HomeMy WebLinkAboutFire Sprinkler Report 7/2/2009
~GILB
FIRE SPRINKLER SYSTEM
INSPECTION & TEST REPORT
Inspected By:
Property Name:
Property Address: 16306 Main Avenue SE
Prior Lake, MN 55372
Contact & Phone: 952-447-9220
Inspection Date: Inspection #: 1038
Bill To: VFW Prior La
Bill To Address: PO Box 116
Prior Lake, MN 55372
Was owner representative contacted prior to inspection? 0 Yes I4r'NO
~
Representative's Name:
,tJ Yes
~Yes
DYes
ONo
o No
~ -
~Ct::!~
Last inspection report available? ~Yes 0 No
o Yes~ No
Rep present during inspection?
Were all rooms available for inspection?
As-built drawings available?
Rep's Name:
o
Zone map available?
.. ,I: .
..'r."1~I.JUIU.:":I'i:I"'T."I~~.I~I:t:i".'I']~
Control Valves
Pressure Regulating Devices
Piping
Hose Connections
Cabinet
Hose
Hose Storage Device
Hose Nozzle
Date of Installation:
No. of Dry: -L No. of Preaction:
No. of Other:
EtU:tl~Ir4".:&.''''''''~~.I~i:lU..'['J~
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
.
Hose Houses
Hose Hydran~ (Dry Barrel & Wall)
Monitor Nozzles
Hydrants (Wet Barrel)
Mainline Strainers
Piping (Exposed)
Piping (Underground)
~~~
-
Watertlow Devices
Water Motor Gong: No. Present:
Did the Alarm Sound?
jRo
%0
R:.CJ
Vane Type: -=::::=...- Pressure Switch Type:
r
Do all waterflow devices operate properly?
Valves Supervisory Devices
No. Present: .::::::::::::
Supervisory Signal Devices
No. Present: ~ Type:
Do all wMerfl!lW"devices operate properly?
.~ -
Main Drain Test
Static: ~ PSI
Residual:
Antifreeze Solution
Specific Gravity at 60' F:-=--
Freezing POint: ~ Adjustment needed? 0 0
.l!"!lll:"'I'J:f!lct.r.!..'~I.I~"'U..'['J\)I"';l~liETiiliBiBmmI
.1I"!'l'l.fl".!1'::I:M:I:t~~I~.II:""''''''':I''l.I~'I..':I''.I['J~.'',:.r:ElififilmRlBi"I'!E1i
'." (ontlOl valves left opened dlld system placed back In ser\lce
NOTES
~ ~~~~.:lIIl'~I.I~aUII..I.]~"_I_II~ICW"'Y:iEI'.I.=-!l!IWY.lIS'I:lII~li1im
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Page 1 of 2
~GllBE
Dry Pipe Valve Trip Test Report
Inspected B :
Gilbert Mechanical Contractors, Inc.
4451 West 76th Street
in ,M N 55435 (952) 835-3810
tfnspection #: 1 038
Bill To: FW Prior Lake #6208
Bill To .~,ddress: PO Box 116
Prior Lake, MN 55372
Property Name: VFW Post #6208
Property Address: 16306 Main Avenue SE
Prior Lake, MN 55372
Contact & Phone #: 952-447-9220
Was owner representative contactedpriorto inspection?
Representative's Name: _
Rep. present d(Jringinspection~es orQ.Jo*
* If no, see notes on following page
OYesor~o
Date conta~ -
Rep'sName: . *
DRY PIPE VALVES System 1 System 2 System 3 System 4
Air Pressure
PSI
PSI
PSI
PSI
PSI
PSI
PSI
PSI
PSI
PSI
PSI
Manufacturer
Valve M6delNliniber
Valve Serial Number
Valve Size
Controlling Number Sprinklers (approx.)
Date Last TripTest
Date Last Operated
Air Pressure Before Test
Water Pressure Before Test
Size & Location of Test Valve
Was Gate Valve Below Dry Valve
Open Wide at Test? (If not, how many turns?)
Water Trip At: I () PSI
Water Pressure
Time
If System Flooded, List Time Water Reached
Test Openings
PSI
Exterior
Interior
a YES 0 NO
aYES a NO
o VES 0 NO
aYES a NO
aVES ONO
OVES a NO
OVES ONO
QVES a NO
Strainers, Filters, Orifices
Notes:
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