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Fire Sprinkler Impairment Form - utdallas

Fire Sprinkler Impairment Form - utdallas 2025

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The document is an Environmental Health and Safety form for reporting fire sprinkler impairments at UT Dallas. It includes sections for detailing the sprinkler valve location, reason for impairment, planned closure time, and personnel information. It also provides emergency contact numbers and instructions to email the completed form.

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Click ‘Get Form’ to open it in the editor.
Begin by filling in the 'Sprinkler Valve Location' field. Clearly indicate where the valve is located to ensure proper identification.
Next, provide the 'Reason for Impairment'. This section is crucial for understanding why the sprinkler system is temporarily out of service.
In the 'Planned Time to Be Closed' field, specify when you expect the impairment to start. Accurate timing helps in planning and safety measures.
Fill in the 'Time Back in Service' section with an estimated time for when the system will be operational again.
Enter your company name in the designated field to identify who is responsible for this impairment.
Print your name in the 'Name of Person Working' field and provide your signature in the corresponding area to validate your involvement.
Lastly, have an authorized person print their name and date it before submitting. Ensure all fields are completed accurately.

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Got questions?

We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

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Fire Sprinkler Impairment Form - utdallas 2025

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