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Home My WebLink AboutFire Protection Inspection ..' , " SUMMIT FIRE PROTECTION ., '" '1301 APotLO'CCrl'JR'f'.'L1NC!lLAKES, MN 5501'4'.' C65 1)'Z5'1! 1'880 . , . .. . 6301 BANDEL ROAD NW #503. ROCHESTER, MN 55901 . (507) 280-0622 1617 FIRST AVE. N. #B' FARGO, ND 58102' (701) 293-0138 418 GREAT OAK DR., WAITE PARK, MN 563117' (320) 257-6390 SHEET 1 OF 2. Use separate sheet for each building inspection REPORT OF INSPECTION MINNESOTA LICENSE NO. COO75 JOB NUMBER Owner's Section (to be answered by Owner or Occupant) A. Explain any occupancy hazard changes since the previous inspection: ~ INSPECTION NAME STREET CITY & STATE B. Describe fire protection modifications made since last inspection: c. Describe any fires since last inspection: When was the system piping last checked for stoppage, corrision of foreign material? hen was the d~.,piping system last checked for proper pitch? A dry va~~atelY ~cted frer freezing? .......; Si ature . ~I Cl,.1 ~ . " Title Date ,~ I P 0 s Section (All responses reference current inspection) oeral a. Is the building occupied? ~~ D No b. Are all systems in service? es D No c. Is there a minimum of 18 in. 457 mm) clearance between the top of the storage and the sprinkler deflectors? tjD'es 0 No d. Does all electrical heat tape appear to be satisfactory? DYes D No lDNA e. Does the hand hose or standpipe on the sprinkler system(s) appear to be satisfactory? DYes D No IJitNA 2. Control Valves (See Item 15,) a. Are all sprinkler system control valves and all other valves in the appropriate open or closed position? ~Yes 0 No b. Are all control valves in the open position locked. sealed or equipped with a tamper switch? ~es D No 3. Tanks, Pumps, Fire Department Connections a. When was fire pump last tested for perfonnance? ~ /4-- b. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? DYes D No ~A c. Are fire department connections in satisfactory condition, couplings free, caps in place"and check valves tight? 19Yes B No 0 NA Are they accessible and visible? ~es D No D NA 4. Wet Systems a. Are cold weather valves (O.S. & Y.) in the appropriate open or closed position? DYes D No ~A b. Have antifreeze system solutions been tested? DYes D No ~A c. What temp is antifreeze? --- d. In areas protected by wet system(s), does the building ~nV'~T tn be properly heated in all areas, including blind attics and perimeter areas where accessible? tiiaYes D No 0 NA 5. Dry System (SeeltJr.; 11 to 13) a. Are dry valve(s) in service? DYes D No 0 NA , b. Are the air pressures and priming water levels in accordance with the,manufacturer's instructions? DYes D No 0 NA . .. c. Has the operation of the air nitr g n s pplies been tested? DYes D No 0 NA Are they in service? DYes D No D NA d. Were low points drained du g t is ction? DYes D No D NA How many? e. Did quick-opening devices I e ily? DYes D No D NA f. Did the dry va\ve(s) trip p trip pressure test? DYes D No DNA g. Did the heating equipme in e alue room(s) operate at time of inspection? DYes D No DNA 6. Special Systems (SeeJlem 14.) a. Did the delu~pwactiotJJal~ s ate properly during testing? DYes D No JIg NA b. Did the heat.responsive dev s r t pr rly during testing? DYes D No 0 NA c. Did supervisory devices 0 r t esting? DYes 0 No 0 NA d. Did flow for kitchen hood y ff gas or electric? DYes D No D NA 7. Alarms ~. a. Did water motor(s) and gong(s) test sati\f.!.ctorily? DYes 0 No lLJ"f'IlA b. Did electric alarm(s) test satisfactory? lSJYes 0 No 0 NA C',Did supervisory alarm service test satisf~o,ry? hies D No 0 NA ~ 'Oct- d. Did tamper swithces test satisfactory? JiYles b No 0 NA 8. Sprinklers. ... , .' a: Are all s~inklers, free. from corrosion, loading or obstruction to spray diSCharge?:!. es D No b. Are sprbiklers lesS than SO years old?,(Older sprinklers require sample testing) , es D No c, Are.quick,response and residential sprinklers less than 20 years old? (Older spli lers require sample testing), ~ D 1'016 d.lsstockof spare sprinkle.rs available? ~es D'No , ., . . e; Does the exterior, condition of sprinkle! system appear to be satisfactory?~es 0 No f. Are sprinklers of pro perature rating for their.J.sl~ations? ~s DNo g. Are any sprinkle ads a recall list? DYes ~o 4: NA =NOT APPLICABLE , .~ d " , , I i , :; Signature: Pscz Date: 1//3/0'/ . / , SUMMIT FIRE PROTECTION . 7301 APOLLO COUR'P'LIllldt.AKES, MN 55014. (651) 251-1880 3026 40TH AVE. NW. ROCffl!SJlfl~.,MN.55901 . (507) 280-0622 418 GREAT OAK DR., WkitE'FMm; Mlilis6387 . (320) 257-6390 760 LIBERTY WAY, NORTH LIBERTY, IA 52317 . (319) 665-4330 .'1 SHEET 2 OF 2 - Use separate sheet for eachsystem inspection Type of System J)~ (I ~,.- Inspes:.!ion Name and l"?'mber. How ManYl...: ..... !!.'f~ ~r$ w . e~~( ~ . . . $"1//0. i owSwi .' . eck with Pressure Switch' 1:: ~:::~:~~:::::~:~ :::::~ i~::::: ::::: i::a~~:~n) . 4 L4-(Se:~';~:tT;;~/:8::c;~:;o:;~WS) .. . 11. Date quick-opening device tested (See Trip Te~: follows) . DRY VALVE T BLE 0.0.0. MAKE MODEL MAKE MODEL SERIAL NO. t.. ! c! DRY PIPE OPERATING TEST Time to Trip Thru Test Pipe MIN. SEC. Alarm Operated Properly YES NO Water Pressure PSI Arri~r:~~~ PSI Time Water Reached Test Outlet MIN. SEC. Without Q,O.D, With a.O.D. .-;:;;-.:_i' .' ~ 12. Date deluge or preaction valve tested tJ I r DELUGE & PAEACTION VALVES (See Trip Test Table which follows) TRIP TEST TABLE Operation 0 PNEUMATIC D HYDRAULIC Piping Supervised 0 YES D NO Detecting media supervised Does valve operate from Ihe manual trip and/or remo ntrol stations Is there an accessible facility in each Circuit fort mg Method attesting-circuits DYES DNa s o NO DYES o NO ;'j;) ::".. \ .i ~. NO r Explain Abnormal Condition MAKE Does each circuit operate su rv~ionlossalarm NO MODEL 13. See Control Valve Maint~naqce Table. Control Valves City Connection Control Valve Tank Control Valves Pump Control Valves Sectional Control Valves System vOrllrol Valves Other Control Valves .~J~i~9he_!1_g0(l~roIVal,~e 16. Water Flow Test at Sprinkler Riser Water Supply Source: 14. Explain any "No" ans~ comm,~ , ~ t.11/1A. -t ~. /1'1 :.~~ ~,~~ ......"/.>) Last Water Flow Test This Water Flow Test Control Valve Maintenance Table Number Type Open Secured Closed Signs Tank Date Size of Test Pipe Static Pressure Differential ... <:) ~~'<'-A~-9~ ~l> 4f Hr;tp::.$ HJ!:y(J;)<;: ("F" r,-.:.~ l II./~ /:7 I (, - /2't:IF,.wH.l , ::! . - -~.-"t.J ",,",:;;::;) ;; ~ Pf e "" '~-r] "hlot Date: