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Inspection, Testing, and Maintenance Cover Sheet

inspection , testing , and Maintenance Cover SheetNFPA25 as amended by CCR, Title 19 Property Information: Name: Occupancy/Use: Address: Construction Type: City: No. Stories: ZIP: Year Constructed: Contact: Telephone: Contractor Information: Number of system Risers Name: Copy sent to: Address:OwnerDate: City: fire AHJ Date: State: Contractor Date: Telephone: NOTES: 1) For specific inspection , testing , and maintenancerequirements and information, see NFPA 25, 2011 edition as amended by California Code of Regulations, Title 19, 901 to ) inspection items may be performed by the owner inaccordance with California Code of Regulations, Title 19, (a) CA License#: Job #: Performed by: Check box for each system inspected and enter the number of forms used for inspection .

2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 2.11 T Pressure Gauges - Calibration 5.3.2 2.12 T Small Hose Connections* 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. Form AES 2.2 Sept. 3, 2013

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