消防系统中断申请表

消防系统中断申请表

Fire Protection Impairment Application Form

Location地点： Site Impairment Coordinator消防系统中断负责人：

The Following Impairment此项消防系统中断： □ Planned 已计划 □ Emergency 紧急

was initiated at 中断工程开始于：Date(年/月/日) Time（时/分）

expected corrected by预计结束于： Date(年/月/日) Time（时/分）

Type of Impairment中断种类：

□ Sprinkler Systerm喷淋系统

□ Fire Pump 消防泵

□ Water Supply 供水系统

□ Special Extinguishing Systerm 其他特设消防系统

□ Smoke or Heat Detection Systerm 火警探测系统

□ Alarm Systerm 警报系统

□ Underground Piping 地下喉管

□ Other 其他消防装置：

Describe详细描述：

The Following Precaution have been taken to minimize the potential for loss during the impairment 为了减少火警危害，当修补防火装置时，已执行如下措施:

□ Fire Protection Impairment Tag on systerm 使用消防系统中断许可证

□ Department Supervisons Notified 通知受影响范围的部门主管：

□ Fire Doors in Area Have Been closed or verified as operable 测试防火门，确保有效

□ Hazardous Operation Discontinued 停止危险作业

□ Combusibles Removed form Area 移除可燃物品

□ Hot Work Operation Discontinued 停止高温作业

□ Safety Department Notified通知公司安全部门：

□ Fire Station Notified 通知公司消防队：

□ Fire Department Notified 通知当地消防机构

□ Fire Watch Established(Hourly/Continuous) 安排每小时/长期火警巡查

Impairment Application Form Completed by(申请人):

Reviewed by(审核人):

Approved by(核准人)：