Sprinkler Impairment Notification

School Board
Location Name
Location Address
Name of Person Responsible
Email Address
Copy To
Phone Number

Fire Protection Information

Type of Protection
Valve Number/Equipment Identifier
Area Protected
Reason for Impairment
Number of Turns to Close
Authorized By
Fire Protection Equipment Operator

Precautions Taken

Emergency organization notifiedContinuous work authorizedPublic fire department notifiedOngoing patrol of areaHazardous operations stoppedHydrant connected to sprinkler riserHot work prohibitedPipe plugs on handSmoking restrictedFire hose laid outOther