HomeMy WebLinkAboutReport of Inspection 6/22/2011 301 York Ave
€ 111 PO, N St. Paul, Minnesota 55130
TOMATIC SPRINKLER co. (651) 558 -3300 • (800) 229 -6263
Setting The Standard... Fax: (651) 558 - 3310
AGREEMENT AND REPORT OF INSPECTION
SHEET 1 of 2 - Use separate sheet for each building inspected #INSPECTION 2 3 33 - 7
MINNESOTA LICENSE NO. C005
REPORT TO L i N /e /.. BUILDING OR LOCATION
STREET y -7 30 )ra E . 4,r S f INSPECTOR ja
CITY & STATE P r 1 e Le, 1r M •-• DATE - 22 T c f I
Customer hires Viking Automatic Sprinkler Company to conduct an inspection of the fire suppression system at the above location or building, and
prepare a written report of that inspection for an agreed upon fee. As part of this agreement, customer agrees to the terms and conditions on rear of
form and will complete the Owner's Section of this document. Viking Automatic Sprinkler Company will not be held liable for incorrect or
unknown answers provided in the Owner's Section.
Owner's Section (To be answered by Owner, Occupant or Customer)
A. Explain any occupancy hazard changes since the previous inspection: In 0 . ,c
B. Describe fire protection modifications made since last inspection:
C. Describe any fires since Last inspection:
D. When was the system piping last checked for stoppage, corrosion or foreign material? < 1, - 7 7 - 7 c I
E. When was the dry- piping system last checked for proper pitch? f is
F. Are dry valves adequately protected from freezing? {(
G. Does the system contain any low point drains? `Ft Yes o No If yes, please state how many and the general location of each:
0 -1 - r
Customer's Signature Title Date
Inspector's Section (All responses reference current inspection) N/A = NOT APPLICABLE
1 General
a. Is the building occupied? )6-Yes o No
b. Are all systems in service? %Yes o No
c. Does there appear to be a minimum of 18 in. (457 mm) clearance between the top of the storage and the sprinkler deflectors? ,x(Yes o No
d. Does the valve hose on the sprinkler system(s) appear to be satisfactory? o Yes o No NN /A
2 Control Valves (See Item 15)
a. Do sprinkler system control valves appear to be in the appropriate open or closed position? yl(Yes o No
b. Are control valves in the open position locked, sealed or equipped with a tamper switch? Q(Yes o No
3 Water Supplies (See Item 16)
a. Was a water flow test of main drain made at the sprinkler riser(s)? irLYes ❑ No
4 Tanks, Pumps, Fire Department Connections
a. Do fire pumps, gravity tanks, reservoirs and pressure tanks appear in good condition and properly maintained? o Yes o No OtN /A
b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight? q(Yes o No o N/A
c. Are they accessible and visible? (Yes o No o N/A
5 Wet Systems
a. Are cold weather valves (O.S. & Y.) in the appropriate open or closed position? o Yes o No N/ A
b. Have antifreeze system solutions been tested? ❑ Yes o No )e!N /A
c. Antifreeze test result:
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? o Yes o No gN /A
e. Do all exterior openings appear to be protected against freezing? g(Yes o No o N/A
6 Dry System (See Items 11 to 13)
a. Are dry valves (s) in service? A Yes o No o N/A
b. Are the air pressures and priming water levels in accordance with the manufacture's instructions? RYes o No o N/A
c. Has the operation of the air or nitrogen supplies been tested? )(Yes o No o N/A Are they in service? X(Yes o No o N/A
d. Were all known low points drained during this inspection ?.Yes o No o N/A
e. Did quick - opening devices operate satisfactorily? o Yes o No yrN /A
f. Did the dry valve(s) appear to trip properly during the trip pressure test? #Yes o No n N/A
g. Did the heating equipment in the dry-pipe valve room(s) appear to operate at time of inspection? y( Yes o No o N/A
7 Special Systems (See Item 14)
a. Did the deluge or pre -action valves operate properly during testing? o Yes o No )4N /A
b. Did the heat - responsive devices operate properly during testing? o Yes o No ;'N /A
c. Did supervisory devices operate during testing? o Yes o No 9(N /A
8 Alarms
a. Did water motor(s) and gong(s) test satisfactorily? o Yes o No y><N /A
b. Did electric alarm(s) test satisfactory? 91 Yes o No o N/A
c. Did supervisory alarm service test satisfactory? o Yes o No ja-N /A
9 Sprinklers
a. Do visible sprinklers appear to be free from corrosion, loading or obstruction to spray discharge? yt(Yes o No
b. Do visible sprinklers appear to be less than 50 years old? (Older sprinklers require sample testing) pkYes o No
c. Do quick response and residential sprinklers appear less than 20 years old? (Older sprinklers require sample testing) o Yes o No A.I /A
d. Do dry sprinklers appear to be less than 10 years old? (Older sprinklers require sample testing) o Yes o No ticN /A
e. Is stock of spare sprinklers available? RYes ❑ No
f. Does the exterior condition of sprinkler system appear to be satisfactory? pes o No
g. Do visible sprinklers appear to be of proper temperature rating for their locations? Yes o No
10 Explain any No answers and comments:
Inspector's Signature: ,/ 3 Date: ( - Z-2 2U l 1
301 York Ave
lir, N CS St. Paul, Minnesota 55130
AUTOMATIC SPRINKLER CO. (651) 558 -3300 • (800) 229 -6263
Setting The Standard... Fax: (651) 558 - 3310
SHEET 2 of 2 - Use separate sheet for each system inspected System No. or Description if multiple
systems .2 '/ " b
z Y
Inspection Report
No. 7 30 3 3`f
11 Date dry -pipe valve trip tested (control valve partially open) C,-10- 7 c.. / to (See Trip Test Table which follows)
12 Date dry-pipe valve trip tested (control valve fully open) ti-12 - 2 p f t (See Trip Test Table which follows)
13 Date quick - opening device tested --u /A (See Trip Test Table which follows)
DRY VALVE TRIP TEST TABLE Q.O.D.
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
('rnj A F" /995 .,7- _
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 PSI MIN. SEC. YES NO
without / - -7 D S `
3 / - /Z
Q.O.D
With
Q.O.D
14 Date deluge or preaction valve tested (See Trip Test Table which follows)
TRIP TEST TABLE
Operation ❑ PNEUMATIC ❑ ELECTRIC ❑ HYDRAULIC
Piping Supervised ❑ YES ❑ NO (Detecting Media Supervised ❑ YES ❑ NO
DELUGE & Does valve operate from the manual trip and /or remote control stations ❑ YES ❑ NO
PREACTION Is there an accessible facility in each circuit for testing ❑ YES ❑ NO (Method of Testing Circuits
VALVES Does each circuit operate Does each circuit Maximum time to
MAKE MODEL supervision loss alarm operate valve release operate release
/, P YES NO YES NO YES NO
15 See Control Valve Maintenance Table
CONTROL VALVE MAINTENANCE TABLE
Explain
Abnormal
Control Valves Number Type Open Secured Closed Signs Condition
City Control Valves
Bypass Valves
Tank Control Valves
Pump Control Valves
Sectional Control Valves j - y G y, 'y
System Control Valves / - 2' /, T' w V'
Other Control Valves
Kitchen Control Valves
16 Water Flow Test at Sprinkler Riser
Water Supply Source: City Tank Pump
Residual
Test Pipe Size of Static (Flow)
• Date Location Test Pipe Pressure Pressure
Last Water Flow Test (; - / t -1 t •.) -7 • 7W Sin
This Water Flow Test U -2 2 - 7c it 2i ) 0 P 2'/2 / '/y - 5 5
17 Explain any "No" answers and comments:
18 Adjustments or corrections made during this inspection:
19 Although the comments are not the result of an engineering review, please see the attached Non - Inspection Related Deficiencies
form for additional items found during the course of the inspection (only attached if applicable).
Inspector's Signature: �-- I_-7 Date: (. . 2 ? - 1 c , , i
Inspection Form P2 1-24-11
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