HomeMy WebLinkAboutReport of Inspection 7/9/2009
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 GRpAT OAK DR., WAITE PARK, MN 56387. (320) 257-6390 760 LffiERTYWAY, NORTH LffiERTY, 1A 52317. (319) 665-4330
4208 ENTERPRISE CIRCLE. DULUTH, MN 55811 · (218) 740-441.2
SHEET I OF 2 - Use separate sheet for each building inspection
REPORT OF INSPECTION
MINNESOTA LICENSE NO. C0075
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INSPECTION NAME !
STREET J /
JOB NUMBER
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BUILDING/LOCATION
INSPECTOR ::::IJ...;I"'7)(\,OP (I
DATE oJ q 0",
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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 of foreign material?
E. When was the dry-piping system last checked for proper pitch?
F. Are dry valves adequately protected from freezing?
Signature
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Title
Date
Inspector's Section (AU responses reference current inspection)
1. General
a. Is the building occupied? ~Yes 0 No
b. Are all systems in service? rs;IYes 0 No
c. Is there a minimum of 18 in. (457 mm) clearance between the top of the storage and the sprinkler deflectors? l;I<Yes 0 No
d. Does all electrical heat tape appear to be satisfactory? DYes 0 No ~ NA
e. Does the hand hose or standpipe on the sprinkler system(s) appear to be satisfactory? DYes 0 No ~A
2. Control Valves (See Item 15.)
a. Are all sprinkler system control valves and all other valves in the appropriate open or closed position? ClJes 0 No
b. Are all control valves in the open position locked, sealed or equipped with a tamper switch? ~es 0 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 0 No Q;NA
c. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight? ~es U No 0 NA
Are they accessible and visible? uYes 0 No 0 NA
4. Wet Systems
a. Are cold weather valves (O.S. & Y) in the appropriate open or closed position? DYes 0 No o"NA
b. Have antifreeze system solution~een tested? DYes 0 No 0 PItA .
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 accessible? ~es 0 No 0 NA
5. Dry System (See Items Il to 13)
a. Are dry valve(s) in service? DYes 0 No 0 NA
b. Are the air pressures and pt;irlling water levels in accordance with the manufacturer's instructions? DYes 0 No 0 NA
c. Has the operation of the air or nitrogen supplies been tested? DYes 0 No 0 NA Are they in service? DYes 0 No 0 NA
d. Were low points drained duripg this inspection? DYes 0 No 0 NA How many?
e. Did quick-opening devices q~erate satisfactorily? DYes 0 No 0 NA
f. Did the dry valve(s) trip pr perly during the trip pressure test? DYes 0 No 0 NA
g. Did the heating equip t in the dry-pipe valve room(s) operate at time of inspection? DYes 0 No 0 NA
6. Special Systems (See Item 14.) "
a. Did the deluge or pre-action valves operate properly during testing? DYes 0 No 0 NA
b. Did the heat-responsive demces operate properly during testing? DYes 0 No DNA
c. Did supervisory devices oPr' during testing? DYes 0 No 0 NA
d. Did flow for kitchen hood sy em shut off gas or electric? DYes 0 No 0 NA
7. Alarms
a. Did water motor(s) and gong(s) test satisfactorily? DYes 0 No ~A
b. Did electric alarm(s) test satisfactorily? t;;!Yes 0 No 0 NA
c. Did supervisory alarm service test satisfactorily? i;lYes 0 No 0 NA
d. Did tamper switches test satisfactorily? ~es 0 No 0 NA
8. Sprinklers
a. Are all sprinklers free from corrosion, loading or obstruction to spray discharge? qVes 0 No
b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing) ~es ONo
c. Are quick response and residential sprinklers less than 20 years old? (Older sprinklers require sample testing) [).Yes 0 No
d. Is stock of spare sprinklers available? Elfes 0 No
e. Does the exterior condition of sprinkler system appear to be satisfactory? [)<yes D No
f. Are sprinklers ofr.rorx;~ t~~perature rating for ~!l_locations? aYes D No
g. Are any spri~e~ a r~calllist? DYes 9(~0
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Signature: !."\ I y'l\ Ni, ,
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NA =NOT APPLICABLE
Date:
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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., WAITE PARK, MN 56387. (320) 257-6390 760 LffiERTYWAY, NORTH LffiERTY, IA52317. (319) 665-4330
4208 ENTERPRISE CIRCLE. DULUTH, MN 55811 . (218) 740-4412
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SHEET 2 OF 2 - Use separate sheet for eachsystem inspection
In~C(ction Name and Num~ I l'
"re, Kr1r3
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~ L::iJ J... 52> -
Type of System "v,) ('+
How Many? I
W~...a!~A:e? _ '7' i
"Mow SW1~f> .
I,. ~with Pressl1!"e Switch
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9. Date dry-pip~ valve trip tested (control valve partially open) ./ (See Trip Test Table which follows)
10. Date dry-pipe valve trip tested (control valve fully open) / (See Trip Test Table which follows)
11; Date quick-opening device tested (See Trip Test TajJkf which follOWS)
DRY VALVE TRIP TEST TABLE a 0 D
12. Date
1./1
MAKE MODEL I SERIAL NO./r MAKE I MODEL SERIAL NO.
// I I
DRY PIPE Time to Trip Water / Air Trip Point Time Water Reached Alarm Operated
OPERATING Thru Test Pipe Pressure / pressure Air Pressure Test Outlet Properly
TEST MIN. SEC. PSI PSI pSf MIN. SEC. YES NO
Without
a.O.D.
With
0.0.0.
, //
deluge or preaction valve tested ~: Trip Test Table which follows)
TEST TABLE
Operation o PNEUMATIC O"ELECTRIC o HYDRAULIC
Piping Supervised o YES /0 NO I Detecting media supervised o YES o NO
DELUGE & Does valve operate from the manual triB-and/or remote control stations o YES o NO
PREACTION Is there an accessible facility in ea~rcuit for testing Method of testing-circuits
VALVES o YES / 0 NO
/' Does each circuit operate Does each circuit Maximum time to
:s MAKE /'MODEL suoervision loss alarm o~erate valve release oDe rate release
/ YES I NO YES I NO YES r NO'"
:t:;. 11 'i // I I 1
ontrol Valve Maintenance Table.
Control Valve Mamtenance 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
Sec\iQ!otal Control Valves
System Control Valves j - (..,1 F}f v' Vi"'...... V/ J/, '/(1<:
Other Control Valves / I , 1- I ! f~o I! / . ,'.... ..(/ I / /"j ~ )
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Kitchen Control Valve
16. Water Flow Test at Sprinkler Riser
Wat~r Supply Source:
Size of
Test Pipe
Static
Pressure
Pump
Residual Differential
(Flow)
Pressure
Date
City
Test Pipe
Location
Tank
Last Water Flow Test
This Water Flow Test
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14. Explain any "No" answers and comments:
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Date:
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Signature: