FORM B

Bomba Fail : JBPM / IP / BKK : 700-2 / 1 / 7 / 39 (45)

APPLICATION AND CERTIFICATION FORM
FOR FIXED INSTALLATIONS AND FIRE ALARM SYSTEMS
(as prescribed in By Laws 245(3), 246)
Date :

To the Local Authority,

JABATAN BOMBA DAN PENYELAMAT, MALAYSIA
I (name of submitting person) : IR.WONG SIEW SHENG

I/C No : 710421-04-5491 of FIG CONSULTANCY SDN.BHD.

Hereby apply for approval to *install/supervise the installation of the *fixed installations/fire alarm
system as described hereunder and as shown on the drawings endorsed for this application which I have
designed in accordance with the current British Standard / BSCP / Malaysia Standards:-

Name of Owner : PRPC REFINERY AND CRACKER SDN BHD

Address of Premises of Installation/s : DI ATAS PLOT 31 (NO. KONTRAK: RAPID/CTC/

08-2013-P5) SEBAHAGIAN DARIPADA PROJEK BERSEPADU LOJI PENAPISAN MINYAK

DAN PETROKIMIA (RAPID), MUKIM PENGERANG, DAERAH KOTA TINGGI, JOHOR DARUL

TAKZIM.

Type and Nature of Installation/s : Fire Alarm System *

Wet Riser *
Dry Riser *
Hose Reel *
Other Fixed Installations *

Building Protected : a) 1 UNIT SUBSTATION DUA TINGKAT

b) 1 UNIT BANGUNAN FAR SATU TINGKAT
c) 9 UNIT PLATFORM BERBILANG TINGKAT
d) 1 UNIT PONDOK SATU TINGKAT
e) 10 UNIT TANGKI SIMPANAN

Number of Risers (*Wet/Dry) :

Number of pumping inlets :

Number of landing valves :

Number of Fire Alarm call points : 21 nos

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Number of indicator panels : 2 no

Location : Outside of FAR building and Outside of Substation

Fire Station link to : Main Fire Alarm Panel

Secondary Power Supply : Rechargeable Battery

Water Supplies : The following water supplies have been provided :-

Number of Fire Hydrant : 43 Minimum : 1365 l/min

Flow

Position / Location : Aboveground

JBA Main / Ring Main : Tap from Hydrant Pump Diameter : 300 mm

Private Reservoir (Type) : Capacity : Cubic meter (m³)

Rate of discharge/replenishment by Water Works Main :

Pump Motive power : Nominal Rating : lpm

Nominal Head : Drawing : Fire Water Tank

Water from

Comments (if any) and departures from British Standard / Malaysian Standard / NFPA / BSCP / CIFS
Regulation:-

Signature of submitting person

FOR OFFICIAL USE ONLY :-

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Date Received : Date Approved:

I, hereby certify that the *Fixed Installations/Fire Alarm System as described in the form of Application
and as shown on the approved drawings have been completed under my personal supervision and have
been tested to my satisfaction and as such, I would like to apply for your department endorsement for
issue of a completion certificate.

Date :
Signature of submitting person

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