Homepage Blank 5 Year Fire Sprinkler Inspection Form
Outline

The 5-Year Fire Sprinkler Inspection form serves as a critical tool in ensuring the safety and functionality of fire sprinkler systems within buildings. This comprehensive document outlines various inspection, testing, and maintenance requirements mandated by the California Code of Regulations, specifically Title 19. It collects essential property information, including the building name and address, as well as details about the contractor or licensed owner responsible for the system. The form is divided into sections that cover a wide array of components, such as control valves, waterflow alarm devices, and backflow preventers, each requiring specific inspections and tests. Notably, it includes a checklist for quarterly and annual inspections, allowing for systematic tracking of the system's condition over time. Each item is marked with pass, fail, or not applicable statuses, ensuring clear communication of the system's compliance with safety standards. Additionally, the form provides space for documenting any deficiencies or comments, thereby fostering transparency and accountability in the maintenance process. By adhering to the guidelines outlined in this form, property owners and contractors can contribute significantly to the overall safety of the buildings they manage.

Sample - 5 Year Fire Sprinkler Inspection Form

Wet Pipe
Fire Sprinkler System
California Code of Regulations - Title 19
Inspection, Testing, and Maintenance
5-Year
Report
1 of 3
Property Information Contractor or Licensed Owner Information
Building Name
Name
Address
Address City St. Zip
City
License #
Phone
Contact Person
SFM Job #
CSLB Misc.
Riser Information Main Drain Test (ANNUAL)
Riser
No.
Location
Riser
Diameter
Main Drain
Diameter
Initial Static
Pressure
Residual
Pressure
Final Static
Pressure
P, F, N/A
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
ed.
Reference
Date Comments Only P, F, N/A
1.1 I Control Valves – Identification Sign 13.3.1
1.2 I Control Valves – Inspection 13.3.2
1.3 I Waterflow Alarm Devices 5.2.5
1.4 I Supervisory Devices 5.2.5
1.5 I Gauges (Wet Pipe Systems) 5.2.4.1
1.6 I
Hydraulic Design Information Sign
(For hydraulically designed systems)
5.2.6
1.7 I
Enter Water Supply Pressure Below Riser Check
5.2.4.1 psi
1.8 I
Enter Water Supply Pr
essure Above Riser Check 5.2.4.1 psi
1.9 I
Pressure Readings Acceptable
5.2.4.1
1.10 I
General Information Sign
(not required for system prior to 2007 Edition NFPA 13)
5.2.8
1.11 I Heat Tape 5.2.7
1.12 I Spare Sprinklers 5.2.1.4
1.13 I Fire Department Connections 13.7
1.14 I Alarm Valves – Exterior Inspection 13.4.1
1.15 I Pressure Reducing Valves 13.5.1.1
1.16 I Backflow Preventers 13.6.1
Form AES 2.
2
Se
p
t. 3, 2013
Wet Pipe
Fire Sprinkler System
California Code of Regulations - Title 19
Inspection, Testing, and Maintenance
5 Year
Report
2 of 3
Property Information Contractor or Licensed Owner Information
Building Name Name
Address Job #
City
ANNUAL INSPECTION, TESTING, AND MAINTENANCE
Include ALL Quarterly Inspections (See AES 2.1)
I = Inspection T = Test M = Maintenance
P = Pass F = Fail N/A = Not Applicabl
e
Item Description
NFPA 25 CA ed.
Reference
Date Comments Only P,F,N/A
1.17 I Small Hose Connections - Hose Valve*
5.1.6, 13.5.2
13.5.5.1
1.18 I PRV – Fire Sprinkler Systems 13.5.1.1
1.19 I Buildings (Freeze Protection) 4.1.1.1 Owner’s Responsibilit
y
1.20 I Sprinklers 5.2.1
1.21
I Sprinklers - Accessible Concealed Space 5.2.1.1.6
1.22
I Pipe and Fittings 5.2.2
1.23
I Pipe and Fittings - Accessible Concealed Space 5.2.2.3
1.24 I Hangers 5.2.3
1.25 I Hangers - Accessible Concealed Space 5.2.3.3
1.26 I Seismic Braces 5.2.3
1.27 I Seismic Braces - Accessible Concealed Space 5.2.3.3
1.28 I Unsprinklered Areas CFC 901.4 Yes No
2.1 T
Field Service Test Required
Send Report to Fire Code Official
5.3.1
If REQUIRED, Enter 'F' until
results are returned from Lab
2.2 T
Recalled Sprinklers
If not present = Pass; If present = Fail
Title 19
904.1(c)
2.3 T
Water Flow Alarm Devices
90 secs max. Enter time
5.3.3
13.2.6
sec.
2.4 T
Main Drain Test
(Enter data on Page 1 of this form)
13.2.5
13.3.3.4
2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1
2.7 T Supervisory Devices 13.3.3.5
2.8 T Backflow Preventer Assemblies 13.6.2
2.9 T
Small Hose Connections*
w/PRV Hose Valves – Partial Flow Test
13.5.2.3
13.5.3.3
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
Se
p
t. 3, 2013
Wet Pipe
Fire Sprinkler System
California Code of Regulations - Title 19
Inspection, Testing, and Maintenance
Property Information Contractor or Licensed Owner Information
Building Name Name
Address Job #
City
ANNUAL INSPECTION, TESTING, AND MAINTENANCE
include ALL Quarterly Inspections (See AES 2.1)
I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable
Item Description
NFPA 25 CA ed.
Reference
Date Comments Only P,F,N/A
3.1 M Check Valves - Internal inspection 13.4.2
3.2 M Control Valves 13.3.4
3.3 M FDC - Backflush
14.3.2.3
14.3.2.4
3.4 M
Internal Pipe Inspection - See Deficiencies and
Comments Section for Results.
14.2
Yes
No
3.5 M
Obstruction Inv
estigation Required. If "Yes", see
Deficiencies and Comments Section for Results
14.3
3.6 M System Returned to Service 4.5.3
Yes
No
D = Deficiency C = Comment (Indicate type )
Item Date Riser 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
See Correction Form AES 10 for corrected deficiencies.
Number attached:
Number attached:
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 Date
Form AES 2.
2
Se
p
t. 3, 2013
5
Year
Report
3 of 3

Form Information

Fact Name Description
Purpose The 5-Year Fire Sprinkler Inspection form is used to document the inspection, testing, and maintenance of fire sprinkler systems.
Regulatory Basis This form is governed by the California Code of Regulations, Title 19.
Inspection Frequency Fire sprinkler systems must be inspected at least every five years, including all quarterly and annual inspections.
Documentation The form requires detailed information about the property, contractor, and inspection results.
Inspection Items Includes items like control valves, water flow alarms, and pressure gauges, all of which must be checked.
Pass/Fail Criteria Each inspection item is marked as Pass, Fail, or Not Applicable, allowing for clear reporting of the system's status.
Additional Forms If a building has more than five risers, an additional AES 2.9 form must be attached to the inspection report.
Certification The form must be signed by the inspecting contractor, certifying that the system has been properly maintained.

Detailed Guide for Filling Out 5 Year Fire Sprinkler Inspection

Completing the 5 Year Fire Sprinkler Inspection form is a crucial step in ensuring that fire protection systems are properly maintained. This form collects important information about the inspection, testing, and maintenance of fire sprinkler systems, which is essential for compliance with safety regulations. Following the steps below will help ensure that the form is filled out accurately and completely.

  1. Gather necessary information: Before starting, collect all relevant details about the property, including the building name, address, and contact information for the contractor or licensed owner.
  2. Fill out property information: Begin by entering the building name, address, city, state, and zip code in the designated sections at the top of the form.
  3. Provide contractor information: Enter the contractor or licensed owner's name, license number, and phone number in the appropriate fields.
  4. Document riser information: If the building has more than five risers, indicate this and attach the additional AES 2.9 forms as needed. Record the number of attached forms.
  5. Complete the inspection section: For each item listed under the inspection section, mark whether it passed (P), failed (F), or is not applicable (N/A). Include the date of inspection and any comments in the designated fields.
  6. Fill in the testing section: Similar to the inspection section, indicate the results of tests conducted. Use the same notation for pass, fail, or not applicable. Record the date and any relevant comments.
  7. Address maintenance items: For maintenance tasks, check the appropriate boxes to indicate whether they were performed. Provide dates and comments where necessary.
  8. List deficiencies and comments: If there were any deficiencies noted during the inspection or testing, detail them in the comments section. Indicate whether the system has been returned to service.
  9. Certify the inspection: At the end of the form, the responsible individual must print their name, sign, and date the document to certify that the inspection was completed in accordance with regulations.
  10. Submit the form: Once completed, submit the form to the appropriate fire code official or agency as required.

Obtain Answers on 5 Year Fire Sprinkler Inspection

  1. What is the purpose of the 5 Year Fire Sprinkler Inspection form?

    The 5 Year Fire Sprinkler Inspection form is designed to ensure that fire sprinkler systems are properly inspected, tested, and maintained according to California regulations. This form documents all necessary inspections, tests, and maintenance activities that must be performed every five years. It helps ensure that fire safety systems are functioning correctly, thereby protecting lives and property.

  2. Who is responsible for completing the inspection form?

    The responsibility for completing the inspection form lies with a licensed contractor or a qualified individual who is authorized to perform fire sprinkler system inspections. This person must have the necessary training and credentials to ensure compliance with California Code of Regulations, Title 19.

  3. What information is required on the form?

    The form requires various details, including:

    • Property information such as building name, address, and job number.
    • Contractor or licensed owner's information including name, address, and contact details.
    • Inspection results for various components of the fire sprinkler system, including control valves, waterflow alarms, and pressure gauges.
    • Comments on any deficiencies or maintenance performed.

    Completing this information accurately is crucial for maintaining compliance and ensuring safety.

  4. What does the inspection process entail?

    The inspection process involves a thorough examination of the fire sprinkler system. This includes checking control valves, waterflow alarms, and pressure gauges, among other components. Each item is categorized as an inspection (I), test (T), or maintenance (M) activity. The inspector will record whether each item passes (P), fails (F), or is not applicable (N/A). A detailed report of findings and any necessary corrective actions will be included.

  5. What should I do if deficiencies are found during the inspection?

    If deficiencies are identified, they must be documented in the “Deficiencies and Comments” section of the form. The licensed contractor or inspector should also provide recommendations for repairs or maintenance. It is essential to address these issues promptly to ensure that the fire sprinkler system remains fully operational and compliant with safety regulations.

Common mistakes

Completing the 5 Year Fire Sprinkler Inspection form accurately is crucial for ensuring compliance and safety. However, many individuals make common mistakes that can lead to complications. One frequent error involves incomplete property information. When filling out the form, it is essential to provide all requested details, including the building name, address, and contractor information. Omitting any of this information can delay processing and create confusion during inspections.

Another common mistake is failing to properly document the main drain test results. This section requires specific pressure readings, including initial static and residual pressures. If these readings are not entered accurately, it can lead to misinterpretation of the system's performance. It is important to double-check these values to ensure they reflect the actual conditions observed during the inspection.

People often overlook the comments section as well. This area is vital for providing context about any issues encountered during the inspection. Failing to include comments can result in misunderstandings about the condition of the fire sprinkler system. If there are any deficiencies or specific observations, they should be clearly documented to inform future maintenance and inspections.

Lastly, individuals sometimes neglect to sign and date the form. The certification at the bottom of the document confirms that the inspection was completed according to regulations. Without a signature and date, the form may be considered invalid. Ensuring that all necessary signatures are present is a simple yet critical step that should not be overlooked.

Documents used along the form

When managing fire sprinkler systems, it is essential to maintain thorough documentation. Alongside the 5 Year Fire Sprinkler Inspection form, several other forms and documents are commonly utilized to ensure compliance and safety. Each of these documents plays a vital role in the overall inspection and maintenance process.

  • AES 2.1 Quarterly Inspection Form: This document outlines the specific quarterly inspections that must be conducted on fire sprinkler systems. It includes details about what should be checked during these inspections, ensuring that all necessary components are evaluated regularly to maintain system integrity.
  • AES 2.9 Additional Riser Information Form: If a building has more than five risers, this form is required. It provides detailed information about each riser, including their locations and specific tests performed. This helps to ensure that all risers are adequately inspected and maintained.
  • AES 10 Correction Form: Should deficiencies be identified during inspections, this form is used to document corrections made. It outlines the specific repairs or replacements performed, ensuring that all issues are addressed and the system remains compliant with safety standards.
  • NFPA 25 Compliance Documentation: This document serves as a reference to the National Fire Protection Association's standards for fire sprinkler systems. It details the requirements for inspection, testing, and maintenance, ensuring that all procedures align with national safety regulations.

These documents collectively contribute to a comprehensive approach to fire safety. By maintaining accurate records and ensuring compliance with regulations, property owners can enhance the safety of their buildings and protect the lives of occupants. Always consult with a qualified professional to ensure that all necessary forms are completed and submitted appropriately.

Similar forms

  • Annual Fire Alarm Inspection Report: Similar to the 5 Year Fire Sprinkler Inspection form, this report covers the annual inspection, testing, and maintenance of fire alarm systems. Both documents ensure that safety systems are regularly checked and maintained to comply with safety regulations.
  • Fire Extinguisher Inspection Report: This document outlines the inspection and maintenance of fire extinguishers. Like the sprinkler inspection form, it includes details about the condition and functionality of the equipment, ensuring readiness in case of a fire.
  • Emergency Lighting Inspection Report: This report focuses on the inspection of emergency lighting systems. Both documents require regular checks and maintenance to ensure that safety measures are operational during emergencies.
  • Building Fire Safety Inspection Report: This report evaluates the overall fire safety of a building, similar to the sprinkler inspection form. It assesses various fire protection systems, ensuring compliance with local codes and regulations.
  • Fire Safety System Maintenance Log: This log records all maintenance performed on fire safety systems, including sprinklers. It is similar to the inspection form in that it documents the ongoing upkeep necessary to keep systems functioning properly.
  • Fire Code Compliance Report: This report verifies that a building meets fire safety codes. Like the sprinkler inspection form, it is essential for maintaining safety standards and ensuring that all fire protection systems are in place.
  • Hazardous Materials Inspection Report: This document assesses the handling and storage of hazardous materials within a facility. Both reports emphasize safety and compliance, focusing on preventing fire hazards in different contexts.
  • Fire Drill Evaluation Report: This report evaluates the effectiveness of fire drills conducted in a building. Similar to the sprinkler inspection form, it aims to ensure that all safety protocols are followed and that occupants are prepared in case of a fire.

Dos and Don'ts

When filling out the 5 Year Fire Sprinkler Inspection form, it is important to follow certain guidelines to ensure accuracy and compliance. Below is a list of things you should and shouldn't do:

  • Do: Provide complete and accurate property information, including the building name, address, and contact details.
  • Do: Use clear and legible handwriting or type the information to avoid misinterpretation.
  • Do: Double-check all entries for accuracy before submitting the form.
  • Do: Include any additional forms, such as the AES 2.9, if the building has more than five risers.
  • Don't: Leave any required fields blank; incomplete forms may lead to delays or rejections.
  • Don't: Use abbreviations or jargon that may confuse the reader.
  • Don't: Forget to sign and date the form, as this is essential for validation.
  • Don't: Submit the form without reviewing the “Deficiencies and Comments” section for any necessary notes.

Misconceptions

Understanding the 5 Year Fire Sprinkler Inspection form is crucial for property owners and managers. However, several misconceptions can lead to confusion. Here are ten common misunderstandings:

  1. It’s only for new installations. Many believe that this form is only necessary for newly installed systems. In reality, it applies to all fire sprinkler systems that require regular inspection, testing, and maintenance, regardless of their age.
  2. Annual inspections are enough. Some think that an annual inspection suffices. However, the 5 Year Fire Sprinkler Inspection form incorporates all quarterly inspections, tests, and maintenance items, making it a comprehensive requirement.
  3. Only licensed contractors can fill it out. While licensed contractors are responsible for conducting inspections, property owners can also keep records and fill out sections of the form to ensure compliance.
  4. It’s optional if the system is rarely used. This is a misconception. Regardless of usage frequency, maintaining compliance with the inspection schedule is essential for safety and legal adherence.
  5. All inspections are the same. Not all inspections cover the same items. The 5 Year Fire Sprinkler Inspection form includes specific tests and maintenance items that may differ from other inspection forms.
  6. Documentation is not necessary. Some property owners believe that they can skip documentation. In fact, thorough records are crucial for proving compliance and ensuring the system's operability.
  7. Deficiencies can be ignored. Ignoring deficiencies noted on the form can lead to serious safety hazards. Addressing any deficiencies promptly is vital for maintaining the effectiveness of the fire sprinkler system.
  8. The form is only for fire departments. While fire departments may review the form, it is also intended for property owners and managers to ensure their systems are functioning correctly and safely.
  9. Once filled out, the form is done forever. This misconception overlooks the ongoing nature of fire sprinkler maintenance. Regular updates and re-evaluations are necessary to keep the system compliant.
  10. It’s not important if the building is small. Size does not determine the necessity of the form. All buildings, regardless of size, must adhere to the same inspection and maintenance requirements to ensure safety.

By clarifying these misconceptions, property owners can better understand their responsibilities and ensure their fire sprinkler systems are properly maintained.

Key takeaways

  • Accurate completion of the 5 Year Fire Sprinkler Inspection form is essential for compliance with California regulations.

  • Property information must be filled out completely, including building name, address, and contact details.

  • Include the contractor or licensed owner's information to ensure accountability and traceability.

  • Document all inspections, tests, and maintenance items clearly, using the provided codes: I for Inspection, T for Test, M for Maintenance, and P, F, or N/A for results.

  • Perform the Main Drain Test annually and record initial, residual, and final pressure readings accurately.

  • Ensure that any deficiencies or comments are noted in the appropriate section to provide a complete overview of the system's condition.

  • Submit the completed form to the appropriate fire code official to maintain compliance and ensure safety.

  • Keep copies of all forms for your records, as they may be required for future inspections or audits.