HomeMy WebLinkAboutFire Sprinkler Report 3/17/2009
Contact & Phone: ~.~: --;.. ~ WITH SUNTIDE 651-603-0321
Was owner repres:nt~d p~ to inspection?
Representative's Name: ~
Rep present during inspection? 0 Yes ~NO
Were all rooms available for inspection? 0 Yes f2r.. No
As-built drawings available? 0 Yes ~o
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SOUTH LAKE VILLAGE -
Property Name:
Property Address: 16731 HIGHWAY 13 SOUTH
PRIOR LAKE, MN 55372
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Date of installation:
Location of V~lve Assy: .,;;l-
No. of Systems:
FIRE SPRINKLER SYSTEM
INSPECTION & TEST REPORT
Inspection Date: : h tJ. Inspection #: 2606
Bill To: BEALMAKZ~:-mERS LLC
Bill To Address: cIa SUNTIDE COMMERCIAL REALTY
2550 UNIVERSITY AVENUE WEST#416-S
SAINT PAUL, MN 551 ~~ /
~'" Co....ct" q4t6?
~ves 0 No
&1 Ves 0 No
Aves 0 No
Rep's Name:
Last inspection report available?
Zone map available?
No. of Wet:
No. of Dry:
No. of Preaction:
No. of Other:
I NSP ECTI ONS ~v~tem components have been Inspected;)$ follows
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Gauges (Dry, Preaction, Deluge)
Waterflow Devices
Valve Supervisory Devices
Supervisory Signal Devices (Except Valve)
Supervisory Switches
Gauges (Wet System)
Hydraulic Nameplate
Hanger/Seismic Bracing (Exposed Only)
Pipe & Fittings (Exposed Only)
Sprinklers
Spare Sprinklers
Fire Department Connection
Control Valves
Alarm Valves
Check Valves
Pre-Action/Deluge
Dry Pipe Valves
Valves - Other
Pressure Reducing & Relief
Backflow Prevention Assemblies
.....I...I~il.Jr.I:.:::."...I.~I::.:.....~..a~ll.I~I.:I:.il........'
Control Valves
Pressure Regulating Devices
Piping
Hose Connections
Cabinet
Hose
Hose Storage Device
Hose Nozzle
~ves
",,1. _
No N/A Other
~
.1I:tIIUIllr.fll:t::.:.II:'I.i._r.lll,ill.,.""I':I:.a..I".,LI
Hose Houses
Hose Hydrants (Dry Barrel & Wall)
Monitor Nozzles
Hydrants (Wet Barrel)
Mainline Strainers
Piping (Exposed)
Piping (Underground)
''Il.,~:::
J
Waterflow Devites
SUPERVISORY DEVICES
,,!"I:-,e-,S~~~rvl~ory Devices
Water Motor Gong:
Vane Type: ___~___I
No. present~
No. Present: ....
Did the Alarm Sound?
Pressure Switch Type:
--
Do all waterflow devices operate properly?
No. Present: ~--Type:--
Do all supervisory devices o~era~e properly?
Supervisory Signal Devices
.~'~I~l".il.':L'"
Main Orain Test
Static: st? PSI
Antifreeze Solution
Specific Gravity at 60. F:
~;'\i:..lIl.I:', .~ ~"=-'~'~I:';""'I..A:_-;''''Ii;.:JII.t..I~C.~-=,,,~'""=-!L..dI.I~'I:'.""."".'I"U~
... 1" 'I'~:'..:'I:':" ~..;.~~\;...:..:n;,~,~",t. .:1:.;,....l....I.~I:.a=-o;l...;ltI.I...~j.I::.a~1II
Residual:
'1D PSI
to
kD
_~_D
Freezing Point: .
"F
Adjustment needed? 0 0
.... ,,!.I';':..':Il.~:o.4 'C'I:=.IUI"f"~~~""~I~=I.IL..AI..I.l:I;"w.o:""'"..I;.....:w'l;"WII.1
.l:i...I I~ ~IIII.I" ,.u';'=<":I:r::"I"'I~~".=W:''':'';''',J.'''''''''~.''.l.J'''I.I:I''=-;''';I.'1:.a......I..a.
~ Control valves left opened and system placed back In service
NOTES
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REQUIRED PERIODIC INSPECTIONS (Check all that apply)
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NFPA 25 (2002)
"An investigation of piping and branch line conditions shall be conducted every 5 years by opening a flushing connection at the end of one main ,and by
removing a sprinkler toward the end of one branch line for the purpose of investigating for the presence of foreign organic and inorganic material."
(Stated in NFPA 2S, 2002 Chapter 13.2.1)
Has the owner been informed of the obstruction investigation requirement?
Has an obstruction investigation been performed?
Is obstruction investigation required with this inspection?
oj
o
Date last obstruction investigation was perform;d:U \.
If yes, owner's authorization: /Vr{
Inspections to be completed every 3 years
D Water Storage Tank
Inspections to be completed every 5 years
D Alarm Valves
1)l Obstruction Inspection (1 Inspection/system)
1KL Check Valves (Interior)
D Preaction/Deluge Valves (Interior)
D Dry Pipe Valves (Interior)
Tests to be completed every 3 years
D Dry Pipe Valves (Full Flow Trip Test)
D Quick-Opening Devices
Tests to be completed every 5 years
D Pressure Reducing and Relief Valves
o Hose Connection Pressure Reducing Valves
D Hose Rack Assembly Pressure Reducing Valves
o Fire Hose
o Standpipe & Hose System Hydrostatic Test
D Standpipe & Hose System Flow Tests
Q Water Sto ge Tanks Level Indicators
~ Gauges
o Sprinklers - xtra HI h Temperature
o Sprinklers - Corrosive Environment
Tests to be completed every 10 years
D Sprinklers - Fast Response
o Sprinklers in service over 50 years
TERMS AND CONDITIONS
1. Definitions .
Nlnspection" is a visual exa.mination of a system or portion thereof to verify that it appears to be undamaged and in operational condition.
"Test'" is a procedure used to determine the status of a system as intended by conducting periodic physical checks on water-based fire protection systems such as waterflow tests, fire
p,ump tests, alarm tests, and trip tests of dry pipe, preaction, or deluge valves. These tests follow up on the original acceptance tests at intervals specified by NFPA 25.
'Maintenance" is work periormed to keep fire system equipment operable or to make repairs.
"Owner" is the owner of the property or the occupant, management firm, or managing individual that has received authority from the owner for the inspection, testing, and mainte.
nance Of the fire protection system.
"NFPA 25" is the Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems (2002 edition) published by the National Fire Protection Association.
"Authority Having Jurisdiction" is an organization, office, or individual responsible for enforcin~ the reguirements of NFPA 25 or for approving procedures,
"Deficiency" is a condition where a system component appears to be damaged, not in operating condition, or the application is not within its designed limits or application.
"Work" is the inspections, tests, and maintenance as reqUired by NFPA 25 and as limited by the scope of the contract.
2. Work
Gilbert Mechanical Contractors, Inc. shall inspect and test the fire sprinkler system for the building in accordance with these terms and conditions. The inspection and tests shall be
performed by qualified inspectors meeting any and all requirements of the applicable Authorities Having Jurisdiction.
The Owner shall provide access to all areas of building containing system equipment and components requiring inspection under the scope of this inspection. The Owner shall provide
a safe working environment and to the best ofthe Owner's knowledge, no unsafe materials or conditions exist. The Owner agrees to provide all MSDS sheets upon Gilbert Mechanical
Contractors, lnc, request.
3. Scope
(al Gilbert Mechanical Contractors, Inc. shall inspect and test the fire sprinkler system(s) in accordance with the applicable requirements as contained in the 2002 edition of NFPA 25.
AI applicable tests and inspections will be periormed on an annual basis.
(b) The following inspections and tests are excluded from the scope of this inspection and test:
(il Inspections: (ii) Tests:
Periodic (5 Yearllnspections Periodic (5 Year) Tests
Fire sprinklers, pipe, fittings, hanger, and bracing in concealed spaces Sample testing for aged fire sprinklers
such as above suspended ceilings Backflow device performance testIs) except for forward flow test
~~~i~~h~kv~lves (iii) ~~i~~~~~~C~r preventative actions including re airs, adjustments, or modifications to
System check and alarm valves (internal) correct deficiencies unless specifically include~in the scope of contract.
Building areas for adequate heat
Records
The Owner shall provide access to original system commissioning documents including maintenance manuals, material test certificates, certified fire ,pump curves, and as-built draw-
ings. The Owner further agrees to provide any and all copies of inspections and tests periormed on the fire sprinkler system post commissioning within the guidelines of NFPA Z5. If
these documents and recards are not available, the Owner shall hold Gilbert Mechanical Contractors, Inc. harmless for all exclusions, omissions, and damage to the system that may
result from the lack of information contained within such documents.
The Owner acknowledges that these inspections and tests are not intended to reveal design or installation deficiencies. The inspections and tests are to verify that the system appears
to be in operating condition and system components appear to be undamaged.
Corrective Action
The Owner is solely responsible for the correction action required to correct deficiencies identified by the inspections and tests periormed under the scope of this inspection. The
Owner further acknowledges that the inspection and tests are limited to the condition of the system found at the time of the work and Gilbert Mechanical Contractors, Inc. is not
responsible for the condition of the system at any time subsequent to the date of the work. - .
In addition, certain comments and recommendations made as a result of the inspections and tests may transcend the scope of NFPA 25. Such observations are made without knowl-
edge ofwh~n the potential deviation occurred and what codes, standards, or jurisdictional amendments or variances were in affect at time of said deviation. Such e)(ceptions are only
a record of observations of potential deviations from current codes and standards and are in no way an implication that any other system components or areas of coveragp. are in or
-- - - out-otcompliance-,.-- -- - - - - - - - -------- -------~.------~--- ----__ - .. __ __ _________________.__ ~____ .____ ______
5~ -1i;~'i)",;,~~';1~n:_T~~r.;:,~~,f~~~:~r; this. ag':;e;;ent. Payment IS due thirty (30) days t,:;;-m th~ date of the invoice. Inspections ma be s<;bject ~ inflationary cost increases. .
This agreement s~aYI remain In effect for a period of (1) year and shall automatically continue from year to year thereafter unless thirty Y30) days prior to the termination of any yearly
period, either party gives wntten notice to other party of Its Intent to terminate or renegotiate the terms and conditions set forth herein,
liability Release and Indemnity
The Owner hereby releases Gilbert Mechanical Contractors, Inc. and its affiliates, and their directors, officers, employees and a,gents, from ail claims, liabilities and damages which
arise or result directly or mdlrectly, from the Owner's negligence, error or omission and the Owner agrees to defend, indemnify and hold harmless GIlbert Mechanical Contractors,
Inc. and its affiliates, and their directors, officers, employees and agents, from and against any and all claims, losses or damages to persons or property resulting indIrectly or directly
from the Owner's conduct or omission.
lImitation of Liability
The Owner agrees that Gilbert Mechanical Contractors, Inc.'s liability for any claims, losses or damages resulting directiy or indirectly from Gilbert Mechanical Contractors, Inc.'s "er-
formance of this agreement, including any negligence, error or omission on the part of Gilbert Mechanical Contractors, Inc., shall be limited to the amount of fees received by Gilbert
Mechanical Contractors, Inc. under thiS agreement.
Waivers
No waiver of any provision of this Agreement shall be effective, except pursuant to a written instrument signed by the party waiving compliance, and any such waiver shall be effective
only in the specific instance and for the specific purpose statea in such writing. ,
10. Subrogation
The Owner hereby releases discharges and agrees to hold Gilbert Mechanical Contractors, Inc. and its affiliates harmless from any and all claims liabilities, damages, losses or expenses
arising from or caused by any hazard covered by insurance resulting from or related to this inspection. whether said claim is made bV Gilbert Mechanical Contractors, Inc., his agent or
insurance company or by any other parties claiming under or through the Owner. The Owner agrees to indemnify Gilbert Mechanical Contractors, Inc. against, defend and hold Gilbert
Mechanical Contractorst Inc. harmless from any claims for subrogation which may be brought against Gilbert MechanIcal Contractors, Inc. by any Insurer or Insurance company or Its
agents or assigns, incluaing payment of all damages, expenses, costs and attorneys fees.
S.
4.
7.
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9.
Gilbert Mechanical Contractors, Inc., 4451 W 76th Street, Edina, MN 55435 (952) 835-3810
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