Lancaster Technology and Development Corporation: Smoke Alarm Maintenance Checklist

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Lancaster Technology and Development Corporation

SMOKE ALARM MAINTENANCE CHECKLIST

Address/Suite Number: _______________________ __ Date:


________________
Smoke alarm has been tested as a result of:
□ routine test and maintenance □ extended absence of occupants
□ annual test and maintenance □ complaint
□ change of tenancy □ other

A. ROUTINE TEST AND MAINTENANCE YES NO


(1) Smoke alarm is securely fastened to the wall or ceiling. □ □
(2) Smoke alarm shows no evidence of physical damage, paint application, or
excessive grease and dirt accumulations. □ □
(3) Ventilation holes on the smoke alarm are clean and free of obstructions. □ □
(4) Smoke alarm signal sounds when the test device is operated. □ □
B. ANNUAL TEST AND MAINTENANCE YES NO
(1) Smoke alarm is securely fastened to the wall or ceiling. □ □
(2) Smoke alarm shows no evidence of physical damage, paint application, or
excessive grease and dirt accumulations. □ □
(3) Smoke alarm has been vacuumed. □ □
(4) Smoke alarm is powered by: □ AC wiring; □ standard battery; □ long life
battery that expires in the year . For battery operated smoke
alarms: □ □
Battery has been replaced and securely connected to the clips. □ □
Battery is of the type as recommended by
the manufacturer. □ □
Battery terminals are free of corrosion and signs of leakage.
(5) Smoke alarm signal sounds when the smoke alarm is tested using smoke
produced from a burning: □ incense stick, □ punk stick, or □ cotton string. □ □
C. SERVICING & REPLACEMENT (Complete this section if “No” is checked in sections A or B.)
Smoke alarm has been serviced as follows:

Smoke alarm has been replaced as a result of:


□ failure to sound alarm during test □ frequent false alarms
□ physical damage □ battery leakage
□ painted exterior case □ age
□ excessive stains, grease or dirt accumulations □ other

OVERALL REMARKS:
_________________________________________________________________________________________
_________________________________________________________________________________________

NAME: ________________________________
CONTRACTOR: ________________________________

SIGNATURE: ________________________________

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