The 5 Year Fire Sprinkler Inspection Form is a crucial document that ensures fire sprinkler systems are properly inspected, tested, and maintained according to California regulations. This form provides a comprehensive record of all inspections and tests performed on a fire sprinkler system over a five-year period, including details about the property, contractor, and specific maintenance tasks. To ensure compliance and safety, it is essential to fill out this form accurately; click the button below to get started.
The 5 Year Fire Sprinkler Inspection form is an essential tool for ensuring the safety and compliance of fire sprinkler systems in buildings. This comprehensive document captures critical information about the property, including the building name, address, and contractor details. It outlines the inspection, testing, and maintenance requirements as specified by the California Code of Regulations, Title 19. The form includes sections for both annual and quarterly inspections, detailing various items such as control valves, waterflow alarm devices, and pressure gauges. Each item is categorized as an inspection, test, or maintenance task, with clear indicators for pass, fail, or not applicable statuses. Additionally, the form allows for comments and references to NFPA 25 standards, facilitating a thorough review of the system's condition. By documenting these assessments, the form helps ensure that fire sprinkler systems remain fully operational and compliant with safety regulations, ultimately protecting lives and property.
Wet Pipe
California Code of Regulations - Title 19
5-Year
1 of 3
Fire Sprinkler System
Inspection, Testing, and Maintenance
Report
Property Information
Contractor or Licensed Owner Information
Building Name
Name
Address
City
St.
Zip
License #
Phone
SFM
Job #
Contact Person
CSLB
Misc.
Riser Information
Main Drain Test (ANNUAL)
Riser
Location
Main Drain
Initial Static
Residual
Final Static
P, F, N/A
No.
Diameter
Pressure
This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached:
5-Year INSPECTION, TESTING AND MAINTENANCE
Includes ALL Quarterly and Annual Inspections, Tests, and Maintenance items
I = Inspection T = Test
M = Maintenance
P = Pass
F = Fail
N/A = Not Applicable
Item
Description
NFPA 25 CA
Date
Comments Only
ed.
Reference
1.1
I
Control Valves – Identification Sign
13.3.1
1.2
Control Valves – Inspection
13.3.2
1.3
Waterflow Alarm Devices
5.2.5
1.4
Supervisory Devices
1.5
Gauges (Wet Pipe Systems)
5.2.4.1
1.6
Hydraulic Design Information Sign
5.2.6
(For hydraulically designed systems)
1.7
Enter Water Supply Pressure Below Riser Check
psi
1.8
Enter Water Supply Pressure Above Riser Check
1.9
Pressure Readings Acceptable
1.10
General Information Sign
5.2.8
(not required for system prior to 2007 Edition NFPA 13)
1.11
Heat Tape
5.2.7
1.12
Spare Sprinklers
5.2.1.4
1.13
Fire Department Connections
13.7
1.14
Alarm Valves – Exterior Inspection
13.4.1
1.15
Pressure Reducing Valves
13.5.1.1
1.16
Backflow Preventers
13.6.1
Form AES 2.2
Sept. 3, 2013
5 Year
2 of 3
ANNUAL INSPECTION, TESTING, AND MAINTENANCE
Include ALL Quarterly Inspections (See AES 2.1)
= Inspection
T = Test
P = Pass F = Fail N/A = Not Applicable
NFPA 25 CA ed.
P,F,N/A
1.17
Small Hose Connections - Hose Valve*
5.1.6, 13.5.2
13.5.5.1
1.18
PRV – Fire Sprinkler Systems
1.19
Buildings (Freeze Protection)
4.1.1.1
Owner’s Responsibility
1.20
Sprinklers
5.2.1
1.21
Sprinklers - Accessible Concealed Space
5.2.1.1.6
1.22
Pipe and Fittings
5.2.2
1.23
Pipe and Fittings - Accessible Concealed Space
5.2.2.3
1.24
Hangers
5.2.3
1.25
Hangers - Accessible Concealed Space
5.2.3.3
1.26
Seismic Braces
1.27
Seismic Braces - Accessible Concealed Space
1.28
Unsprinklered Areas
CFC 901.4
Yes
No
2.1
T
Field Service Test Required
5.3.1
If REQUIRED, Enter 'F' until
Send Report to Fire Code Official
results are returned from Lab
2.2
Recalled Sprinklers
Title 19
If not present = Pass;
If present = Fail
904.1(c)
2.3
Water Flow Alarm Devices
5.3.3
sec.
90 secs max. Enter time
13.2.6
2.4
Main Drain Test
13.2.5
(Enter data on Page 1 of this form)
13.3.3.4
2.5
Control Valve - Position
13.3.3.2
2.6
Control Valve – Operation
13.3.3.1
2.7
13.3.3.5
2.8
Backflow Preventer Assemblies
13.6.2
2.9
Small Hose Connections*
13.5.2.3
w/PRV Hose Valves – Partial Flow Test
13.5.3.3
2.10
13.5.1.3
2.11
Pressure Gauges - Calibration
5.3.2
2.12
13.5.6.2.2
* Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems.
3 of 3
include ALL Quarterly Inspections (See AES 2.1)
F = Fail N/A = Not Applicable
3.1
M
Check Valves - Internal inspection
13.4.2
3.2
Control Valves
13.3.4
3.3
FDC - Backflush
14.3.2.3
14.3.2.4
3.4
Internal Pipe Inspection - See Deficiencies and
14.2
Comments Section for Results.
3.5
Obstruction Investigation Required. If "Yes", see
14.3
Deficiencies and Comments Section for Results
3.6
System Returned to Service
4.5.3
D = Deficiency C = Comment (Indicate type )
D C
Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced
Check here if additional Deficiencies and Comments are listed on Form AES 9
Number attached:
See Correction Form AES 10 for corrected deficiencies.
I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form.
Print Name
Signature
After gathering the necessary information, you will need to fill out the 5 Year Fire Sprinkler Inspection form. This form is crucial for documenting the inspection, testing, and maintenance of fire sprinkler systems. Ensure that all sections are completed accurately to avoid any issues.
The 5 Year Fire Sprinkler Inspection form is designed to document the inspection, testing, and maintenance of fire sprinkler systems. It ensures compliance with California regulations and helps maintain the safety and functionality of these systems.
The form should be completed by a licensed contractor or a qualified individual responsible for the fire sprinkler system's maintenance. This ensures that the inspection meets all regulatory requirements.
The form requires several key pieces of information, including:
Inspections should be conducted annually, with additional quarterly inspections as outlined in the form. This regular maintenance is crucial for ensuring the system operates effectively in an emergency.
Each inspection item is marked as follows:
This system allows for clear communication about the status of each component.
If a component fails inspection, it must be repaired or replaced as soon as possible. Document any repairs on the form and ensure the system is re-inspected to confirm it is fully operational.
Yes, the form references several codes from the National Fire Protection Association (NFPA) and California regulations. These codes provide guidelines for inspection and maintenance practices to ensure safety and compliance.
If your building has more than five risers, you must attach additional AES 2.9 forms to the inspection report. This ensures all risers are properly documented and inspected.
Once the form is completed, it should be submitted to the appropriate fire code official. Keep a copy for your records to ensure compliance and for future reference.
Inaccurate Property Information: Failing to provide complete and correct property details, such as the building name and address, can lead to confusion and potential delays in processing the inspection report.
Missing Contractor Information: Omitting or incorrectly filling out the contractor or licensed owner's information, including the license number and contact details, can hinder communication and accountability.
Inconsistent Test Results: Entering inconsistent or incorrect pressure readings during the main drain test may result in inaccurate assessments of the fire sprinkler system's performance.
Neglecting Comments Section: Failing to utilize the comments section for noting deficiencies or special circumstances can lead to misunderstandings about the inspection findings.
Improper Use of Pass/Fail Notations: Mislabeling inspection items with incorrect notations (P, F, N/A) can misrepresent the condition of the system and lead to compliance issues.
Ignoring Additional Forms: Not attaching the necessary AES 2.9 forms when the building has more than five risers can result in incomplete documentation and may violate regulatory requirements.
When dealing with fire sprinkler systems, several important documents accompany the 5-Year Fire Sprinkler Inspection form. Each of these documents plays a vital role in ensuring compliance, safety, and proper maintenance of fire protection systems. Below is a list of these forms and their brief descriptions.
These documents collectively ensure that fire sprinkler systems are properly maintained and compliant with safety regulations. Keeping them organized and up to date is essential for effective fire protection management.
The Fire Alarm Inspection Report serves a similar purpose to the 5 Year Fire Sprinkler Inspection form. Both documents are essential for ensuring that fire safety systems are functioning correctly. The Fire Alarm Inspection Report details the inspection, testing, and maintenance of fire alarm systems, including components such as detectors, alarms, and control panels. Like the sprinkler inspection form, it includes checklists for various inspections and tests, and it requires documentation of any deficiencies found during the inspection process.
The Annual Fire Safety Inspection Report is another document that aligns closely with the 5 Year Fire Sprinkler Inspection form. This report evaluates the overall fire safety compliance of a building, encompassing all fire protection systems, including sprinklers and alarms. It is conducted annually and includes a thorough examination of the premises to identify potential hazards. Both forms emphasize the importance of maintaining fire safety systems and require the completion of detailed checklists to ensure compliance with safety standards.
The Fire Extinguisher Inspection Form shares similarities with the 5 Year Fire Sprinkler Inspection form in that both documents are focused on the maintenance and functionality of fire safety equipment. The Fire Extinguisher Inspection Form records the inspection and testing of portable fire extinguishers, ensuring they are charged and accessible. Just as the sprinkler inspection form includes specific items to check, the extinguisher form outlines criteria for inspection, such as pressure levels and physical condition.
The Emergency Lighting Inspection Report also resembles the 5 Year Fire Sprinkler Inspection form. This report is crucial for ensuring that emergency lighting systems function correctly during power outages. It includes a checklist of components to inspect, similar to the sprinkler inspection form. Both documents require a record of findings, including any issues that need to be addressed, ensuring the safety of occupants in case of an emergency.
The Backflow Prevention Device Inspection Report is another document that parallels the 5 Year Fire Sprinkler Inspection form. This report focuses on the inspection and testing of backflow prevention devices, which are critical for maintaining water quality in fire protection systems. Like the sprinkler inspection form, it includes specific inspection criteria and requires documentation of test results and any necessary repairs, ensuring compliance with health and safety regulations.
The Fire System Maintenance Log serves a similar function to the 5 Year Fire Sprinkler Inspection form by documenting ongoing maintenance activities for fire protection systems. This log tracks inspections, tests, and repairs over time, providing a comprehensive history of system performance. Both documents emphasize the importance of regular maintenance and require detailed records to ensure systems remain operational and compliant with safety standards.
The Building Fire Safety Plan is another document that shares similarities with the 5 Year Fire Sprinkler Inspection form. This plan outlines the fire safety protocols and procedures for a building, including the roles of fire protection systems. While the sprinkler inspection form focuses specifically on the inspection and maintenance of sprinkler systems, the fire safety plan provides a broader context for how these systems fit into overall fire safety strategies.
The Fire Protection System Design Document also relates closely to the 5 Year Fire Sprinkler Inspection form. This document outlines the specifications and design criteria for fire protection systems, including sprinklers. It serves as a reference for compliance with codes and standards, much like the inspection form, which ensures that the installed systems meet the necessary requirements for safety and functionality.
Lastly, the Certificate of Occupancy includes information relevant to the 5 Year Fire Sprinkler Inspection form. This certificate is issued once a building is deemed safe for occupancy, confirming that all fire protection systems, including sprinklers, have been installed and inspected according to code. Both documents play critical roles in maintaining safety standards and ensuring that fire protection measures are in place before a building is occupied.
When filling out the 5 Year Fire Sprinkler Inspection form, attention to detail is crucial. Here are seven essential do's and don'ts to ensure accuracy and compliance.
Misconceptions about the 5 Year Fire Sprinkler Inspection Form
When filling out and using the 5-Year Fire Sprinkler Inspection form, keep these key takeaways in mind: