Name of Signatory Applicant: Applicant Organisation: Applicant Signature: Technical Expert Name: Technical Expert Signature: Date: Scope Category Type of System Standard Installation and In-service Technical Expert Review Commissioning Inspection Inspection Sig Appln TE Sig Appln TE Witness / Interview Initial / Review Initial / Review Comments W / I Reassess Agree / Reassess Agree / I / R Disagree I / R Disagree Y / N Y / N Inspection of Simple fire sprinkler systems (wet pipe up to ordinary hazard 3 including systems with pumps and tanks) Residential 4515 Commercial/offices 4541 Wet pipe systems up to OH3 Apartments 4541 Industrial 4541 Air cooled diesel pump 4541 cooled diesel pump 4541 With: Electric pump 4541 Pumps and tanks Storage tank 4541 Infill tank 4541 Inspection of Fire sprinkler systems with the following features and characteristics: OH4 - Storage 4541 EHH - Warehousing in racks 4541 – OH4 and EH hazard EHH - Ceiling only EHH - Process Inspection of Fire sprinkler systems for special applications: Pre-action systems 4541 Deluge installations 4541 Special applications Water mist systems 4541 Dry pipe systems 4541 Other complex systems: Antifreeze Installations 4541 (specify)
Name of Signatory Applicant: Applicant Organisation: Applicant Signature: Technical Expert Name: Technical Expert Signature: Date: Scope Category Type of System Standard Installation and Commissioning Inspection In-service Inspection Technical Expert Review Sig Appln Initial / Reassess I / R TE Review Agree / Disagree Y / N Sig Appln Initial / Reassess I / R TE Review Agree / Disagree Y / N Witness / Interview W / I Comments Inspection of Simple fire sprinkler systems (wet pipe up to ordinary hazard 3 including systems with pumps and tanks) Wet pipe systems up to OH3 Residential 4515 Commercial/offices 4541 Apartments 4541 Industrial 4541 With: Pumps and tanks Air cooled diesel pump 4541 cooled diesel pump 4541 Electric pump 4541 Storage tank 4541 Infill tank 4541 Inspection of Fire sprinkler systems with the following features and characteristics: OH4 and EH hazard OH4 - Storage 4541 EHH - Warehousing – in racks 4541 EHH - Ceiling only EHH - Process Inspection of Fire sprinkler systems for special applications: Special applications Pre-action systems 4541 Deluge installations 4541 Water mist systems 4541 Dry pipe systems 4541 Other complex systems: Antifreeze Installations 4541 (specify)
Signatory_Scope_Application_Form_-_Fire_Sprinklers.docx