| Project Address |
|
| General Contractor |
|
DOB Job No. |
|
| SSM Name |
|
SSM License No. |
|
| CSFSM Name |
|
CSFSM COF No. |
|
| Month / Year |
|
System Type |
Wet
Pressurized Air
Combination
|
KEY: C = Compliant NC = Non-Compliant N/A = Not Applicable. All NC items must be corrected before operations proceed. Record corrective actions below.
| # |
Weekly Inspection Item — BC §3320 / FDNY RCNY §15-03 |
Wk 1 |
Wk 2 |
Wk 3 |
Wk 4 |
Wk 5 |
| W1 |
Hose outlet valves at all active floors verified accessible — no obstructions at outlet connections |
| |
| | |
| W2 |
Siamese connection (FDC) accessible, properly capped, free of damage, and signage intact |
| |
| | |
| W3 |
Air compressor running and maintaining system pressure within the specified operating range (pressurized-air systems) |
| |
| | |
| W4 |
Compressor low-pressure alarm and auto-restart tested and confirmed functional |
| |
| | |
| W5 |
All system control valves in the required open position — tamper indicators intact and no unauthorized alterations observed |
| |
| | |
| Weekly Sign-Off |
Date |
SSM Signature & License # |
CSFSM Signature & COF # |
Deficiencies / Notes |
| Week 1 | | | | |
| Week 2 | | | | |
| Week 3 | | | | |
| Week 4 | | | | |
| Week 5 (if applicable) | | | | |
Hydrostatic Test Record — BC §3320.3
| Test Date |
Test Pressure (PSI) |
Duration (min.) |
Pass / Fail |
Tested By |
License / COF # |
| | | | | |
| | | | | |
| | | | | |