HomeMy WebLinkAboutInspection Report 12/10/2009
FIRE SPRINKLER SYSTEM
INSPECTION & TEST REPORT
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Bill To: Air-Pure Sy em
Bill To Address: 16873 Fish Point Road SE
Prior Lake, MN 55372
I nspected By:
Property Name: Air-Pure Syste
Property Address: 16873 Fish Point Road SE
Prior Lake, MN 55372
Contact & Phone:
Was owner representative contacted prior to inspection?
Representative's Name:
Rep present during inspection?
Were all rooms available for inspection?
As-built drawings available?
-,
DYes -BtNO
o Yes ~ No Rep's Name:
~es 0 No Last inspection report available?
o Yes No Zone map available?
Date Contacted:
...---
r/!t!.es 0 No
o Yes No
---....,
. ..
Date of Installation: --;-- No. of Systems: --I-- No. of Wet: --.f--.- No. of Dry: _ No. of Preaction: _ No, of Other:
Yes No N/A bther~YeS No N/A Other
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Gauges (Dry, Pre action, Deluge) Control Valves
Waterflow Devices Pressure Regulating Devices
Valve Supervisory Devices Piping
Supervisory Signal Devices (Except Valve) Hose Connections
Supervisory Switches Cabinet
Gauges (Wet System) Hose
Hydraulic Nameplate Hose Storage Device
Hanger/Seismic Bracing (Exposed Only) Hose Nozzle
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 Hydrants (Dry Barrel & Wall)
Monitor Nozzles
Hydrants (Wet Barrel)
Mainline Strainers
Piping (Exposed)
Piping (Underground)
~~~~
.
SUPERVISORY DEVinS
Valves Supervisory Devices
Water Motor Gong: No. Present: ....::::::=
Vane Type: -L Pressure Switch Type: ----.
No. Present: <Q
~NDo
Did the Alarm Sound? ~
Do all waterflow devices operate properly? h' 0
Do all supervisroy devices operate properly? ~ D
Waterflow Devices
Main Drain Test
No. Present: ~ Type:
Static: ~ PSI
Supervisory Signal Devices
~":"'~I"I'r.'~..:I.''''
Residual:~ PSI
.
. '
Adjustment needed? 0 0
.
Antifreeze Solution
Specific Gravity at 6 ' .
reezing Point:
. WATER SPRAY FIXED SYSTEM INSPECTION (See attached sheet) . FOAM WATER SPRINKLER SYSTEM INSPECTION (See attached she ct)
~~ Control valves lelt opened and system pldced bdlk In ser, Ice
MJTES
Gilbert Mechanical Contractors, Inc., 4451 W 76th 5treet, Edina, MN 55435 (952) 835.3810
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REQUIRED PERIODIC INSPECTIONS (Check all that apply)
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NFPA 25 (2002)
"An investigation of piping and branch line conditions shall be conducted every 5 years by opening a flushing connection at the end of one main and by
removing a sprinkler toward the end of one branch line for the purpose of investigating for the presence of foreign organic and inorganic material."
(Stated In NFPA 25, 2002 Chapter 13,2.1)
yest
o Date last obstruction investigation was performed:
o _
If yes, owner's authorization:
o Hose Connection Pressure Reducing Valves
o Hose Rack Assembly Pressure Reducing Valves
o Fire Hose
o Standpipe & Hose System Hydrostatic Test
o Standpipe & Hose System Flow Tests
[J '!later Storage Tanks Level Indicators
.2(Gauges I
o Sprinklers - Extra High Temperature
o Sprinklers - Corrosive Environment
Tests to be completed every 10 years
o Sprinklers - Fast Response
o Sprinklers in service over SO years
Has the owner been informed of the obstruction investigation requirement?
Has an obstruction investigation been performed?
Is obstruction investigation required with this inspection?
Inspections to be completed every 3 years
o Water Storage Tank
Inspections to be completed every 5 years
o Systems
~bstruction Inspection (1 Inspection/system) I'
1l?'Check Valves (Interior) (
-O"i'reaction/Deluge Valves (Interior)
o Dry Pipe Valves (Interior)
Tests to be completed every 3 years
o Dry Pipe Valves (Full Flow Trip Test)
o Quick-Opening Devices
Tests to be completed every 5 years
o Pressure Reducing and Relief Valves
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1. Definitions .
Hlnspe~tion'" is a visual examination of a system or portion thereof to verifv that it appears to be undamaged and in operational condition.
"Test" IS a procedure used to determine the status of a system as intended by conducting periodic physical" checks on water-based fire protection systems such as waterflow tests, fire
p,ump tests, alarm tests, and trip tests of dry pipe, preaction, or deluge valves. These tests follow up on the original acceptance tests at intervals specified by NFPA 25.
'Mamtenance" is work performed to keep fire system equipment operable or to make repairs_
"Owner" is the owner of the property or the occupant, management firm, or managing individual that has received authority from the owner for the inspection, testing, and mainte.
nance of the fire protection system.
"NFPA 25" is the Standard for the Inspection, Testing, and Maintenance of Water-Based Fire Protection Systems (2002 edition) published by the National Fire Protection Association.
"Authority Having Jurisdiction" is an organization, office, or individual responsible for enforcing the reguirements of NFPA 25 or for approving procedures.
"Deficiency" is a condition where a system component appears to be damaged, not In operating condition, or the application is not within its designed limits or application.
~~kk" is the inspections, tests, and maintenance as reqUired by NFPA 2S and as limited by the scope of the contract.
Gilbert Mechanical Contractors, Inc. shall inspect and test the fire sprinkler system for the building in accordance with these terms and conditions. The inspection and tests shall be
performed by qualified inspectors meeting any and all requirements of the applicable Authorities Having Jurisdiction.
The Owner shall provide access to all areas of building containing system equipment and components requiring inspection under the scope of this inspection. The Owner shall provide
a safe working environment and to the best of the Owner's knowledge, no unsafe materials or conditions exist. The Owner agrees to provide all M5D5 sheets upon Gilbert Mechanical
Contractors, Inc. request.
Scope
(al Gilbert Mechanical Contractors, Inc, shall inspect and test the fire sprinkler system(s) in accordance with the applicable requirements as contained in the 2002 edition of NFPA 25,
AI applicable tests and inspections will be performed on an annual basIS.
(b) The following inspections and tests are excluded from the scope of this inspection and test:
(i) Inspections: (ii) Tests:
Periodic (5 Yearllnspections Periodic (5 Year) Tests
~~~hs~2~b~~:'s~~:e~:d~sein~~~er, and bracing in concealed spaces ~~~tff:~~ed~~i~:o~e~~:~csff~~~:irexcePt for forward flow test
Roadway, valves (Iii] Maintenance
~~=~ "ch"e"ckk ';,"~~e:larm valves (internal) ~~~~::d=fio~~~~~~n~re~~ ~~~~i~sc~71~Y~~r~i"J~~r:h:~{,":~~r~~no(ra~r.dificatiOnS to
Building areas for adequate heat
Records
The Owner shall furovide access to original system commissioning documents including maintenance manuals, material test certificates, certified fire I?ump curves} and as-built draw-
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result from the lack of information contained within such documents.
The Owner acknowledges that these inspections and tests are not Intended to reveal design or installation deficiencies. The inspections and tests are to verify that the system appears
to be in operating condition and system components appear to be undamaged.
Corrective Action
The Owner is solely responsible for the correction action required to correct deficiencies identified by the inspections and tests performed under the scope of this inspection, The
Owner further acknowled~es that the inspection and tests are limited to the condition of the system found at the time of the work and Gilbert Mechanical Contractors, Inc, is not
responsible for the condition of the system at any time subsequent to the date of the work.
In addition, certain comments and recommendations made as a result of the insl?ections and tests may transcend the scope of NFPA 25. Such observations are made without knowl-
edge of when the potential deviation occurred and what codes, standards, or junsdicticnal amendments or variances were in affect at time of said deviation. Such exceptions are only
a record of observations of potential deviations from current codes and standards and are in no way an implication that any other system components or areas of coverage are in or
out of compliance.
~~i~"o~~e~~ra1r::~ T~~~~e~~~d~~~~~~r~ this agreement. Payment is due thirty (30) days from the date of the invoice. Inspections ma be subject to inflationary cost increases.
This a9reement shaYI remain in effect for a period of (1) year and shall automatically continue from year to year thereafter unless thirty (30) days prior to the termination of any yearly
fi~~"iive~~:~~:~jil~de~~~~n notice to other party of its intent to terminate or renegotiate the terms and conditions set forth herein.
The Owner hereby releases Giloert Mechanical Contractors, Inc. and its affiliates, and their directors, officers, employees and agents, from all claims, liabilities and damages which
arise or result directly or indirectly, from the Owner's negligence, error or omission and the Owner agrees to defend, indemnify and hold harmless Gilbert Mechanical Contractors,
Inc, and its affiliates, and their directors, officers, employees and agents, from and against any and all claims, losses or damages to persons or property resulting indirectly or directly
from the Owner's conduct or omission.
Umltation of Uablllty ,
The Owner agrees that Gilbert Mechanical Contractors, Inc:s liability for any claims, losses or damages resulting directly or indirectly from Gilbert Mechanical Contractors, Inco's per-
formance of this agreement, includin~ any negligence, error or omission on the part of Gilbert Mechanical Contractors, Inc., shall be limited to the amount of fees received by Gilbert
Mechanical Contractors, Inc. under thiS agreement.
Waivers
No waiver of any provision of this Agreement shall be effective, except pursuant to a written instrument signed by the party waiving compliance, and any such waiver shall be effective
only in the specific instance and for the specific purpose stateo in such writing.
Subrogation '
The Owner hereby releases discharges and agrees to hold Gilbert Mechanical Contractors, Inc. and its affiliates harmless from any and all claims liabilities, damages, losses or expenses
arising from or caused by any hazard covered bV insurance resulting from or related to this inspection, whether said claim is made by Gilbert Mechanical Contractors, Inc., his agent or
insurance company or by any other parties claiming under or throu~h the Owner. The Owner agrees to indemnify Gilbert Mechanical Contractors, Inc. against, defend and hoid Gilbert
Mechanical Contractors/Inc. harmless from any claims for subrogation which may be brought against Gilbert Mechanical Contractors, Inc. by any insurer or insurance company or its
agents or assigns, incluaing payment of all damages, expenses, costs and attorneys fees.
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Gilbert Mechanical Contractors, Inc., 4451 W 76th Street, Edina, MN 55435 (952) 835-3810
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