Office of Licensure & Certification—
Facility Engineering Information Forms and Reports
CONTENTS: Construction Reports | Construction Reports from Outside Companies | Miscellaneous Reports |
Preventive Maintenance Activities | Housekeeping Activities |
Construction Reports (use ADOBE for all)
- Contractor’s Material and Test Certificate for Aboveground Piping (13 kb) - 2002 Edition Installation of Sprinkler Systems, NFPA 13 Section 16.1. Must be completed upon installation of an automatic sprinkler system.
- Contractor’s Material and Test Certificate for Underground Piping (76 kb) - 2002 Edition Installation of Sprinkler Systems, NFPA 13 Section 10.10.1. Must be completed to document testing of the underground piping serving the automatic sprinkler system.
- Contractor’s Material and Test Certificate for Aboveground Piping(2,604 kb) - 2002 Edition Installation of Sprinkler Systems, NFPA 13R Section 6.2.1. Must be completed upon installation of an automatic sprinkler system.
- Fire Alarm System Record of Completion(73 kb) - 2002 Edition National Fire Alarm Code NFPA 72 Section 4.5.2. Must be completed upon installation of an fire alarm system.
- Emergency and Standby Power Systems Installation Acceptance(106 kb) -2002 Edition Emergency and Standby Power Systems, NFPA 110 Section 7.13. Must be completed to verify testing of emergency and standby power systems.
- Natural Gas Systems Inspection, Testing, and Purging (106 kb) -2002 Edition National Fire Gas Code, NFPA 54 Section 7.1.4. Must be completed after installation of natural gas piping.
- Medical Gas Systems Installer Performance Testing (93 kb) -2002 Edition Health Care Facilities, NFPA 99 Section 5.1.12.2. Must be completed by the plumbing contractor after installation of medical gas piping, but prior to tests listed in 5.1.12.3.
- Disinfection of Potable Water System(75 kb) -2003 Uniform Plumbing Code, Section 609.9. Must be completed by the plumbing contractor after installation of domestic water piping and fixtures. (back to top)
Other construction reports available from outside companies
- Medical Gas Piping Test 2002 Edition Health Care Facilities, NFPA 99 Section 5.1.12.3. This system verification test is completed by the medical gas testing company. A report supplied by the testing company must be completed to verify testing of medical gas piping in health care facilities in accordance with 5.1.12.3.
Miscellaneous Reports
Preventive Maintenance Activities
These documents may be used to develop a preventive maintenance checklist.
Housekeeping Activities
These documents may be used to develop a housekeeping program checklist.
