HomeMy WebLinkAboutSummit Fire Inspection - 2/11/14 �UMMIT FIRE PROTECTI�N
575 MinnehahaAve. W• St PaW, MN 55103 • 651-251-18$0 ' 30�6 4U'� �ve. NV�' • Rochester, MN 55901 • 507=280-0622
418 Great Oak Dr. '• Waite Park, MN Sb38 �+ 320-257-6390 76U Liberty Way •'�iorth Liberty, IA 52317 • 319-6b5-4330
4208 �nterprise Circle • Duluth, MN 55811 •�18-740-q412 4353 NW Urbandale Dr. •'Urbandale, IA 50322 • S15-86'12424
SFIEET l OF 2. TTse sepatate sheet for esch lnrikling inapecNon ItEPO�T QF INSPECTION
MINNESC?TA LICEN�SE NO. CW73 / IOWA LICENSE N0, FP-036 JOB NLJMBER ���&�� �
IIVSPECTION NAME ��� � � ' BiJIL,DING/LOCATION V
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STREST '��� ��" � �;� » �. ;�t ��r �` �' � � � �� � ` ' � � � �"�- '��; '� INSPEGTOR ' � ��^w � �..� � � � � � ''
CITY & STATE � �. ��` � �"'' �� �' � �..'�'� "�'�. DATE � � � � � I �'l
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Qwner's Sec�lon (tp be answered by;Owner or +Occupant)
A. Exprain any occupancy hazard chattges' sinca the previous inspection:
B. Describe fire'protection madifications made siuce last inspec:tion:
C. Describe any fires since last inspection:
' D. When was the system piping last checked far stoppage, corrosion of foreign material?
E. When was the dry-pipintg system last checked for ptoper pitch7
F. Are dry valves adequa�ely protccted from freezing7
Signature '15tIe Date
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Insp+ecWr's Section (Afl responses refetence enrrent in�pection) NA NUT APPLTC�,BLE ' j
l. Generat �
a. Is the building occupied?'L�dY�s ❑ No
b. Are alI systems in service3 (�Yes O No ,
c. Is there a mi,nzmum of 1� in. (457 �un) cli�ranr.e between the top of the storage and the spxinkler deS cta�s? p�'es ❑ 1�To
d. boes the hand hose or standpipe' on tl�e aprinkler system(s) appear to be satisfactory7, L]Yes ❑ No�NA
2. Cantrol Yslves (See Item 1 S.) ' ' '
a. Are all sprinkler system control ��atves and all other valves in the appropriate opeu or closed p sidon7 �Yes ❑ No i
`b. �,xe all conhrol valves in #he open posidon locked, ;seated or eqwipped with a tamper sw�ttchT �Yes O No
3. Tanks, Pumps, T�ire D�partment Connections
a. When was fire'pump last fested for performance? :
b. Are fire pumps, gravity ta�nks � restrvoits and pressure tanks in good condition and pmperly maintained7 DYeS L� No G�1A
c. Are fire department oonnecdons ' satisfactory condition, couplings'':&ee, caps in place, and eheck valvcs tight? ��Yes 0 No ❑ NA
Are thay aecessible and visible? ►,�tes O No C! NA
A. Wet 5ystems
a. Have antifree�e system solutions #�een tested? OYes ❑ No C�NA �
b. VVk�at temp is antifreez�? ° �
c. In &reas protected by wet system(s), dces'the building appear to be properly heated in' all areas 7 OYes O No O NA
5. Dry Sqstem {See Iterns Il to I3) ;
a. Are dry valv�s) in service? Yes ❑ Na ❑ NA
b. Are the air pressures and 'ng water levels in accoxdance wiW the manufacturer's insiructions? DYes 0 No O NA '
`c Has the operadon of the or nitragen aupplies been tested? OYes O No 0 NA Are thcy in service? DYes O No ❑ NA
d. Were loK� points dr ' duzing this inspection2 OYes ❑ No O NA How tnany7
!e. Did quick-opening operate satisfacwrily7 ''DYes ❑ No ❑ NA
f, Did tkie dry valxe(a} trip properly during the hip p;essure test? DYes ❑ No C] NA
g. Did the heatin�„�qniptnent in the dry-pipe vatve room(sj operate at time of inspection ? OYes' ❑ No 0 NA
6. 'Special5ystetns {See Item 14.) '
a. Did the deluge or pxe-action t�alves qperate properly during testing? ❑Yes ❑ 1�Tc� ��NA
b. Did the k�est-�'espansive devices operate properly during testing7 Ye� ❑ No aNA
c. Did s�pervisory devices operate during testing? DYes C] No ❑�
'd. Did flow fox kitchen hood systezn shut pff gas ar electric? ❑Yes O No ❑ NA
7. Alaime
a. Did water motar(s) and gong(s} test sa1' artorily7 OYes 0 No �NA
b. Did elactric alarm(s) test satisfactorily7 es 01 �o� C] NA
o. Did aupervisory alarm service test satisfa�ily7 C�4'es q No ❑ NA
d. Did tatnper switc6es test sa�isfactorily? , es 0 No O NA
8. 'Spriuklas ' '
a. Are all sprinklers free from �orrosion, paiint, loading or abstruo#ion to spray discharge? OYes' q No
b. Are sprinklers less tttan'S0 yeara' ol�.? (Older sprinkl�ers require s�mpXe testin� �Yes ONa ' �� '
c. Are quick reaponse and reSidaatiat sprinklers lass than 20 years old7 (Oldez sprinklers require sample testing} C3Yes O No ❑ NA
d. Ia stock of spaze spzinklers available? C1Yes O No
e. Does the exterior conJition of sprinkler system appeaz to l� �atisf�ctory7 �CiYes O No
f. Are aprinkters of pn�oper temperadue ting for theu Iocations7 QYes O No '
g. Is location ftee of recalled h�ads? �es `❑ No �
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Signalure,��"�������"� � i�a�• �4^� � � �,����`�
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�UMMIT FIRE'PROTECT�+ON
575 Miuu�ehaha Ave. W•' St. Paul, MN 55103 • bS�-251-1880 ° 3026 40th Ave. NW • Rochester, MN 55901 • 507 280-Od22 '
418 Great Oak Dt: • Waite Park, MN 5b387 • 320-25'1-6390 760 Liberty Way + Nortb Liberky, IA 52317 •'' 319-665-�4330 -
420$ �nterprise Circle � Duluth, MN 55811 ■ 218-740-4412 4353 NW Urbandale Dr. • Urbandale, Ir150322 • 515-867-2424
SHBET 2'OF 2- Us�-.aepa te shset for e�rch syst �ction Type of System �
Inspection Name �`� °�"'�� �'� �� How Manp1 ' �
� � x � � �� �,
Inspecrion Work Otder � '� � � �� W�iat Siz�?� , ,,.,�, � — � ! "Z.-
��Flow- Switch� oi„.h�+u�n ('heck�with Px+eaanr��wltcti""''
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9. Date dry-IriPe valve �orip teaud (controi valve Pa�tiallY opan) ~,��� jsee Trip Test Table which folla�s)
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' 10. Date dry-Pil�e valve trip teated {c�ntrol valve fully open) �*' ` (�ee Trip Test T$ble wlvch follow^s)
11. Date quick-opening de. tested �,� ��_ (aee Trip TesC'T�ble whicb follows)
n��aL� ' �TRIP TEST TA�BLE Q.o.n..
n�,�,s� n�on�z, ��, xo. � �ions, s�ar. �va.
DRY PIPE 'I5� to 7}ip Wecer �resawe Air Aseau� 'hip Poiut '�me Watar Reached Atsrm Operated
OPERATRNG Thcu Tik§sc Plpe � Au Prasare Tasc Outlat ' Pmperty
T�� �'�: Min. Sx ��. � P51 �' PSI PSI -:: Mi¢. '.��. Sa: Ya ;��. No
VYftLaut �
r'� .O.D. *"
, With , i ,�"
' .OD.
I 12. Dau deluge or preaction valve tested (aee Trip Test Table wbzch follows)
�` ' �TEST TABLE
Opersdee ❑ Pnenmatic � Eleckic ❑ Hydcsulic�''�"
r;ping supuv;aea p Yes ❑ No �°' netecfl�e I��ea;e su�erv;sea ❑ Yes ❑ No
D P'REACTI N Docs valve operate tram the manoal trip andlor ranote cnu statia+s? ❑ Yes ❑ No
vALVES ]s thenc an scassible facilfty in each circuit for testi�ng7"� ❑ Yes ' t] No ' MetLod of 7lesting (,"ucuits'
MAKE �'`" MODEL' Doas Aach (Srcuit dpetate Dces Each Circuit' Max�unn'ISme W
�, Supecvision Losa ACaTm2 ppernte Yalve Releasc? Opei�ete Re]ease?
P� ❑Xes ❑ No ' i ❑Yes ' ❑ No ❑Yes ❑ No
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Y3 , See Control Valvo Mainoenance'I�ble CUNTROL VAT.VE MAIIVTENANCE TABLE
CON�'BOL VALFES NUMBER SIZE & TYPE OPEN SECURED CLOSED SIGN3 $XPLAIN ABNORMAI. CONDITiONB
" !CYt� Counecdam Controt Valve '
Tacka� Control Vatve
Pump Control Vei�es
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' Addittonsl Pump Convol Velves
lbst H�ader
a er
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Sec.tional Contml Valves
System c:ontrol Vatves �' �� � � ��,°�� �"�� �a� '�`,��
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Other Control Velves
TCi6chen Control Valt�es �""*" �� k � � �� � � �� w b �, � �
• � ���
Waterl+lmr'1� at Sprinkler Rfaee �� ���
Water Supply Source: City' �`' '� Well 'i�nk Pamp '
STA 9URB RESIDUAI, (FLDW)
DATE T83T PIp'E LOCA110iY STZE O� TF�T PIP� DIFF6REN17AL
I.ast Watcr k�lOw 1k�k d� � � �i��. � � � *°'� °� � �"'�� �
T6ic Wa[er Plow Teat � "':.� ,� � ' �,� '�° � � " � �
14. �aplain eny "No" anarvers and comments: "� �
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Print Name°� � �� �� ��'�� �� � � �� Signature, ��� � �"�������"�"�'�� pate � � � � � �'��
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SUMMI�' FIRE PROTECTION
575 Ma,nnehaha Ave. W. = St. Paul, MN 55103 •(G51):251-i880
�18 Great Oak Dr. • Waite Park, MN 56387 •(320) 25?-6390
4208 Enterprise Circle •' Duluth, MN SS811 �(2I$) �40-4412 '
3026 4Uth Av�e. NW • Rochester, MN 55901 •(S47) 2$Q-0622 '
760 Liberty Way � North Liberty, XA 52317 �(�19} 6fi5-4330
4353 NW Urbandal.e Dr., Urbax�dale, IA. 5Q322 �(�I5) 867-242�
Job# _ ty � �..:�J.:�
KITCHEN f��UD INSPECTI�N REP4RT
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Inspection Name: "' � �u�*�� ' i � � � Date:� � � t � � ���
Street: �J � # f �'3;� �fi, tn.t� � ,� � +� .� +� Inspector:��� �� �; ;; .,.�. � f
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City/ State. ��� �� : ,.` �,^��h .� � � �� �-. Bldg/Location:
a
Ts supply to hood system taken from �isting fire'sprinkler system? Yes' �+ No
Does gas or electric shut off with ffow? Yes � Nv
Daes gas or electric shut off with control valve tamper? ' Yes Na�„
Is hood system rnonitored? ' Yes: Co: Nn�
Haw was flow obtained? Water �low: M�ua1 Trip of flow switck� �
Control Valve 1�pe: �_� f � ��"i ""'
Candition of Control Valve: Good� Fair Need to Rep
' Condition of Sprinklers and Automatic Spray Nozzels: Good'� Fair Need to Rep
Condition of Fipe' and Fittings: Good "?� Fair Need to Rep
Are sprinklers above grease fryers in proper position above grease? Yes � No ' N/�
Is there a nc�anual reset to restore gas or electric to cooking unit? Yes � No
I.oca.tion of reset for gas or electric? f �: } ;� ;���'
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Commenta�Recommez�dations:
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' Signature ' �� ' �����F Customer signature:
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