HomeMy WebLinkAboutFire Sprinkler Report 12/31/2007
"....t.Ne::;
AUTOMATIC SPRINKLER CO.
Setting The Sta.ndard...
1301 L'Orient Street
St. Paul, Minnesota 55117
(651) 558-3300 . (800) 229-6263
Fax: (651) 558-3310
SHEET 1 of 2 - Use separate sheet for each building inspected
MINNESOTA LICENSE NO. COOS
AGREEMENT AND REPORT OF INSPECTION
#INSPECTION
.....Il..'~<--......,\.:,
~".~~. '" I I
REPORT TO
STREET
CITY & STATE
e'b
\.-
I
L, ,f, ti.....
BUILDING OR LOCA nON
<, ,f. INSPECTOR
DATE
-c::......-
J{ \.. ~'''''~
P,..I \. ,'\ ~ l'(~'-~
i,K/7 f';'
';:'
'{!(or L,,"1k~
, 1./
i'l ? ;.,,(
( ') . ~, \
'- .J '
('I
Owner hires Viking Automatic Sprinkler Company to conduct an inspection of the fire suppression system at the above location or building, and
prepare a written report of that inspection for an agreed upon fee. As part of this agreement, owner agrees to terms and conditions on rear of form and
will complete the Owner's Section of this document.
Owner's Section (To be answered by Owner or Occupant)
A. Explain any occupancy hazard chan~es since the previous inspection: ,'1.'. :', Ii.<:
B. Describe fire protection modifications made since last inspection:
.~ II L 1 .;.' c.' '.1";"'" ('.J.> -, i V #-', I
f r
C. Describe any fires since last inspection: j/'I i .. ., e
.!,.. v';
D. When was the system pipin~ last checked for stoppa~e, corrosion or forei~n material? '.j !.. t C ;.' i,.:
E. When was thEt dfy-piping sY.'steullast checked for proper pitch? A .' I' \
F. Are dry valver;}dequately protected from freezing? A i' I)
.'~.. ' f
Signature \ l .}....7 Title Date
Inspector's Sectioq (All responses reference current inspection) N/A = NOT APPLICABLE
1 General
a. Is the building occupied?~l;'es I] No
b. Are all systems in service? )(Yes 0 No
c. Does there appear to be a nlmimum of 18 in. (457 mm) clearance between the top of the storage and the sprinkler deflectors?\<!:Yes [J No
d. Does the valve hose on the sprinkler system(s) appear to be satisfactory? 0 Yes n No ~ N/ A
2 Control Valves (See Item 15)
a. Do sprinkler system control valves appear to be in the appropriate open or closed positiont.,6 Yes 0 No
b. Are control valves in the open position locked, sealed or equipped with a tamper switch~es 0 No
3 Water Supplies (See Item 16) /
a. Was a water flow test of main drain made at the sprinkler riser(s)~ Yes 0 No
4 Tanks, Pumps, Fire Department Connections .
a. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? n Yes 0 No~/ A
b. Are fire department connections if! satisfactory condition, couplin~s free, caps in place, and check valves ti~t?'4 Yes n No 0 N/ A
Are they accessible and visible?)6 Yes 0 No 0 N/ A
5 Wet Systems '
a. Are cold weather valves (0.5. & Y.) in the appropriate open or clpsed position? 0 Yes 0 No \,.6 N/ A
b. Have antifreeze system solutions been tested? n Yes 0 No ~/ A
c. Were the antifreeze test results satisfactory? DYes D No ...~/ A
d. In areas protected bl wet system(s), does the building appear to be properly heated in all areas, including blind attics and perimeter areas
where accessible?)Q..Yes 0 No 0 N/ A Do all exterior openings appear to be protected against freezing"'R'Yes uNo 0 N/ A
6 Dry System (See Items 11 to 13), '
a. Are dry valves (s) in service? DYes 0 No ')6. N/ A
b. Are the air pressures and priming water levels in accordance with the manufacture's instructions? 0 Yes 0 No ';wQ N/ A
c. Has the operation of the air or nitrogen supplies been tested? eYes 0 No 't;J:N/ A Are they in service? rl Yes 0 No )oI.! N/ A
d. Were all know low points drained during this inspection? Cl Yes D No~N/ A
e. Did quick-openin~ devices operate satisfactorily? CJ Yes 0 No ~q,N/ A
f. Did the dry valve(s) trip properly durin~ the trip pressure test? [] Yes 0 No ")Q.N/ A
~. Did the heating equipment in the dry-pipe valve room(s) operate at time of inspection? 0 Yes [] No b(N/ A
7 Special Systems (See Item 14)
a. Did the deluge or pre-action valves operate properly during testing? [J Yes 0 No ~/ A
b. Did the heat-responsive devices operate properly during testing? DYes 0 No.;(N/ A
c. Did supervisory devices operate during testing? 0 Yes 0 NO\.<.1:J N/ A
8 Alarms
a. Did water motor(s) and gong(s) test satisfactorily? 0 Yes LJ No )Q:N/ A
b. Did electric alarm(s) test satisfactory?)p Yes 0 No 0 N/ A
c. Did supervisory alarm service test satisfactory? 0 Yes 0 No '\1=1 N / A
9 Sprinklers '.
a. Do visible sprinklers appear to be free from corrosion, loading or obstruction to spray discharge?~ Yes 0 No
b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing}Xq, Yes 0 No
c. Are quick response and residential sprinklers less than 20 years old? (Older sprinklers require sample testing) DYes D No'}b Nj A
d. Is stock of spare sprinklers available?"qYes D No
e. Does the exterior condition of sprinkler system appear to be satisfactory~ Yes D No
f. Do visible sprinklers appear to be of proper temperature rating for their locations~D Yes 0 No
10 Explain any "No" answers and comments:
\
,',
Signa hue:
(Rev. 2/8/06)
I ) '. ,~L_"7
I ..~..... /
Date:
, ;>
I (~
:>r
'"') I
L/
1301 L'Orient Street
St. Paul, Minnesota 55117
(651) 558-3300 . (800) 229-6263
Fax: (651) 558-3310
Inspection Report
.-"'" ".', --, '71
No. ,.,l.L,"" _I 1.::>
... -..
n Date dry-pipe valve trip tested (control valve partially open)
12 Date dry-pipe valve trip tested (control valve fully open)
13 Date quick-opening device tested
DRY VALVE
System No. or Description if multiple
4" .
systems b{~-r"
S~ ~EET 2 of 2 - Use separate sheet for each system inspected
(See Trip Test Table wllichf"llows)
(See Trip Test Table which f,'llows)
(See Trip Test Table which follows)
I
itA
)--.In
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
Time to Trip Water Air Trip Point lime Water Reached Alarm Operated
Thru Test Pipe Pressure Pressure Air Pressure Test Outlet Properly
MIN. SEC PSI PSI PSI MIN. SEC YES NO
Without
Q.O.D
With
Q.O.D
TRIP TEST TABLE
Q.O.D.
DRY PIPE
OPERATING
TEST
14 Date deluge or pre action valve tested
(See Trip Test Table which follows)
TRIP TEST TABLE
DELUGE &
PRE ACTION
VALVES
Operation I: PNEUMATIC iJ ELECTRIC o HYDRAULIC
Piping Supervised DYES I~ NO I Detecting Media Supervised DYES .. NO
Does valve operate from the manual trip and/ or remote control stations ] YES ] NO
Is there an accessible facility in each circuit for testing " YES o NO IMethod of Testing Circuits
Does each circuit operate Does each circuit Maxinlulll time to
MAKE MODEL supervision loss alarm operate valve release operate rell'as(~
YES I NO YES I NO YES I NO
I I I
l)V~
15 See Control Valve Maintenance Table
CONTROL VALVE MAINTENANCE TABLE
Explain
Abnormal
Control Valves Number Type Open Secured Closed Signs Condition
City Control Valves
Bypass Valves
Tank Control Valves
Pump Control Valves
Sectional Control Valves
System Control Valves 7':"l/" f)~1 '( - -- .-
Other Control Valves
Kitchen Control Valves
16 Water Flow Test at Sprinkler Riser
Water Su 1 Source:
Last Water Flow Test
This Water Flow Test
Tank
Size of
Test Pi e
"
17 Explain any "No" answers and comments:
18 Adjustments or corrections made during this inspection:
19 Although these comments are not the result of an engineering review, the following desirable improvements are recommended:
\
Signature:
I '~,
i
I
/
\~" i L__
.. Ii i
. /
Date:
! ,,) - :5.1 [> ")
/
(Rev. 2/8/(6)