医院建筑消防设施巡查记录表.doc

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XXX医院建筑消防设施巡查记录表巡查项目巡查内容巡查情况正常故障故障原因及处理情况消防供配电设施消防电源工作状态自备发电机状况火灾自动报警系统火灾报警探测器外观区域显示器运行状况、CRT图形显示器运行状况、火灾报警控制器、消防联动控制器外观和运行状况手动报警按钮外观火灾警报装置外观消防控制室工作环境消防供水设施消防水池外观消防水箱外观消防水泵及控制柜工作状态稳压泵、增压泵、气压水罐工作状态水泵接合器外观、标识管网控制阀门启闭状态泵房工作环境消火栓灭火系统室内消火栓外观室外消火栓外观消防炮外观启泵按钮外观自动喷水灭火系统喷头外观报警阀组外观末端试水装置压力值气体灭火系统气体灭火控制器工作状态储瓶间环境气体瓶组或储罐外观选择阀、驱动装置等组件外观紧急启/停按钮外观气体灭火系统放气指示灯及警报器外观喷嘴外观防护区状况防烟排烟系统挡烟垂壁外观送风阀外观送风机工作状态排烟阀外观电动排烟窗外观自然排烟窗外观排烟机工作状态送风、排烟机房环境应急照明和疏散指示标志应急灯外观应急灯工作状态疏散指示标志外观疏散指示标志工作状态应急广播系统扬声器外观扩音机工作状态防火分隔设施防火门外观防火门启闭状况防火卷帘外观防火卷帘工作状态消防电梯紧急按钮外观轿厢内外观消防电梯工作状态灭火器灭火器外观设置位置状况巡查人（签名）年月日消防安全管理人（签名）年月日备注注1：情况正常的打“√”，存在问题或故障的打“×”；注2：对发现的问题应及时处理，当场不能处置的要填报《建筑消防设施故障处理记录表》附件3：建筑消防设施巡查记录表序号：巡查项目巡查内容巡查情况部位数量正常故障及处理故障描述当场处理情况报修情况消防供配电设施消防电源主电源、备用电源工作状态发电机启动装置外观及工作状态消防配电房、UPS电池室、发电机房环境消防设备末端配电箱切换装置工作状态火灾自动报警系统火灾探测器、手动报警按钮、信号输入模块、控制模块外观及运行状态火灾报警控制器、火灾显示盘、CRT图形显示器运行状况消防联动控制器外观及运行状况火灾报警装置外观建筑消防设施远程监控、信息显示、信息传输装置外观及运行状况系统接地装置外观消防控制室工作环境电气火灾监控系统电气火灾监控探测器的外观及工作状态报警主机外观及运行状态可燃气体探测报警系统可燃气体探测器的外观及工作状态报警主机外观及运行状态消防供水设施消防水池、消防水箱外观，液位显示装置外观及运行状况，天然水源水位、水量、水质情况，进户管外观消防水泵及控制柜工作状态稳压泵、增压泵、气压水罐及控制柜工作状态水泵接合器外观、标识系统减压、泄压装置、测试装置、压力表等外观及运行状况管网控制阀门启闭状态泵房照明、排水等工作环境消火栓（消防炮）灭火系统室内消火栓、消防卷盘外观及配件完整情况屋顶试验消火栓外观及配件完整情况、压力显示装置外观及状态显示室外消火栓外观、地下消火栓标识、栓井环境消防炮、炮塔、现场火灾探测控制装置、回旋装置等外观及周边环境启泵按钮外观自动喷水灭火系统喷头外观及距周边障碍物或保护对象的距离报警阀组外观、试验阀门状况、排水设施状况、压力显示值充气设备及控制装置、排气设备及控制装置、火灾探测传动及现场手动控制装置外观及运行状况楼层或区域末端试验阀门处压力值及现场环境，系统末端试验装置外观及现场环境泡沫灭火系统泡沫喷头外观及距周边障碍物或保护对象距离泡沫消火栓、泡沫炮、泡沫产生器、泡沫比例混合器外观泡沫液贮罐外观及罐间环境，泡沫液有效期及储存量控制阀门外观、标识，管道外观、标识火灾探测传动控制、现场手动控制装置外观、运行状况泡沫泵及控制柜外观及运行状况气体灭火系统气体灭火控制器外观、工作状态储瓶间环境，气体瓶组或储罐外观，检漏装置外观、运行状况容器阀、选择阀、驱动装置等组件外观紧急启/停按钮外观，喷嘴外观、防护区状况，预制灭火装置外观、设置位置、控制装置外观及运行状况放气指示灯及警报器外观低压二氧化碳系统制冷装置、控制装置、安全阀等组件外观、运行状况防烟、排烟系统送风阀外观送风机及控制柜外观及工作状态挡烟垂壁及其控制装置外观及工作状况、排烟阀及其控制装置外观电动排烟窗、自然排烟设施外观排烟机及控制柜外观及工作状况送风、排烟机房环境应急照明和疏散指示标志应急灯具外观、工作状态疏散指示标志外观、工作状态集中供电型应急照明灯具、疏散指示标志灯外观、工作状况，集中电源工作状态字母型应急照明灯具、疏散指示标志灯外观、工作状态应急广播系统扬声器外观功放、卡座、分配盘外观及工作状态消防专用消防主机外观、工作状况分机外观，插孔外观，插孔机外观防火分隔设施防火窗外观及固定情况防火门外观及配件完整性，防火门启闭状况及周围环境电动型防火门控制装置外观及工作状态防火卷帘外观及配件完整性，防火卷帘控制装置外观及工作状况防火墙外观防火封堵外观消防电梯紧急按钮外观，轿箱内外观电梯井排水设施外观及工作状况消防电梯工作状况细水雾灭火系统灭火控制器工作状态，火灾探测部分巡查内容见6.2.2条储气瓶和储水瓶（或储水罐）外观、工作环境高压泵组、稳压泵外观及工作状态，末端试水装置压力值（闭式系统）紧急启/停按钮、释放指示灯、报警器、喷头、分区控制阀等组件外观防护区状况干粉灭火系统灭火控制器工作状态，火灾探测部分巡查内容见6.2.2条设备储存间环境、驱动气瓶和灭火剂储存装置外观选择阀、驱动装置等组件外观紧急启/停按钮、放气指示灯、警报器、喷嘴外观防护区状况灭火器灭火器外观设置位置状况其他设施巡查人（签名）年月日消防安全管理人（签名）年月日备注注：1、情况正常打“√”，存在问题或故障的打“×”，并填写“故障及处理”栏中相关内容； 2、对发现的问题和故障应及时处理，当场不能处置的要填报《建筑消防设施故障维修记录表》； 3、本表为样表，单位可根据建筑消防设施实际情况和巡查时间段制表。附件C1：Annex C1 建筑消防设施巡查记录表 Inspection record table for building fire protection facilities 序号： NO: 巡查项目 item 巡查内容 content 巡查情况 Situation 部位 Part 数量 Qty. 正常 Normal 故障及处理 Fault 故障描述 Description 当场处理情况 On-site handling state 报修情况 Repair 消防供配电设施 Fire power supply and distribution 消防电源主电源、备用电源工作状态 Status of main power and standby power 发电机启动装置外观及工作状态 The appearance and working state of the generator starting device 消防配电房、UPS电池室、发电机房环境 The environment of power distribution room, UPS battery room, generator room 消防设备末端配电箱切换装置工作状态 Working status of power distribution switch box for firefighting equipment 火灾自动报警系统 Fire automatic alarm system 火灾探测器、手动报警按钮、信号输入模块、控制模块外观及运行状态 The appearance and operation state of fire detector, manual alarm button, signal input module and control module. 火灾报警控制器、火灾显示盘、CRT图形显示器运行状况 Operation status of fire alarm controller, fire display panel and CRT graphic display 消防联动控制器外观及运行状况 Appearance and operation status of fire linkage controller 火灾报警装置外观 Appearance of fire alarm device 建筑消防设施远程监控、信息显示、信息传输装置外观及运行状况 Appearance and operation status of remote monitoring, information display and information transmission device for building fire facilities 系统接地装置外观 System appearance of grounding device 消防控制室工作环境 Work environment of fire control room 电气火灾监控系统Electric fire monitor system 电气火灾监控探测器的外观及工作状态 Appearance and working state of electric fire detector 报警主机外观及运行状态 Appearance and working state of the alarm host 可燃气体探测报警系统Combustible gas detection and alarm system 可燃气体探测器的外观及工作状态 Appearance and working state of combustible gas detectors 报警主机外观及运行状态 Appearance and working state of the alarm host 消防供水设施 Fire water supply facilities 消防水池、消防水箱外观，液位显示装置外观及运行状况，天然水源水位、水量、水质情况，进户管外观 Appearance of fire water pool and fire water tank, appearance and operation status of water level display device; Level, volume and quality of natural source of water; Appearance ofwater pipe 消防水泵及控制柜工作状态 Working state of fire pump and control cabinet 稳压泵、增压泵、气压水罐及控制柜工作状态 Working state of steady pressure pump, booster pump, pneumatic water tank and control cabinet 水泵接合器外观、标识 Appearance and identity plate of pump connector 系统减压、泄压装置、测试装置、压力表等外观及运行状况 Appearance and working state of pressure reduce/relief system, test devices, pressure gauges, etc. 管网控制阀门启闭状态 Opening and closing state of pipe control valve 泵房照明、排水等工作环境 Lighting and drainage of the pump house 消火栓（消防炮）灭火系统 Fire hydrant (Fire monitor) system 室内消火栓、消防卷盘外观及配件完整情况 Appearance and accessories integrity of indoor fire hydrant and fire reel 屋顶试验消火栓外观及配件完整情况、压力显示装置外观及状态显示 Appearance and accessories integrity of roof test hydrant; Appearance and status of pressure display device 室外消火栓外观、地下消火栓标识、栓井环境 Appearance of exterior hydrant, marking of underground fire hydrant, environment of fire hydrant chamber 消防炮、炮塔、现场火灾探测控制装置、回旋装置等外观及周边环境 The appearance and surrounding environment ofFire monitor, turret, field fire detection control device, gyratory device 启泵按钮外观 Appearance of pump button 自动喷水灭火系统Automatic sprinkler system 喷头外观及距周边障碍物或保护对象的距离 Appearance of sprinkler and the distance from the surrounding obstacles or protection objects 报警阀组外观、试验阀门状况、排水设施状况、压力显示值 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 充气设备及控制装置、排气设备及控制装置、火灾探测传动及现场手动控制装置外观及运行状况 Appearance and operation status of aerated equipment and control devices, exhaust equipment and control devices, fire detection drive and field manual control devices. 楼层或区域末端试验阀门处压力值及现场环境，系统末端试验装置外观及现场环境 Pressure value and field environment of terminal test valve on floors/in areas; Appearance and field environment of system terminal test device on floors/in areas 泡沫灭火系统 Foam extinguisher 泡沫喷头外观及距周边障碍物或保护对象距离 Appearance of foam sprinkler and distance from surrounding obstacles or protection objects 泡沫消火栓、泡沫炮、泡沫产生器、泡沫比例混合器外观 Appearance of foam hydrant, foam gun, foam generator and foam proportioning mixer 泡沫液贮罐外观及罐间环境，泡沫液有效期及储存量 Appearance and environment of foam tank; Validity date of foam liquid; storage capacity 控制阀门外观、标识，管道外观、标识 Appearance and identity plate of control valve and pipe 火灾探测传动控制、现场手动控制装置外观、运行状况 Appearance and operation status of fire detection drive control system and field manual control device 泡沫泵及控制柜外观及运行状况 Appearance and operation status of foam pump and control cabinet 气体灭火系统 Gas fire extinguishing system 气体灭火控制器外观、工作状态 Appearance and working state of gas extinguisher controller 储瓶间环境，气体瓶组或储罐外观，检漏装置外观、运行状况 Environment of the storage tank; Appearance of the gas cylinder or storage tank; Appearance and operation state of the leak detector. 容器阀、选择阀、驱动装置等组件外观 Appearance of components such as container valves, selector valves and driving devices 紧急启/停按钮外观，喷嘴外观、防护区状况 Appearance of emergency start/stop button and nozzle; Condition of protection area 预制灭火装置外观、设置位置、控制装置外观及运行状况 Appearance of pre-fabricated fire extinguishing system; setting position; appearance and operation state of control device 放气指示灯及警报器外观 Appearance of gas release indicator light and alarm 低压二氧化碳系统制冷装置、控制装置、安全阀等组件外观、运行状况 Appearance and operationstate of components such as refrigeration devices, control devices and safety valves for low pressure carbon dioxide systems 防烟、排烟系统 Smoke prevention and exhaust system 送风阀外观 Appearance of air supply valve 送风机及控制柜外观及工作状态 Appearance and working state of air blower and control cabinet 挡烟垂壁及其控制装置外观及工作状况、排烟阀及其控制装置外观 The appearance and working state of smoke retaining wall and its control device; the appearance of smoke exhaust valve and its control device 电动排烟窗、自然排烟设施外观 Appearance of electric smoke window, natural smoke exhaust facilities 排烟机及控制柜外观及工作状况 Appearance and working state of smoke exhauster and control cabinet 送风、排烟机房环境 Appearance and working state of smoke exhauster and control cabinet 应急照明和疏散指示标志 Emergency lighting and evacuation indicator 应急灯具外观、工作状态 Appearance and working state of emergency lamps and lanterns 疏散指示标志外观、工作状态 Appearance and working state of the evacuation indicator 集中供电型应急照明灯具、疏散指示标志灯外观、工作状况，集中电源工作状态 Appearance and working state of centralized power supply emergency lighting, evacuation indicator lights; Working state of centralized power supply 字母型应急照明灯具、疏散指示标志灯外观、工作状态 The appearance and working state of letter type emergency lighting and evacuation indicating lights 应急广播系统 Emergency broadcasting system 扬声器外观 Appearance of loudspeaker 功放、卡座、分配盘外观及工作状态 The appearance and working state of power amplifier, cassette tape deck and distribution plate 消防专用 Firefighting telephone 消防主机外观、工作状况 Appearance and working condition of firefighting telephone host 分机外观，插孔外观，插孔机外观 Appearance of the extension telephone; Appearance of telephone jack, the appearance of jack phone. 防火分隔设施 Fireproof facility 防火窗外观及固定情况 Appearance and fixation of fireproof windows 防火门外观及配件完整性，防火门启闭状况及周围环境 Fire door appearance and accessories integrity; Fire door opening and closing situation and surrounding environment 电动型防火门控制装置外观及工作状态 Appearance and working condition of electric fire door control device 防火卷帘外观及配件完整性，防火卷帘控制装置外观及工作状况 Fire shutter appearance and accessories integrity; fire shutter control device appearance and working condition 防火墙外观 Firewall appearance 防火封堵外观 Fire prevention and closure appearance 消防电梯 Fire elevator 紧急按钮外观，轿箱内外观 Emergency button appearance, telephone appearance in the elevator car 电梯井排水设施外观及工作状况 Appearance and working condition of drainage facilities in elevator shaft 消防电梯工作状况 Working state of fire elevator 细水雾灭火系统 Water mist fire-extinguishing system 灭火控制器工作状态 Working state of the fire extinguisher controller; 储气瓶和储水瓶（或储水罐）外观、工作环境 Appearance and working environment of gas cylinders and water storage tank 高压泵组、稳压泵外观及工作状态，末端试水装置压力值（闭式系统） 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) 紧急启/停按钮、释放指示灯、报警器、喷头、分区控制阀等组件外观 Appearance of emergency start/stop button, indicator of release, alarm, sprinkler, partition control valve and other components 防护区状况 Condition of protection zone 干粉灭火系统 Dry powder fire extinguishing system 灭火控制器工作状态 Working state of the fire extinguisher controller 设备储存间环境、驱动气瓶和灭火剂储存装置外观 Equipment storage room environment; appearance of driving cylinder and extinguisher storage device 选择阀、驱动装置等组件外观 Appearance of selector valves and driving devices 紧急启/停按钮、放气指示灯、警报器、喷嘴外观 Appearance of emergency start/stop button, indicator of release, alarm, sprinkler 防护区状况 Condition of protection zone 灭火器 Fire extinguisher 灭火器外观 Appearance of fire extinguisher 设置位置状况 Status of setting position 其他设施 Other facilities 巡查人（签名） Inspecting person (signature) 年月日 Date 消防安全管理人（签名） Fire Safety Manager (signature) 年月日 Date 备注 Remarks 注：1、情况正常打“√”，存在问题或故障的打“×”，并填写“故障及处理”栏中相关内容； Note: 1. If the situation is normal, put a tick. If not, put a cross and fill the‘Fault’ part. 2、对发现的问题和故障应及时处理，当场不能处置的要填报《建筑消防设施故障维修记录表》； 2, The problem/failure should be dealt with in time. If inspector cannot handle the problem/failure on-

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