√ - SATISFACTORY X – UNSATISFACTORY N/A – NOT APPLICABLE N/T – NOT TESTED
NOTE:
1. National Fire Code of Canada (NFCC) requires that these records be retained a minimum of two (2) years.
2. Tests to be conducted in accordance with this Standard (CAN/ULC-S536).
3. The monthly test is not required during the month that the annual test is completed.
CAN/ULC-S536-04
Monthly Fire Alarm System Test and Inspection Record
(Reference Clauses 3.7 &4.2.1)
Building Name:
Region
Settlement
Building Asset Number
FA
DATE INSPECT FIRE ALARM SYSTEM BATTERY
VOICE COMMUNICATION
PERSON
CONDUCTING
TEST
(SIGNATURE)
DEPARTMENT
OR COMPANY
CONDUCTING
TEST
YEAR: 20 .
SYSTEM TROUBLE SIGNAL
INDICATOR “OFF”
POWER INDICATION LAMP
“ON”
LOCATION
OF ALARM
INITATING
DEVICES
OPERATION AND
INSPECTION OF ONE INITATING
FIELD DEVICE - ROTATIONAL
ALERT/ALARM SIGNAL CONFIRMED -
ROTATIONAL
INSPECT (REQUIRED ANNUNCIATOR):
TESTED DEVICE ANNUNCIATES
CORRECTLY
OPERATION OF COMMON AUDIBLE
AND VISUAL TROUBLE SIGNAL
CONFIRMED
TERMINALS CLEANED AND
LUBRICATED
TERMINAL CLAMPS SECURE
ELECTROLYTE LEVEL AND SPECIFIC
GRAVITY TO SPECIFICATIONS
LOCATION OF
EMERGENCY
TELEPHONE
TEST (ROTATIONAL): ONE
EMERGENCY TELEPHONE FOR TWO-
WAY COMMUNICATION AND
INDICATION
LOCATION
OF VOICE
PAGE ZONE
TEST (ROTATIONAL): VOICE PAGING
TO ONE ZONE
JAN
FEB
MAR
APR
MAY
JUNE
JULY
AUG
SEPT
OCT
NOV
DEC
