Fire Protection System

Fire Protection System Out of Service / On Test Notification

In accordance with the New Jersey Uniform Fire Code (N.J.A.C. 5:70), required fire protection systems shall not be removed from service, impaired, or placed on test without notification to the local enforcing agency and the implementation of approved interim life safety measures, including fire watch when required

Property Name*

Street Address*

Suite / Building / Area Affected*

Responsible Person Name*

Title / Company*

24-Hours Contact Phone Number

Email*

Areas / Spaces Protected by the System*

Reason for placing system on test / out of service.*

Start Date & Time*

Anticipated Restoration Date & Time

Will the system be impaired longer than 4 hours?*

Is a Fire Watch being provided?*

Fire Watch Personnel Name*

Fire Watch Contact Number*

Typed Name*

Certification Date*