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Home My WebLink AboutFire Sprinkler Inspection PG. OF PGS. FIRE-GUARD INSPECTION CONTRACT NO. INSPECTION SPRINKLER SERVICE, INC. REPORT NO. MN LICENSE NO: 2055 White Beer Ave. No.. Suite C BUREAU CONFIRMED ....... St. Paul, Minnesota 55109 COOO18 FILE NO. WITH , PH: 651-748-9499 . FAX: 651-748-9143 REPORT TO: STREET: CITY, STATE, ZIP: TECHNICIAN: OWNER'S SECTION (To be answered by owner Of occupant) A. Explain any occupancy hazard changes since the previous inspection. BLDG. NAME: {'L:t.pfA:~ ~J::.':S ADDREss.-:;q~ G....~~. CITY. STA;E. ZIP: Ib r 7 z... LICENSE NO. . ~D-.50C.1 CATE: 10/13/0<( 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? E. When was the dry-piping system last checked for proper pilch? F. Are dry valves adequately protected from fre,zlng? INSPECTOR'S SECnON (All responses reference current Inspection) 1, GENERAL 8.ls the building occupied? .................................................................... b. Are all systems in service? ................................................................. c.ls there a minimum of 18 in. (457 mm) clearance between the top of the storage and the sprinkler deflector? ........................................ d. In areas protected by wet system, does the building appear to be properly heated in all areas, including..b1lnd atUes and perimeter areas, were accesslbJe? Do all exterior openings appear to be e. 6::~~: ::~~n~~:~~~~: ~~;i~k.I~~.~;;i~;.~~~~F~ii~i~~t~~?::: 2. CONTROL VALVES (See item 14) a. Are all sprinkler system control valves alt all other valves In the appropriate open or closed posltion?......................,.......................... b. Are all control valves in the open position and locked, sealed or equipped with a tamper switch? ......................................................... yes n.a. no yas n.a. no 3. WATER SUPPLIES (See item 15) a. Was a water now test of main drain made at the sprinkler riser? ....... 4. TANKS, PUMPS, FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, reservoirs and pressure tanks In good conditlon and properly maintained? .......................................... b. Are fire department connections In satisfactory condllion, _' couplings free, caps In place, and check valves tight? Are . $her accessible and visible? .............................................,................ " 5. w.&r SYSTEMS (See item 13) ~:.Are cold weather valves (O.S.& Y.) In the appropriate open :, '"9r closed'posltlon? ..........................................,.,................................ b:.Have antifreeze systems solutions been tested?.............................. C!f,tJere the antitreeze test results satisfactory? .................................... 4 -'.i~~t. _, .6: 'O,flV SYSTEMS (S~ellems 10 10 14 and attached report) .J """tho dry valve in service? " - bi'..AFe the air pressure and priming water level in accordance X .wlth the manufacturer's instructions? .......................................,......... :.,: ~ ...._.~..- c. Has the operation of the air or nitrogen supply been tested? Is It In service? ..................................................................................... d. Were low points drained during this Inspection? ................................. e. Did qulck-openlng devices operate satisfactorily? ............................... f. Did the dry valve t~lp properly during the trip pressure test? ............... g. Did the heating equipment In Ihe dry-pipe valve room operate at the time of inspection?.....................................,............................... 11. Date dry-pipe valve trip tested (control valve fully open) (see trip test which follows) .................................".............,. 7. SPECIAL SYSTEMS (Ssellem 16) a. Old the defuge or pre-action valves operate properly during testing?.. b. Ok! the heat-responsive devices operate property during testing? ...... c. Old the supervisory devices operate during testing? ........................... 8. ALARMS a. Did water motor Bnd gong test satisfactorily1...................................... b. Did electrtc alarm test satisfactorily? .........................................,......... c. Did supervtsory alarm S8rvtce test satisfactorily? ............................... 8, SPRINKLERS a. Are all sprinklers free from corrosion, loading Of obstruction to spray diSCharge? ......"...........................".... .,........."..................................... b. Are sprinklers over 50 years old, thus requiring sample testing? ........ c. Is stock of spare sprinklers available? ................................................. d. Ooes the Interior condition of sprinkler system appear to be satisfactory? ........................................................................................ 10. Date dry-pipe valve trip tested (control valve partlally open) (see trip test which follows) ...................,...........",............................... 12. Date qulck.opening device tested (see ASCOA trip lest report) ......... j 13. Date deluge or preactlon valve tested .....................................".......... 14. See Controt ValVe Maintenance Table. Number Secured Closed CONTROL MAINTENANCE TABLE E)(plain Abnormal Condition ContmtValves System Control Valves Other Control Valves " Open . Signs Pressure Before 1S,WATER FLOW ST 16. Type of Equipment I"" Condition: Manufaclurer: Model: Auxiliary Equipment: No? Type? Location? 17. Explain any "No' answers and comments: B A ~ Nt) I"Y ~i de.. J.toc" ~ "Stc-.Obe. qA ~~~ Q.~.u e.14"..Jhur #tro~~a:'._ Test Pipe locala<1 Size Test Pipa , Flow Pressure Pressure After Tesl Pipe Located Size Test Pipe Pressure Before Row Pressure Pressure After fbsc:.. Test Result? 18. Adjustments or corrections made during this inspection:-A)nn'P 19. Although these ~\ ye.ca\l.p~.~Js ,Iew, the following dellrabfe improvements are recommended: WHITE: CLIENT YEUOW: OFFICE PINK: INSURANCE AUTHORITY .......... FIRE-GUARD SPRINKLER SERVICE, INC. 2055 White Bear Ave. No., Su"e C St. Paul, Minnesota 55109 PH: 651-748-9499 . FAX: 651-748=9143 SIZE, MAKE, MODEL & YEAR OF MANUFACTURER CONTROL SPRINKLERS IN PRESSURE (LB.) AIR BEFORE TESTS WATER CONTROL VALVE WIDE OPEN? <IF NOT, HOW MANY TURNS?) OPERATED AT: AIR PRESSURE (LB,) TIME (MIN., SEC,) OPERATION INDICATE: (SATISFACTORY, PARTLY SATISFACTORY, OR FAILED) REASON FOR FAILURE OR PARTLY SATISFACTORY VALVE RESET DRY? LIST REPAIRS MADE CONDITION: INTERIOR OF BODY WATER FROM TEST PIPE MOVING PARTS SEALS RUBBER FACING ALARMS OPERATED? MAKE, MODEL, YEAR OPERATION INDICATE: SATISFACTORY, FAILED OR SHUT OFF MN License No. COOO18 DATE: 10/ /3/1')4 ISO FILE NO. NO.2 NO.3 y.2..? WY!L. ~\.is.\aJo"l eS NO'i\:€... f( ( 1 , 'y- ING DEVICES \ (' ..5eN. WHITE: CLIENT YELLOW: OFFICE PINK: INSURANce AUTHOA"" ----.- ---.- _._._~._._--_...,_.