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45 6 " FIRE AND LIFE SAFETY PROGRAM Sample Sprinkler Impairment Tag
Before Impairment: ATTACH TO VALVE, FDC
READ INSTRUCTIONS ON OTHER SIDE Notify Fire Department
Notify Building Owner/Supervisors SPRINKLER VALVE Shut Down Hazardous Operations (Hot Work)
No Smoking SHUT Portable Fire Extinguisher(s) Ready
Work Exclusively on Impairment Project THIS VALVE CONTROLS SPRINKLERS IN BUILDING(S): No Smoking in Building
SHUT BY (SIGNATURE): DATE: No Unrelated Cutting or Welding (Hot Work)
Check if Fire Watch Required After valve is opened, make 50-mm (2-in.) drain test.
Drop in pressure should be normal. If pressure drop is
extreme and does not build up, the system is impaired and
immediate investigation is necessary. After Impairment:
Perform Main Drain Test
Notify Fire Department DRAIN TEST RESULTS
STATIC PRESSURE Notify Building Owner/Supervisors FLOWING PRESSURE bar (psi)
DRAIN TEST MADE BY
(SIGNATURE) Remove Tag bar (psi)
DATE: FRONT BACK < FIRE AND LIFE SAFETY PROGRAM (This page left intentionally blank) $0 FIRE AND LIFE SAFETY PROGRAM CHAPTER 4: Planning
Emergency Planning and Preparedness
Responding to a Fire Emergency
If a fire emergency occurs, all persons have a responsibility to take immediate and appropriate action
to ensure their own safety. The Emergency Response Plan will be activated and all personnel must
evacuate the building.
There is no employer expectation for employees to attempt to extinguish a fire or otherwise stay in
their workplace for any reason upon being notified of a fire emergency. However, a specific employee
may be required to maintain critical equipment or services or to arrange for the...
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- Fall '13
- ........., Fire protection, Fire Prevention Bureau, Grand Rapids Fire Department Fire Prevention Bureau, GRFD Fire Prevention Bureau, GRAND RAPIDS FIRE DEPARTMENT