HomeMy WebLinkAboutFire Sprinkler Report 11/5/2008
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AUTOMATIC SPRINKLER CO.
Setting Tbe Standard...
UUl L'Unent ::.treet
St. Paul, MilUlesota 55117
(651) 558-~~00 . (800) 229-626~
Pax: (651) 558-~~ I 0
S~ [FFT 1 of 2 - USe' Sl'pardte 5h('('t for each building inspected
MINNESOTA LICENSE NO. COOS
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CITY & ST A TE "'ii:: \ 'A1,.e 1.,
AGREEMENT AND REPOlU OF INSPECTION
#INSPECTION
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REPORT TO
BLJ]LDlNG OR LOCAT]ON
j,
" & INSPECTOR
DATE
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STREET
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 Sect'ion of this document.
Owner's Section (To be answered by Owner or Occupant)
A. Explain any occupancy h<17ard changes since the previous inspection:
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C. Describe any fires since last inspection:
B, Describe fire protection modifications made since last inspection:
D. When was thc system piping last checked for stoppage, corrosion or foreign material7
E When was the dry-piping system last checked for proper pitch?
l'. Are dry valves adequately protected from freezing?
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Signature\;..... .".......,:.... ,_~...__. Title Date
Inspector's Sectfd"n (All responses r.l'ference current inspection) NjA = NOT APPLICABLE
1 General V /
a. Is the building occupied? 9 y~ LJ No
11. Are all systems in service? WYes L I No I
c. Does there appe'ar to be a minimum of 18 in. (457 mm) clearance between the top of the storage.and the sprinkler deflectors? ~. i No
d. Does the' valve hose on the sprinkler system(s) appear to be satisfactory? L I Yes L I No L.NfA
2 Control Valves (See Itell/lS)
a. Do sprinkler system control valves appear to be in the appropriate open or closed position? ~s II No
11. Are control valves in the open position locked, sealed or equipped with a tamper switch? JvG:~ CI No
3 Water Supplies (See Item 16) , ,/
a. Was a water flow test of main drain made at the sprinkler risl'r(s)? ""'Yes n No
4 Tanks, Pumps, Fire Department Connections
a. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintainl"P II Yes u ~ WA
b. Are fire department connections in sa)isfactory condition, couplings free, caps in place, and check valves tight? (.....>res LI No II N! A
Are they accessible and visible? ~ u No I I N! A
:; Wet Systems
a. Are cold weather valves (0.5. & Y.) in the appropriate open or rlosed position? II Yes II No 4.;.WjA
b. ] lave antifreeze system solutions been tested? n Yes Il No ~NlA
c. Were the antifreeze test results satisfactory? II Yes I I No I,...N/ A
d. In areas protecled py v~system(s), does the building appear to be properly heated in all areas, including bljnd a~~~?and perimeter areas
where accessible? ~~s 0 No 0 N! A Do all exterior op,'nings appear to be protecled against freezing? ~~ No II N! A
6 Dry Syslem (See Items 11 to 13)
a. Arc dry valv,'s (s) in service? LJ Yes LJ No LJ N! A
b. Are lhe air pressures and priming water levels in accordance with the manufaclure's instructions? " Yes II No II Nj A
~ c. Has the operation of the air or nitrogen supplies been tested? 0 Yes II No [J Nj A Are they in service? 0 Yes LJ No I I N! A
d. Were all know low points drained during this inspection? lJ Yes LJ No N! A
e. Did quick-opening devices operate satisfactorily? II y"s 0 No [] Nj A
f. Did the dry valve(s) trip properly during the trip pressure test? II Yes II No uN! A
g. Did the heating equipment in the dry-pipe valve room(s) opera Ie at time of inspL'Ction? LJ Yes II No II Nj A
7 SpL'Cial Systems (See Ikm 14)
....0' a. Did thede1ugeor pre-action valves operate properly during lesting? II Yes II No [J Nj A
~ b. Did the heal-responsive devices operate properly during testin?;? lJ Yes n No n N! A
c. Did supervisory devices operate durin?; testin?;? LJ Yes 0 No 0 N! A .'
8 Alarms \ ../. /
a. Did water molor(s) and gong(s) test saVsfac;!9rily? n Yes ,I No i'J-I'<r! A
b. Did electric a]arm(s) test satisfactory? ~~ lJ No. n Nj A
c. Did supervisory alarm service tesl satisfactory?\.V1es n No II Nj A
9 Sprinklers //
a. Do visible sprinklers appear to be free from corrosion, loadin~ or obstruction 10 s,pray~harl';e? LCrYes 0 No
b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing) b..-y~ LJ No
c. Are quick response and residential spr!nk,!pS less than 20 years old? (Older sprinklers require sample testing) L.~' LJ No I IN! A
d. Is stock of spare sprinklers available? lYfes [] No ,/
e. Does the exterior condition of sprinkler system appear to be satisfactory? l~es LJ No ,,/
f. Do visible sprinklers appear to be of proper temperature rating for their locations? k>fes LJ No
10 Explain any "No" answers and comments:
Signature:
(Rev.2/KI..!.)6)
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Date:
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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
Inspection RePf:t~~
No. /!,\,,?IIL
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
(See Trip Test Table which filllows)
(See Trip Tl'st Table which follows)
(See Trip Test Table which follows)
TRIP TEST TABLE
QOD
f DRY PIPE
OPERATING
TEST
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
Time to Trip Water Air Trip Point Time Water Reached Alarm Operated
Thru Test Pipe Pressure Pressure Air Pressure Test Outlet Properly
MIN. SEe. PSI PSI PSI MIN. SEe. YES NO
Without
Q.O.O
With
Q.OO
t
DELUGE &
PRE ACTION
VALVES
Operation :J PNEUMATIC II ELECTRIC I HYORACLlC
Piping Su pervised L; YES :J NO IDetecting Media Supervised YES NO
Does valve operate from the manual trip and/ or remote control stations i: YES NO
Is there an acC{~ssible facility in each circuit for testing :.J YES In; NO IMethod of Testing Circuits
Docs each circuit operate Does each circuit Maximum lillll..' to
MAKE MODEL sU~ll'rvision loss alarnl operate valvl' release operlllc rclei:lsl'
YES I NO YES I NO YES I NO
I I 1
(See Trip Test Table which follows)
TRIP TEST TABLE
14 Date deluge or preaction valve tested
15 See Control Valve Maintenance Table
CONTROL VALVE MAINTENANCE TABLE
Explain
Abnormal
Control Valves Number Typi/ t9pen Secured Closed Signs Condition
Citv Control Valves "7_ IJ.V I':. " f \..... '-- '-'
Bvpass Valves
Tank Control Valve'S
Pump Control Valves
Sectional Control Valves ,
Svstem Control Valves \ f,~V t ~' ~ ~
Other Control Valves
Kitchen Control Valves
16 Water Flow Test at Sprinkler H.iser
Water Su Iy Source:
Citv
Tank
Last Watcr Flow Tcst
This Water Flow Test
Test Pipe
Location
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17 Explain any "No" an:,.wers and comments:
18 Adjustments or corrections made during this inspection:
19 Although these comments are not the result of an engineering review, the following desin,ble improvements are recommended:
Signature:
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Date:
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(Re>,.2/K/116j