医院建筑消防设施巡查记录表

1、XXX医院建筑消防设施巡查记录表巡杳 项目巡杳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

2、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

3、注注1情况正常的打“V”，存在问题或故障的打“ X”；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:建筑消防设施巡杳记录表序号: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T八态、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

4、传输装置外观及运行b.、/r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

5、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

6、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、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

7、中供电型应急照明灯具、疏散指示标志灯外观、工作状况，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622条储气瓶和储水瓶（或储水罐）外观、工作环境高压泵组、稳压

8、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“X”，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

9、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In specti on record table for build ing fire protecti on facilities序号:NO:巡查项目item巡查内容content巡查情况Situati on部位Part数量Qty.正常Normal故障及处理Fault故障描述Descripti on当场处理情况On-site handlingstate报修情况Repair消防供配电设施Fire power supply anddistributio n消防电源主电源、备用电源工作状态Status of main

10、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

11、 automatic alarmsystem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 CRTgraphic display消防联动控制器外观及运行状况Appearanc

12、e 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

13、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

14、 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 supplyfacilities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 andoperation status of water level display device;Level, volume and

15、 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

16、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Firehydra nt(Firemon itor) system室内消火栓、消防卷盘外观及配件完整情况Appearance and a

17、ccessories 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 firehydrant, environment of fi

18、re 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Automaticsprinklersystem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

19、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 e

20、quipment 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 devic

21、e on floors/in areas泡沫灭火系统Foam exti nguisher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 foamproportioning 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 env

22、ironment 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 opera

23、tion status of foam pump and control cabinet气体灭火系统Gas fire extinguishingsystem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

24、detector.容器阀、选择阀、驱动装置等组件外观Appearance of components such as container valves, selector valvesand 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; settin

25、gposition; 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 system

26、s防烟、排烟系统Smokepreve nti onand 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 valv

27、e 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Emerge ncylight ingandev

28、acuati onin dicator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;W

29、orking 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 lightingand evacuation indicating lights应急广播系统Emerge ncy broadcasti ng 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, ca

30、ssette tapedeck 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

31、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 appear

32、ance and accessories integrity; fire shutter controldevice 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 condit

33、ion 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Watermistfire-exti nguish ing 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

34、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Drypowderfire灭火控制器工作状态Working state of the fire