Spillane Fire Protection Request Form
Name
Company
Title
Address
City/State
Phone
Fax
E-Mail
Please tell us about your company's Fire Sprinkler System
1. What is your Fire Sprinkler System Inspection Frequency?
Annual
Bi-Annual
Quarterly
2. What Fire Sprinkler System do you have?
WET
Dry
Other
3. How many RISERS does the system have?
4. Do you have an Anti-Freeze Loop?
Yes
No
5. Do you have an Electric/Diesel Fire Pump?
Yes
No
6. How many backflows do you have?
7. Do you have more than 1 location?
Yes
No
8. If Yes, the Location:
9. Do you have any immediate inspection need for:
Fire Alarm
Yes
No
Fire Extiguisher
Yes
No
Emergency Lighting
Yes
No
