Professional Fire and Life Safety Services
Annual Fire and Life Safety Inspection
c/o North York Women's Shelter
940 Sheppard Avenue West
North York, Ontario
November 24, 2009
Article 1.1.1.1. -“Unless otherwise specified, the Owner is responsible for
carrying out the provisions of this code. The penalties for not complying
with this code can be quite severe with fines of up to $50,000 for individuals and
up to $100,000 for corporations. This may be in addition to 1 year imprisonment.”
Article 1.1.2.1. - "A written record shall be kept of all tests and corrective
measures for a period of two years after they are made, and the record shall
be made available upon request to the Chief Fire Official.”
ProFire Safety Services
Div. of PMVR Industries Ltd.
15 Kenview Blvd., Unit 1, Brampton, Ont., L6T 5G5
Tel: (416) 410-7221 ~ Fax: (905) 799-6439 ~ Email: info@profire.ca
JOB #: C09-392
c/o North York Women's Shelter
940 Sheppard Avenue West
Fire and Life Safety Deficiencies and Recommendations Quotation
November 24, 2009
Parts Labour
Price
Time
Labour
Cost
Total
Cost
Fire and Life Safety Deficiencies (E3.12)
Requirements
X1
As per report total of seven (7) Manual Pullstation missing "In Case of Fire"
adhesive signs by code. Require to install.
X2
Recommendation
Electrical Room and Linen Room total of two (2) CR-135 Heat Detectors
did not function. Require to replace with CR-135.
$44.00
1.00
$60.00
$104.00
X3
Dining Area one (1) Smoke Detector covered with plastic. Require to remove.
0.25
$15.00
$15.00
X4
Food Freezer one (1) CR-135 Heat Detector is damaged. Require to replace. $22.00
0.50
$30.00
$52.00
X6
See report for the locations. Total of five (5) Heat Detectors require to replace
$110.00
2.50
$150.00
$260.00
$3.00
0.25
$15.00
$18.00
$80.00
1.00
$60.00
$140.00
$60.00
0.75
$45.00
$105.00
X12
Kitchen Hallway one (1) 6lb BC Extinguisher require Hydro-Static Testing. $20.00
0.25
$15.00
$35.00
X13
Kitchen one (1) K type Extinguisher require to install.
$205.00
0.25
$15.00
$220.00
X14
Play Room one (1) 5lb ABC Extinguisher require to recharge.
$20.00
0.25
$15.00
$35.00
X15
Board Room one (1) 2.5lb ABC Extinguisher is missing. Require to replace. $35.00
0.25
$15.00
$50.00
X16
Adj. South-West Exit one (1) 5lb ABC Extinguisher require to replace because
0.25
$15.00
$60.00
with CR-135 Heat Detectors for fire simulated test by code.
X8
Adj. Kitchen one (1) 12V DC Bulb blown in Exit Sign. Require to replace.
X10
As per report total of four (4) 5lb ABC Extinguishers require Hydro-Static
Testing.
X11
As per report total of three (3) 5lb ABC Extinguishers require 6 years
maintenance.
it is outdated by code.
X17
$45.00
Require Fire Log Book onsite to log inspections and maintenance to fire system.
$39.95
***Continued on 2nd Page
2 of 15
C09-392 North York Women's Shelter
ProFire Safety Services
Div. of PMVR Industries Ltd.
15 Kenview Blvd., Unit 1, Brampton, Ont., L6T 5G5
Tel: (416) 410-7221 ~ Fax: (905) 799-6439 ~ Email: info@profire.ca
JOB #: C09-392
c/o North York Women's Shelter
940 Sheppard Avenue West
Fire and Life Safety Deficiencies and Recommendations Quotation
November 24, 2009
Parts Labour
Price
Time
Labour
Cost
Total
Cost
Fire and Life Safety Deficiencies (E3.12)
***Continued from 1st Page
Note: The above pricing is based on all above deficiencies being corrected at the same time. If not, the
pricing will be based on a minimum of 2 hours labour plus any required parts.
Note : That according to insurance and Fire Department requirements, it is your responsibility to have
these deficiencies corrected as per Ontario Building Code and Ontario Fire Code respectively.
A certificate cannot be issue until the above deficiencies are completed as soon as possible.
** If the above deficiencies meet with your approval, please sign below and return by fax
so we can quickly schedule a convenient time to proceed with repairs to your fire
protection system.
Sign :
Print :
Purchase Order Number :
In servicing of Extinguishers or Hoses any parts or return trips needed will be billed extra.
Prices do not include GST.
3 of 15
$644.00
7.50
$450.00 $1,133.95
C09-392 North York Women's Shelter
ProFire Safety Services
Div. of PMVR Industries Ltd.
15 Kenview Blvd., Unit 1, Brampton, Ont., L6T 5G5
Tel: (416) 410-7221 ~ Fax: (905) 799-6439 ~ Email: info@profire.ca
JOB #: C09-392
c/o North York Women's Shelter
940 Sheppard Avenue West
Fire and Life Safety Deficiencies and Recommendations Quotation
November 24, 2009
Parts Labour
Price
Time
Labour
Cost
Total
Cost
Fire and Life Safety Deficiencies (E3.12)
Recommendation
X5
Counseling Room, Assistant Executive Office and Children Service
Recommendation
Room total of three (3) 1400 BRK Smoke Detectors require to install.
X7
Electrical Room in Basement one (1) CR-135 Heat Detector require
Recommendation
to install.
X9
Basement Electrical Room one (1) 6V 36Watt Battery Lamp Unit
Recommendation
require to install.
Note: The above pricing is based on all above deficiencies being corrected at the same time. If not, the
pricing will be based on a minimum of 2 hours labour plus any required parts.
Note : That according to insurance and Fire Department requirements, it is your responsibility to have
these deficiencies corrected as per Ontario Building Code and Ontario Fire Code respectively.
A certificate cannot be issue until the above deficiencies are completed as soon as possible.
** If the above deficiencies meet with your approval, please sign below and return by fax
so we can quickly schedule a convenient time to proceed with repairs to your fire
protection system.
Sign :
Print :
Purchase Order Number :
In servicing of Extinguishers or Hoses any parts or return trips needed will be billed extra.
Prices do not include GST.
4 of 15
$0.00
0.00
$0.00
$0.00
C09-392 North York Women's Shelter
ProFire Safety Services
FIRE ALARM ZONE SCHEDULE
(Reference: Clause 6.4.1, 6.4.2 and Appendix E3.6, E3.7)
BUILDING NAME: c/o North York Women's Shelter
ADDRESS: 940 Sheppard Avenue West
North York, Ontario
DATE: November 24, 2009
JOB#: C09-392
Zone Address Label
1
Basement
2
Ground Floor
3
2nd Floor & Attic Duct Detector
4
East Stairwell
5
West Stairwell
6
Furance DS #1
7
Furance DS #2
8
Attic Heat Detector
Control Relay Zone
Furnace # 2 Shutdown
Furnace # 1 Shutdown
Furnace # 3 Shutdown
Door Holder Release
ProFire Safety Services
(416) 410-7221
ProFire Safety Services
Annual Fire Alarm Inspection Report
as per CAN/ULC S-536 M04
Page : 1 of 5
BUILDING NAME : c/o North York Women's Shelter
ADDRESS : 940 Sheppard Avenue West
North York, Ontario
SITE CONTACT :
PHONE # : 416-635-9427
x224
JOB # : C09-392
E2.
DATE :
SYSTEM MANUFACTURER :
SYSTEM MODEL # :
FACP LOCATION :
SINGLE STAGE OPERATION :
TWO STAGE OPERATION :
DISCONNECT LOCATION :
SPECIAL BYPASS FEATURES :
November 24, 2009
Notifier
5000
Main Lobby
(
(
Y )
)
Basement Electrical Room
FIRE ALARM SYSTEM ANNUAL (INITIAL) TEST AND INSPECTION REPORT
(Reference : Section 5 - Note)
1. THIS IS TO CERTIFY THAT THE FIRE ALARM SYSTEM HAS BEEN TESTED AND INSPECTED IN ACCORDANCE
WITH SECTION 5, PERIODIC INSPECTIONS AND TESTS - DAILY AND MONTHLY; AND SECTION 6, PERIODIC
INSPECTIONS AND TESTS - YEARLY. THESE RECORDS DOCUMENT THE RESULTS OF TESTING PERFORMED.
2. THE FIRE ALARM SYSTEM IS NOW FULLY FUNCTIONAL
YES(
)
NO (
)
YES(
Y )
NO (
)
OR
3. THE FIRE ALARM SYSTEM HAS DEFICIENCIES NOTED ON THE PAGES
ATTACHED.
4. COMMENTS:
5. A COPY OF THIS REPORT WILL BE GIVEN TO
WHO IS THE OWNER OR OWNER'S REPRESENTATIVE FOR THIS BUILDING.
B. Shah
PRINTED NAME of Primary or
Supervising Technician
Conducting the Test
SIGNATURE of Primary or
Supervising Technician
Conducting the Test
19-993848
CFAA Certification Number of Primary
or Supervising Technician
Conducting the Test
D. Maisuria
PRINTED NAME of
Technician Conducting the Test
SIGNATURE of
Technician Conducting the Test
CFAA Certification Number of
Technician Conducting the Test
ProFire Safety Services
Tel: (416) 410-7221
Page : 2 of 5
E3.
YES - (TESTED CORRECTLY)
CONTROL UNIT TEST RECORD
NO - (DID NOT TEST CORRECTLY)
(SEE REMARKS, E3.11)
E3.1
N/A - NOT APPLICABLE
(FUNCTION OR FEATURE NOT
PROVIDED ON THIS FIRE ALARM SYSTEM)
CONTROL UNIT TEST
(Reference: Clauses 6.1.1, 6.6.11.1, and 6.6.11.2)
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
T
U
V
W
X
Y
Z
AA
BB
CC
DD
POWER 'ON' VISUAL INDICATOR
COMMON VISUAL TROUBLE SIGNAL
COMMON AUDIBLE TROUBLE SIGNAL
TROUBLE SIGNAL SILENCE SWITCH
MAIN POWER SUPPLY FAILURE TROUBLE SIGNAL
GROUND FAULT TESTED ON POSITIVE AND NEGATIVE TROUBLE SIGNAL
ALERT SIGNAL OPERATION
ALARM SIGNAL OPERATION
AUTOMATIC TRANSFER FROM ALERT SIGNAL TO ALARM SIGNAL
ACKNOWLEDGE SWITCH OPERATION
ALARM SIGNAL SILENCE INHIBIT
ALARM SIGNAL SILENCE OPERATION
ALARM SIGNAL SILENCE VISUAL INDICATION
ALARM SIGNAL, WHEN SILENCED AUTOMATICALLY REINITIATE UPON SUBSEQUENT ALARM
ALARM SIGNAL SILENCE AUTOMATIC CUT-OUT TIMER
INPUT CIRCUIT, ALARM AND SUPERVISORY OPERATION INCLUDING VISUAL INDICATOR
INPUT CIRCUIT TROUBLE OPERATION
OUTPUT CIRCUIT TROUBLE OPERATION
VISUAL INDICATOR TEST (LAMP TEST)
CODED SIGNAL SEQUENCES OPERATE NOT LESS THAN THE REQUIRED NUMBER
OF TIMES AND THE CORRECT ALARM SIGNAL OPERATES THEREAFTER
CODED SIGNAL SEQUENCES ARE NOT INTERRUPTED BY SUBSEQUENT ALARM
INPUT CIRCUIT TO OUTPUT CIRCUIT OPERATION, INCLUDING ANCILLARY
DEVICE CIRCUITS FOR CORRECT MATRIX OPERATION, AS PER DESIGN AND SPECIFICATION
RESET OPERATION
MAIN POWER SUPPLY TO EMERGENCY POWER SUPPLY TRANSFER
DATA COMMUNICATION LINK (DCL) SUPERVISION AND OPERATION
CONTROL UNIT INTERCONNECTION TO MONITORING STATION
NAME OF MONITORING STATION:
TELEPHONE NUMBER OF MONITORING STATION :
SYSTEM IDENTIFICATION:
E3.2
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
TIME
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
YES
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
infinity
NO
NO
NO
NO
NO
N/A
N/A
N/A
N/A
N/A
N/A
N/A Y
N/A
N/A Y
N/A Y
N/A
N/A
N/A
N/A
NO
NO
N/A Y
N/A
N/A
N/A
N/A
N/A
N/A Y
Y
Y
NO
N/A
NO
N/A
NO
N/A Y
Y
NO
N/A
ADT
1-800-668-4809
J0802E0034
VOICE COMMUNICATION TEST
N/A Y
(Reference: Clauses 6.2.2)
A
B
C
D
E
F
G
H
I
J
K
L
M
POWER 'ON' VISUAL INDICATOR
COMMON VISUAL TROUBLE SIGNAL
COMMON AUDIBLE TROUBLE SIGNAL
TROUBLE SIGNAL SILENCE SWITCH
ALL-CALL VOICE PAGING INCLUDING VISUAL INDICATOR
OUTPUT CIRCUITS FOR SELECTIVE VOICE PAGING, INCLUDING VISUAL INDICATION
OUTPUT CIRCUITS FOR SELECTIVE VOICE PAGING TROUBLE INDICATION,
INCLUDING VISUAL INDICATION
MICROPHONE INCLUDING PRESS TO TALK SWITCH
OPERATION OF VOICE PAGING DOES NOT INTERFERE WITH INITIAL INHIBIT OF
ALERT SIGNAL AND ALARM SIGNAL
ALL-CALL VOICE PAGING OPERATES (ON EMERGENCY POWER SUPPLY)
UPON FAILURE OF ONE AMPLIFIER, SYSTEM
AUTOMATICALLY TRANSFERS TO BACK-UP AMPLIFIERS(S)
CIRCUITS FOR EMERGENCY TELEPHONE CALL-IN
OPERATION, INCLUDING AUDIBLE AND VISUAL INDICATION
CIRCUITS FOR EMERGENCY TELEPHONE FOR
OPERATION INCLUDING TWO-WAY VOICE COMMUNICATION
ProFire Safety Services
YES
YES
YES
YES
YES
YES
YES
NO
NO
NO
NO
NO
NO
NO
N/A
N/A
N/A
N/A
N/A
N/A
N/A
YES
YES
NO
NO
N/A
N/A
YES
YES
NO
NO
N/A
N/A
YES
NO
N/A
YES
NO
N/A
Tel: (416) 410-7221
N
O
P
CIRCUITS FOR EMERGENCY TELEPHONE TROUBLE OPERATION INCLUDING VISUAL INDICATION YES
EMERGENCY TELEPHONE VERBAL COMMUNICATION
YES
EMERGENCY TELEPHONE OPERABLE OR IN-USE TONE AT HANDSET
YES
NO
NO
NO
Page : 3 of 5
N/A
N/A
N/A
E3.3 CONTROL UNIT INSPECTION
(Reference: Clauses 6.2.3)
A
B
C
D
E
F
G
H
I
J
INPUT CIRCUIT DESIGNATIONS, CORRECTLY IDENTIFIED IN RELATION TO
CONNECTED FIELD DEVICES
OUTPUT CIRCUIT DESIGNATIONS, CORRECTLY IDENTIFIED IN RELATION TO
CONNECTED FIELD DEVICES
DESIGNATIONS FOR COMMON CONTROL FUNCTIONS AND INDICATORS
CABINET, PLUG-IN COMPONENTS AND MODULES SECURELY IN PLACE
PLUG-IN CABLES SECURELY IN PLACE
RECORD THE DATE, REVISION AND VERSION OF FIRMWARE AND SOFTWARE
CLEANLINESS
FUSES IN ACCORDANCE WITH MANUFACTURER'S SPECIFICATION
CONTROL UNIT LOCK
TERMINATION POINTS FROM WIRING TO FIELD DEVICES SECURE
YES
Y
NO
N/A
YES
Y
NO
N/A
YES
YES
YES
DATE:
REV.:
YES
YES
YES
YES
Y
Y
Y
YES
YES
Y
Y
NO
NO
NO
N/A
,VER.:
NO
NO
NO
NO
Y
Y
Y
Y
N/A
N/A
N/A
N/A
N/A
N/A
N/A
E3.4 POWER SUPPLY INSPECTION
(Reference: Clauses 6.3.1)
A
B
FUSED IN ACCORDANCE WITH MANUFACTURER'S MARKED RATING OF THE SYSTEM
ADEQUATE TO MEET THE REQUIREMENTS OF THE SYSTEM
NO
NO
N/A
N/A
NO
NO
N/A
N/A
E3.5 BATTERY TEST AND INSPECTION
(Reference: Clauses 6.3.2)
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
CORRECT BATTERY TYPE AS RECOMMENDED BY MANUFACTURER
YES Y
CORRECT RATING AS DETERMINED BY BATTERY CALCULATIONS BASED ON FULL SYSTEM LOAD
YES Y
BATTERY VOLTAGE MAIN POWER 'ON' IS
2 x 12V7.2AH
BATTERY VOLTAGE AND CURRENT WITH MAIN
VOLTAGE:
POWER SUPPLY 'OFF' AND FIRE ALARM SYSTEM IN SUPERVISORY CONDITION
CURRENT:
BATTERY VOLTAGE AND CURRENT WITH MAIN
VOLTAGE:
POWER SUPPLY 'OFF' AND FIRE ALARM SYSTEM IN FULL LOAD CONDITION
CURRENT:
CHARGING CURRENT IS:
INSPECTED FOR PHYSICAL DAMAGE
YES Y
TERMINALS CLEANED AND LUBRICATED
YES Y
TERMINALS CLAMED TIGHTLY
YES Y
CORRECT ELECTROLYTE LEVEL
YES
SPECIFIC GRAVITY OF ELECTROLYTE WITHIN MANUFACTURER'S SPECIFICATIONS
YES
ELECTROLYTE LEAKS
YES
ADEQUATELY VENTILATED
YES Y
WITHIN MANUFACTURER'S RATED LIFE DATE CODE
YES Y
DISCONNECT CAUSES TROUBLE SIGNAL
YES Y
E3.6
27.4
V dc
V dc
mA
V dc
mA
mA
26.8
26
NO
NO
NO
NO
NO
NO
NO
NO
NO
ANNUNCIATOR TEST AND INSPECTION
N/A
N/A
N/A
N/A Y
N/A Y
N/A Y
N/A
N/A
N/A
N/A Y
(Reference: Clauses 6.4.1)
A
B
C
D
E
F
G
H
I
J
POWER 'ON' INDICATOR
YES
INDIVIDUAL ALARM AND SUPERVISORY ZONE INDICATION
YES
INDIVIDUAL ALARM AND SUPERVISORY ZONE DESIGNATION LABELS ARE PROPERLY IDENTIFIED
YES
COMMON TROUBLE SIGNAL
YES
VISUAL INDICATOR TEST (LAMP TEST)
YES
INPUT WIRING FROM CONTROL UNIT IS SUPERVISED
YES
ALARM SIGNAL SILENCE VISUAL INDICATOR
YES
SWITCHES FOR ANCILLARY FUNCTIONS OPERATE AS INTENDED
YES
OTHER ANCILLARY FUNCTIONS VISUAL INDICATORS
YES
MANUAL ACTIVATION OF ALARM SIGNAL AND INDICATION
YES
ProFire Safety Services
NO
NO
NO
NO
NO
NO
NO
NO
NO
NO
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Tel: (416) 410-7221
E3.7
Page : 4 of 5
N/A Y
SEQUENTIAL DISPLAY TEST AND INSPECTION
(Reference: Clauses 6.4.2)
A
B
C
D
E
F
G
H
INDIVIDUAL ALARM, SUPERVISORY AND TROUBLE
YES
INPUTS ARE CLEARLY INDICATED AND SEPARATELY DESIGNATED
INDIVIDUAL ALARM AND SUPERVISORY INPUT DESIGNATION LABELS ARE PROPERLY IDENTIFIED
YES
ALARM INPUT OVERRIDES SUPERVISORY AND TROUBLE INPUT
YES
SUPERVISORY INPUT OVERRIDES TROUBLE INPUT
YES
DIPOLE CAN BE MANUALLY ADVANCED
YES
FIRST ALARM IS CONTINUOUSLY DISPLAYED UNTIL MANUALLY ADVANCED
YES
FIRST ALARM IS CLEARLY IDENTIFIED EACH TIME IT IS DISPLAYED
YES
ALARM AND SUPERVISORY INPUTS CAN BE RETRIEVED UNTIL SYSTEM IS RESET
YES
NO
N/A
NO
NO
NO
NO
NO
NO
NO
N/A
N/A
N/A
N/A
N/A
N/A
N/A
E3.8 REMOTE TROUBLE UNIT TEST AND INSPECTION
N/A Y
(Reference: Clauses 6.4.3)
A
B
C
D
INPUT WIRING FROM CONTROL UNIT IS SUPERVISED
VISUAL TROUBLE SIGNAL
AUDIBLE TROUBLE SIGNAL
AUDIBLE TROUBLE SIGNAL SILENCE
E3.9
YES
YES
YES
YES
NO
NO
NO
NO
PRINTER TEST
N/A
N/A
N/A
N/A
N/A Y
(Reference: Clauses 6.5.1)
A
B
C
OPERATION AS INTENDED
ZONE OF EACH ALARM INITIATING DEVICE IS CORRECTLY PRINTED
RATED VOLTAGE IS PRESENT
E3.10
YES
YES
YES
NO
NO
NO
PRINTER IN A PROPRIETARY CONTROL CENTER TEST AND INSPECTION
N/A
N/A
N/A
N/A Y
(Reference: Clauses 6.5.2)
A
B
C
D
E
F
G
EVENTS AND ACKNOWLEDGMENTS ARE AUTOMATICALLY PRINTED
TIME AND DATE OF EACH EVENT ARE RECORDED BY THE PRINTER
EACH EVENT IS RECORDED AS THEY OCCUR, IRRESPECTIVE OF EVENT ACKNOWLEDGMENT
SYSTEM RECORDS STATUS CHANGES WITHOUT THE LOSS OF ANY DATA
PAPER ADVANCES AUTOMATICALLY SUCH THAT PRINTED RECORD IS VISIBLE
PRINTER OPERATES UNDER LOSS OF MAIN POWER SUPPLY
PRINTER IS MONITORED FOR 'LOW PAPER' AND 'PAPER OUT'
YES
YES
YES
YES
YES
YES
YES
NO
NO
NO
NO
NO
NO
NO
N/A
N/A
N/A
N/A
N/A
N/A
N/A
NO
N/A
E3.11 ANCILLARY DEVICE CIRCUIT TEST
Specific Circuit
Maglocks (Door Holder)
YES
Furnace Shut Down (Furnace #1, Furnace #2)
YES
NO
N/A
Furnace Shut Down (Furnace # 3)
YES
NO
N/A
YES
NO
N/A
ProFire Safety Services
Y
Tel: (416) 410-7221
E3.12 REMARKS
Page : 5 of 5
(Reference: E3 See Fire and Life Safety Deficiencies and Recommendations Quotations)
E3.13 DEVICE TESTING - LEGENDS AND NOTES
(Reference: Clauses 6.6.4.1.3, 6.6.4.3.1, 6.6.4.5.1, 6.6.8.1.1, 6.6.8.2.2, 6.6.8.2.4)
TYPE AND MODEL NO.
M
MANUAL PULL STATION
Notifier 950B
GA
MANUAL PULL STATION WITH GA KEYSWITCH
DOC MANUAL PULL STATION WITH DUAL CONTACTS FOR MAGS
RHT
HEAT DETECTOR, RESTORABLE (see note 9)
CR135
HT
HEAT DETECTOR, NON- RESTORABLE (see note 9)
CF135
FHT
FIXED TEMP/RESETTABLE HEAT DETECTOR (see note 9)
TD 135
S
SMOKE DETECTOR (I) ION or (PH) PHOTO (see notes 1,2,9)
1400A
DS
DUCT SMOKE DETECTOR (I) ION or (PH) PHOTO (see notes 1,3,9)
System Sensor DH 100PA
LED
REMOTE INDICATOR LIGHT
FS
SPRINKLER FLOW SWITCH (see note 4)
TS
SPRINKLER GATE TAMPER SWITCH (see note 5)
PS
SPRINKLER LOW TEMP/PRESSURE SWITCH (see note 5,6,7)
B6
BELL 6"
B10
BELL 10"
H
HORN
V
VISUAL ALARM APPLIANCE
SP
EVC SPEAKER
HSP
EVC HORNSPEAKER
T
FIRE-FIGHTERS TELEPHONE
AD
ANCILLARY DEVICE (see note 8)
R
RELAY (see note 8)
Wheelock MT 12/24 - R
MMX ADDRESSABLE MONITOR MODULE
CMX ADDRESSABLE CONTROL MODULE
ISO
FAULT ISOLATION MODULE
EOL
END OF LINE DEVICE
ITV
Inspectors Test Valve
SA
Smoke Alarm
CAUTION: The tests reported on this Form do not include the actual operational test of ancillary devices
ProFire Safety Services
Tel: (416) 410-7221
ProFire Safety Services
E3.14 INDIVIDUAL DEVICE RECORD
(Reference: Clause 6.6.4.1.4.6.6.8.1.1-B)
BUILDING NAME : c/o North York Women's Shelter
PAGE : 1
OF
ADDRESS : 940 Sheppard Avenue West
DATE : November 24, 2009
JOB # : C09-392
3
CORRECTLY INSTALLED
| REQUIRES SERVICE, REPAIRS, MISSING OR CLEANING
|
| ALARM OPERATION CONFIRMED
|
|
| ANNUNCIATION CONFIRMED
|
|
|
| CIRCUIT NUMBER OR ADDRESS
|
|
|
|
| SUPERVISION AND GROUND CONFIRMED
|
|
|
|
|
| SMOKE SENSITIVITY
DEVICE |
|
|
|
|
|
|
NOTES
Note: Devices and notes are listed
in Appendix E3.13
LOCATION
2nd Floor
Bathroom # 3
Amaryllis Room
Butter Cup Room
Super Room # 1
Clenatis Room
Hallway Adj. to Bathroom 3
Adj. to West Stair
West Stairwell
Dahlai Room
Adj. Supply Room # 3
Supply Room # 3
Bathroom # 4
Supply Room # 2
Bathroom # 5
Echinacea room
Adj. Bathroom # 5
East Stair
East Stair
Freesia Room
Gladiola Room
By Entrance to Attic
Hallway Adj. West Exit
Echinacea room
Hallway Adj. East Exit
FHT
S
S
RHT
S
S
M
S
S
S
RHT
RHT
RHT
FHT
S
S
M
S
S
S
DS
H
H/V
H
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Ground Floor
Executive Director Office
Electrical Room
Hallway Adj. Main Office
Main Office
Living Room
Dining Area
Adj. East Exit
Adj. East Exit
Adj. East Exit
Food Freezer
Kitchen
S
RHT
S
RHT
RHT
S
S
M
H
RHT
FHT
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
X1
X1
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
3
3
3
3
3
3
3
3
4
Require "911" adhesive sign
3
EOL
Y
2
2
Did not function, Require to replace
Y
Y
Y
Y
Y
Y
2
Y
Y
Y
Y
Y
Y
Y
X3
X4
Require "911" adhesive sign
3
3
1
1
1
X2
X1
3
3
3
3
3
3
3
5
3
Y
Y
2
2
2
2
2
Bell 2
2
2
ProFire Safety Services
Covered with plastic, req. to remove
Damaged, Require to replace
Tel: (416) 410-7221
ProFire Safety Services
E3.14 INDIVIDUAL DEVICE RECORD
(Reference: Clause 6.6.4.1.4.6.6.8.1.1-B)
BUILDING NAME : c/o North York Women's Shelter
PAGE : 2
OF
ADDRESS : 940 Sheppard Avenue West
DATE : November 24, 2009
JOB # : C09-392
LOCATION
Counseling Room
Assistant Executive Office
Children Services Room
North Parking Exit
South Main Entrance
Washroom
Programme Manager's Office
Vacant Room
West Stair Exit
By West Stair Exit
By West Stair Exit
Server Room
Basement
Food Storage Room
Hardware Supplies
West Exit Hallway
West Exit Hallway
West Exit Hallway
West Exit Hallway
3
CORRECTLY INSTALLED
| REQUIRES SERVICE, REPAIRS, MISSING OR CLEANING
|
| ALARM OPERATION CONFIRMED
|
|
| ANNUNCIATION CONFIRMED
|
|
|
| CIRCUIT NUMBER OR ADDRESS
|
|
|
|
| SUPERVISION AND GROUND CONFIRMED
|
|
|
|
|
| SMOKE SENSITIVITY
DEVICE |
|
|
|
|
|
|
NOTES
S
S
S
M
M
RHT
S
S
M
S
H
S
RHT x 4
RHT
M
S
H
EOL
Finance Manager Office adj. W Exit HT
Fund Raising and Volunteer's Rm
RHT
Board Room
RHT
Adj Meeting Room Hallway
S
Bathroom #1
RHT
Linen Room
RHT
Laundry Room
FHT
Furnace Room
FHT
Furnace Room
DS x2
Furnace Room
DS x2
Furnace Room
EOL
Furnace Room
EOL
Play Room West
RHT
East Stair Exit
S
East Stair Exit
M
East Stair Exit
EOL
East Stair Exit
H
Electrical Room
RHT
Play Room East
HT
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
X5
X5
X5
X1
X1
X1
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
2
2
2
2
2
2
2
2
2
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
1
1
1
1
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
X2
Y
Require "911" adhesive sign
Bell 2
Bell 2
X6
X1
Require to install
Require to install
Require to install
Require "911" adhesive sign
Require "911" adhesive sign
1
1
1
1
1
1
1
1
7
6
7
6
1
1
1
1
Require to replace with CR-135
Did not function, Require to replace
Require "911" adhesive sign
Bell 2
X7
X6
ProFire Safety Services
Require to install
Require to replace with CR-135
Tel: (416) 410-7221
ProFire Safety Services
E3.14 INDIVIDUAL DEVICE RECORD
(Reference: Clause 6.6.4.1.4.6.6.8.1.1-B)
BUILDING NAME : c/o North York Women's Shelter
PAGE : 3
OF
ADDRESS : 940 Sheppard Avenue West
DATE : November 24, 2009
JOB # : C09-392
LOCATION
2nd Floor
By Entrance to Attic
Attic Area
Ground Floor
Kitchenhood System
3
CORRECTLY INSTALLED
| REQUIRES SERVICE, REPAIRS, MISSING OR CLEANING
|
| ALARM OPERATION CONFIRMED
|
|
| ANNUNCIATION CONFIRMED
|
|
|
| CIRCUIT NUMBER OR ADDRESS
|
|
|
|
| SUPERVISION AND GROUND CONFIRMED
|
|
|
|
|
| SMOKE SENSITIVITY
DEVICE |
|
|
|
|
|
|
NOTES
RHT
Y
HT x 3
Y
KH
Y
Y
8
X6
Y
Y
8
TD135
CF135, Req. to replace with CR-135
2
(Checked by Dale on panel)
ProFire Safety Services
Tel: (416) 410-7221
ProFire Safety Services
EMERGENCY LIGHTING ANNUAL INSPECTION REPORT
as per OFC 2.7.3.3.3(b)
BUILDING NAME : c/o North York Women's Shelter
PAGE :
1 of
ADDRESS : 940 Sheppard Avenue West
DATE : November 24, 2009
JOB # : C09-392
Unit Types:
CORRECTLY INSTALLED
U = Battery unit
| # OF REMOTE HEADS
L = Lamp
|
| # OF DC EXIT LAMPS
S = Exit sign
|
|
| REQUIRES SERVICE OR REPAIR
U/L= Battery / Lamp unit
|
|
|
| OPERATION CONFIRMED
U/S= Battery / Exit unit
|
|
|
|
| VOLTAGE
U/L/S= Battery / Lamp / Exit unit
|
|
|
|
|
| WATTAGE
|
|
|
|
|
|
| LAMP TYPE
NO.
LOCATION
TYPE
|
2xL
S
2xL
S
2xL
Y
Y
Y
Y
Y
S
2xL
S
2xL
U/L
S
2xL
S
S
S
L
S
2xL
Y
Y
Y
Y
S
2xL
2xL
S
L
U/L
Y
Y
Y
Y
Y
|
|
|
|
|
|
|
1
Lamp Types:
B = Bayonet
S = Screw
M = Mini
P = Micro
Q = Quartz
W = Wedge
SB = Sealed Beam
REMARKS
2nd Floor
North East Stairwell
North East Exit
Adj. Room 6
South West Exit
South West Stairs
Y
Y
Y
Y
Y
1st Floor
South West Stairs
South West Stairs
South West Exit
South West Adj. Exit
Centre Closet
Main Entrance
Adj. Main Office
Adj. North East Stair
Adj. North East Stair Exit
Adj. Kitchen
Adj. Kitchen Exit
Adj. Kitchen Exit
Adj. North East Stair Exit
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
Y
X8
Y
12 250 W Lumacell 12V30Ah batt., RE12LL250 12V250watt
1 x 12V DC Bulb blown, Require to replace
Y
Y
Y
Basement
Adj. Play Room
Adj. Laundry Room
South East Hall
Adj. South West Exit
South West Stair
Electrical Room
Y
Y
Y
Y
Y
Y
Y
Y
X9
ProFire Safety Services
Require to install
Tel: (416) 410-7221
ProFire Safety Services
FIRE HOSE AND EXTINGUISHER ANNUAL INSPECTION REPORT
as per NFPA 1962 and NFPA 10
BUILDING NAME : c/o North York Women's Shelter
PAGE : 1
of
1
ADDRESS : 940 Sheppard Avenue West
DATE : November 24, 2009
JOB # : C09-392
SIZE / LENGTH
H
FIRE HOSE
|
ABC DRY CHEMICAL EXTINGUISHER
|
DATE OF MANUFACTURE
BC
DRY CHEMICAL EXTINGUISHER
|
|
PW
PRESSURE WATER EXTINGUISHER
|
|
LAST H-TESTED
HAL HALON EXTINGUISHER
|
|
|
CO2 CARBON DIOXIDE EXTINGUISHER
|
|
|
LAST SERVICED
|
|
|
| OK TO TAG?
No.
LOCATION
ITEM
|
|
|
|
|
REMARKS
2nd Floor
1
2
North East Hall
South West Hall
ABC
ABC
5lb
5lb
08
97
ABC
ABC
ABC
BC
K-type
2.5lb
5lb
5lb
6lb
6lb
96
97
03
88
ABC
ABC
ABC
ABC
ABC
ABC
ABC
ABC
5lb
5lb
5lb
2.5lb
5lb
5lb
10lb
5lb
79
88
88
85
84
97
92
84
03
Y
X10 Hydro-Static Testing & seal
1st Floor
3
4
5
6
6-A
SW Office (Exec. Director Office)
South Centre Hall
Dinning Room
Kitchen Hall
Kitchen
7
8
9
10
11
12
13
14
Play Room
Laundry Room
South East Hall
Board Room
Adj. South West Exit
Storage Room
Electrical Room
Furnace Room
02
03
99
05
95
00
00
00
96
08
94
94
94
02
03
99
02
X10
X11
X12
X13
Hydro-Static Testing
Require 6-year maintenance
Missing Sealand req. to mount
Require to install K-type Extinguisher
X14
X11
X11
X15
X16
X10
Y
X10
Require to recharge
Require 6-year maintenance and seal
Require 6-year maintenance
Missing, Require to replace
Require H-Testing, Require to replace
Require Hydro-Static Testing
Basement
04
96
ProFire Safety Services
Require Hydro-Static Testing
Tel: (416) 410-7221