types and class Type joint

Pipe conforms to standard ❑ Yes ❑ No

Underground Fittings conform to standard
pipes and joints If no, explain ❑ Yes ❑ No

Joints needing anchorage clamped, strapped, or blocked in ❑ Yes ❑ No

accordance with standard
If no, explain

Flushing: Flow the required rate until water is clear as indicated by no collection of foreign material in burlap bags at outlets such as
hydrants and blow-offs. Flush in accordance with the requirements of 6.10.2.1.3.
Hydrostatic: All piping and attached appurtenances subjected to system working pressure shall be hydrostatically tested at 200 psi
(13.8 bar) or 50 psi (3.4 bar) in excess of the system working pressure, whichever is greater, and shall maintain that pressure ±5 psi
(0.34 bar) for 2 hours.
Hydrostatic Testing Allowance: Where additional water is added to the system to maintain the test pressures required by 6.10.2.2.1,
Test
the amount of water shall be measured and shall not exceed the limits of the following equation (for metric equation, see 6.10.2.2.6):
description
L = testing allowance (makeup water), in gallons per hour
S = length of pipe tested, in feet
SD P
L= D = nominal diameter of the pipe, in inches
148, 000
P = average test pressure during the hydrostatic test, in pounds per square inch (gauge)

New underground piping flushed according to ❑ Yes ❑ No

standard by (company)
If no, explain

How flushing flow was obtained Through what type opening

Flushing ❑ Public water ❑ Tank orreservoir ❑ Fire pump ❑ Hydrant butt ❑ Open pipe
tests
Lead-ins flushed according to standard by (company)
❑ Yes ❑ No
If no, explain

How flushing was obtained Through what type opening

❑ Public water ❑ Tank orreservoir ❑ Fire pump ❑ Y connectionto flange andspigot ❑ Open pipe

NFPA 25 Handbook (p. 1 of 2)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 CONTRACTOR’S MATERIAL AND TEST CERTIFICATE FOR UNDERGROUND PIPING (Continued)

All underground piping hydrostatically tested at Joints covered

Hydrostatic
test
psi for hours ❑ Yes    ❑ No

Total amount of leakage measured

psi for hours
Leakage
test
Allowable leakage
psi for hours

Forward flow
Foward flow test performed in accordance with 6.10.2.5.2:
test of backflow
❑ Yes    ❑ No
preventer

Number installed Type and make All operate satisfactorily

Hydrants
❑ Yes    ❑ No
Water control valves left wide open
❑ Yes    ❑ No
If no, state reason
Control
valves
Hose threads of fire department connections and hydrants ❑ Yes    ❑ No
interchangeable with those of fire department answering alarm

Date left in service

Remarks

Name of installing contractor

Tests witnessed by

For property owner (signed) Title Date

Signatures

For installing contractor (signed) Title Date

Additional explanation and notes:

NFPA 25 Handbook (p. 2 of 2)

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or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
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E FIRE PUMP WEEKLY INSPECTION

Property Name: Inspector:

Property Address: Contract No.:

Property Phone Number: Date:

Inspections: Weekly Pump House

Yes No N/A Heat in pump room is 40°F (4°C) or higher
Yes No N/A Ventilation louvers are free to operate
Yes No N/A Excessive water does not appear on the floor
Yes No N/A Coupling guard is in place
Yes No N/A Heat in pump room is not less than 70°F (21°C) for diesel engine pump without
engine heater
Pump Systems
Yes No N/A Pump suction, discharge, and bypass valves are open
Yes No N/A No piping or hoses leak
Yes No N/A Fire pump leaking one drop of water per second at seals

Yes No N/A Suction line pressure is within acceptable range

Yes No N/A System line pressure is within acceptable range
Yes No N/A Suction reservoir is full
Yes No N/A Wet pit suction screens are unobstructed and in place
Yes No N/A Waterflow test valves are in closed position, hose connection valve is closed, and the
line to test valves is free of water

Electrical Systems
Yes No N/A Controller pilot light (power on) is illuminated
Yes No N/A Transfer switch normal power light is illuminated
Yes No N/A Isolating switch for standby power is closed
Yes No N/A Reverse-phase alarm light is not illuminated
Yes No N/A Normal-phase rotation light is illuminated
Yes No N/A Oil level in vertical motor sight glass is within acceptable range
Yes No N/A Pressure maintenance (jockey) pump has power
Diesel Engine Systems

Yes No N/A Diesel fuel tank is at least two-thirds full

Yes No N/A Controller selector switch is in “auto” position
Yes No N/A Voltage readings for batteries (2) are within acceptable range
Yes No N/A Charging current readings are within acceptable range for batteries

Pilot lights for batteries are “on” or battery failure

Yes No N/A
pilot lights are “off”

NFPA 25 Handbook (p. 1 of 2)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE PUMP WEEKLY INSPECTION (Continued)

Inspections: Weekly
Yes No N/A All alarm pilot lights are “off”

Yes No N/A Record engine running time from meter

Yes No N/A Oil level is within acceptable range in right angle gear drive pumps

Yes No N/A Crankcase oil level is within acceptable range

Yes No N/A Cooling water level is within acceptable range

Yes No N/A Electrolyte level in batteries is within acceptable range
Yes No N/A Battery terminals are free of corrosion
Yes No N/A Water-jacket heater is operational
Battery cranking voltage exceeds 9 volts for a 12 volt system and 18 volts for a 24 volt
Yes No N/A
system (Alternative ITM A.8.1.1.2)
Yes No N/A Water pump(s) is not leaking (Alternative ITM A.8.1.1.2)

Yes No N/A Jacket water heater operational (Alternative ITM A.8.1.1.2)

Flexible hose and connections are in good operating condition (Alternative
Yes No N/A
ITM A.8.1.1.2)
Yes No N/A Check lube oil heater for operation (Alternative ITM A.8.1.1.2)
Yes No N/A Oil lube level is within acceptable range (Alternative ITM A.8.1.1.2)
Yes No N/A Check for water in diesel fuel tank (Alternative ITM A.8.1.1.2)
Steam System
Yes No N/A For steam-driven pumps, steam pressure is within acceptable range
Exhaust System
Yes No N/A Examine exhaust system for leaks (Alternative ITM A.8.1.1.2)
Yes No N/A Drain condensate trap (Alternative ITM A.8.1.1.2)

Comments

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:
NFPA 25 Handbook (p. 2 of 2)

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INSPEC FIRE PUMP WEEKLY OPERATING TESTS

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Property Name:   Inspector:

Property Address:    Contract No.:

Property Phone Number:   Date:

Inspections: Weekly

Pump Systems

Yes No N/A Record pump starting pressure psi

Yes No N/A Operate fire pump for 10 minutes (30 minutes for diesel pump)
Yes No N/A Check packing gland tightness (slight leak at no flow)
Yes No N/A Record suction pressure from gauge in psi
Yes No N/A Record discharge pressure from gauge in psi
Yes No N/A Adjust gland nuts if necessary
Yes No N/A Check for unusual noise or vibration
Yes No N/A Check packing boxes, bearings, or pump casing for overheating
Record pressure switch or pressure transducer and compare with pump
Yes No N/A
discharge gauge
Record pumps highest psi and lowest psi ­pressure
Yes No N/A
on the fire pump control log
Yes No N/A Circulation relief valve functions correctly
Check fuel system solenoids for proper operation (Alternative
Yes No N/A
ITM A.8.1.1.2)
Yes No N/A Check tank float switch for proper operation (Alternative ITM A.8.1.1.2)
Electrical Systems
Record time controller is on first step (for reduced voltage or reduced
Yes No N/A
current starting)
Yes No N/A Observe time for motor to accelerate to full speed
Record time pump runs after starting for pumps having automatic stop
Yes No N/A
feature
Diesel Engine Systems
Yes No N/A Record time for diesel engine to crank
Yes No N/A Record time for diesel engine to reach running speed
Check oil pressure gauge, speed indicator and water and oil temperatures
Yes No N/A
while engine is running
Yes No N/A Check heat exchanger for cooling water flow
Yes No N/A Operate speed governor (internal combustion engine only)
Steam System
Yes No N/A Observe the time for turbine to reach running speed
Yes No N/A Record steam pressure for steam-operated pumps
Yes No N/A Check steam trap
Yes No N/A Check steam relief valve

Record any notes that the inspector believes to be significant in the corresponding action’s comments field.

NFPA 25 Handbook (p. 1 of 2)

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or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE PUMP WEEKLY OPERATING TESTS (Continued)

Comments

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

Controller: Work shall be completed, to the extent that such work can be completed without opening an energized electric motor-driven fire
pump controller.
NFPA 25 Handbook (p. 2 of 2)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
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FIRE PUMP MONTHLY INSPECTION, TESTING, AND MAINTENANCE
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Property Name: Inspector:

Property Address: Contract No.:

Property Phone Number: Date:

Frequency: Monthly Action Electric Fire Pump

Yes No N/A Test Non-flow test — operate 10 minutes

Yes No N/A Test Record pump starting pressure

Yes No N/A Test Check packing gland tightness (slight leak at no flow)

Yes No N/A Test Record suction pressure from gauge psi (bar)

Yes No N/A Test Record discharge pressure from gauge psi (bar)

Yes No N/A Test Adjust gland nuts if necessary

Yes No N/A Test Check for unusual noise or vibration

Record pressure switch or pressure transducer and compare with

Yes No N/A Test
pump discharge gauge
Yes No N/A Test Record pumps highest psi and lowest
psi pressure on the fire pump control log

Yes No N/A Test Circulation relief valve functions correctly

Yes No N/A Test Record time controller is on first step (for reduced voltage or reduced
current starting)

Electrical System

Exercise isolating switch and circuit breaker

Yes No N/A Test
(Alternative ITM A.8.1.1.2)

Yes No N/A Inspect Circuit breakers or fuses (Alternative ITM A.8.1.1.2)

Battery System

Yes No N/A Inspect Case exterior clean and dry (Alternative ITM A.8.1.1.2)

Yes No N/A Test Specific gravity or state of charge (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect Charger and charge rate (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect Equalize charge (Alternative ITM A.8.1.1.2)

NFPA 25 Handbook (p. 1 of 2)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
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 FIRE PUMP MONTHLY INSPECTION, TESTING, AND MAINTENANCE (Continued)

Comments:

Comments: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

Controller: Work shall be completed, to the extent that such work can be completed without opening an energized electric motor-driven fire
pump controller.

NFPA 25 Handbook (p. 2 of 2)

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or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
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Property Name: Inspector:

Property Address: Contract No.:

Property Phone Number: Date:

Frequency: Quarterly Action Diesel Engine System

Fuel
Yes No N/A Clean Strainer, filter, or dirt leg, or combination thereof
(Alternative ITM A.8.1.1.2)
Lubrication System
Yes No N/A Inspect/Change/Test Crankcase breather (Alternative ITM A.8.1.1.2)
Cooling System
Yes No N/A Clean Water strainer (Alternative ITM A.8.1.1.2)
Exhaust System

Yes No N/A Inspect Insulation and fire hazards (Alternative ITM A.8.1.1.2)

Battery System
Yes No N/A Inspect Terminals clean and tight (Alternative ITM A.8.1.1.2)
Electrical System
Yes No N/A Inspect Wire chafing where subject to movement
(Alternative ITM A.8.1.1.2)

Comments:

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

Controller: Work shall be completed, to the extent that such work can be completed without opening an energized electric motor-driven fire
pump controller.
NFPA 25 Handbook

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
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FIRE PUMP SEMIANNUAL INSPECTION, TESTING, AND MAINTENANCE Your Logo
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Property Name: Inspector:

Property Address: Contract No.:

Property Phone Number: Date:

Frequency: Semiannual Action Electric Fire Pump System

Electrical System

Yes No N/A Test Operate manual starting means (Alternative ITM A.8.1.1.2)

Diesel Engine System

Cooling System

Yes No N/A Test Antifreeze protection level (Alternative ITM A.8.1.1.2)

Exhaust System

Yes No N/A Inspect Flexible exhaust section (Alternative ITM A.8.1.1.2)

Electrical System

Yes No N/A Inspect/Test Operation of safeties and alarms (Alternative ITM A.8.1.1.2)

Yes No N/A Clean Boxes, panels, and cabinets (Alternative ITM A.8.1.1.2)

Comments:

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

Controller: Work shall be completed, to the extent that such work can be completed without opening an energized electric motor-driven fire
pump controller.
NFPA 25 Handbook

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
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FIRE PUMP ANNUAL INSPECTION, TESTING, AND MAINTENANCE Your Logo

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Property Name: Inspector:

Property Address: Contract No.:

Property Phone Number: Date:

Frequency: Annual Action Electric Fire Pump

Pump System

Inspect/Change
Yes No N/A Lubricate bearings
(as needed)

Yes No N/A Test Power transfer switch

Yes No N/A Inspect Check parallel and angular alignment

Yes No N/A Test Main relief valve

Yes No N/A Inspect Check flexible hoses and connections

Yes No N/A Inspect Check plumbing parts — inside and outside panels

Yes No N/A Inspect Check pump shaft end play

Yes No N/A Inspect/Change Check accuracy of pressure gauges and sensors

Yes No N/A Inspect Pump coupling alignment

Mechanical Transmission

Yes No N/A Change Lubricate coupling (Alternative ITM A.8.1.1.2)

Yes No N/A Change Lubricate right angle gear drive (Alternative ITM A.8.1.1.2)

Electrical System

Yes No N/A Inspect Corrosion on printed circuit boards

Yes No N/A Inspect Cracked cable/wire insulation

Yes No N/A Test Electronic control module (ECM)

Yes No N/A Maintenance Sacrificial anode

Yes No N/A Test Trip circuit breaker (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect/Test Operate emergency manual starting means (Alternative ITM A.8.1.1.2)
Yes No N/A Inspect Lubricate mechanical moving parts (except starters and relays)
(Alternative ITM A.8.1.1.2)

Yes No N/A Inspect Calibrate pressure switch settings (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect Lubricate motor bearings (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect Leaks in plumbing parts (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect Signs of water on electrical parts (Alternative ITM A.8.1.1.2)

NFPA 25 Handbook (p. 1 of 3)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE PUMP ANNUAL INSPECTION, TESTING, AND MAINTENANCE (Continued)

Frequency: Annual Diesel Engine System

Pump System

Yes No N/A Test Main relief valve

Fuel

Yes No N/A Test Diesel fuel

Yes No N/A Test Fuel pump alarm signals

Yes No N/A Maintenance Active fuel maintenance system

Yes No N/A Clean Change fuel filter every 50 operating hours or annually

Yes No N/A Clean Water/foreign material in tank (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect/Test Tank vents and overflow piping unobstructed

Yes No N/A Inspect Fuel tank piping (Alternative ITM A.8.1.1.2)

Lubrication System

Yes No N/A Change Oil change (50 hour maximum)

Yes No N/A Change Oil filter(s) (50 hour maximum)

Cooling System

Yes No N/A Maintenance Replace circulating water filter

Yes No N/A Test Supervisory signal for high cooling water temperature

Yes No N/A Inspect Antifreeze (Alternative ITM A.8.1.1.2)

Yes No N/A Clean Heat exchanger (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect/Change Duct work/louvers (Alternative ITM A.8.1.1.2)

Exhaust System

Yes No N/A Inspect Check exhaust system and drain condensate trap

Yes No N/A Test Check for excessive backpressure

Yes No N/A Inspect Hangers and support in good condition (Alternative ITM A.8.1.1.2)

Battery System

Yes No N/A Maintenance Check specific gravity, state of charge, and charger rates

Yes No N/A Maintenance Clean terminals

Check battery cranking voltage exceeds 9 volts for a 12 volt
Yes No N/A Maintenance system and 18 volts for a 24 volt system

Yes No N/A Maintenance Ensure only distilled water is used

NFPA 25 Handbook (p. 2 of 3)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE PUMP ANNUAL INSPECTION, TESTING, AND MAINTENANCE (Continued)

Frequency: Annual Electrical System

Yes No N/A Inspect Corrosion on printed circuit boards

Yes No N/A Test Electrical control module (ECM)

Yes No N/A Inspect Tighten control and power wiring connectors (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect Voltmeter and ammeter for accuracy (5%) (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect Cracked cable/wire insulation (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect Leaks in plumbing parts (Alternative ITM A.8.1.1.2)

Yes No N/A Inspect Signs of water on electrical parts (Alternative ITM A.8.1.1.2)

Comments:

Signature: Date:

Contractor Name:

Contractor Address:

License/Certification No.:

Controller: Work shall be completed, to the extent that such work can be completed without opening an energized electric motor-driven fire
pump controller.
NFPA 25 Handbook (p. 3 of 3)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
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Contractor Information Test performed for:

Name:

Address:

Phone:

Fax:
Test location:
Job Name:

Job No.:

Test Date:

Test Method:

Test header       Flow meter to drain or suction reservoir       Flowmeter back to suction (closed-loop metering)

Pump Nameplate Information: Motor Nameplate Information:

Make: Make:

Model: SN:

Stages: Volts:

Coupling: Amps:

SN: Frame:

Imp. Diam.: Speed:

Speed: HP:

Rating Capacity:

Rated Pressure:

Water Supply Type: Pump Controller Nameplate Information:

Make:

Model:

SN:

Time set for minutes

Turns on at:

Turns off at:

NFPA 25 Handbook (p. 1 of 6)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE PUMP ANNUAL PERFORMANCE TEST (Continued)

Pressure Maintenance Pump Nameplate Pressure Maintenance Pump Controller Nameplate

Information: ­Information:

Make: Make:

Model: Model:

SN: SN:

Speed: Turns on at:

HP: Turns off at:

Volts:

Flow Test
A. Is a copy of the manufacturer’s certified pump test curve attached? Yes       No
B. Test results compared to the manufacturer’s certified pump test curve? Yes       No
C. Gauges and other test equipment calibrated? Yes       No
D. No vibrations that could potentially damage any fire pump component? Yes       No
E. The fire pump performed at all conditions without objectionable overheating of
any component? Yes       No
F. For each test, record the required information for each load condition using the
following formulas (or other acceptable methods) and tables:

PNet = PDischarge – PSuction

Q = 29.83 cd 2P 0.5
Pv = 0.43352V 2/(2g) = (Q 2)/(890.47D 4)

where:
PNet = net pump pressure (psi)
PDischarge = total pressure at the pump discharge (psi)
PSuction = total pressure at the pump suction (psi)
Q = flow through a circular orifice (gpm)
c = nozzle discharge coefficient
d = nozzle orifice diameter (in.)
P = pressure measured on gauge (pitot)
Pv = velocity pressure (psi)
V = velocity of liquid (ft/sec)
g = gravitational constant (32.174 ft/sec)
D = internal pipe diameter (in.)

NFPA 25 Handbook (p. 2 of 6)

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or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE PUMP ANNUAL PERFORMANCE TEST (Continued)

Nozzle size (in.)

Discharge pressure (psi)

Suction pressure (psi)
Pump speed (rpm)

Rpm adjusted flow

Discharge velocity
Net pressure (psi)

Oil pressure (psi)2

Rpm adjusted net

pressure (in. Hg)2

Velocity adjusted
Suction velocity
Nozzle coefficient

pressure (psi)1

pressure (psi)1

pressure (psi)1

pressure (psi)2
Exhaust back

temperature2
Cooling loop
Diesel water
Flow (gpm)

pressure

(psi)
Test

Pitot readings (psi)

1 2 3 4 5 6
0%

25%

50%

75%

100%

125%

150%

0%

100%

150%

Pump is constant speed variable speed

Notes:
Velocity pressure adjustments provide a more accurate analysis in most cases and as a minimum should be included whenever the
1

pump suction and discharge diameters are different and the pump fails by a narrow margin. The actual internal diameter of the pump
suction and discharge should be obtained from the manufacturer.
These readings are applicable to diesel engine pumps only. Recording these readings is not specifically required in Chapter 14.
2

NFPA 25 Handbook (p. 3 of 6)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE PUMP ANNUAL PERFORMANCE TEST (Continued)

For electric motor–driven pumps also record:

Test Voltage Amperes

L1-L2 L2-L3 L1-L3 L1 L2 L3

0%

25%

50%

75%

100%

125%

150%

0%

100%

150%

G. F or electric motors operating at rated voltage and frequency, is the ampere demand less than or equal to the
product of the full load ampere rating times the allowable service factor as stamped on the motor nameplate? Yes No N/A
H. For electric motors operating under varying voltage:
1. Was the product of the actual voltage and current demand less than or equal to the product of the rated
full load current times the rated voltage times the allowable service factor? Yes No N/A
2. Was the voltage always less than 5% above the rated voltage during the test? Yes No N/A
3. Was the voltage always less than 10% above the rated voltage during the test? Yes No N/A
I. Did engine-driven units operate without any signs of overload or stress? Yes No N/A
J. Was the engine overspeed emergency shutdown tested? Yes No N/A
K. Was the governor set to properly regulate the engine speed at rated pump speed? Yes No N/A
L. Did the gear drive assembly operate without excessive objectionable noise, vibration, or heating? Yes No N/A
M. Was the fire pump unit started and brought up to rated speed without interruption under the conditions
of a discharge equal to peak load? Yes No N/A
N. Did the fire pump performance equal the manufacturer’s factory curve within the accuracy limits of the
test equipment? Yes No N/A
O. Did the electric motor pumps pass phase reversal test on normal and alternate (if provided) power? Yes No N/A

NFPA 25 Handbook (p. 4 of 6)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE PUMP ANNUAL PERFORMANCE TEST (Continued)
Multiple Pump Operation
A. fire pumps are required to operate in series in parallel N/A to meet the maximum fire protection demand.
B. Record the following information for each of the pumps operating simultaneously

Discharge pressure (psi)

Suction pressure (psi)

Velocity adjusted net

Nozzle size (in.)

RPM adjusted flow

Pump speed (rpm)

Net pressure (psi)

Rpm adjusted net

Flow through this
Total flow (gpm)

Suction velocity

Suction velocity
pressure (psi)

pressure (psi)

pressure (psi)
pump (gpm)
Nozzle coefficient

pressure

(psi)
Test

Pitot readings (psi)

1 2 3 4 5 6 7 8 9 10 11 12
0%

25%

50%

75%

100%

125%

150%

0%

100%

150%

Pump is constant speed variable speed

C. Did the fire pump performance equal the manufacturer’s factory curve within the accuracy limits of the test
equipment during the multiple test? Yes No N/A

Additional Tests Transfer Switch

Yes No N/A Simulate power failure while pump is operating at peak load

Yes No N/A Power transferred to alternate power source

Yes No N/A Pump performed for 2 minutes on alternate power

Yes No N/A Record the following while the pump is operating at peak load and alterate
power
- Voltage where an external means is provided on the controller
- Amperage where an external means is provided on the controller
- RPM
- Suction Pressure psi
- Discharge Pressure psi
Yes No N/A Pump reconnects to normal power source
Yes No N/A Alarm indicating (visual and audible) functions correctly
Yes No N/A Suction screens inspected and cleared of any debris
Yes No N/A ECM sensors (primary and redundant) function correctly

NFPA 25 Handbook (p. 5 of 6)

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or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
use, contact [email protected].
 FIRE PUMP ANNUAL PERFORMANCE TEST (Continued)

Pump room temperature control is functioning and being maintained at

Yes No N/A
appropriate temperatures

Yes No N/A Parallel and angular alignment of the pump verified

Yes No N/A Fire pump supplies 100 percent of the rated flow

Net pressure at each flow point is at least 95% of either the original
Yes No N/A manufacturers pump curve, original unadjusted field test curve, or test
curve generated from the fire pump nameplate.

N 1.85

140

130

120

110

100

90

80

70

60

50

40

30

20

10

12 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
Flow–gal. per min (gpm)

Comments

Controller: Work shall be completed, to the extent that such work can be completed without opening an energized electric motor-driven fire
pump controller.
NFPA 25 Handbook (p. 6 of 6)

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
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box

starting
troubles
Fire pump

for gpm discharge

stant for same gpm
No water discharge
Pump unit will not start

Pump loses suction after

Pump is noisy or vibrates
Pump or driver overheats

Too much power required

Discharge pressure too low

Insufficient water discharge
Discharge pressure not con-
Excessive leakage at stuffing

use, contact [email protected].

1
Air drawn into suction connection through leak(s)

2
Suction connection obstructed

3
Air pocket in suction pipe
Suction

4
Well collapsed or serious misalignment
Stuffing box too tight or packing improperly

5
installed, worn, defective, too tight, or incorrect type

6
Water seal or pipe to seal obstructed

7
Air leak into pump through stuffing boxes

8
Impeller obstructed

9
Wearing rings worn
10 Impeller damaged

Wrong diameter impeller

11

Actual net head lower than rated

12

Casing gasket defective, permitting internal leakage

13

(single-stage and multistage pumps)

Pump

Pressure gauge is on top of pump casing

14

Incorrect impeller adjustment (vertical shaft

15

turbine-type pump only)

Impellers locked
16

Pump is frozen
17

Pump shaft or shaft sleeve scored, bent, or worn

18

Pump not primed

POSSIBLE CAUSES OF PUMP TROUBLES

19

Seal ring improperly located in stuffing box, preventing

20

© 2019 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale
or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized
water from entering space to form seal
Excess bearing friction due to lack of lubrication, wear,
21

dirt, rusting, failure, or improper installation

Rotating element binds against stationary element
22

Pump and driver misaligned

23
Pump
Driver and/or

Foundation not rigid

24

Engine-cooling system obstructed

25

Faulty driver
26

Lack of lubrication
27

Speed too low

28

Wrong direction of rotation

29
Driver

Speed too high

30

Rated motor voltage different from line voltage

31

Faulty electrical circuit, obstructed fuel system,

32

obstructed steam pipe, or dead battery

Here

NFPA 25 Handbook
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