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Home My WebLink AboutAnnual Spinkler System Inspection Report LID #: 3150625 Page 1 of 3 �.. M " . x .. � Ahern Fire Protection AnnUal S Y'lI1�eI' 13705 26th Avenue, Suite 110 � Work Order #: Minneapolis, MN 55441 System Inspection g54701 i (763) 268-0515 p•(763) 268-0516 f For Month/'Year: �'�� www.ahernfice.com • Since 1880 Report MaCCh 2012 Invoice: SOUTH OF THE RIVER CONDO Phone #: (952) 898-5760 Street: 12280 NICOLLET AVE # 103 City: BURNSVILLE State: MN Zip: 55337- I,ocation: Courtwood Village Dept.: SUeet: 17092 Adelman Street SE City: Prior Lake State: MN Zip: 55372 Phone #: (952) 898-57b0 Fax #: (952) 405-7101 Foreman: Chris Moe Date: Signature: , ;_.. Wet 1 Foam FireDoors Suppression BF RP Dry 1 Alarms FirePumps Anti Freeze BF DC Preaction Detectors Va1veTT 1 Water Spray BF Generic Deluge Hydrants BF Lincoln Stand PipelHose Internal Sprinkler BF Omaha Contacts: Joe I,ehrer Direct: (952) 898-5760 Ext: Invoice/Deficiency Cell/P ALARM DEVICES TESTS Y N N/A 1. Didwaterfloworpressureswitchesoperatesatisfactorily? _____________________________________________________---___ [�.� ❑ -- 2. Did tamper switches operate satisfactorily? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - �/`[] ❑ 3. Didwatermotoralarmgongsorelectricbelisoperatesatisfactorily? ________________________________________________________________ � � 4. Didalarmserviceorcentralstationoperatesatisfactorilyandreceivepropersignals? ______________________________________ _--------_.�� ALARM SIGNALS System # ,' • � Test Times ,. 5 YEAR INSPECTION Y N( N!A 1. Was the 5 year Inspection performed on the following items? ------------------------------------------------------------------------------ ❑ ✓ ❑ A. Alarm valves B. Check valves � Gauges D.InternalExaminationofPiping D�tedue;_ -- --,--- ------- -- -------- -------- -------- -------- --------- ------❑ ✓[� ❑ 5 TESTING Y N N/A 1. Was the 5 year testing performed on the following items? .---------------------------------------------------------------- ❑�] ❑ A. Sprinkler heads in corrosive environments or rated 325°F or hi er. Date Due: '� � ----- -------------- --------- ---------- ❑ L I ❑ B. Standazdsprinklersinservicefor75+years. DateDue: --___--_--_-_---_-----_-_-_--__--------_-_-- ❑ � ❑ 10 TESTING Y N N/A 1. Was the 10 yeaz testing performed on the following items? ----------------------------------------------------------------------------- ❑❑❑ A. Standazd sprinklers in service for 50+ years. Date Due: __� �� ---- — --------- -------- — --------- B. Quickresponsesprinklersinservicefor20+years. DateDue: _________________________._________________.____ � t� � C. Dry pendant sprinklers. Date Due: ----------------------------------------------- ❑�❑ Tlils document PROPERTY OF AHERN FIRE PROT'ECTION. Copyright 2005 J.F. Ahem Co. REPRODUCTIONS IN ANY FORM VIOLAI'ES COPYRIGHT. �ptlnspection_Anmial � LID #: 3150625 Page 2 of 3 CONTROL VALVE 5ERVICE "' �""'"'` "' '" Y N N/A 1. Were the following service items performed on all control valves? C� �� -- - -- -- A. Fullyopenedandclosed? --- - --- --- - -- - ---- -� ❑ ❑ B. Valve packing checked? ----- - ---- ---- - - - --- - ----- - ❑ ❑ C. Va1ve stem lubricated? � � � --- ----- -- --- - ---- - ------- - ---- ----- D. Is the valve properly secured and locked in it's normal operating position? �� ---- --- - --------- BACKFLOW PREVENTOR TEST Y N N/A 1. Did the backflow preventar(s) pass the test of backflow and forward flow capabilities? �[�+ � ANTI-FREEZE TEST Y N N/A 1. Has the anti-freeze solution for each system below been tested by measuring specific gravity? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ❑ ❑ HANGERS AND SEISMIC BRACING Y N N1A 1. Did hangers and seismic bracing appeaz to be in good condition, firmly attached, and free from corrosion, from a visual inspection performed from floor level? [� ❑ ❑ --- ---- - - ---- -------- - ----------- -------------- PIPING Y N N/A 1. Was the exterior of exposed sprinkler piping in good condition, not subjected to external loads, free of inechanical damage? I �' �� --- �_ � NOTE: Piping located in concealed spaces, such as above a drop ceiling, are not required to be inspected FIRE DEPARTMENT CONNECTIONS . , .- ' Y N N/A " ' 1. Are fire department connections visible and in good condition? 0 �� --- ------- - - ----------- --------------- 2. Are caps and plugs in place? _------ - ---------- ------ --------- - ------- - ---------- � ❑ ❑ 3. Are automatic drain valves operating properly? �' �� ---- - --------- - ----------- - - ------------- ---------------- 4. Do hose connections operate freely? --------- -------- -- ----------- ------------- -°----------- - � ❑ ❑ - - } HOSE RACKS PRESENT? � Yes � No CONDITION: � Good � Fair � Bad Y N N/A MAIN DRAIN TEST System Number i Static Pressure Residual Pressure `t : Size of drain 1. Were ali main drains tested at full flow? [�' �� If no, explain: 2. Were test results similar to the last test? ----- ------ - ---------------- -- ---------------- -------------- --- -- [�' ❑ ❑ If no, explain: � 3. Was there any dischazge of obstructive material, heavy discoloration of water, or plugging of the inspector's test connection? � � GENERAL INFORMATION Y N N/A 1. Are all the sprinkler systems in service? _ _ _ _ . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ [�, � � ------ ----------------- - ---------------- ----------------- 2. Is the building completely sprinklered? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ [✓7 ❑ ❑ ------ - ------------- -----------------° ------------------ - 3. Are all sprinklers in good condition? ________ _ ,, - - � -- -- -°------ - - -.a--- ----- --- --- --- - - ._ -.- : � _ � ❑ 4. Are all sprinklers free of obstruction? � . - J _ -- ---- ; �_. _ � /❑ ❑ ----- ----- ---- -- ---- - --- --- - 5. Are spaze sprinklers and wrenches auailable? �` �� - ----------- --------------- - - ----------------- ----------- 6. In spray coating area, aze sprinklers free from accumulation? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ � � [� -------------- ----------- - -- � 7. IshydraulicnameplateandinforrnaYionsignsecurelyinplaceandlegible? ______________________________________._______--_----_-------- (�;� � 8. Is emergency service contact information readily available? _--_---------------------------------------------------------------- � j❑ ❑ 9. Are alarm devices provided and in good condition? -- ------- ------------- ----------------- --------------- - ------- �; ❑ ❑ 10. Are all standazd sprinklers dated 1920 or later? _ _ _ _ _ _ _ _ _ _ _ [t/� � � -- ------------- - ---------------- ------------- - --- OWNER QUESTIONS Y N N/A 1. Any changes in sprinkler system since last inspection? ------------ --------------- -------------- ---------------- ❑ ❑ ' 2. Any fires since last inspecUon? __ ❑ �' ❑ _ This document PROPERTY OF AHERN FIItE PROTEC7'ION. Copyright 2005 J.F. Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT. rptInspection_Anwal LID #: 3150625 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 ha�e an outside alarm service? �. ❑❑ If yes, name and phone number. 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: Date New Deficiencies found during this inspection? �es No , Customer receive copy of New Deficiency Report? Yes No NOTES , � , � ��_ �. ___.. —• ...._. r - —r-�,; �_ _ �, �„ �,,._ � � � �-�'; �, ;�� , / �` � � ,�, � _ _ a � ��, . �_. `..�-- /J +j ^� ' ,.r ' � G' 1' ';� / ^ '1' � i �Y" � �' r l �-� � ) r � "�- � ,' L �nv' f � ,. i !.� .i: , i i f l.. : � �r-� c� - c---�-��'� z-,�,� r �� c.� � ��..... t. , . , . � � . > . , ., . � . , .;, . , . . . . ,,., ; . ,,; : � . . : , r , � SERVICES PERFORMED: ��arm Test � Drain Test � Flow Test � Walk Through � Annual Inspection � Other , : . _ ; , , . . _. . _ i . :. , c_ , : : _ _ ; . . . . . , ::..�..._.� - _.. _ , _ -.: . , , ; , ,. � � � j This document PROPERTY OF AHERN FIItE PROTECTION. Copyright 2005 I.F. Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT. iptL�spec[ion_Annual . - r r , , . - . . ' . � . .: . .. ,- . � . :. . . . .. Ahern Fire Protectiort DI��Y.eaCtlOil� 13705 26th Avenue, S'n�te 1�b�'"` Date: 3/1/2012 Minneapolis, MN 55441 Delu e Pi e � � (763) 268-0515 p•(763) 268-0516 f g P Work Order #: g54701 �,�� www.ahernfire.com • Since 1880 Valve Trip Test i LID #: 3150625 Location: ourtwood Village Dept.: Street: � 17092 Adelman Street SE City: Prior Lake State: MN Zip: 55372 Phone #: (952) 898-5760 Faa� #: 952) 405-7101 Foreman: hris Mce Date: Signature: S StBIri #: System Type: Valve Serial #: Manufacturer Name: Valve ModeL• Valve Size: Controlling Sprinklers Location: i-� Controllin$ Sprinklers Number: . _ . � aPP�oX s ? � ' � ; _ , , , , , _, _ . . . { x � . , , ,. . �. . v , Y � � - � , �. 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: Presswe Before Test - Air ]bs. Pressure Before Test - Water �! ]bs. Size and I.ocation of Test Valve: ; Was gate valve below dry valve open wide at test? (if not, how many turns?) Valve Tripped At- Air pressure lbs. Valve Tripped At - Water Pressure r : ` lbs. Valve Tripped At - Time min. •� �,sea If system flooded, list time water reached test opening. min. sec. PERFORMANCE Poor Fair Good Interior of Body Poor Fair Good Moving Parts Poor Fair Good Rubber Facing Poor Fair Good Seats Poor Fair Good i Reset? Yes ' No N/A Did alarms operate at trip test? Yes No N/A Have low poinf drains beZn emptied? � ' , ' Yes � xo :, ' rr>A ` . � ; , . : ° " Water control valve left open and sealed? Yes No N/A Are the valves accessible? :Yes rro N/a Are the valve enclosures heated adaquately? Yes No N/A Interior of pipe that passes through freezers � free of ice blockage? Yes No N/A uick O enin Devices Device Serial #: Device Manufacturer Name: Device Type and ModeL• Air pressure in upper chamber lbs. Quick opening device tripped at sec. lbs. Quick opening device left in service and control open and sealed? Yes No N/A :�� +�o��soi� C� �i�# ��nf � 14��t11;�1' � At��m��f4� : � . .: �� Oil Level? ' Add Oil? '! Belt Tight? ' Belt Conditions? Cuts In? lbs. : Cuts Out? lbs. Tested? Reset? Yes No N/A �� Page 1 of � 1 This �document PROPERI'Y OF�AHERN FIRE BR01'ECT10N. Copyright 2008 J.F. �Ahem Co. REPRODUCTIONS IN ANY FORM VIOLAT'ES COPYRIGHT. rptValveTripTest