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Home My WebLink AboutFire Sprinkler Test 5/21/2008 LID #: 3150135 "\ 1'_).~_ ~ ~! Page 1 of 3 ~ Ahern Fire Protection 13705 26th 1\venue, Suite 110 :Minneapohs, ;\IN 55441 (763) 268-0515 P . (763) 268-0516 f www.ahemfire.com. Since 1880 Annual Sprinkler System Inspection Report I Work Order #: 850667 I For MonthN ear: I May 2008 Invoice: COURTWOOD VILLAGE 17092 ADELMAN ST SE City: PRIOR LAKE Dept.: 'Phone #: 1(~~3) 286-4904 State: MN Zip: 55372- Street: Location: Courtwood Village Condos Street: 17092 Adelman Street SF ICity: Prior Lake State: MN Zip: 55372 1--1 Foreman: ~. ./l;' I L--__ __J___ L: Phone #: (763) 286-4904 Fax #: (952) 513-2010 Date: ;; Signature: ~ , Wet Dry Preaction Deluge Stand Pipe/Hose Foam Alarms Detectors Hydrants FireDoors FirePumps ValveTT Suppression ,Anti]reeze jWater Spray iSFRP SF DC ISF Generic SF Lincoln 'SF Omaha Internal Sprinkler Contacts: Ron Fitch On Site Direct: (763) 286-4904 Ext Cell/Pager: IALARM DEVICES TESTS I. Did waterflow or pressure switches operate satisfactorily? 2. Did tamper switches operate satisfactorily? 3~ Did water motor alarm gongs or electric bells operate satisfactorily? 4. Did alarm service or central station operate satisfactorily and receive proper signals? Y N N/A k" I " ~-;>K ~-1'_____ .)..1 -~/ X",- .- , Xc IALARM SIGNALS ~- 1 _ ___{.". -"-l~__/' :~~ System # Test Times \~'- . ~ ~ \ "<'I , -'>. --,-1 '. '.=-' u-..-_'-___.. _ ..... Y N N/ A?~ J -, f>( " \" 15 YEAR INSPECTION I. Was the 5 year Inspection performed on the following items? A. Alarm valves B. Check valves C. Gauges D. Internal Examination of Piping Date due: IS-YEAR TESTING Y N N/A J 1. Was the 5 year testing performed on the following items? A. Sprinkler heads in corrosive environments or rated 325' F or higher. Date Due: B. Standard sprinklers in service for 75+ years. Date Due: 110- YEAR TESTING Y N N/A \ I. Was the 10 year testing performed on the following items? \ A. Standard sprinklers in service for 50+ years. Date Due: S. Quick response sprinklers in service for 20+ years. Date Due: I! jl C. Dry pendant sprinklers. Date Due: . i This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2005 JF. Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT rptlnspection _Annual ,&':,-- '-."tt.... :. LID #: 3152q~ ICONTROL VALVE SERVICE 1. Were the following service items performed on all control valves? A. Fully opened and closed? S. Valve packing checked? C. Valve stem lubricated? D. Is the valve properly secured and locked in it's normal operating position? IBACKFLOW PREVENTOR TEST I ~ Did the backflow preventor(s) pass the test of back flow and forward flow capabilities? IANTI-FREEZE TEST I. Has the anti-freeze solution for each system below been tested by measuring specific gravity? IHANGERS AND SEISMIC BRACING I. Did hangers and seismic bracing appear to be in good condition, firmly attached, and free from corrosion, from a visual inspection performed from floor level? IPIPING I. Was the exterior of exposed sprinkler piping in good condition, not subjected to extemalloads, free of mechanical damage? NOTE: Piping located in concealed spaces, such as above a drop ceiling, are not required to be inspected. IFIRE DEPARTMENT CONNECTIONS I. Are fire department connections visible and in good condition? 2. Are caps and plugs in place? 3. Are automatic drain valves operating properly? 4. Do hose connections operate freely? IHOSE RACKS PRESENT? IMAIN DRAIN TEST System Number 'StiificViessure Residual Pressure Size of drain Yes ,.. No CONDITION: Good Fair Sad .. r No 1 1 fC.' .~ ./ 1. Were all main drains tested at full flow' lfno, explain: 2. Were test results similar to the last test? lfno, explain: " 3. Was there any discharge of obstructive material, heavy discoloration of water, or plugging ofthe inspector's test connection? IGENERAL INFORMATION I. Are all the sprinkler systems in service? 2. Is the building completely sprinklered? 3. Are all sprinklers in good condition? 4. Are all sprinklers free of obstruction? 5. Are spare sprinklers and wrenches available? 6. In spray coating area, are sprinklers free from accumulation? 7. Is hydraulic nameplate and information sign securely in place and legible? 8. Is emergency service contact information readily available? 9. Are alarm devices provided and in good condition? 10. Are all standard sprinklers dated 1920 or later' !-~~ ~ .' .;' <;' c IOWNER QUESTIONS I ~ Any changes in sprinkler system since last inspection? 2. Any fires since last inspection') This document PROPERTY OF AHERN FIRE PROTECTION Copyright 2005 JF. Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT '.. Page 2 of 3 Y N N/A Y N N/A Vi .., N N/A 1- '\'" j"".1o N N/A y Y I"'.". y' Y N N/A ,~ / Y N N/A Y N N/A ] J i " ."t " I~:I- Y N N/A J /1> I:r-~ "'i" ,~ , ., ~c ~', I :>r!. .' Y N N/A !Of . v; " ,)'L rptlnspection _Annual LID #: 3150135 Page 3 of 3 """ "'-" "" A. Number of sprinkler heads that operated. B. How long was system out of service? C. Area where fire occured. 3. Are all areas of the building properly heated to prevent freezing where wet pipe systems exist? 4. Do you have an outside alarm service? '-".,,"0,..:.': If yes, name and phone number. -<.:~~ ,L'"'l~ /" Note to Owner - Our inspections will only report conditions as they exist at time of inspection and do not guarantee the operation of the System due to factors beyond our control. (i.e., potentially closed valves or depleted municipal water supply.) Per NFPA-2S, this inspection is based on the assumption that the system has been installed in accordance with all applicable codes and standards. Owner/Representative's Signature: Date New Deficiencies found during this inspection? Yes No Customer receive copy of New Deficiency Report? Yes No INOTES .t" { SERVICES PERFORMED: Alarm Test Drain Test Flow Test Walk Through ; rj \t Annual Inspection /, . \ / \ Other This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2005 JF Ahern Co REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT. rptInspection _Annual ~ Invoice To: IStreet: Location: Street: Phone #: IDate: i ( System Number Quantity .~"'" Ahern Fire Protection 13705 26th Avenue, Suite 110 '\Iinneapohs, MN 55441 (763) 268-0515 P . (763) 268-0516 f www.ahemfire.com · Since 1880 Location on site . --'--..- \. ........ ..... New Deficiencies City: Dept.: iCity: ,Fax #: I ISignatutk: 1 i Phone #: Dtficiency Description T ~ ) .. 1 ~ + ~. l I " f " \ .i State: State: Page] of 1 This document PROPERTY OF AHERN FIRE PROTECTION Copyright 1998 JF Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT LlD#: Work Order #: Zip: Zip: IForeman: I . . . ~ j i , (" <,,' { j /., J: .. ~_.V_.i("\\. rptBlank _Deficiency ~ Location: Courtwood Village Condos Street: 17092 Adelman Street SE Phone #: (763) 286-4904 Date: ISystem #: I System Type: IValve Serial #: Manufacturer Name: Valve Model: r Valve Size: IControlling Sprinklers Location: IControlling Sprinklers Number: Date of Last System Pressure Test: (Must be done every 3rd Year) . A Date of Last Full-Flow Trip Test: (Must be done every 3rd Year) Date Last Operated: Pressure Before Test - Air Pressure Before Test - Water Ahern Fire Protection 13705 26th Avenue, Suite 110 Minneapolis, MN 55441 (763) 268-0515 P . (763) 268-0516 f www.ahemfire.com · Since '1880 Fax #: 1(952) 513-2010 I Signatur,e: ~.~,:.< ::.' -.,.-...f:: _.~.~ .,' \ ~.-../ \ (, approx ~'t/ :'.' l-''' (' ,."..' I J Ibs~ lbs. .... v __.~ ISize and Location of Test Valve: " " Was gate valve below dry valv~ ?pen wi~e at test? (if not, how many turns?) ,_"""-' ,.."-"-_._'~,,"-"-~ _.-,-" -<1'-'"'+'_=.''' n_' '..-=.=_~.o""-'C-_""""'-_'.-<- ";alve Tripped At - Air pressure Valve Tripped At - Water Pressure Valve Tripped At - Time If system flooded, list time water reached test opening.~ IPERFORMANCE Ilnterior of Body IMoving Parts IRubber Facing Seats Reset? Did alarms operate at trip test? Have low point drains been emptied? # Water control valve left open and sealed? IAre the valves accessible? IAre the valve enclosures heated adaquately? Interior of pipe that passes through freezers free of ice blockage? Quick ODenine Devices Device Serial #: AIR COMPRESSOR Oil Level? Cuts ill? Ibs. Ibs. min. sec. \ min. sec~ I i'~. r. . ., Poor Poor Poor Fait ~ GoplL.,..1 Fat.~G.ool1.::: :- Fair ~2. ,/,1.... .... ., Ory /Pre action/ Deluge Pipe Valve Trip Test Date: 5/1/2008 Work Order #: 850667 IUD#: 3150135 Dept.: 'City: Prior Lake State: MN ('I. .., \ ().,/\\....; Page I of I This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2008 J.F. Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT No i Device Manufacturer Name: i\ l Device Type and Model: " ; \! L~, lAir pressure in upper chamber ,: \ i / . Quick opening device tripped at :"1: \, / sec. Quick opening device left in service, and control open and sealed? Yes No Poor Fair<~ / POQr Fair~) ('~ y'!i:'-:'No N/A ,'---Y~~).Jo Nih ._- Yes No~ N/A Yes ,'No N/A ~'."'~~~.)No N/A .--"..~ No N/A ,- Yes _~ Yes No N/A ) Ibs. lbs. N/A Plant System IIAdd Oil? lbs. ICuts Out? Ibs. Manual Belt Tight? Tested? I i 1./ / Automatic Belt Conditions? Reset? Yes I . r'~':(t.~~ i~~ 1 \ (;A. t N/A rptValveTripTest