1、附件C1：Annex C1建筑消防設施巡查記錄表Inspection record table for building fire protection facilities 序號： NO:巡查項目item巡 查 內 容content巡 查 情 況Situation部位Part數量Qty.正常Normal故障及處理Fault故障描述Description當場處理情況On-site handling state報修情況Repair消防供配電設施Fire power supply and distribution消防電源主電源、備用電源工作狀態Status of main power and st

2、andby power發電機啟動裝置外觀及工作狀態The appearance and working state of the generator starting device消防配電房、UPS電池室、發電機房環境The environment of power distribution room, UPS battery room, generator room消防設備末端配電箱切換裝置工作狀態Working status of power distribution switch box for firefighting equipment火災自動報警系統Fire automatic a

3、larm system火災探測器、手動報警按鈕、信號輸入模塊、控制模塊外觀及運行狀態The appearance and operation state of fire detector, manual alarm button, signal input module and control module.火災報警控制器、火災顯示盤、CRT圖形顯示器運行狀況Operation status of fire alarm controller, fire display panel and CRT graphic display消防聯動控制器外觀及運行狀況Appearance and opera

4、tion status of fire linkage controller火災報警裝置外觀Appearance of fire alarm device建筑消防設施遠程監控、信息顯示、信息傳輸裝置外觀及運行狀況Appearance and operation status of remote monitoring, information display and information transmission device for building fire facilities系統接地裝置外觀System appearance of grounding device消防控制室工作環境Wo

5、rk environment of fire control room電氣火災監控系統Electric fire monitor system電氣火災監控探測器的外觀及工作狀態Appearance and working state of electric fire detector報警主機外觀及運行狀態Appearance and working state of the alarm host可燃氣體探測報警系統Combustible gas detection and alarm system可燃氣體探測器的外觀及工作狀態Appearance and working state of co

6、mbustible gas detectors報警主機外觀及運行狀態Appearance and working state of the alarm host消防供水設施Fire water supply facilities消防水池、消防水箱外觀，液位顯示裝置外觀及運行狀況，天然水源水位、水量、水質情況，進戶管外觀Appearance of fire water pool and fire water tank, appearance and operation status of water level display device; Level, volume and quality

7、of natural source of water;Appearance of water pipe 消防水泵及控制柜工作狀態Working state of fire pump and control cabinet穩壓泵、增壓泵、氣壓水罐及控制柜工作狀態Working state of steady pressure pump, booster pump, pneumatic water tank and control cabinet水泵接合器外觀、標識Appearance and identity plate of pump connector系統減壓、泄壓裝置、測試裝置、壓力表等外

8、觀及運行狀況Appearance and working state of pressure reduce/relief system, test devices, pressure gauges, etc.管網控制閥門啟閉狀態Opening and closing state of pipe control valve 泵房照明、排水等工作環境Lighting and drainage of the pump house消火栓（消防炮）滅火系統Fire hydrant (Fire monitor) system室內消火栓、消防卷盤外觀及配件完整情況Appearance and accesso

9、ries integrity of indoor fire hydrant and fire reel屋頂試驗消火栓外觀及配件完整情況、壓力顯示裝置外觀及狀態顯示Appearance and accessories integrity of roof test hydrant;Appearance and status of pressure display device 室外消火栓外觀、地下消火栓標識、栓井環境Appearance of exterior hydrant, marking of underground fire hydrant, environment of fire hyd

10、rant chamber消防炮、炮塔、現場火災探測控制裝置、回旋裝置等外觀及周邊環境The appearance and surrounding environment of Fire monitor, turret, field fire detection control device, gyratory device啟泵按鈕外觀Appearance of pump button 自動噴水滅火系統Automatic sprinkler system噴頭外觀及距周邊障礙物或保護對象的距離Appearance of sprinkler and the distance from the sur

11、rounding obstacles or protection objects報警閥組外觀、試驗閥門狀況、排水設施狀況、壓力顯示值Appearance of the alarm valve group, the state of the test valve, the state of the drainage facilities, and the indication value of the pressure充氣設備及控制裝置、排氣設備及控制裝置、火災探測傳動及現場手動控制裝置外觀及運行狀況Appearance and operation status of aerated equip

12、ment and control devices, exhaust equipment and control devices, fire detection drive and field manual control devices.樓層或區域末端試驗閥門處壓力值及現場環境，系統末端試驗裝置外觀及現場環境Pressure value and field environment of terminal test valve on floors/in areas;Appearance and field environment of system terminal test device on

13、 floors/in areas泡沫滅火系統Foam extinguisher泡沫噴頭外觀及距周邊障礙物或保護對象距離Appearance of foam sprinkler and distance from surrounding obstacles or protection objects泡沫消火栓、泡沫炮、泡沫產生器、泡沫比例混合器外觀Appearance of foam hydrant, foam gun, foam generator and foam proportioning mixer泡沫液貯罐外觀及罐間環境，泡沫液有效期及儲存量Appearance and environ

14、ment of foam tank;Validity date of foam liquid; storage capacity控制閥門外觀、標識，管道外觀、標識Appearance and identity plate of control valve and pipe 火災探測傳動控制、現場手動控制裝置外觀、運行狀況Appearance and operation status of fire detection drive control system and field manual control device 泡沫泵及控制柜外觀及運行狀況Appearance and operati

15、on status of foam pump and control cabinet 氣體滅火系統Gas fire extinguishing system氣體滅火控制器外觀、工作狀態Appearance and working state of gas extinguisher controller儲瓶間環境，氣體瓶組或儲罐外觀，檢漏裝置外觀、運行狀況Environment of the storage tank;Appearance of the gas cylinder or storage tank;Appearance and operation state of the leak

16、detector.容器閥、選擇閥、驅動裝置等組件外觀Appearance of components such as container valves, selector valves and driving devices緊急啟/停按鈕外觀，噴嘴外觀、防護區狀況Appearance of emergency start/stop button and nozzle; Condition of protection area 預制滅火裝置外觀、設置位置、控制裝置外觀及運行狀況Appearance of pre-fabricated fire extinguishing system; sett

17、ing position; appearance and operation state of control device放氣指示燈及警報器外觀Appearance of gas release indicator light and alarm 低壓二氧化碳系統制冷裝置、控制裝置、安全閥等組件外觀、運行狀況Appearance and operation state of components such as refrigeration devices, control devices and safety valves for low pressure carbon dioxide sy

18、stems防煙、排煙系統Smoke prevention and exhaust system送風閥外觀Appearance of air supply valve 送風機及控制柜外觀及工作狀態Appearance and working state of air blower and control cabinet 擋煙垂壁及其控制裝置外觀及工作狀況、排煙閥及其控制裝置外觀The appearance and working state of smoke retaining wall and its control device; the appearance of smoke exhaus

19、t valve and its control device電動排煙窗、自然排煙設施外觀Appearance of electric smoke window, natural smoke exhaust facilities排煙機及控制柜外觀及工作狀況Appearance and working state of smoke exhauster and control cabinet送風、排煙機房環境Appearance and working state of smoke exhauster and control cabinet應急照明和疏散指示標志Emergency lighting

20、and evacuation indicator應急燈具外觀、工作狀態Appearance and working state of emergency lamps and lanterns疏散指示標志外觀、工作狀態Appearance and working state of the evacuation indicator集中供電型應急照明燈具、疏散指示標志燈外觀、工作狀況，集中電源工作狀態Appearance and working state of centralized power supply emergency lighting, evacuation indicator lig

21、hts;Working state of centralized power supply字母型應急照明燈具、疏散指示標志燈外觀、工作狀態The appearance and working state of letter type emergency lighting and evacuation indicating lights應急廣播系統Emergency broadcasting system揚聲器外觀Appearance of loudspeaker 功放、卡座、分配盤外觀及工作狀態The appearance and working state of power amplifie

22、r, cassette tape deck and distribution plate消防專用電話Firefighting telephone消防電話主機外觀、工作狀況Appearance and working condition of firefighting telephone host分機電話外觀，電話插孔外觀，插孔電話機外觀Appearance of the extension telephone; Appearance of telephone jack, the appearance of jack phone.防火分隔設施Fireproof facility防火窗外觀及固定情

23、況Appearance and fixation of fireproof windows防火門外觀及配件完整性，防火門啟閉狀況及周圍環境Fire door appearance and accessories integrity; Fire door opening and closing situation and surrounding environment電動型防火門控制裝置外觀及工作狀態Appearance and working condition of electric fire door control device防火卷簾外觀及配件完整性，防火卷簾控制裝置外觀及工作狀況Fi

24、re shutter appearance and accessories integrity; fire shutter control device appearance and working condition防火墻外觀Firewall appearance防火封堵外觀Fire prevention and closure appearance消防電梯Fire elevator緊急按鈕外觀，轎箱內電話外觀Emergency button appearance, telephone appearance in the elevator car電梯井排水設施外觀及工作狀況Appearanc

25、e and working condition of drainage facilities in elevator shaft消防電梯工作狀況Working state of fire elevator細水霧滅火系統Water mist fire-extinguishing system滅火控制器工作狀態Working state of the fire extinguisher controller; 儲氣瓶和儲水瓶（或儲水罐）外觀、工作環境Appearance and working environment of gas cylinders and water storage tank高

26、壓泵組、穩壓泵外觀及工作狀態，末端試水裝置壓力值（閉式系統）Appearance and working state of the high pressure pump group and the steady pressure pump;Pressure value of the terminal water test device (closed system)緊急啟/停按鈕、釋放指示燈、報警器、噴頭、分區控制閥等組件外觀Appearance of emergency start/stop button, indicator of release, alarm, sprinkler, pa

27、rtition control valve and other components 防護區狀況Condition of protection zone 干粉滅火系統Dry powder fire extinguishing system滅火控制器工作狀態Working state of the fire extinguisher controller設備儲存間環境、驅動氣瓶和滅火劑儲存裝置外觀Equipment storage room environment; appearance of driving cylinder and extinguisher storage device 選擇閥、驅動裝置等組件外觀Appearance of selector valves and driving devices緊急啟/停按鈕