Security Smoke Screen Inspection Checklist Form
Complete this checklist to record the condition, test results, and follow-up actions for a security smoke screen inspection.
Inspection Details
Inspection Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspection Time
*
Hour Minutes
AM
PM
AM/PM Option
Site / Location Name
*
Inspecting Person or Team Name
*
First Name
Last Name
Smoke Screen System Identifier / Asset Tag
*
Inspection Type
*
Routine
Post-Incident
Corrective Follow-Up
Smoke Screen Checklist
Power / Supply Status
*
Pass
Fail
Needs Attention
Activation Test Result
*
Pass
Fail
Needs Attention
Smoke Output Effectiveness
*
1
2
3
4
5
Coverage / Distribution and Control Panel Indicators
*
Rows
Pass
Fail
Needs Attention
Coverage / Distribution
1
2
3
Control Panel Indicators
4
5
6
Faults or Alarms Observed
No faults or alarms
Low power warning
Panel fault indicator
Activation fault
Smoke output issue
Coverage issue
Other
Inspection Outcome and Follow-Up
Overall Inspection Result
*
Pass
Pass with Notes
Fail
Defects or Issues Found
Corrective Action Required
*
Yes
No
Next Inspection Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit
Should be Empty: