Fire System Impairment Form

Safety procedures should be followed whenever it’s necessary to impair a fire protection system. Business owners should assign an individual as the impairment coordinator, responsible for:

  • Authorizing the shutdown of the fire protection system.
  • Ensuring that the impairment procedures are being followed closely.
  • Verifying that the system is back up and running after the work is completed.

Fill out the Impairment form below before you shut down your system, and then fill out the Restoration form when the project is complete.

Form Type
Impairment checklist
  • Inform key personnel
  • Inform fire department
  • Inform alarm company
  • Inform Arbella Insurance Company
  • Shut down all hazardous operations
  • Prohibit hot work
  • Prohibit smoking
  • Supplement manual fire protection
  • Provide fire watch/patrol
Impairment Tag Removed
Restoration checklist
  • Verify all valves now open
  • Verify by test that system is now operable
  • Verify that alarm is restored
  • Notify fire department
  • Notify alarm company
  • Notify Arbella Insurance