FIREPROTECT INC
929-6059 / 926-3696
DOORFAN INTEGRITY TEST FORM
Enclosure Integrity Test
Date: Contract: Job #
Customer:
Address:
City: State: Zip:
Contact: Phone: FAX:
Site:
Building:
Address:
City: St.: Zip:
Contact: Phone: FAX:
Zone:
Test Standard: NFPA 2001/2004 NFPA 2001/2012
Room Location:
Description:
Other fire protection: Sprinkler y/ n Type pre- action or ?
Security: Zone y/n Type: Cameras? Or Building y/n 24/7 y/n Type:
Suppression gas:
Trade name: Concentration: Weight volume: Manufacture:
Control Panel mfg: Model: Installer:
Heights:
Raised floor ht.: Floor to drop Drop ceiling to:
ceiling: upper deck:
Total protected
height:
High hazzard, Height of high
description: hazzard:
Minimum Per (AHJ or ?):
protected height:
Volume:
Overall protected volume: Volume of solid object:
Net Protected volume: Floor area
Temperature: Outside temperature is the temperature surrounding the zone,
not necessarily outside the building
Temperature inside zone: Temperature outside zone:
Free return air flow path Must have open air path from outside zone walls back to fan
Confirmed:
Test Set up Door: Weather Stripped? Drop seal/ door sweep Door Closer?
Prestest Maximum Leakage: Based on the zone's specifications, the calculated maximum allowable leakage for a 10
minutes hold time (0.00 static pressure)
Maximum leakage:
Static air pressure: Must be less that 25% of target test pressure
(+) Positive if blowing out of zone, (-) Negative if blowing into zone
** BE SURE OUTSIDE SAMPLING TUBE IS THROUGH DOOR PANEL**
Static air pressure: Discharge Condition Test Condition
Holding Time Condition: Test Type
Descending Interface Continous Mixing Standard Total Zone Suspended Ceiling Leakage
Leakage Neutralization(Below ceiling
Leakage BCLA)
Test
Data: NFPA 2001/2004: Use indicate target pressure
NFPA 2001/2012: Use 10pa & 50pa, if can not reach 50pa check box and test at 10pa
Depres Target pressure: Press: Target Pressure:
Test pressure: Test pressure:
Flow: Flow:
Low Flow Plate: Low Flow Plate:
Test Results:
Total Leakage Sq. Inches: Sq. Feet:
Hold time Height(ft): Minutes:
Height(ft): Minutes:
Height(ft): Minutes:
Height(ft): Minutes:
Possible leakage areas
Problem area Y/N (1) Corrected Comments
Walls floor to deck
Walls caulked at floor
Walls caulked at deck
Doors weather- stripped
Doors, drop seals
Door closers installed, adjusted
Windows caulked
Exiting conduits sealed
Exiting cables sealed
Cable trays sealed
All holes, penetrations sealed
Floor drains trapped and filled
Dampers installed on all existing ducts
Dampers working and adjusted
Block walls painted
Ceiling tiles clipped
HVAC shut down
Halon exhaust dampered
Halon exhaust damper closed
1. Y - yes
N - No
R - Reported
? - Unknown
N/A - Not Applicable
I/A - Inaccesible
CONDUCTED BY: ATTESTED & CERTIFIED CORRECT BY:
FIREPROTECT INC. REPRESENTATIVE CUSTOMER AUTHORIZED REPRESENTATIVE
(PLEASE SIGN OVER PRINTED NAME)
