Appendix 1

NOTIFICATION OF INTERRUPTION

OF

FIRE ALARM OPERATION

From:.………………..Position: ……….……………Date: ……….....

The following system or parts of will be disconnected due to breakdown/modification:-

From:(date)……………………to (time) ………………………….

To:(date)……………………to (time)…………………..………

The areas affected are;

HospitalVilla/Ward/Department

During the above period, I, the Nominated Officer (Fire) for the site shall ensure that a plan of action is in place during the interruption in the areas affected.

Signed:………………………………….

Nominated Officer for Fire

Date:…………………………….

Copy of this document to be given to Competent Person to ensure time scale and areas approved

Appendix B

Modification Certificate

Certificate of modification for the fire alarm system at:

Address:……………………………………………………………………………………………………………………………………………………………………………I/We being the competent person(s) responsible (as indicated by my /our signatures below) for the modification of the fire alarm system, particulars of which are set out below, CERTIFY that the said modification work for which I/we have been responsible has to the best of my/our knowledge and belief been carried out in accordance with the recommendations of 46.4 of BS 5839 – 1:2002, except for the variations, if any, stated in this certificate.

Name (in block letters):……………………………… Position:……….………………

Signature: ………………………………………………….. Date:……………………..

For and on behalf of: …………………………………………………………………….

Address:……………………………………………………………………………………

………………………………………………………………………………………………

……………………………………………. Postcode: ………………………………….

The extent of liability of the signatory is limited to the system described below.

Extent of system covered by this certificate:

………………………………………………………………………………………………………………………………………………………………………………………………

Variations from the recommendations of 46.4. of BS 5839-1:2002: ………………..

………………………………………………………………………………………………

………………………………………………………………………………………………

………………………………………………………………………………………………

Following the modifications, the system has been tested in accordance with the recommendations of 46.4.2. of BS 5839-1:2002.

Following the modifications, “as fitted” drawings and other system records have been updated as appropriate.

I/we the undersigned confirm that the modifications have introduced no additional variations from the recommendations of BS 5839-1:2002, other than those recorded below:

Signed: ………………………………………………………………………………….

Capacity: ………………………………………………………………………………..

(e.g. maintenance organization, system designer, consultant or user representative)

Appendix C

Fire hazard rooms and areas and hazard departments

Examples of fire hazard rooms and areas:

  • Chemical stores;
  • Cleaner’s rooms;
  • Clothes storage;
  • Dayrooms;
  • Disposal rooms;
  • Laboratories;
  • Lift motor rooms;
  • Linen stores;
  • Patient bedrooms provided for:
  • those suffering a mental illness;
  • people with learning difficulties;
  • Relatives’ overnight rooms;
  • Staff changing and locker rooms;
  • Staff (overnight) on-call rooms;
  • Store rooms;
  • Ward kitchens;
  • X-ray film and record stores;
  • All rooms within the main laundry in which delivery,sorting, processing, packing and storing are carriedout.

The following are hazard departments:

  • Atrium;
  • Boilerhouse;
  • Central staff change;
  • Central stores;
  • Commercial enterprises;
  • Central sterile supplies or healthcare sterilizing anddisinfecting unit;
  • Flammable store;
  • Health records;
  • Laundry;
  • Main electrical switchgear;
  • Main kitchens;
  • Main stores;
  • Medical gas stores;
  • Pathology;
  • Pharmaceutical (manufacturing);
  • Refuse collection/incineration;
  • Works.

This list is neither exhaustive nor comprehensive. Theresponsibility is upon the designer to assess the level offire risk in any location.

1

Northumberland, Tyne and Wear NHS Foundation Trust

E-PGN-07- Management of Fire Detection-Alarm Installations –Appendix 1 - Notification of Interruption of Fire Alarm OperationV01-Iss 2 – Nov17

Part of NTW(O)32 – Estates Operations and Maintenance Policy – V01