HomeMy WebLinkAboutSprinkler Report 7/8/2008
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AUTOMATIC SPRINKLER CO.
Setting T.he Standard...
1:>01 I :Orient Street
St. Paul, Milmesota 55117
(651) 558-:>:>00 . (800) 229-626:>
Fax: (651) 558-:>:>10
SHEET 1 012 - Use separate sheet for each huilding inspected
MINNESOTA LICENSE NO. COOS
AGREEMENT AND REPORT OF INSPF.CTION
#INSPECTION
1. .2- () I <.,
REPORT TO
STREET
CITY & STATE
,
N(~ If'>)( BUILDING OR LOCATION
C t::. C c:- '1' \ \ I . INSPECTOR
J _J "> i.. {, ttcvIWOO" '-<.~tvrR
PI' IC'(" L. ~ e .i.-1>4 DATE
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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 al,'Teement, 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 changes since the previous inspection: VI 1...' vI <:.
B. Describe fire protection modifications made since last inspection:
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C. Describe any fires since last inspection:
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D. W1,en was the system piping last checked for stoppage, corrosion or foreign material? r "or:.,.., .,~,., 1.."0 ,.I 2. DC: ?
E W111'n was the dry-piping system last checked for proper pitch? 1"1 (', PI.o..J b L ..;,., _~ -
F. Are drv valves adequately protected from freezing? I.A <: 1:::,. -
Signature Title Date
Inspector's Section (All responses reference current inspection) NjA = NOT APPLICABLE
1 General
a. Is the building occupied7'~es No
b. Are all systems in service?)"~~'es L No
c. Does there appear to be a minimum of 18 in. (457 mm) clearance between the top of the storage and the sprinkler ddkctors?,X es [I No
d. Does the valve hose on the sprinkler system(s) appear to be satisfactory? II Yes I J No ).itl/ A
2 Control Valves (See I telll 15)
a. Do sprinkler system control valves appear to be in the appropriate open or closed position? ~s n No
b. Are control valves in the open position locked, sealed or equipped with a tamper switch? ,~s [I No
3 Water Supplies (See Item 16)
a. Was a water flow test of main drain made at the sprinkler riscr(s)? )l::/.es [I No
4 Tanks, Pumps, Fire Department Connections '
a. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? 0 Yes 0 No [)4:j/ A
b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight?)4 Yes [[ No II N/ A
Arc they accessible and visibk?~es II No [I N/ A
S Wet Systems
a. Are cold weather valves (OS. & Y.) in the appropriate open or dosed position? n Yes 0 No ,)(.N/ A
b. Have antifreeze system solutions been tested? Cl Yes n No ~/ A
c. Were the antifreeze test results satisfactory? II Yes II No ~-N/ A
d. In areas protected by wet system(s), does the building appear to be properly heated in all areas, including blind attics and perimeter areas
where accessible? O<<es [I No ,1 N/ A Do all exterior openings appear to be protected against fre,'zing? !)4'es [I No I) N/ A
6 Dry System (See /tellls 11 to 13)
a. Are dry valves (s) in service?.J!'Yes [I No I N/ A
b. Are the air pressures and priming water levels in accordance with the manufacture's instructions?)t{Yes ! I No I J Nj A
c. lIas the operation of the air or nitrogen supplies been tested?)<O'es LI No LJ Nj A Are they in service?"'<yes 'I No LJ N/ A
d. Were all know low points drained during this inspection?.Af):es II No [[ N/ A
e. Did quick-opening devices operate satisfactorily? ~ [I No I J N/ A
f. Did the dry valve(s) trip properly during the trip pressure test? )'<Yes II No II N/ A
J1,. Did the heating equipment in the dry-pipe valve room(s) operate at time of inspection? pes 0 No 0 N/ A
7 Special Systems (See item 14)
a. Did the deluge or pre-action valves operate properly during lesting?1 Yes II No .,(Nj A
b. Did the hcat-responsiv(~ devices operate properly during tesling? IJ Yes LI No )(N/ A
c. Did supervisory devices operate during testing? [J Yes II No [WI A
8 Alarms
a. Did water motor(s) and gong(s) test satisfactorily? n Yes 11 No ~/ A
b. Did electric alarm(s) test satisfactory?)<!. Yes 0 No 0 NI A
c. Did supervisory alarm service test satisfactory? ~ Yes 0 No lJ Nj A
9 Sprinklers '
a. Do visible sprinklers appear to be free from corrosion, loading or obstruction to spray discharge~ Yes [1 No
b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing~ Yes ,I No
c. Are quick response and residential sprinklers less than 20 years old? (Older sprinklers require sample testing) 1(Yes [I No X N/ A
d. Is stock of spare sprinklers available? p(Yes 0 No I
e. Does the exterior condition of sprinkler system appear to be satisfactory? )t(Yes LI No
f. Do visible sprinklers appear to be of proper temperature rating for their locations? )<. Yes LI No
10 Explain any "No" answers and conmlents:
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Signature:
Date:
7-
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(Rl'V.1/R/06)
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AUTOMATIC SPRINKLER CO.
Setting The Standard...
1301 L'Orient Street
St. Paul, Minnesota 55117
(651) 558-3300 . (800) 229-6263
Fax: (651) 558-3310
SHEET 2 of 2 - Use separate sheet for each system inspected
System No. or Description if multiple
systems lJ" Z ~7-l'., 2~
Ji, 2 - '-1 0; ["d '1
lnspection Report
No. ,') \ 2 c I .3
11 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 / _ q - 0 R
DRY VAL VE
-; _ I _.~ - Co '7 (See Trip Test Table whicll follotUs)
-7.. s:;: - 0 M (See Trip Test Table which follows)
, (See Trip Test Table which follows)
TRIP TEST TABLE
Q.O.D.
DRY PIPE
OPERATING
TEST
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
Ie' '. \. II~) \ E f}.. Z\....0~ L.f C z.c Go I"? .., I (4 \,1 (' R.- I 7C:;7l.,9 (0
Time to Trip Water Air Trip Point Time Water Reached Alarm Operated
Thru Test Pipe Press u rc Press u rc Air Pressure Test Outlet Properly
MIN. SEe. PSI PSI PSI MIN. SEe. YES NO
Without
Q.O.D
With e
,,/ ~E:? <'. (Lr; r----- / ---
Q.O.D .__ .~,J (.) ...>
14 Date deluge or preaction valve tested
(See Trip Test Table which follows)
TRIP TEST 'I' ABLE
)..)11
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Operation o PNEUMATIC [ ELECTRIC o HYDRAULIC
Piping Su pervised :~ YES [1 NO IDetecting Media Supervised [J YES I NO
Docs valve operate from the manual trip and/ or remote control stations [] YES NO
Is there an acce:3sible facility in each circuit for testing - YES u NO IMethod of Testing Circuits
Does each circuit operate Does each circuit Maxin1um time to
MAKE MODEL supervision loss alarm operate valve release operate release
YES I NO YES I NO YES I NO
I I I
DELUGE &
PREACTlON
VALVES
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 J - '"+,' O:,;:/l 'r' - - -
Other Control Valves
Kitchen Control Valves
16 Water Flow Test at Sprinkler Riser
Water Su I Source:
Tank
I.'
~H
....'('-
Pum
Residual
(Flow)
Pressure
( .
-7,".
Last Water Flow Test
This Water Flow Test
Test Pipe
Location
Size of
Test Pi e
Sta tic
Pressure
<f>c
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:
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Date:
7-,0-0<'-\
Signature:
(Rev.2/K/06)
"...t...C3
AUTOMATIC SPRINKLER CO.
Setting The Standard...
1301 L'Orient Street
St. Paul, Minnesota 55117
(651) 558-3300 . (800) 229-6263
Fax: (651) 558-3310
SHEET 2 of 2 - Use separate sheet for each system inspected
Inspection Report
No c;?\ 20 (
11 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
systems fl) cr2..
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(See Trip Test Table wlzich follows)
(See Trip Test Table which follows)
(See Trip Test Table whiclz follows)
TRIP TEST 'I' ABLE
Q.O.D.
f+
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
Time to Trip Water Air Trip Point Time Water Reached Alarlll Operated
Tllfu Test Pipe Pressure Pressure Air Pressure Test Outlet Properly
MIN. SEe. PSI PSI PSI MIN. SEe. YES NO
Without
Q.O.D
With
Q.D.D
DRY PIPE
OPERATING
TEST
14 Date deluge or preaction valve tested
(See Trip Test Table wlzich follows)
TRIP TEST TABLE
;-;t
Operation o PNEUMA TIC CI ELECTRIC o HYDRAULIC
Piping Supervised DYES CI NO I Detecting Media Supervised rc YES "1 NO
Does valve operate from the manual trip and/ or remote control stations DYES II NO
Is there an accessible facility in each circuit for testing n YES n NO IMethod of Testing Circuits
Does each circuit operate Does each circuit Maximu111 time to
MAKE MODEL supervision loss alarm operate valve release operate release
YES I NO YES I NO YES I NO
I I I
DELUGE &
PREACTION
V ALVES
15 See Control Valve Maintenance Table
CONTROL VALVE MAINTENANCE TABLE
Explain
Abnormal
Control Valves Number Type Open Secured Closed Signs Condition
City Control Valves f P/V - -
Bypass Valves
Tank Control Valves
Pump Control Valves
Sectional Control Valves 1- I " (:S' ,. "'-'- -
System Control Valves I . '-f" I?~ i= - - -
Other Control Valves ; 4' j"7(. J:: - . -
Kitchen Control Valves
16 Water Flow Test at Sprinkler Riser
Water Su I Source:
...-:::.::'''~
Cit j
Tank
Last Water Flow Test
This Water Flow Test
Test Pipe
Location
Size of
Test Pi e
Static
Pressure
C
Pum
Residual
(Flow)
Pressure
-7;:..
7'
Ii,.,
",?14
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:
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Signature: r' ~'\ i.'_. Date: 7- f..J. LiP
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(Re\'.2/K/1l6)