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SYSTEM RECORD OF COMPLETION (continued) <br />9. NOTIFICATION APPLIANCES <br />Type Qua <br />Audible <br />Visible <br />Combination Audible and Visible Cl <br />10. SYSTEM CONTROL FUNCTIONS <br />f-fold-Open Door Releasing Devices <br />HVAC Shutdown <br />Fire/Smoke Dampers <br />Door Unlocking <br />Elevator Recall <br />Elevator Shunt Trip <br />11. INTERCONNECTED SYSTEMS <br />% This system does not have interconnected systems. <br />❑ Interconnected systems are listed on supplementary sheet <br />12. CERTIFICATION AND APPROVALS <br />12.1 System Installation Contractor <br />Description <br />This system s sp ci(icd herein has been installed according to all NFPA standards cited herein. Signed: Printed name: —ttk. Date: 1-6n• 1k • a3 r� <br />Organization: 5��1 Title: t-ESIo Phone: <br />12.2 System Operational Test <br />This system as . ectfi herein has tested according to all NFPA standards cited herein. <br />Signed: C Printed name:Date: • ay• �a 3 <br />Organization:Title: OaLS,',�� Phone:„�I 4ap� <br />12.3 Acceptance Test <br />Date and time of acceptance test: mk(Z, Lg <br />Installing contractor representative: <br />Testing contractor representative:E. <br />Property representative: <br />AHJ representative: <br />Copyright © 2012 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. <br />(p 3 of 3) <br />