Facility Engineering Information Forms and Reports
CONTENTS: Construction Reports | Construction Reports from Outside Companies | Miscellaneous Reports | Preventive Maintenance Activities | Housekeeping Activities |
Construction Reports
- Contractor's Material and Test Certificate for Aboveground Piping - 2010 Edition Installation of Sprinkler Systems, NFPA 13 Section 24.1. Must be completed upon installation of an automatic sprinkler system.
- Contractor’s Material and Test Certificate for Underground Piping - 2010 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 - 2010 Edition Installation of Sprinkler Systems, NFPA 13R Section 10.1.2. Must be completed upon installation of an automatic sprinkler system.
- Fire Alarm and Emergency Communication System Record of Completion - 2010 Edition National Fire Alarm Code NFPA 72 Section 10.18.1. Must be completed upon installation of a fire alarm system.
- Emergency and Standby Power Systems Installation Acceptance - 2010 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 - 2012 Edition National Fire Gas Code, NFPA 54 Chapter 8. Must be completed after installation of natural gas piping.
- Medical Gas Systems Installer Performance Testing - 2012 Edition Health Care Facilities Code, 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 - 2015 Uniform Plumbing Code, Section 609.9. Must be completed by the plumbing contractor after installation of domestic water piping and fixtures.
Other Construction Reports Available from Outside Companies
- Medical Gas Piping Test 2012 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
- Health Care Facility Fire Incident Report - Used to report a fire incident in health care facilities.
- Drill Report - Fire – Tornado – Other. Used to document fire or tornado drills conducted in health care facilities.
- Fire Alarm and Automatic Sprinkler System Out of Service Policy - 2012 Edition Life Safety Code, NFPA 101 Section 9.6.1.8 & 9.7.6.1. Used as a policy when the fire alarm or automatic sprinkler systems are out of service for more than 4 hours in a 24 hour period.
- Emergency Lighting Test Log - 2012 Edition Life Safety Code, NFPA 101 Section 7.9.3. Used to document monthly and yearly functional test of battery-powered emergency lighting systems. (back to top)
Preventive Maintenance Activities
These documents may be used to develop a preventive maintenance checklist.
- Daily Preventative Maintenance Activities
- Weekly Preventative Maintenance Activities
- Monthly Preventative Maintenance Activities
- Quarterly Preventative Maintenance Activities
- Semi-annual Preventative Maintenance Activities
- Annual Preventative Maintenance Activities
- Preventative Maintenance Activities - 2, 3, 4, 5, 6, 10 and 12 year preventive maintenance activities.
- Prior to Heating Season / Cooling Season Preventative Maintenance Activities
- Work Order (back to top)
Housekeeping Activities
These documents may be used to develop a housekeeping program checklist.