HomeMy WebLinkAboutReport of Inspection 6/17/2009
SUMMIT ~ 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., WAITE PARK, MN 56387 · (320) 257-6390 7(fJ LIBElITYWAY, NORTH LffiERTY, IA 52317. (319) 665-4330
4208 ENTERPRISE CIRCLE. DULUTH, MN 55811 . (218) 740-4412
SHEET 1 OF 2 - Use separate sheet for each building inspection
REPORT OF INSPECTION
JOB NUMBER 7 '1 :3 Lt(
BunDINGILOCATION
INSPECTOR ::::::t) t~-C;--JK(Jc. 1\
DATE G' 17 -Of!
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:
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C. Describe any fires since last inspection:
D. When was the system piping last checked for stoppage, corrosion offoreign material?
E. When was the dry-piping system last checked for proper pitch?
F. Are dry valves adequately protected from freezing?
Signature Title
Date 1;, /7. ny
Inspector's Section (AU responses reference current inspection)
1. General ,
a. Is the building occupied? I5LYes D No
b. Are all systems in service? -~Yes D No
c. Is there a minimum of 18 in. (457 rom) clearance between the top of the storage and the sprinkler deflectors? DYes~o
d. Does all electrical heat tape appear to be satisfactory? DYes D No )d NA
e. Does the hand hose or standpipe on the sprinkler system(s) appear to be satisfactory? DYes D No br'NA
2. Control Valves (See Item 15.) .
a. Are all sprinkler system control valves and all other valves in the appropriate open or closed pqsition? i(Yes D No
b. Are all control valves in the open position locked, sealed or equipped with a tamper switch? E1Yes 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 No.NA
c. Are fire department connection~_ satisfactory condition, couplings free, caps in place, and check valves tight? 9(,Yes D No D NA
Are they accessible and visible? JJl'Yes D No DNA
4. Wet Systems
a. Are cold weather valves (O.S. & Y.) in the appropriate open or closed position? DYes D No j(NA
b. Have antifreeze system solutions been tested? DYes D No O'<NA
c. What temp is antifreeze? -
d. In areas protected !>y wet system(s), does the building appear to be properly heated in all areas, including blind attics and perimeter areas
where accessible? ~es D No D NA
5. Dry System (See Items Il to 13)
a. Are dry valve(s) in service? DYes D No A
b. Are the air pressures and priming water 1 els in accordance with the manufacturer's instructions? DYes D No D NA
c. Has the operation of the air or nitroge upplies been tested? DYes D No D NA Are they in service? DYes D No D NA
d. Were low points drained during thi 'nspection? DYes D No D NA How many?
e. Did quick-opening devices oper satisfactorily? DYes D No D NA
f. Did the dry valve(s) trip pro y during the trip pressure test? DYes D No D NA
g. Did the heating equipment' the dry-pipe valv7l'OOm(s) operate at time of inspection? DYes D No D NA
6. Special Systems (See Item 14.) ,,/
a. Did the deluge or pre-action valves ope e properly during testing? DYes D No D NA
b. Did the heat-responsive devices ope e properly during testing? DYes D No DNA
c. Did supervisory devices operate d 'ng testing? DYes D No DNA
d. Did flow for kitchen hood syst 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!3.NA
b. Did electric alarm(s) test satisfactorily? til)'es D No D NA
c. Did supervisory alarm service test satisfactorily? lJ(Yes D No . D NA
d. Did tamper switches test satisfactorily? l:lIYes D No D NA
8. Sprinklers
a. Are all sprinklers free from corrosion, loading or obstruction to spray discharge? DYes JAJ'l0
b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing) )jiYes DNo
c. Are quick response and residential sprinklers less than 20 years old? (Older sprinklers require sample testing) JijYes D No
d. Is stock of spare sprinklers available?G4Yes D No
e. Does the exterior condition of sprinkler system appear to be satisfactory? !;;IYes D No
f. Are sprinkler~er temperature rating for their locations? CJYes D No
g. Are any s~er, I).eaia~ec)dllist? DYes !:):No
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S. . ~",,-' f'!' j 1- ~-" D I
Ignature. , :y' \ t vli\~ '-' ate: \)
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NA =NOT APPLICABLE
709
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SUMMIT FIRE.PROTECTION
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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, WAITE PARK, MN 56387 · (320) 257-6390 760 LffiERTY WAY, NORTH LIBERTY, IA 52317 · (319) 665-4330
4208 ENTERPRISE CIRCLE. DULUTH,MN 55811 . (218) 740-4412
SHEET :2 OF 2 - Use separate sheet for eachsystem inspection
In~tion Nam. e and Nu;nl>er '. 793 t-f,
'c"l "", \v'; J...-t A t~r I -
Type of System ,Ale.)....
How Many? I
~~~. 1.-1 I!
(' /"PIow SWitch or -=> '
,-,~th Pressure Switch
9. Date dry-pipe valve trip tested (control valve partially open)
10. I>ate dry-pipe valve trip tested (control valve fully open)
11; Date
/ (See Trip Test Table which follows)
-1See Trip Test Table which follows)
/
12. Date
quick-opening device tested . (See Trip Test ,r;t;;which follows)
DRY VALVE TRIP TEST LE 0.0.0.
MAKE MODEL T SERIAL NO. .J" MAKE I MODEL SERIAL NO.
71 I
DRY PIPE Time to Trip Water // Air Tri~ Point Time Water Reached Alarm Operated
OPERATING Thill Test Pipe Pressure /' pressure Air ressura Test Outlet Property
TEST MIN. SEC. PSI PSI PSI MIN, SEC. YES NO
Without .//
0.0.0.
WIlh ,-
0.0.0.
f
./
deluge or preaction valve tested (See Trifl/Test Table which follows)
TRIP TESt TABLE
Operation o PNEUMATIC o ELECTRJe o HYDRAULIC
Piping Supervised DYES o NO/ Dete<;ting media supervised DYES o NO
DELUGE & Does valve operate from the menual trip andIQf ~ control stations DYES o NO
PREACTION Is there an accessible facility in each clrcu~esting Method of testing-clrcuits
VAlVES DYES 0
/ Does each circuit operate Does each circuit Maximum time to
MAKE MO,9El s"""rvislon Joss alarm I """rate valve ralaase ooerate release
/ YES I NO YES I NO YES I NO
I I
ontrol Valve Maintenance Table.
Control Valve Maintenance Table
13. See C
Explain
Abnormal
Control. Valves Number Type Open Secured Closed Signs Condition
City Connection Control
Valve
Tank Control Valves
Pump Control Valves
Sectional Control Valves
System Control Valves J _ II II ('')c,t-. V '1,.-"., V?-o. i/ Ij '))<...
Other Control Valves / / "-' ,I
I
Kitchen Control Valve
16. Water Flow Test at Sprinkler Riser
Water Supply Source:
Date
City
Test Pipe
Location
Tank
Static
Pressure
Differential
Size of
Test Pipe
Last Water Flow Test
This Water Flow Test
14. Explain any "No" answers and comments:
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Date: C I J 0 0/
Signature: