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Home My WebLink AboutSprinkler Report 8/1/2008 LID #: 3150134 - ....... '''. ~ Ahern Fire Protection 13705 26th Avenue, Suite 110 .Minneapolis, J'vfN 55441 (763) 268-0515 P . (763) 268-0516 f www.ahemfire.com · Since 1880 Invoice: PRIOR LAKE BAPTIST CHURCH 5690 CREDIT RIVER ROAD Street: Annual Sprinkler i System Inspection Report TPhone #: 1(952) 447-2824 State: MN Zip: 55372- Location: Prior Lake Baptist Church City: PRIOR LAKE iDept.: City: Prior Lake State: MN Zip: 55372 Street: ,Phone #: I : Date: !5690 Credit River Road (952) 447-2824 iFax #: i(952) 447-2837 ! Signature: Wet Dry Preaction ,Deluge ,Stand Pipe/Hose Contacts: Wade Waddell IF;reDoor~-n ~~~~mps ValveTT Suppression Anti_Freeze 2 Water Spray rBF-RP iBFDC !BF Generic BF Lincoln !BF Omaha 2 Foam Alarms Detectors Hydrants [Internal Sprinkler Invoice/Deficiency Direct: (952) 447-2824 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? IALARM SIGNALS System # :Test Times ; L",,-, '....;.).;~ ,....-- --""/ "7 v: ..-...-. I , i r----- , L Y 1';J N/A :~ 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: Y N N/A . .,,(' i IS-YEAR TESTING I. Was the 5 year testing performed on the following items? A. Sprinkler heads in corrosive environments or rated 325' F or higher. B. Standard sprinklers in servnce for 75+ years. Date Due: Date Due: Foreman: Chris Moe l...,,/ ./ i:' ; (:' Page 1 of 3 Work Order #: 851288 For MonthlYear: August 2008 Y N N/A i} ~:' I ' 110- YEAR TESTING I. Was the 10 year testing perforrned on the following items? A. Standard sprinklers in service for 50+ years. B. Quick response sprinklers in service for 20+ years. C. Dry pendant sprinklers. Date Due: Date Due: Date Due: This document PROPERTY OF AHERN FIRE PROTECTION Copyright 2005 J.F. Ahern Co REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT Y N N/A kf' rptlnspection _Annual -------~...._--,.----"_O,-..,....~,_,_-.......,.,..,...~.----'-_;~-__.~~..,....----,..~__~.__'_..._________ _ __'.__-'_"'-_-~'-"'-"-' '-C---~" _...___'----.,-.-___._..~__~._. __._~~_._____ ____.___,_....__ _~___ _~_..___..__________~_ ". UD #,; 3150134 ICONTROL VALVE SERVICE I. Were the following service items performed on all control valves? A. Fully opened and closed? B. 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? Page 2 of 3 Y N N/A -'~ Xi I Y N N/A J: Y N N/A :.V' Y N N/A iL " Y N N/A IANTI-FREEZE TEST I. Has the anti-freeze solution for each system below been tested by measuring specific gravity? IHANGERS AND SEISMIC BRACING 1. 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? IplPING I. Was the exterior of exposed sprinkler piping in good condition, not subjected to external loads, free of mechanical damage? NOTE: Piping located in concealed spaces, such as above a drop ceiling, are IlOt required to be inspected. I FIRE 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? Y N N/ A I" , .r-I \: IHOSE RACKS PRESENT? Yes .'#). No IMAIN DRAIN TEST iSystem Number r !Static Pressure .-., .,' b Residual Pressure "- :;:- \-I-l Size of drain j d I. Were all main drains tested at Dull flow? If no, explain: 2. Were test results similar to the last test? Ifno, explain: CONDITION: Good Fair Bad v Y N N/A I I 3. Was there any discharge of obslructive material, heavy discoloration of water, or plugging ofthe inspector's test connection? ... IGENERAL INFORMATION 1. Are all the sprinkler systems in service? 2. Is the building completely sprinklered? 3. Are all sprinklers in good condition? 4. "'-re all sprinklers free of obstruction? 5. Are spare sprinklers and wrench~s available? 6. In spray coating area, are sprinklers free from accumulation? 7. Is hydraulic nameplate and infonnation 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? ~ Y N N/A I ...". , ,;: IOWNER QUESTIONS I. Any changes in sprinkler system since last inspection? 2. Any fires since last inspection? /1 ,}1 )J Y N N/A This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2005 IF Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT rptInspection _Annual LIQ -Ii; 3150134 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? _'r:"'" '"." If yes, name and phone numb<:r. /"-- 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 thalt the system has been installed in accordance with all applicable codes and standards. Owner/Representative's Signature: Date iNew Deficiencies found during this inspection? Yes No Customer receive copy of New Deficiency Report? Yes No INOTES 2009 WILL BE SHORT TRIPS - $500.00 ! It. / // ,,_,( _.,C ~ _ ~ f.; ..c ~ .... _ , ; ~.,~ li..'" ,,~j \._~ ~K~. -/ _ 1,. e_~~_:C"G-:J /' :. -r~--~' ~' _i__t_ /J: ;- ? h.t ,/ /iI V"< -; r- ~/"" ..-.~~ .:;::.t / " ,/ i -- -- , r:6r' 1~-7~/ rl. //C,.-i-i- -t '''( Ir'l (~. ~'.c v J --', ") ,?d iT" ..-r" 1" S S L_ v -r-- {.:-/(~"'___~_ v-- 2~-~' ..' / A ,;/ /(/ -:' <. ,..! i-' 'v.{<::, f. SERVICES PERFORMED: Alarm Test Drain Test Flow Test Walk Through Annual Inspection Other .----' L ! i/ I Vi\ 1'--' - ,I / I (Jp --1 W ,(.1 ..- / I. . '," '",- ! .. 1 " "'\ .' i/ r /' , .vf;:-.o ......-~ : \._~~ . J v ') ~..... . I Li ---;; ~" "...)-j I (! I ( , --.. ('. ~..\,;.. b A '-. j...fl/ k.. 'y: .. .. ,. '" This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2005 JF. Ahern Co REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT rptlnspection _Annual ----~-,-._-_._-,-----,.---,------..-.....,~_..~~~.-.~~C'"T-__,_.,_-_~~,.,.~~~"'.',..-.,...,...,.,._...,_~~.-,-.----c-;-------.-----.---.-~.-~--.--,-.~.-___,.,,__~___no__~__~._.___._.._.__~_____...~-~~-~~_._____....._~~..~.___.___.._______.___ ~ HERN Location: Prior Lake Baptist Church ,5690 Credit River Road I (952) 447-2824 Street: i Phone #: I Date: System #: System Type: Valve Serial #: Manufacturer Name: Valve Model: Valve Size: Controlling Sprinklers Location: Controlling Sprinklers Number: Date of Last System Pressure Test: (Must be done every 3rd Year) Date of Last Full-Flow Trip Test: (Must be done every 3rd Year) Date Last Operated: Pressure Before Test - Air Pressure Before Test - Water Size and Location of Test Valve: ~ Ahern Fire Protection 13705 26th ___;\venue, Suite 11"6"' 0_' Minneapolis, MN 55441 (763) 268-0515 P . (763) 268-0516 f www.ahernfire.com . Since 1880 Fax #: (952) 447-2837 I Signature: 1 Dry 64 8301 Reliable Box Model D 4 Main building front entr approx . ".... "\ - /) t~' ,< u,' F' , . .. .....~ '. / /,,j . _.~-r lbs. lbs. ! . Was gate valve below dry valve open wide at test? (if not, how many turns?) A/ <; Valve Tripped At - Air pressure Valve Tripped At - Water Pressure Valve Tripped At - Time _3 <>7 Ibs. Ibs. min. (~c. PERFORMANCE If system flooded, list time water reached test opening. / J ::", I,.f, Interior of Body ,MovUi@ Parts Rubber Facing Seats Reset? Did alarms operate at trip test? Have WlW point drains been emptied? # Water control valve left open and sealed? Are the valves accessible? ~"..- i~ . I -1 ,/ min. ,/ c$ec. '."-&. ; Fair ..Go;;-d) ..~rf'air Good Poor FaiL Good POo.r Fair '\GOod Poo~'Tair Good '-~ No N/A Y;; ) No N/A ..~\ -'Yes) No N/A , Yes No N/A ;~es ; No N/A 'ft,s .-J No N/A .. Yes No N/A/ Are the valve enclosures heated adaquately? Interior of pipe that passes through fre,ezers free of ice blockage? IOuick Oneninl! Devices / /1 Device Serial #: /V/'./-.... Device Manufacturer Name: I Device Type and Model: Air pressure in upper chamber Oil Level? Cuts In? Ibs. Dry /Preaction/ Deluge Pipe Valve Trip Test TDept.: iCity: Prior Lake State: MN Zip: 55372 Foreman: Chris Moe System #: System Type: Valve Serial #: Manufacturer Name: Valve Model: Valve Size: Controlling Sprinklers Location: Controlling Sprinklers Number: Date of Last System Pressure Test: (Must be done every 3rd Year) Date of Last Full-Flow Trip Test: (Must be done every 3rd Year) Date Last Operated: Pressure Before Test - Air Pressure Before Test - Water Size and Location of Test Valve: ,-- LDate: 8/1/2008 Work Order #: 851288 LID #: 3150134 2 Dry Tyco 84FM 4 addition <- :' -:: V) i r'~ .:.:/ I 1" approx ,\ k--' lbs. lbs. Was gate valve below dry valve open ",ide at test? (if not, how many turns?) :'/-r/ <;' Valve Tripped At - Air pressure ;.,. (f. Valve Tripped At - Water Pressure Valve Tripped At - Time If system flooded, list time water reached test opening. PERFORMANCE Interior of Body Moving Par1s Rubber Facing Seats Reset? Did alarms operate at trip test? Have low point drains been emptied? # :~ Water control valve left open and sealed? Are the valves accessible? Are the valve enclosures heated adaquately? Interior of pipe that passes through freezers free of ice blockage? Quick Oneninl! Devices Device Serial #: I Device Manufacturer Name:;/ './ Device Type and Model: Air pressure in upper chamber Belt Conditions? Reset? Yes - ". [/ Poor Poor Poor Poor Poor Yes) -Yes ~../ Ibs. lbs. m~h sec. min~1;"; sec. Fair/ Good Fair~6d, Fai~&la Fair .::-Ci\oOf . '-.,.,J ~ FaIr.. Good No~ No N/A No N/A -Yes, No N/A -;~ No N/A :Yes . _.-~,/ Yes / ,- J .. ,/ ..L -. .. / i No N/A Quick opening device tripped at sec. Ibs. Quick opening device tripped at sec. Quick opening device left in ~ervice, ~md control open and sealed? Quick opening device left in service, and control open and sealed? / / --.,'. - .. Yes No N/A 1.J ...-; Yes No --, , e L 7 i'- I (7~ ~a~fe f C' ,~~;:. t/ "~Mk:ual I ~~ 'ij Page I of I This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2008 IF. Ahern Co REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT --~_._'--_.__._~--'._-_._.........,-----~---_..,.,...--,..,,-..,-.., No N/A No ,~_~~/.; lbs. Ibs. N/A rptValveTripTest