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[]
["IMPAIRMENT NOTIFICATION FORM"]
["IMPAIRMENT AND RESTORATION NOTIFICATION FORM OF SAFETY AND SECURITY SYSTEMS"]
["Company:",null,null,"Contact person:"]
["Location address:",null,null,"Email address:"]
["Town:",null,null,"Telephone #:"]
["Instructions"]
[1,"Impairment: Please fill out Part A of this form and submit using the button above or to:",null,null,null,"impairments@inspiredsolutions.ch"]
[2,"Restoration: Please fill out Part B of this form and submit using the button above or to:",null,null,null,"impairments@inspiredsolutions.ch"]
[]
["PART A: NOTIFICATION OF IMPAIRMENT"]
["Date of the notification (DD/MM/YYYY):"]
["Date of the anticipated impairment (DD/MM/YYYY):"]
["Duration of the anticipated impairment:",null,null,"Days           Hours"]
["Date of the anticipated restoration (DD/MM/YYYY):"]
["Indicate the type of system(s) impaired:"]
[null,"Sprinkler system",null,null,"Automatic fire detection system"]
[null,"Fire pump",null,null,"Automatic fire alarm transmission"]
[null,"Fire water storage tank / basin / reservoir",null,null,"Intrusion detection system"]
[null,"Sprinkler deluge system",null,null,"CCTV system"]
[null,"Fixed automatic fire extinguishing system",null,null,"Other (please describe)"]
[null,"Private hydrant system"]
[null,"Public fire water supply"]
["Describe the reason(s) for the impairment."]
[]
[]
["Describe the specific area at the facility impacted by the impairment, including the present acivities in this area."]
[]
[]
["Additional safety precautions being taken during the impairment period."]
[null,"Fire brigade notified",null,null,"Non-smoking policy enforced"]
[null,"Private alarm station notified",null,null,"No hot works allowed"]
[null,"Management notified",null,null,"Emergency alarm transmission implemented"]
[null,"Fire watch present",null,null,"24 hour watchmen service implemented"]
[null,"Hazardous operations temporary terminated",null,null,"Other (please describe)"]
[null,"Additional fire fighting equipment ready"]
[null,"Fire blankets"]
["PART B: NOTIFICATION OF RESTORATION"]
["Date of restoration (DD/MM/YYYY):"]
["Are all impaired systems fully restored and operational",null,null,"Yes                                      No"]
["If 'No', please describe which elements are still impaired and what actions will be taken to restore the system."]
[]
[]
["Comments (please describe any relevant information or circumstances related to the impairment)."]