NYC 9/11 Public Portal Document
Candidate
Instructions to Inspector—If any asterisk (*) items are marked “NO”, terminate the test immediately. See Section VIII for YES NO N/A
further information:
V. Fire Emergencies and Class E. System Operations (if system inoperative, see Comments VII);
Examiner—Read this statement to the candidate “You are the Fire Safety Director of the building. You receive notice during normal
operational hours that an actual fire is occurring above on a floor in this building. Explain all steps of what actions must be taken. /\gain
make no assumptions of any actions taken and start at the beginning.”
Did FSD have ^wledge to:____________
*A. Rep
Yes
Fire Command?
No □
B. Check
YesB^
ird status?
No □ N/A □
*C. Noth
Yes-
'Department?
No □
D. Send runngpto Alarm Box?
YeU3-^o □ 3
*E. Make contact witji, floor Wardens on fire floor
immediately ablM?
* F. Make announcements on
PA System?
Yes 0^0 □
G. Record information—all?
Ye^z0^No □
3
No □ N/A □ N/A □
*H. Evacua Kre floor and floor above? I. InstrurtFJfi/ to re-contact in safe area? *J. Activate,jifd brigade?
Yes S' No □ Yes0 No □ Yes'Q No □
*K. Ensure irs recall? L. Shut do^A/C? M. Keeplobgy-clear and entrance doors unlocked?
Yes 0 No □ N/A □ Yes a No □ N/A □ Yes-B"^ No □ 3
* N. Reset Notification System or if System O. Perform—Make available Fire Safety Plan, *P. Describe—Silence Alarm?
out-of- ice? Floor Plans, 'neer to NYCFD?
Yes^ No □ N/A □ Yes □ No Yes No □ N/A □
*Q. Perform—The FSD Candidate uses the PA System on one floor states “This is only a test of ’.A. System. The Floor Warden /
should call back on the Floor Phone immediately to confirm that this message is clear.” yes E No □ n/aQ
TOTAL (17)
VI. Building
Instructions to Examiner—Verify all information stated by the candidate by comparison with the Fire Safety Plan or visual inspection. A “NO” answer
does not mandate failure.
ELEVATOR—(Page 13, O 7 of F.S. Guidelines): Special Extinguishing System (P. 14, Q. 2) & Lighting Equipment (P. 15, Q. 16)
Does candidate know location/type of: of F.S. Guidelines:
A. Elevators with common shafts? .................... Yes 13'^ □ N/A □ Does candidate know location/type of:
Yes □ No □ N/A<Q^
B. Elevator machinery room? ............................. Yes D-lio □ N/A □ A. Special extinguishing systems within building?
C. Operation of control necessary to deactivate B. Extinguishing systems location(s)?.............. Yes □ No □ N/aCJ
□ N/A □
"Ho □
elevator circuits?............................................. Yes S^o C. Auxiliary sources of lights or power?.......... Yes □ No □ N/A0r
D. Identification of elevators and elevator bank? Yes □ NO.0N/A □
Yes 0^0 □ N/A □ Standpipe systems (P. 14, Q. 10) of F.S. Guidelines:
E. Firemen's service elevators?
Does candidate know location/type of:
Yes •0^0 □ N/A □
Air Conditioning and Heating—(Page 15, of F.S. Guidelines):
A. Risers and control valves? ..........................
A. Type of air conditioning system?.................. Yos'^0No El N/A El YesS^No □ N/A □
B. Zones serviced by systems?........................... Yes-0^0 □ N/A □ B. Procedure should system become inoperable?
C. Pump rooms? ............................................... YesB^NoD N/aD
C. Controls to activate movement?.................... Yes- o □ N/A □ Yes S^ No □ N/A □
D. Water supply controls? .................................
D. Electronic automatic detection controls? .... Yes o □ n/aD
E. Type, location and controls of heating systems? Yes
F. Smoke shaft location and operation? Yes LJ
□ n/aO
No □ N/A □
Stairways (R 13, Q. 5) of F.S. Guidelines;
Does candidate know location/type of;
4+^
A. Identification/location?.........................
Yes 0'^ □ N/A □
Sprinkler System (Page 14 Q 11) of F.S. Guidelines:
Does candidate know location/type of; B. Floors served?..................................... Yes ts: □ N/A □
A. Automatic or non-automatic systems? N/A L C. Pressurized stairs? ............................. Yes0 □ N/A □
N/A □
B. Main shut off?....................................
N/A E
D. Access stairs (Open or Closed)? .... No □ N/A □
C. Valves each floor? ......................................... Yes
D. Valves for more than one floor?.................... Yes N/A E Other (Special Features, i.e. Atrium) (write
E. Area controlled by sprinkler system?............ Yes N/A E question);
F. Primary source of water? ............................... Yes N/A E
G. Fire pump? ..................................................... Yes 'No N/A E
A. Yes □ No □ N/A JS*”
H. Six (6) extra sprinkler heads and wrench? .. Yes No N/A E
Alarm System: B_____ Yes □ No □ N/A
Does candidate know location/type of:
A. Various alarm sending station? . ■ Yes o □ n/aD
C. Yes □ No □ N/aCT”
B. Various Warden phones?............ Yes □ N/A □
C. Street fire alarm box?.................. Yes No □ N/A □
TOTAL (22) 3
Yes
Z2No N/A
TOTAL (11)
Yes No N/A
Section C: (V, VI) 12 or more answered “NO” in Section C fails. SECTION C TOTAL (S3)
Number of correct answers in this section is I. Number of incorrect answers is . Number of N/A answers is
NYC-WTC_000168871
OCR can misread numbers and units. Confirm readings against the page image before using them.