消防系统中断申请书
Fire Protection Impairment Application Form
Location地点：
Site Impairment Coordinator消防系统中断负责人：
The Following Impairment此项消防系统中断：□ Planned 已计划□ Emergency 紧急
was initiated at中断工程开始于：Date(年/月/日)Time（时/分）expected corrected by预计结束于： Date(年/月/日)Time（时/分）
Type of Impairment中断种类：
□ Sprinkler Systerm喷淋系统
□ Fire Pump 消防泵
□ Water Supply 供水系统
□ Special Extinguishing Systerm 其他特设消防系统
□ Smoke or Heat Detection Systerm 火警探测系统
□ Alarm Systerm 警报系统
□ Underground Piping 地下喉管
□ Other 其他消防装置：
Describe详细描述：
The Following Precaution have been taken to minimize the potential for lo during the impairment 为了减少火警危害，当修补防火装置时，已执行如下措施:
□ Fire Protection Impairment Tag on systerm 使用消防系统中断许可证
□ Department Supervisons Notified 通知受影响范围的部门主管：
□ Fire Doors in Area Have Been closed or verified as operable 测试防火门，确保有效
□ Hazardous Operation Discontinued 停止危险作业
□ Combusibles Removed form Area 移除可燃物品
□ Hot Work Operation Discontinued 停止高温作业
□ Safety Department Notified通知公司安全部门：
□ Fire Station Notified 通知公司消防队：
□ Fire Department Notified 通知当地消防机构
□ Fire Watch Established(Hourly/Continuous) 安排每小时/长期火警巡查
Impairment Application Form Completed by(申请人):
Reviewed by(审核人):
Approved by(核准人)：
