HomeMy WebLinkAboutSPRINKLER REPORT - AUG. 2009
,Invoice: IPRIOR LAKE BAPTIST-CHURCH
! -----_._----- ----------------.------,-
~tre~ CR~~~! ~~~~~OAD___ .. !City:!~I?R LAKE
~_oc~ti~n: !Prior Lake Baptist Church ----1. Dept.: I
'Street: 5690 Credit River Road City: Prior Lake State: MN Zip: 55372
~------------------
Foreman: Chris Moe
____ ____...... ..._,_____________________________n_
_",0134
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~
Ahern Fire Protection
13705 26th Avenue, Suite 110
l\finneapolis, MN 55441
(763) 268-0515 P . (763) 268-0516 f
www.ahemfire.com. Since 1880
Phone #:
_J(952) _442-~24---
S~/ 7-01
IDate:
Wet
-- ---'----' .-----1
Foam
Alarms
FireDoors
,FirePumps
LValveTT
I
I
-I
!
!
,
Dry T
,Preactio~--I
r::--:-------I
LDeluge
Stand Pipe/Hose
Contacts: Diane
Invoice/Deficiency
2
--,
.Detector3
!Hydrants
, I
!
Internal Sprinkler
Direct: (952) 447-2824 Ext:
Cell/Pager:
IALARM DEVICES TESTS
I. Did waterflow or pressure switches operate satisfactorily?
2. Did tamper switches operate satisfactorily?
3. Did water motor alarm gongs or electric bells operate satisfactorily?
4. Did alarm service or central station operate satisfactorily and receive proper signals?
IALARM SIGNALS
I System # ./Y. /
iTestTime;-- cP.5
15 YEAR INSPECTION
I. Was the 5 year Inspection performed on the following items?
5, :< !
2;;F-T'
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_ _ . _" _.._.. N"" __ ~
A. Alarm valves
B. Check valves
C. Gauges
D. Internal Examination of Piping
Date due:
15- YEAR TESTING
I. Was the 5 year testing performed on the following items?
A. Sprinkler heads in corrosive environments or rated 3250 F or higher.
B. Standard sprinklers in service for 75+ years.
I to-YEAR TESTING
I. Was the 10 year testing performed on the following items?
A. Standard sprinklers in service for 50+ years.
B. Quick response sprinklers in service for 20+ years.
C. Dry pendant sprinklers.
Annual Sprinkler '
System Inspection
Report
Phone #: '(952) 447-2824
, ,
State: MN Zip: 55372-
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,
2
I Suppression
iAnti Freeze
'Water Spray
!BFRP
!BFDC
,
~G~neric
IBF Lincoln
,BF Omaha
This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2005 IT Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT
. -~-
Page 1 of 3
Work Order #:
852128
For Month/Year:
August 2009
Y N N/A
P
cl'
a?
W
Y N N/A
Y
rptInspection _Annual
~~134
,....DNTROL VALVE SERVICE
/-
1. Were the following service items performed on all control valves?
A. Fully opened and closed?
B. Valve packing checked?
C. Valve stem lubricated?
D. Is the valve properly secured and locked in it's normal operating position?
~~ -.. -
Page 2 of 3
Y N N/A
...1-
.~
[
-~
y N N/A
Y
Y N N/A
1
Y N N/A
K"
Y N N/A
,V
Y N N/A
IBACKFLOW PREVENTOR TEST
1. Did the backflow preventor(s) pass the test of back flow and forward flow capabilities?
IANTI-FREEZE TEST
1. Has the anti-freeze solution for each system below been tested by measuriog specific gravity?
IHANGERS AND SEISMIC BRACING
1. Did hangers and seismic bracing appear to be in good condition, firmly attached, and free from corrosion, from a visual inspection
performed from floor level?
IpWING
I. Was the exterior of expose~ ~pr\nkler ~iping i~ g90d ~ondition, not subjected to external loads, free of mechanical damage?
NOTE: Piping located in concealed spaces, such as above a drop ceiling, are not required to be inspected.
IFIRE DEPARTMENT CONNECTIONS
I. Are fire department connections visible and in good condition?
2. Are caps and plugs in place?
3. Are automatic drain valves operating properly?
4. Do hose connections operate freely?
HOSE RACKS PRESENT?
'lit Yes
No
CONDITION:
Bad
MAIN DRAIN TEST
~tem Number
! Static Pressure
,
~esidual Pressure
'Size of drain
____=r
--1-
,
t--
L___
I. Were all main drains tested at full flow?
Ifno, explain:
2. Were test results similar to the last test?
Ifno, explain:
.."~
3.''''Was there any discharge of obstructive material, heavy discoloration of water, or plugging of the inspector's test connection?
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GENERAL INFORMATION
y
I. Are all the sprinkler systems in service?
2. Is the building completely sprinklered? ............ .............,
3. Are all sprinklers in good condition?
4. Are all sprinklers free of obstruction?
,Aj'~'i\re spare sprinklers and wrenches available?
/'"
6. In spray coating area, are sprinklers free from accumulation?
7. Is hydraulic nameplate and information sign securely in place and legible?
8. Is emergency service contact information readily available?
9. Are alarm devices provided and in good condition?
10. Are all standard sprinklers dated 1920 or later?
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y
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y ~"
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y
OWNER QUESTIONS
I. Any changes in sprinkler system since last inspection?
2. Any fires since last inspection?
This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2005 J.F. Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT.
rptInspection _Annual
_/...-~--
/",,:50134
...~ ..:. ~
Page 3 of 3
/A. Number of sprinkler heads that operated.
B. How long was system out of service? ___,_______ _ _ __________,_"
C. Area where fire occured.
3. Are all areas of the building properly heated to prevent freezing where wet pipe systems exist?
4. Do you have an outside alarm service?
If yes, name and phone number.
~
"l
Note to Owner - Our inspections will only report conditions as they exist at time of inspection and do not guarantee the operation of the
System due to factors beyond our control. (i.e., potentially closed valves or depleted municipal water supply.) Per NFPA-25, this inspection is
based on the assumption that the system has been installed in accordance with all applicable codes and standards.
Owner/Representative's Signature:
INew D-;fi~i~n~ies i~~nd~llri~g~i;~p~ctiOn?_~~es~~ Cll~t~mer recei"e copy of New Deficien~~_~~p~rt?_~~~~O -n,
A previous inspection for your facility revealed the following deficiency in your Fire Protection System:
Date
Def Date: 9/5/2008
Def#: 3150825
System #
Quote:
Quantity:
Should rebuild dry valve on system #1, change internal ~asket.
IF THIS DEFICIENCY HAS BEEN REPAIRED" PLEASE FILL IN DATE' OF REPAIR:. . FOREMAN'S INITIALS: .
AHERN FIRE PROTECTION will perform this repair per your verbal or written approval. Should you elect to proceed with this work, please call or sign 'al'rd
fax or mail a copy of this page. We will call to set up an appointment. Thank you.
ACCEPTED BY: DATE:
A previous inspection for your facility revealed the following deficiency in your Fire Protection System:
Def Date: 9/5/2008
Def#: 3150826
System #
Quote:
Quantity:
Heads in lobby area next to kitchen are recalled central EX coverage heads.
IF THIS DEFICIENCY HAS BEEN REPAIRED, PLEASE FILL IN DATE OF REPAIR: FOREMAN'S INITIALS:
AHERN FIRE PROTECTION will perform this repair per your verbal or written approval. Should you elect to proceed with this work, please call or sign and
fax or mail a copy of this page. We will call to set up an appointment. Thank you.
ACCEPTED BY:
DATE:
A previous inspection for your facility revealed the following deficiency in your Fire Protection System:
Def Date: 9/2/2008
Def#: 3150827
System #
Quote:
Quantity:
Air compressor should be on its own circuit.
IF THIS DEFICIENCY HAS BEEN REPAIRED, PLEASE FILL IN DATE OF REPAIR: FOREMAN'S INITIALS:
AHERN FIRE PROTECTION will perform this repair per your verbal or written approval. Should you elect to proceed with this work, please call or sign and
fax or mail a copy of this page. We will call to set up an appointment. Thank you.
ACCEPTED BY: DATE:
INOTES
2009 WILL BE SHORT TRIPS - $500.00
I,
/----
SERVICES PERFORMED:
Alarm Test
Drain Test
Flow Test
Walk Through
Annual Inspection
Other
This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2005 I,F, Ahern Co. REPRODUCTIONS IN ANY FORM ViOLATES COPYRIGHT,
rptInspection _Annual
/
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"1
Ahern Fire Protection
13705 26th Aven~~., ~cit';110 Dry /Preaction/
Minneapolis, MN 55441 Deluge Pipe
(763) 268-0515 P · (763) 268-0516 f .
www.ahernfue.com. Since 1880 Valve Trip Test
i Date: 8/112009
-----.----
1 ~ork Order #: 85~!~.
I LID #: 3150134
HERN
Location: rrior Lake Baptist Church
If-------,,--------,----__.,___
! Street: i5690 Credit River Road
i---
Phone #:
Date:
-f(95Z) 447-2824--~~#: iC952~~47-2837
I Signature:
System #:
System Type:
Valve Serial #:
Manufacturer Name:
Valve Model:
Valve Size:
Controlling Sprinklers LocatiQn:
Controlling Sprinklers Number:
Date of Last System Pressure Test:
(Must be done every 3rd YOIll')
Date of Last Full-Flow Trip Test:
(Must be done every 3rd Year)
Date Last Operated:
1
Dry
64 8301
Reliable Box
Model D
4
.'. .. Main building>front'entt
.z0
approx.
//'
\
c'8
075
<yo
go
S.::.f-...- 'ltL J ,.
Was gate valve below dry valve open wide atu'est? (if not, how many turns?)
...1
Valve Tripped At - Air pressure / f;J lbs.
f(l)
Pressure Before Test - Air
Pressure Before Test - Water
Size and Location of Test Valve:
Valve Tripped At - Water Pressure
lbs.
min.<::I /?sec.
Valve Tripped At - Time
If system flooded, list time water reached test opening. ___ min. _sec.
Poor Fair (~
Poor Fair WooV
Poor Fair (bawl
Poor Fair . c;caok"
Poor Fair ( 00001
(Y~ NoN/A
Yes) No N/A
;< YeV No N/A
\'.as i No N/A
L~ No N/A
( Yes) No N/A
Yes No <f)
PERFORMANCE
Il'Iter~[ of Body
Moving Parts
Rubber Facing
Seats
Reset?",
Did alarms operate at trip test?
Have low point drains been emptied? #
W ater:;;ontrol valve left open and sealed?
... ~ the valves accessible?
Are the valve enclosures heated adaquately?
Interior of pipe that passes through freezers
free of ice blockage?
Ouick Oneninll Devices I
Device Serial #: I / I
Device Manufacturer Name: i// /. /1
Device Type and Model: ' v /.r-r
Air pressure in upper chamber I f lbs.
Quick opening device tripped at sec. Ibs.
Quick opening device left in service, and control open and sealed?
Yes No N/A
AIR COMPRESSOR
Oil Level?
Cuts In?
~) Pint
Add Oil?
lbs. Cuts Out?
!Dept.: !
'~
iCity: Prior Lake
State: MN Zip: 55372
r----T
! Foreman: )Chris Moe
__m
System #:
System Type:
Valve Serial #:
2
Dry
Manufacturer Name:
lbs.
Tyco
84FM
4
ConlroUing Sprink)ers Location,: pt/e W adaition
/ ~z:: "
?
'of>
0[(
Y'O
?5
Size and Location of Test Valve: 11/. t:. . / I'
Was gate valve below dry valve open wide aj5st? (if not, how many turns?)
Valve Tripped At - Air pressure )I b lbs.
75
Valve Model:
Valve Size:
Controlling Sprinklers Number:
approx.
Date of Last System Pressure Test:
(Must be done every 3rd Year)
Date of Last Full-Flow Trip Test:
(Must be done every 3rd Year)
Date Last Operated:
Pressure Before Test - Air
lbs.
lbs.
Pressure Before Test - Water
lbs.
Valve Tripped At - Water Pressure
Ibs.
Valve Tripped At - Time
min~ sec.
If system flooded, list time water reached test opening. ___ min. - sec.
"""
PERFORMANCE
Interior of Body
Moving Parts
Rubber Facing
Seats
Reset?" . .. .
Did alarms operate at trip test?
Have low point drains been emptied? #
Water control valve left open and sealed?
Are the valves accessible?
Are the valve enclosures heated adaquately?
Interior of pipe that passes through freezers
free of ice blockage?
IOuick Ooeninl! Devices
Device Serial #:
Poor Fair(QgOO
Poor Fair (Oood,.
Poor Fair COo<'>d
Poor Fair lG;oL
P-'lOr Fair ~0I
[y~ .No.- N/A
(Yes ) No N/A
/ {(~ No N/A
(yes>.... No N/A
( Yes.-J No N/A
IYe,yI No N/A
Yes
No
(~~
Device Manufacturer Name:
Device Type and Model:
Air pressure in upper chamber
J
/
1/( /, /
r VI I.iJr
/ r \
!
Ibs.
lbs.
Quick opening device tripped at sec.
Quick opening device left in service, and control open and sealed?
Yes No
N/A
@iManual
Belt Tight?
Tested?
@) Automatic
Belt Conditions?
Reset? Yes
No
NIA
Page 1 of I This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2008 IF. Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT
rptValveTripTest