HomeMy WebLinkAboutReport of Inspection 11/3/2008
,.,~.:"
<-.;- -J
SUMMIT FIRE PROTECTION
575 MINNEHAHA AVE. W. ST, PAUL, MN 55103 · (651) 251-1880
3026 40TH AVE. NW. ROCHESTER, MN 55901 · (507) 280-0622
418 GREAT OAK DR., WAITEiPARK, MN 56387. (320) 257-6390
760 LTBERTYWAY, NORTH UBERTY, IA52317. (319) 665-4330
SHEET 1 OF 2 - Use separate sheet for each building inspection
REPORT OF INSPECTION
JOB NUMBER 7 (; J.. 62>
BUILDINGILOCATIQN .....', ."
IN~PECTOR .~QJ.w,~Jt~'.~
DATEIJ"'~ -o~ . .' .
MINNESOTA LICENSE NO, COO75
INSPECTION NAME'
STREET
CITY & STATE
Owner's Section (to be answered by Owner or Occupant)
A. Explain any occupancy hazard changes since the previous inspection:
B. Describe fire protection modifications made since last inspection:
C. Describe any fires since last inspection:
D. When was the system piping last checked for stoppage, corrision of foreign material?
E. When was the dry-piping sYstem 11ist checked "for'proper pitch? .: ..:."'-\ -""j" '.:ttor-"''''",">l7'''''''''",=,,,~ ; ="",,-, ~".. ,-~c -',,,,,.-
F. Are dry valves adequately protected from freezing?
Signature Title Date
Inspector's Section (All responses reference current inspection)
1. General " /
a. Is the building occupied? ~~s D No
b. Are all systems in service?I'JYes D No
c, Is there a minimum of 18 in. (457 mm) clearance between the top of tp<;storageand the sprinkler deflectors? JiYes D No
d. Does all electrical heat tape appear to be satisfactory? DYes D No ~-~.,.
e. Does the hand hose or standpipe on the sprinkler system(s) appear to be satisfactory? DYes D No ~A
2. Control Valves (See Item IS.) ~u
a. Are all sprinkler ~ystem control valves and all other valves in the appropriate open or closed l'9Sition? UYes D No
b.Are all con~olvalves in the open position locked, sealed or equipped with a~~r switch? ...aYes D No
3. Tanks, Pumps,.Fire Department Connections .-- -
a. When was fire pump last tested for performance? --
b. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? DYes D J'lo C'tNA
c. Are fire department connection0n satisfactory condition, couplings free, caps in place, and check valves tight? l!!l.Yes D No DNA
Are they accessible and visible? '\iJYes D No DNA
4. Wet Systems x
a. Are cold weather valves (O.S. & Y) in the appropriate open ~c1osed position? DYes D No 'U NA
b. Have antifreeze system solutil;ms been tested? DYes D NolQ NA
c. What temp is antifreeze?
d, In areas protected by wet system(s), does the building appear to be properly heated in all areas, including blind attics and perimeter areas
where accessibleTWYes D No D NA
'~'" ~~ Drr.,System (See Items II to 13)
a. Ar~drYvalve(s) in service? DYes P No DNA
b. Are the air pressures and primin 'ater levels in accordance with the man.~factprer's ins~ctions? DYes. D No D NA
~~ ~~~:i~~;~;:i~n~~~~ro,~g tJ;:s;~~~J;'d~~ebe~o g~A D~~W~~~? Are they iifser\iictl?" DYes D No CJ NA
e. Did quick-opening devi~ operate satisfactorily? DYes D No D NA
f. Did'the"dry valve(s) trjpproperly during the trip pressure test? DYes D No DNA
g. Did the heating e~pment in the dry-pipe value room(s) operate at time of inspection? DYes D No D NA
6. Special Systems (See Item 14.)
a. Did the deluge or pre-action vat yes operate properly during testing? DYes D No DNA
b. Did the hf'lat-responsiv~dev' s. operate properly during testing? DYes D No DNA
c. Did supetvisory devices rate during testing? DYes D No D NA
d. Did flow for kitcheryt od system shut off gas or electric? DYes D No D NA
7. Alarms'
a. Did water motor(s) and gong(s) test satisfactorily? DYes D No '\iiit'NA
b, Did electric alarm(s) test satisfactory? 'if Yes D No DNA
c. Did supervisory alarm service test satisfactory? 1i!!fYes D No D NA
d. Did tamper'switP,ces test satisfactory? ~es D No DNA
8. Spnnklers . ,
a, Are llllsprinklers free from corrosion, loading or obstruction to spray discharge? CfYes D No
b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing)\,E1Yes DNo
c. Are quick response and residential sprinklers less than 20 years old? (Older sprinklers require sample testing) [JYes D No
d. Is stock of spare sprinklers availablepgYes D No
e. Does the exterior condition of sprinkler system appear to be satisfactory? t:JYes D No
f. Are sprinklers of proper temperature rating for their locations? !:aYes D No
g. Are any spri~Oii1r'i'ec'lrtl~.Q.Y~l' 'ilNo
(,,) /1 I,': / :\4J)~""
Signature: ,.' /' . 'r- ,/. 'Ii' t 'i-V' \ j \, i
/' " VI
l.....~
NA =NOT APPLICABLE
Date: J I J. OS
> ".,./ ...--..:.c ;- .f-1~~ .-"<::}? SUMMIT FIRE "OTECTIQN
'" ~ .
575 MINNEHAHA AVE. W- ST. PAUL, MN 55103 - (651) 251-1880 1 302640THAVE,NW - ROCHESTER, MN 55901-(507) 280-0622
418 GREAT OAK DR., WAITE PARK, MN 56387 - (320) 257-6390 .760 LIBERTY WAY, NORTH LffiERTY, IA52317 - (319) 665-4330
4208 ENTERPRISE CIRCLE - DULUTH, MN 55811 - (218) 740-4412 Ii
wnhout
0.0.0.
With
Q.O.D.
Water
Pressure
PS
/
I-
SHEET 2 OF 2 - Use separate sheet for eachsystem inspection
/
~In s e 'on Nam~ an~NU,be % /,,/, M, II . '-
Il'l/)~SQ l\' I I."CI/'''<
. V,/' tIY
?pate dry-Pl~Valvetifp tested (cbotrQI.valvepartiallyppe, n,r
':',,":.'.,' - ,";- -,,' ".-,."'-, --,'" '::_'- - , -" ""; ".' - ,',-
to. Dateliry7pipe valve' trip tested (control valve fully open)
11. Datequick~opening device tested . (See Trip
DRY VALVE
MAKE
MODEL
'" ,($ee!rip Test' Table. WhiClffOi~()W~)
.' ,,(See trip Test Table, whlctJfollowsJ2.
sf Table whichfoflows) .
EST TABL:E 0.0.0.
L NO. MAKE
MODEL
SERIAL NO.
DR'" PIPE
OPERATING
TEST
Time to Trip
Thru Test Pipe
MIN. SEC.
Trip Point
Air Pressure
PSI
Time Water Reached
Test OuUet
MIN. SEC.
Alarm Operated
Property
YES NO
~___""",-.o_"~~"_._____.,.,,_.,.+--...~.__.~_,,___ ;...~._____~~ .L?_'______ - -'--~~------ .'~---
DELUGE &
PREACTION
VALVES
o PNEUMATIC
DYES
o NO
o NO
12. Date deluge or preaction valve tested
MAKE
NO
13~ S~eContrblytilveMl.Unteriance Table.
Control Valve Maintenanci! Table
Control Valves
City Connection Control
Valve
Tank Control Valves
Pump Control Valves
Sectional Control Valves
..... System Control Valves
Other cOntrol alVes
Kitchen Control Valve
16, WatetFlow Test3r'Spiinlder RlS-er
Water Supply Source:
Number
Type
Open
Secured
Closed Signs
explain
Abnormal
Condition
) '" ", ,;'-/,.,.,.,>.~",....bi'~:;:';""",.,;'-
Date
City
Test Pipe
Location
Tank
Static
Pressure
Differential
Size of
Test Pipe
Last Water Flow Test
This Water Flow Test
"
(V=AJ ~
(})~acl
A 6'fJfY '5 et~' ~~ 1\4- ~ L'O~ I "
\'., ,'~,~r,1- 'i\",'" Qff \<.~ C,'"')
';:,
14. Explain any "No" answers and co
0# 1(4)-
rL .1 \.
,', .,~^-<,' -.;..
Of'. ,di,~tr {}.fir- . '
f:'y.J. :' (i ~ .
1:11~
Signature: ,::..> '(~/{/1,.,., .... . ./\.""
.... )./ -', . \/
/ / '
_.~...,,~. ,
Date:
/l309->
, . -'