CAN/ULC-S537-04 - Fire Alarm Verification Report Form

CAN/ULC-S537-04 - Fire Alarm Verification Report Form
CAN/ULC S537-04 (AMENDED FOR CAN/ULC-S524-06)
APPENDIX “C” ( INFORMATIVE) – FIRE ALARM SYSTEM (FAS)
VERIFICATION REPORTS
(Reference: Subsection 4.1-Note, Clause 4.2.1, 4.2.2)
C1. FIRE ALARM SYSTEM VERIFICATION REPORT
(Reference: Clause 4.1.6, 4.1.7, 4.2.2)
Electrical Permit Number:
-
Date:
Building
Name &
Address:
New FAS
System Manufacturer:
A
B
C
D
E
F
G
H
I
J
K
Existing FAS
Model Number:
(See Note 1)
System provides single-stage operation.
System provides two-stage operation.
The entire fire alarm system has been verified in accordance with CAN/ULC-S537-04, Standard for
Verification of Fire Alarm Systems.
This is a partial verification for a partial occupancy.
Components of the existing Fire Alarm System have been modified or replaced with components from a
different manufacturer and are compatible with the existing Fire Alarm System components. (See Note
2)
This is a partial verification for a Fire Alarm System that has been replaced in stages.
This is a verification of a portion of an existing Fire Alarm System verified in accordance with Section 6,
System Modifications.
Installed in accordance with the design and CAN/ULC-S524, Standard for the Installation of Fire Alarm
Systems.
The Fire Alarm System documentation is on site and includes a description of the system.
The Fire Alarm System is now fully functional with
without
deficiencies. (See Note 3)
The Fire Alarm System is connected to an acceptable ULC Listed central monitoring station.
The communicator is ULC Listed for the purpose.
The connections between the FAS and the communicator are supervised.
If connected, the name and location of the central monitoring station is:
ULC “Central Station Fire Protective Signalling Service” Certificate Number:
which is issued for the above noted central monitoring station address is
is not
L
Comments:
M
A copy of this report will be given to:
who is the owner or owner’s representative for this building.
Yes
Yes
No
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
No
Yes
Yes
Yes
Yes
Yes
No
No
No
No
No
Yes
No
N/A
attached.
CERTIFICATION
This certifies that the information contained in this Fire Alarm System Verification Report (which incorporates the attached
pages)
is correct and complete. The system and equipment described here-in was tested/inspected in conformance with CAN/ULC-S537-04 by a qualified
technician. The equipment was left in an operational condition except as noted above. A copy of this report must be maintained on the premises for
examination by the Fire Marshal, Building Inspector, or other Authority Having Jurisdiction at their request.
Supervising Technician:
Company & Contact Information:
Print Name:
Assisting Technician/Electrician:
Telephone:
Company & Contact Information:
(Stamp Field)
Print Name:
Designer:
Telephone:
Company & Contact Information:
Print Name:
Telephone:
NOTES:
1. Extent of Verification of the existing FAS:
2.
3.
If “Yes”, ULC test report/compatibility listing is attached.
The identified deficiencies relate to:
(a) the existing portion of the FAS not covered by the scope of work under the above referenced permit.
(b) the newly installed FAS (or modified/added portion of FAS) under the above referenced permit.
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CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Audit
Verification
Address:
“Yes” - Tested correctly
“No” - Did not test correctly (NO answers are typically detailed in “Comments/Remarks”)
“NA” = Not applicable
C2. Documentation
Yes
No
N/A
Instructions for resetting the system and silencing alarm signals.
Instructions for silencing the trouble signal and action to be taken when
B
the trouble signal sounds.
Description of the function of each operating control and indicator on the
C
fire alarm control unit.
Description of the area or fire zone protected by each alarm detection
D
circuit (this may be in the form of a list or plan drawing).
E
Description of alarm signal operation.
F
Description of ancillary equipment controlled by the fire alarm system.
In systems that provide logical control of a smoke control system,
documentation is on site and includes a sequence of operation of the
G
smoke control system.
Smoke control installed in accordance with Measure:
Building diagrams are on site that clearly indicate the type and location of
H
all smoke control equipment (fans, dampers, etc.).
Recommended Additional Documentation (not mandated by the Standard):
Yes
No
Additional documentation relating to smoke control measures in the
building is appended to this report.
Fire Safety Plan documentation is on site.
Instructions to Occupants/Evacuation Floor Plans are posted.
remotely installed amplifiers in this FAS.
supervised power supplies in this FAS.
remote sequential display units in this FAS.
There are a total of:
remote annunciators in this FAS.
remote trouble units in this FAS.
stand-by batteries in this FAS.
remote booster/power supplies in this FAS.
List all locations where remote booster/power supplies, batteries & amplifiers are installed:
A
C3. Field Device and Related Circuits – Test and Inspection
Yes
A
B
C
D
E
F
G
H
I
J
K
L
No
N/A
Correct field termination and wiring size.
Correct circuit polarities.
An open circuit fault on a conventional device circuit causes a trouble
signal.
Removal of any active or supporting field device circuit causes a trouble
signal.
One contact device and one non-contact device tested for operation and
annunciation at the control unit or transponder, when using a field
verifying device.
Class “A” circuits serving conventional field devices tested for the
capability of providing an alarm signal on each side of an open circuit fault
connection at the electrically most remote point in the circuit.
Ground fault indications occur when tested at the electrically furthest field
device, and do not result in normal to off-normal status change conditions.
Field device at the electrically furthest point from the power source (in
every circuit) receives rated power in accordance with the manufacturer’s
specifications.
Replaceable over-current devices are of the correct rating.
Where a power buss circuit serves more than one fire alarm zone, a single
fault (open circuit fault, short circuit fault or ground fault) on the power
circuit does not prevent the normal operation of input or output field
devices in more than one fire alarm zone.
Conductor type and wire gauge are in accordance with the equipment
manufacturer’s installation wiring requirements at all system termination
points.
Confirm that where multiple strand optical fibre cable used with a fire
alarm system is not dedicated to the fire alarm system, the fire alarm
system shall continue to function as required despite impairment to other
systems which may share the cable.
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CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Audit
Verification
Address:
C4. Data Communication Link Testing
Control Unit/Transponder Field Location:
Control Unit/Transponder Identification:
DCL Identification:
A
B
C
D
E
F
Yes
No
N/A
Yes
No
N/A
Each system abnormal condition specified in Table 1 – Abnormal System
Conditions, tested for each data communication link at the control unit or
transponder.
Tests for alarm and trouble received under a single ground fault condition
conducted on each conductor of that data communication link
independently.
Each conductor in a data communication link, Class A (DCLA) tested for
the capability of providing an alarm signal on each side of a single open
circuit fault condition.
Where a data communication link serves devices on more than one floor
area, impose a wire-to-wire short circuit fault within each floor area and
confirm receipt of trouble and alarm condition from another floor area.
Where fault isolation modules are installed in data communication links
serving field devices, wiring shorted on the isolated side, annunciation of
the fault confirmed, and then a device on the source side operated, and
activation confirmed at the control unit or transponder.
Where fault isolation in data communication links is provided between
control units or transponders, the field wiring shorted between each pair of
control units or transponders, in turn, annunciation of the fault confirmed
and operation outside the shorted section is confirmed.
Control Unit/Transponder Field Location:
Control Unit/Transponder Identification:
DCL Identification:
A
B
C
D
E
F
Each system abnormal condition specified in Table 1 – Abnormal System
Conditions, tested for each data communication link at the control unit or
transponder.
Tests for alarm and trouble received under a single ground fault condition
conducted on each conductor of that data communication link
independently.
Each conductor in a data communication link, Class A (DCLA) tested for
the capability of providing an alarm signal on each side of a single open
circuit fault condition.
Where a data communication link serves devices on more than one floor
area, impose a wire-to-wire short circuit fault within each floor area and
confirm receipt of trouble and alarm condition from another floor area.
Where fault isolation modules are installed in data communication links
serving field devices, wiring shorted on the isolated side, annunciation of
the fault confirmed, and then a device on the source side operated, and
activation confirmed at the control unit or transponder.
Where fault isolation in data communication links is provided between
control units or transponders, the field wiring shorted between each pair of
control units or transponders, in turn, annunciation of the fault confirmed
and operation outside the shorted section is confirmed.
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CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Audit
Verification
Address:
C5. Control Unit or Transponder Record
(Reference Clause 5.1.1)
C5.1 Control Unit or Transponder Tests
Control Unit/Transponder Field Location:
Control Unit/Transponder Identification:
Power ‘on’ visual indicator operates.
Common visual trouble signal operates.
Common audible trouble signal operates.
Trouble signal silence switch operates.
Main Power supply failure trouble signal operates.
Ground fault tested on positive and negative initiates trouble signal.
Alert signal operates.
Alarm signal operates.
Automatic transfer from alert signal to alarm signal operates.
Time:
Manual transfer from alert signal to alarm signal.
Automatic transfer from alert to alarm signal cancel (acknowledge) operates on a
K
two stage system.
Alarm signal silence inhibit function operates.
L
Alarm signal manual silence operates.
M
N
Alarm signal silence visual indication operates
Alarm signal and visible signal devices, when silenced, automatically reinitiate
O
upon subsequent alarm.
In same zone
In other zone/circuit
P
Alarm signal silence automatic cut-out timer.
Time:
Audible, visual, alert, and alarm signals programmed and operate as per
Q
manufacturer’s design and specification.
Input circuit alarm and supervisory operation including audible and visual indicator
R
operates.
S
Input circuit supervision fault causes a trouble indication.
T
Output circuit alarm indicators operate.
U
Output circuit supervision fault causes a trouble indication.
V
Visual indicator test (lamp test) operates.
Coded signal sequence operate not less than the required number of times and
W
the correct alarm signal thereafter.
X
Coded signal sequences are not interrupted by subsequent alarms.
Y
Ancillary device control circuit is rated for the intended purpose.
Z
Ancillary device by-pass results in trouble signal.
Input circuit to output circuit operation including ancillary device circuits (refer to
AA
Appendix C5.12, Ancillary Device Circuit Test), for correct program operation as
per design and specification.
BB
Fire alarm reset function operates.
CC
Main power to emergency power supply transfer operates.
DD
Control unit or transponder enclosure bonded to ground.
EE
Status change confirmation feature (smoke detectors only) verified.
Recommended Additional Testing (not mandated by the Standard):
Alarm, trouble, & supervisory relays function correctly.
Is an AC disconnecting switch installed?
YES
NO
(ULC CAN4-S524 restricts this, but some AHJ’s will accept it.
A “YES” answer here must be noted in the “Comments/Remarks” section of this report.)
Yes
No
N/A
Yes
No
N/A
A
B
C
D
E
F
G
H
I
J
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CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Audit
Verification
Address:
C5.2 Voice Communication Test
Location:
Identification:
Power ‘on’ visual indicator operates.
Common visual trouble signal operates.
Common audible trouble signal operates.
Trouble signal silence switch operates.
All-call voice paging, including visual indicator, operates.
Output circuits for selective voice paging, including visual indication,
F
operates.
Output circuits for selective voice paging trouble operation, including
G
visual indication, operates.
Microphone, including press to talk switch, operates.
H
Operation of voice paging does not interfere with initial inhibit time of alert
I
signal and alarm signal.
All-call voice paging operates (on emergency power supply).
J
Upon failure of one amplifier, system automatically transfers to backup
K
amplifier(s).
Circuits for emergency telephone call-in operation, including audible and
L
visual indication operates.
Circuits for emergency telephones for operation, including two-way voice
M
communication, operates.
Circuits for emergency telephone trouble operation, including visual
N
indication, operates.
O
Emergency telephone verbal communication operates.
P
Emergency telephone operable or in-use tone at handset operates.
While in standby mode, voice communication busses used for paging,
alert signal, alarm signal, and emergency telephone communication
Q
circuits, an open circuit fault, or short circuit fault, or operation of an
overcurrent protective device provided for the purpose, shall result in a
specific trouble indication specific to the faulty buss.
Recommended Additional Testing (not mandated by the Standard):
Visual indicator test (lamp test) operates.
Main power to emergency power supply transfer operates.
Communication control enclosure bonded to ground.
Trouble signal on the voice communication system results in common trouble signal
on the fire alarm system.
Dead-front panel(s) in place & as per manufacturer’s specification.
Yes
No
N/A
Yes
No
N/A
A
B
C
D
E
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CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Audit
Verification
Address:
C5.3 Required System Response Times
Control Unit/Transponder Field Location:
Control Unit/Transponder Identification:
A
B
C
D
E
F
Yes
No
N/A
Yes
No
N/A
Yes
No
N/A
Yes
No
N/A
Audible signal devices and visible signal devices operated within ten
seconds and;
subsequent input operated within ten seconds.
Remote connection operated within ten seconds.
Release device start of sequence operated within ten seconds.
Required Annunciation operated within ten seconds
and;
subsequent input operation within ten seconds.
Required central alarm and control facility operated within ten seconds
and;
subsequent input operation within ten seconds.
Ancillary circuits operated within ten seconds.
Control Unit/Transponder Field Location:
Control Unit/Transponder Identification:
A
B
C
D
E
F
Audible signal devices and visible signal devices operated within ten
seconds and;
subsequent input operated within ten seconds.
Remote connection operated within ten seconds.
Release device start of sequence operated within ten seconds.
Required Annunciation operated within ten seconds
and;
subsequent input operation within ten seconds.
Required central alarm and control facility operated within ten seconds
and;
subsequent input operation within ten seconds.
Ancillary circuits operated within ten seconds.
Control Unit/Transponder Field Location:
Control Unit/Transponder Identification:
A
B
C
D
E
F
Audible signal devices and visible signal devices operated within ten
seconds and;
subsequent input operated within ten seconds.
Remote connection operated within ten seconds.
Release device start of sequence operated within ten seconds.
Required Annunciation operated within ten seconds
and;
subsequent input operation within ten seconds.
Required central alarm and control facility operated within ten seconds
and;
subsequent input operation within ten seconds.
Ancillary circuits operated within ten seconds.
Control Unit/Transponder Field Location:
Control Unit/Transponder Identification:
A
B
C
D
E
F
Audible signal devices and visible signal devices operated within ten
seconds and;
subsequent input operated within ten seconds.
Remote connection operated within ten seconds.
Release device start of sequence operated within ten seconds.
Required Annunciation operated within ten seconds
and;
subsequent input operation within ten seconds.
Required central alarm and control facility operated within ten seconds
and;
subsequent input operation within ten seconds.
Ancillary circuits operated within ten seconds.
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CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Audit
Verification
Address:
C5.4 Control Unit or Transponder Inspection
Control Unit/Transponder Field Location:
Control Unit/Transponder Identification:
Input circuit designations correctly identified in relation to connected field
devices.
Output circuit designations correctly identified in relation to connected field
B
devices.
C
Correct designations for common control functions and indicators.
D
Plug-in components and modules securely in place.
E
Plug-in cables securely in place.
Record the date, revision and version of firmware:
Date:
Revision:
Version:
F
Record the date, revision and version of the program software:
Date:
Revision:
Version:
G
Control unit/transponder is clean and free of dust and dirt.
H
Fuses in accordance with the manufacturer’s specification.
I
Control unit/transponder lock is functional.
J
Termination points for wiring to field devices secure.
Control unit/transponder power disconnects in accordance with C22.1,
K
Safety Standard for Electrical Installations, Canadian Electrical Code,
Part 1.
Field wiring entry points for the various circuits and circuit separations are
L
in accordance with the manufacturer’s installation instructions.
Main power supply feed wiring is in accordance with the manufacturer’s
M
specifications.
Verify control units/transponders with stand alone capability serve the
N
same area for both input circuits and output circuits.
Control units or transponders which operate with stand alone capability
have signal silence, reset, and trouble silence switches with visual
O
indications, degraded mode capability and stand alone capability
indicators.
Each control unit/transponder has been furnished with installation,
P
operating and maintenance instructions.
Control unit/transponder visual indicators comply with Table 3 – Visual
Q
Indicators Colour Code.
Recommended Additional Visual Inspection (not mandated by the Standard):
Dead-front panel(s) in place & as per manufacturer’s specification.
Yes
No
N/A
Yes
No
N/A
A
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CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Audit
Verification
Address:
C5.5 Large Scale Network Systems
Yes
A
B
C
D
E
No
N/A
Verify control units/transponders serve the same area for both input
circuits and output circuits.
Verify control units/transponders with stand alone capability have signal
silence, reset, and trouble silence switches with visual indicators,
degraded mode capability and stand alone capability indicators.
Confirm that between any nodes a single open circuit fault, wire-to-wire
short circuit fault, or ground fault on the network results in a trouble signal
at each node and continued alarm receipt capability at each node under
these conditions.
To test stand alone capability, create a condition of data communication
link failure, and confirm each control unit or transponder is capable of
receiving an alarm initiation and provides output operation in the area as
served by the control unit or transponder in degraded mode.
To test degraded mode capability, create a condition of data
communication link failure in two separate locations creating two network
segments, and confirm each segment of the network has the following
operation:
Operate the alarm signals in accordance with the system operating
(i)
sequence;
Maintain synchronization of control units or transponders for alert
(ii)
signals and alarm signals;
Operate local relays in control units or transponders connected to
(iii)
ancillary devices as required;
Confirm the operation of acknowledge, signal silence, reset and
trouble silence switches with visual indicators, degraded mode
(iv)
capability and stand alone capability indicators are functional for
each network segment.
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CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Audit
Verification
Address:
C5.6 Power Supply Inspection
Power Supply Field Location:
Power Supply Identification:
Circuit Disconnect Means Location:
Circuit Panel/Breaker Identification:
Conforms with the requirements of CAN/ULC-S524, Standard for the Installation of Fire Alarm
A
Systems; and C22.1, Safety Standard for Electrical Installations, Canadian Electrical Code, Part
1, Section 32.
B
Fused in accordance with the manufacturer’s marked rating of the system.
C
Equipped with the identified disconnect means.
D
Adequate to meet the requirements of the system.
Power for ancillary devices is taken from a source separate from the fire alarm system control
E
unit or transponder power supply.
Power for ancillary devices is taken from the control unit or transponder that is designed to
F
provide such power.
G
Ancillary devices, which are powered from the control unit or transponder, are recorded.
Where fault isolation in power distribution riser has been provided, tests have been conducted
to ensure a wire-to-wire short in the field wiring between each pair of control units or
H
transponders, in turn, results in annunciation of the fault and continued operation outside of the
shorted section confirmed.
Recommended Additional Visual Inspection (not mandated by the Standard):
Dead-front panel(s) in place & as per manufacturer’s specification.
Circuit disconnect means painted RED and locked “on”.
Power supply cabinet (where applicable) is clean and free of dust and dirt.
Yes
No
N/A
Yes
No
N/A
No
N/A
C5.7 Emergency Power Supply Test And Inspection
Emergency Power Supply Field Location:
Emergency Power Supply Identification:
Battery Type (as installed):
Battery Capacity (as installed):
Required Building Code Alarm Operation:
Sealed Lead Acid
30 minutes
Ni-Cad
AH
120 minutes
Lithium-Ion
Wet Lead
Yes
Correct battery type as recommended by the manufacturer.
Correct battery rating as determined by battery calculations based on full system load.
Battery voltage (main power “on”):
VDC
Battery voltage – main power “off” – FAS in supervisory condition:
VDC
D
Battery current - main power “off” – FAS in supervisory condition:
mA
Battery voltage – main power “off” – FAS in full load ALARM:
VDC
E
Battery current – main power “off” – FAS in full load ALARM:
A
F
Battery charging current (main power “on”):
mA
G
Inspected for physical damage.
H
Terminals cleaned and lubricated.
I
Terminals clamped tightly.
J
Correct electrolyte level.
K
Specific gravity of the electrolyte is within the battery manufacturer’s specifications.
L
Inspected for electrolyte leakage.
M
Adequately ventilated.
N
Record manufacturer’s date code or in-service date:
O
Disconnection causes trouble signal.
Indicate type of tests performed on a fully charged battery:
(i) Required supervisory load for 24 h followed by the required full load operation
P
(ii) Silent test using load resistor method for full duration test (refer to Appendix D1)
(iii) Silent accelerated test (refer to Appendix D2)
Q
Record calculated battery capacity (refer to Appendix D3.1-C).
AH
R
Record the battery terminal voltage after tests are completed.
VDC
S
Battery voltage not less than 85% of its rated capacity after tests completed.
T
Generator provides power to the AC circuit serving the fire alarm system.
Trouble condition at the emergency generator results in an audible common trouble signal and
U
a visual indication at the required annunciator.
Recommended Additional Inspection (not mandated by the Standard):
Generator fueled by:
Diesel
Natural Gas
Other:
Fuel Level:
% of full capacity
Estimated run time:
Hours
A
B
C
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Page _______of _______
CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Audit
Verification
Address:
C5.8 ANNUNCIATOR AND DISPLAY AND CONTROL CENTRE TEST AND INSPECTION
Annunciator Location:
Annunciator Identification:
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
Yes
No
N/A
Yes
No
N/A
Yes
No
N/A
Power “on” indicator operates.
Individual alarm and supervisory input zone clearly indicated and separately
designated.
Individual alarm and supervisory input zone designation labels are properly identified.
Where active and supporting field devices are utilized, device labels correspond with
actual field location.
Common trouble signal operates.
Visual indicator test (lamp test) operates.
Input wiring from control unit or transponder is supervised and of the correct type and
gauge in accordance with the equipment manufacturer’s installation wiring
requirements.
Alarm signal silence visual indicator operates.
Switches for ancillary functions operate as per design and specification.
Ancillary functions visual indicators operates.
Manual activation of alarm signal and indication operates.
Displays are visible in the installed location.
Operates on emergency power.
Visual indicators comply with Table 3 – Visual indicators Colour Code
Multi-line sequential display operates as per Appendix C5.9 (Annunciators or
Sequential Displays), where utilized.
C5.9 ANNUNCIATORS OR SEQUENTIAL DISPLAYS
Annunciator/Sequential Display Location:
Annunciator/Sequential Display Identification:
A
B
C
D
E
F
G
H
I
J
K
L
Power “on” indicator operates.
Individual alarm and supervisory zone indication operates.
Exception: Operation of each individual alarm and supervisory zone indication gives
the identical indication, or lights the identical indicators at the other annunciator(s)
and sequential display(s).
Specify method of confirmation:
Minimum of one alarm zone and one supervisory zone tested per annunciator or
sequential display to confirm operation.
Individual alarm and supervisory input zone designation labels are properly identified.
Where active and supporting field devices are utilized, device labels correspond with
actual field location.
Common trouble signal operates.
Visual indicator test (lamp test) operates.
Input wiring from control unit or transponder is supervised and of the correct type and
gauge in accordance with the equipment manufacturer’s installation wiring
requirements.
Alarm signal silence visual indicator operates.
Switches for ancillary functions operate as per design and specification.
Ancillary functions visual indicators operates.
Manual activation of alarm signal and indication operates.
Displays are visible in the installed location.
C5.10 Remote Trouble Signal Unit Test And Inspection
Remote trouble signal unit location:
Remote trouble signal unit identification:
A
B
C
D
Input wiring from control unit or transponder is supervised.
Visual trouble signal operates.
Audible trouble signal operates.
Audible trouble signal silence operates.
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CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Audit
Verification
Address:
C5.11 Printer Test
Printer Location:
Printer Identification:
Yes
A
B
C
No
N/A
Operates as per design and specification
Zone of each alarm initiating device is correctly printed.
Rated voltage is present.
C5.12 Ancillary Device Circuit Test
Record Specific Type of Ancillary Circuit
Operation of
Ancillary Circuit
Confirmed
Yes
No
N/A
Note: The tests reported on this form do not include the actual operational test of ancillary devices except where noted.
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CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Audit
Verification
Address:
C5.13 Interconnection to the Fire Signal Receiving Centre
Communicator Location:
Circuit Disconnect Means Location:
Circuit Panel/Breaker Identification:
A
B
C
D
E
F
G
H
I
J
K
L
M
N
Yes
No
N/A
Yes
No
N/A
The fire signal receiving centre transmitter is integral to the fire alarm control unit.
The fire signal receiving centre transmitter is located remotely from the fire alarm
control unit.
Where an interconnection between the fire alarm control unit and a separate fire signal
receiving centre transmitter is provided, a demarcation terminal box with a minimum of
twelve (12) terminals is installed.
The demarcation terminal box is located in the same room as the fire alarm control unit
it is connected to.
The demarcation terminal box is labeled “Fire Alarm Demarcation” and/or “Limitation
D’Alarme Incendie”.
The conductors installed between the fire alarm control panel and the demarcation
terminal box complies with Section 3.4 of CAN/ULC-S524-06.
Tested and confirmed operation of alarm relay.
Tested and confirmed operation of trouble relay.
Tested and confirmed operation of supervisory relay.
Confirm that the alarm transmission to the fire signal receiving centre is received.
Confirm that the supervisory transmission to the fire signal receiving centre is received.
Confirm that the trouble transmission to the fire signal receiving centre is received.
Record the name and telephone number of the fire signal receiving centre.
Company:
Telephone:
Address:
Operation of the fire signal receiving centre transmitter bypass means results in a
specific trouble indication at the fire alarm control unit or transponder and transmits a
trouble signal to the fire signal receiving centre.
Additional Information (not mandated by the Standard):
The communicator is installed in accordance with CAN/ULC-S561-13.
The fire signal receiving centre is ULC Listed.
The fire signal receiving centre ULC certification number is:
The communicator is being tested in accordance with CAN/ULC-S561-13.
Supporting documentation attesting to this is on site and has been reviewed.
The ULC “Central Station Fire Protective Signalling Service” Certificate is valid.
The ULC “Central Station Fire Protective Signalling Service” Certificate expires on:
The last inspection noted on the Certificate occurred on:
The communicator has been reset following completion of testing.
The communicator has been placed back into service.
The communicator is trouble free.
ADDITIONAL NOTES:
4. Smoke detector sensitivity measurement should be recorded in the “Remarks” column of the Individual Device Test Record. Analog smoke
detectors may report their obscuration level (sensitivity) to the fire alarm’s common control. This information should be retrieved and
recorded in the “Remarks” column.
5. Status change, including time delay (where applicable), should be recorded in the “Remarks” column.
6. Duct smoke detector pressure differential should be confirmed and recorded in the “Remarks” column. Detector tubes must be pulled and
their alignment confirmed if results indicate any abnormalities. Record any discrepancies in the “Remarks” column.
7. Time delay setting of water flow switch should be recorded in the “Remarks” column.
8. Sprinkler supervisory switches should cause a “trouble” condition to be annunciated. This should be a latching type trouble (or “supervisory
trouble”) only restorable by pressing “Reset” on the fire alarm control panel. Exceptions must be noted in “Comments”.
9. Upper and lower pressure setting of supervisory devices should be recorded in the “Remarks” column.
10. Low temperature setting should be recorded in the “Remarks” column.
11. Identify the specific ancillary devices in the “Remarks” column.
12. Where possible, identify the date a fire detector is changed. If housing discolouration is noted, attempt to identify the source and note the
date of manufacture. Heat detectors whose labels are missing, faded and unreadable, or painted are considered failed and require
replacement. This information should be noted in the “Remarks” column.
13. Identify type and function of each addressable device in the “Remarks” column.
14. Exposure to charging currents in excess of 100 mA will significantly shorten the service life of Ni-Cad and sealed lead acid batteries.
15. Relays tied to listed fire alarm equipment initiating/supervisory circuits must be properly supervised. Note exceptions in “Comments”.
16. The system’s documentation should provide information concerning the number of addressable devices that are connected to each isolator.
Ensure this number does not exceed the Manufacturer’s requirements. Any exceptions should be noted in “Comments”.
17. The building owner/manager must maintain the records for the Verification on site for inspection by the local authority.
18. Operation of each annunciator or sequential display must be confirmed visually.
19. Stand-by batteries that are remotely located more than twelve (12) meters from the Fire Alarm Common Control must be fused (or installed
in accordance with the manufacturer’s recommendations or requirements).
Any exceptions to the above are noted in the “Remarks/Comments” area on the last page of this report.
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Page _______of _______
CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Address:
C6.1 Field Device Testing - LEGEND
Device
M
MAS
HD
RHD
Description
Type
Model Number
Manual Initiating Devices
Manual pull station
Manual Abort Station
Automatic Fire Detection Devices
Heat Detector, restorable or non-restorable, fixed temperature (12)
Heat Detector, restorable, rate-of-rise thermostat (12)
Ionization Smoke detector (4)
Sensitivity Test Method (or Test Equipment Model/Method):
S
Manufacturer’s Sensitivity Test Range:
Photo-electric Smoke detector (4)
Sensitivity Test Method (or Test Equipment Model/Method):
PS
Manufacturer’s Sensitivity Test Range:
Duct Smoke detector (4, 5, 6)
Sensitivity Test Method (or Test Equipment Model/Method):
DS
Manufacturer’s Sensitivity Test Range:
Multi-Criteria type detector (specify detection types)
Sensitivity Test Method (or Test Equipment Model/Method):
MC
Manufacturer’s Sensitivity Test Range:
CO
OD
EOL(R)
FS
FPS
TS
LA
LT
HTC
TLW
B
H
BZ(S)
SSB
V
SP
HSP
AV
SCIM
ET
RPM
SRIM
DRIM
RPIM
SCRM
RRM(S)
DH(M,FL)
DM
R
AD
SA
Carbon Monoxide detector
Other Detector type (specify)
End-of-Line resistor (“R” indicates “Power Supervision Relay”)
Fire Sprinkler Devices
Sprinkler Flow Switch (7)
Sprinkler Flow Pressure Switch (7)
Sprinkler valve supervisory Tamper Switch (8)
Low Air supervisory device (9)
Low Temperature supervisory device (10)
Heat Trace Controller
Tank Low Water supervisory device
Fire Alarm Signalling Devices
Bell
Horn
Mini Buzzer (“S” indicates “silenceable” type)
Smoke Sounder Base
Visual alarm device (specify strobe type or corridor indicator)
Cone type Speaker
Horn Speaker
Combination Audible/Visual Device - specify type (i.e. Horn/Strobe Unit)
Signal Circuit Isolation Module
Emergency Telephone (Fire Fighter’s Phone)
Supporting Field Devices (Addressable Systems)
Remote Point Module (13)
Single point Remote Initiating Module
Dual input Remote Initiating Module
Remote Point Isolator Module (16)
Signal Circuit Remote Module
Remote Relay Module (“S” provides supervised outputs)
Ancillary Devices
Door Holder (“M” is Magnetic, “FL” is Fusible Link)
Damper Motor
Relay
Other Ancillary Device (11)
Smoke Alarm (specify single or multi-station type)
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Page _______of _______
CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Individual Device Record
Date:
Building Name:
Address:
Column Legend
A
B
C
Correctly installed
Unit requires service, repair, missing, or cleaning
Alarm operation confirmed
“ “ Yes - Acceptable
Location
D
E
F
G
Annunciator indication confirmed
Circuit number or address
Supervision and ground fault detection
Smoke detector sensitivity
“X” No – Unacceptable (Explain NO answers in comments)
Device
A B C D
E
F
G
www.firetechs.net (Form 537-04 Version 16.2)
“Dash” - Not applicable
Remarks
Page _______of _______
CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Address:
C6.3 SIGNALLING DEVICE SOUND LEVEL MEASUREMENT
(Reference: Clause 5.10.1-C)
Zone
Location/Description
Ambient dBA
Alarm dBA
Remarks
Remarks/Comments
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Page _______of _______
CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Address:
C6.4 SIGNALLING DEVICE INTELLIGIBILITY MEASUREMENT
(Reference: CAN/ULC-S537-13 Clause 6.10.1-C and 6.10.1-G, NBCC 2010 Sentence 3.2.4.22-2)
Zone
Location/Description
Intelligibility CIS
Remarks
Remarks/Comments
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Page _______of _______
CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Address:
C6.5 Deficiencies
C6.6 Recommendations
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Page _______of _______
CAN/ULC-S537-04 – FIRE ALARM SYSTEM VERIFICATION REPORT
Date:
Building Name:
Address:
C6.7 Remarks
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Page _______of _______
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