HomeMy WebLinkAboutSprinkler Inspection 12/29/2008
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UTOIIA11C .....-.... co.
Setting The Standard...
St Paul, Minnesota 55117
(651) 558-3300 . (800) 229-6263
Fax: (651) 558-3310
AGREEMENT AND REPORT OF INSPE010N
#INSPECTION
L) '17/<J
REPORT TO
STREET
CITY & STATE
BUILDING OR LOCATION
L S; /' INSPECTOR
DATE
Owner hires Viking ~utomatic rinkler 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 changes since the previous inspection:
B.
'on:
/
C. Describe any fires since last inspection.
D. When was the system piping last checked for stoppage, corrosion or foreign material?
E. When was the dry-piping system last checked for proper pitch?
F. Are dry valv adequately protected from freezing?
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Insp r's SeJ ion (All responses refe NjA = NOT APPLICABLE
1 General
a. Is the building occupied?~es 0 No
b. Are all systems in service? Jf'f'Yes 0 No
c. Does there appear to be a minimum of 18 in. (457 mm) clearance between the top of the storage and the sprinkler deflectors? d'Yes 0 No
d. Does the valve hose on the sprinkler system(s) appear to be satisfactory? 0 Yes 0 No ytN/ A
2 Control Valves (See Item 15) "
a. Do sprinkler system control valves appear to be in the appropriate open or closed position? r1'Yes 0 No
b. Are control valves in the open position locked, sealed or equipped with a tamper switch? iTYes 0 No
3 Water Supplies (See Item 16) ~-
a. Was a water flow test of main drain made at the sprinkler riser(s)? P'fes 0 No
4 Tanks, Pumps, Fire Department Connections
a. Are fu'e pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? 0 Yes 0 No ,..n:J/ A
b. Are fire, department cOImections ~sfactory condition, couplings free, caps in place, and check valves tight? ~ 0 No 0 N/ A
Are they accessible and visibl~ Yes 0 No 0 N/ A
5 Wet Systems
a. Are cold weather valves (0.5. & Y.) in the appropriate open or c~d position? 0 Yes 0 No ~
b. Have antifreeze system solutions been tested? 0 Yes 0 No -1JN.J A
c. Were the antifreeze test results satisfactory? 0 Yes 0 No ~A
d. In areas protected b~ system(s), does the building appear to be properly heated in all areas, including _blinj-a'fucs and perimeter areas
where accessibl~Yes 0 No 0 N/ A Do all exterior openings appear to be protected against freezingyres 0 No 0 N/ A
6 Dry System (See Items 11 to 13)
a. Are dry valves (s) in service? 0 Yes 0 No 0 N/ A
b. Are the air pressures and priming water levels in accordance with the manufacture's instructions? 0 Yes 0 No 0 Nj A
c. Has the operation of the air or nitrogen supplies been tested? 0 Ye 0 No 0 Nj A Are they in service? 0 Yes 0 No 0 N/ A
d. Were all know low points drained during this insPB'on? 0 Yes 0 No 0 N/ A
e. Did quick-openmg devices operate SatisfactorilY1Ees 0 N 0 N/ A
f. Did the dry valve(s) trip properly during thefP ~ure t? 0 Yes 0 No 0 N/ A
g. Did the heating equipment in the dry-pipe v *' 10 perate at time of inspection? 0 Yes 0 No 0 N/ A
7 Special Systems (See Item 14) , \J
a. Did the deluge or pre-action valves operate pr erl ouring testing? 0 Yes 0 No 0 N/ A
b. Did the heat-responsive devices operate properly: uring testing? 0 Yes 0 No 0 N/ A
c. Did supervisory devices operate during testing? 0 Yes 0 No 0 Nj A
8 Alarms /
a. Did water motor(s) and gong(s) test satisfactorily? 0 Yes 0 No rfN/ A
b. Did electric alarm(s) test satisfactory? fies ~ ~ 0 Nj A
c. Did supervisory alarm service test satisfactory/, ,es 0 No 0 Nj A /1'J ,1 /'~/1 _ ./
9 Sprinklers } '1 ~ <- _ ! V!'l / cJ. C')(J /
a. Do visible sprinklers appear to be free from corrosion, loading or obstruction to spray discharge? rPfes 0 No \" I .,1 / / .
b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing) ~ es 0 No . ~
c. Are quick response and residential s~' s less than 20 years old? (Older sprinklers require sample testing~Yes 0 No 0 Nj A
d. Is stock of spare sprinklers available? es 0 No /"
e. Does the exterior condition of sprin er system appear to be satisfactory? fies 0 No
f. Do visible sprinklers appear to be of proper temperature rating for their locations~s 0 No
10 Explain any "No" answers and comments:
Date
Signature:
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1301 L'Orient Street
St. Paul, Minnesota 55117
(651) 558-3300 . (800) 229-6263
Fax: (651) 558-3310
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AUTOMATIC SPRINKLER CO.
Setting The Standard...
SHEET 2 of 2 - Use separate sheet for each system inspected
&?ttyt,(JJUi~~~ sC
1:~~~7 &~ fi."....'--\System No. Descri
c::':'C -:7 - systems ~ ,
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Inspection R~E-~rt d d ;1'/ - ~ L2- 1I~. t~/jh/l..t)
No. 2 If /10 ;t-"" '-/~--
Date dry-pipe valve trip tested (control valve partially open)
Date dry-pipe valve trip tested (control valve fully open)
Date quick-opening device tested
MAKE MODEL SERIAL NO. MAKE ,MODEL SERIAL NO.
"'
Time to Tlip Water Air Trip :~ Time Water Reached Alarm Operated
Thru Test Pipe Pressure Pressure Air Pre re Test Outlet Properly
MIN. SEe. PSI PSI A"sI MIN. SEe. YES NO
Without 7
Q.O.D 1",
With ,~,^, /'
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Q.O.D
e or preaction valve tested \\\ , ),.- (See Trip Test Table which follows)
\ '-v TRIP TEST TABLE
Operation o PNEUMATIC o ~CTRIC o HYDRAULIC
Piping Supervised DYES J'f'NO Detecting Media Supervised DYES o NO
Does valve operate from the manual trip and/ or reIl)d'ie control stations DYES lJ NO
Is there an accessible facility in each circuit for tesJfng o YES o NO I Method of Testing Circuits
~DEL Does each circuit operate Does each circuit Maximum time to
MAKE supervision loss alarm operate valve release operate release
/' YES I NO YES NO YES NO
v I
11
12
13
DRY PIPE
OPERATING
TEST
14 Date delug
DELUGE &
PREACTION
VALVES
DRY VALVE
(See Trip Test Table which follows)
(See Trip Test Table which follows)
(See Trip Test Table which follows)
TRIP TEST TABLE Q.O D
15 See Control Valve Maintenance Table
Control Valves
Cit Control Valves
By ass Valves
Tank Control Valves
Pum Control Valves
Sectional Control Valves
S stem Control Valves
,,k, Other Control Valves
~0~ ~ Control Valves
V' 16 Water Flow Test at Sprinkler Riser
j
Water Su I Source:
Last Water Flow Test
This Water Flow Test
17 Explain any 11
18
.
CONTROL VALVE MAINTENANCE TABLE
Explain
-jAbnormal
/ Condition
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City
Tank
Test Pipe
Location
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19 Although these comments are not the result of an engineering review, the following desirable improvements are recommended:
Signature:
..........
Date:
(Rev, 2/8/06)
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