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Customer Royal London New Build Fire Compliance 2021 Project 15 Fire and Smoke Dampers Asset RLS-014-M-V-FID-035 Survey Date March 24, 2021 Surveyor Name Mariant Ninis Door Status: Compliant Fault Checklist 1. Damper Opens PASS 2. Damper can be closed PASS 3. Damper can be reset PASS 4. Access Hatch Present/Operational PASS 5. Actuator Functional PASS 6. Clean/Lubricate Operational Moving Parts PASS 7. Fusible Link PASS 8. Damper Free from Dirt, Dust and Debris PASS 9. Damper Replacement PASS Remedial Works Required Fire Survey Door Report

Door Status: Compliant

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Page 1: Door Status: Compliant

Customer Royal London New Build Fire Compliance 2021

Project 15 Fire and Smoke Dampers

Asset RLS-014-M-V-FID-035

Survey Date March 24, 2021

Surveyor Name Mariant Ninis

Door Status: Compliant Fault Checklist

1. Damper Opens PASS

2. Damper can be closed PASS

3. Damper can be reset PASS

4. Access Hatch Present/Operational PASS

5. Actuator Functional PASS

6. Clean/Lubricate Operational Moving Parts PASS

7. Fusible Link PASS

8. Damper Free from Dirt, Dust and Debris PASS

9. Damper Replacement PASS

Remedial Works Required

Fire Survey Door Report

Page 2: Door Status: Compliant

This door was surveyed by an FDIS qualifiedsurveyorSurveyor Name Surveyor Signature Date

Page 3: Door Status: Compliant

Mariant Ninis March 24, 2021

This fire door was inspected on the date shown and this report is based on the condition of the door onthat day only

Repair Priority Category Definition1 – Most Urgent5 – Least Urgent

Damage Category Definition:

1. Impact Damage2. End of Lifecycle3. Excessive Use4. Modification5. Incorrect Installation6. Construction Defect7. Other