ULC Report — Graham Alarm Monitoring

Building Name

Building Address

System Number

Monitoring System Description

Alarm Signal Transmitter Manufacture Model Number

Equipment Listing Number

Fire Signal Receiving Centre Name

Fire Signal Receiving Centre Phone Number

1. This is to certify that the monitored system has been tested and inspected in accordance with CAN ULC-5561, Standard for Installation and Services for Fire Signal Receiving Centres and Systems Section 11, Periodic Inspections and Tests, and these records document the results of testing performed.

3. Comments

4. A copy of this report will be given to the owner or representative for this building.

Name of Service Personnel Conducting Test

Signal Transmitting Unit Test — YES - Tested Correctly || NO - Did NOT Test Correctly || N/A - Feature NOT available

Signal Transmitting Unit — YES - Tested Correctly || NO - Did NOT Test Correctly || N/A - Feature NOT available

Power Supply Inspection — YES - Tested Correctly || NO - Did NOT Test Correctly || N/A - Feature NOT available

Primary A/C Supply Voltage At The Output Of The Power Transformer

Annual Battery Inspection Report

Type Of Battery Used

Battery Charging Voltage Reading

Battery Charging Current Reading

Battery Voltage With Primary Power Off

Current Draw From Battery Power Off

Measured Ah Rating Battery 1

Measured Ah Rating Battery 2

Total Ah Measured

Ah Rating Required (Total Ah measured x 24hrs)

Battery 1 Manufactured Date

Battery 2 Manufactured Date