| Project Address |
|
| General Contractor |
|
DOB Job No. |
|
| CSFSM Name |
|
COF No. |
|
| SSM Name |
|
SSM License No. |
|
| Date |
|
Shift |
AMPMNight |
| System Type |
Wet Standpipe
Pressurized Air
Combination
Dry
|
| Highest Active Floor |
|
System Pressure (PSI) |
|
| System Status — BC §3320 / FDNY RCNY §15-03 | C | NC | N/A |
| 1 | Standpipe riser in service to all active construction floors — 2½" outlet valve available at each active floor level | | | |
| 2 | Hose outlet valve at highest active floor accessible, properly capped and chained | | | |
| 3 | System pressure recorded above and within required operating range | | | |
| 4 | FDC (Siamese connection) at street level unobstructed — caps in place, signage intact | | | |
| 5 | Required FDC identification and no-obstruction signage present and readable at street level | | | |
| Hose & Equipment — BC §3320.5 | C | NC | N/A |
| 6 | Fire hose (1½" minimum) and nozzle present and accessible at each required floor | | | |
| 7 | Hose cabinet / rack accessible — not blocked by stored materials or construction equipment | | | |
| 8 | Hose in good condition — no cuts, abrasion, kinks, or visible deterioration | | | |
| 9 | Hose coupling thread protectors in place when hose is not connected for use | | | |
| Air Compressor System (Pressurized-Air Standpipes Only) — BC §3320 | C | NC | N/A |
| 10 | Air compressor running; maintaining system pressure within required limits | | | |
| 11 | Low-pressure supervisory alarm tested — signal is audible at street level | | | |
| 12 | Compressor automatic restart function tested and confirmed operable | | | |
| 13 | Compressor fuel level adequate; no fuel leaks or combustible debris near unit | | | |
| Physical Condition & Integrity | C | NC | N/A |
| 14 | All exposed standpipe risers protected from physical damage by construction activity | | | |
| 15 | All system control valves positioned open — tamper indicators intact and no unauthorized alterations observed | | | |
| 16 | System free of unapproved taps, bypass connections, or field alterations | | | |
KEY: C = Compliant NC = Non-Compliant N/A = Not Applicable | All NC items must be corrected before construction operations begin.
Deficiencies & Corrective Actions
| CSFSM Name (print) | | COF No. | |
| CSFSM Signature | | Date & Time | |
| SSM Name (print) | | License No. | |
| SSM Signature | | Date | |