HomeMy WebLinkAboutSprinkler Inspection Report
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AUTOMATIC SPRINKLER CO.
1301 L'ORIENT STREET
ST. PAUL, MINNESOTA 55117
(651) 558-3300 . (800)-229-6263
FAX: (651) 558-3310
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_. 2'~' Use aeparate Iheet lor each building i~
~!'Wf"f'!:m,. IUPORT OF II'!8PECTlON S
' '.. .' INSPECTION # O~OOO
BUD:.DlNG OR LOCATION ~. :~
INSPECfOR ,~:. ~
DATE ~~ r~-01;
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~TA LICENSE NO. COOS .
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Owner hires Viking Automatic Sprinkler COI1lpany to cond-dct an inspection ofthe 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, owner agrees to tenDs
and conditions on rear of form and will complete the Owper's Section of this document.
OwDer's~tion (To - be answered by Owner or Occupant)
A. Explain any occupancy hazard changes since the previous inspection:
B. Describe fire protection modiq.cations made since last inspection.
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,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 pitch?
F. Are dry valves adeqnately protected from freezing?
Signature Title
Date
Inspector's Section (AU responses reference current inspection)
1. General
a. Is the building occupied~Yp 0 No
b. Are all systems in service?ZYes 0 No,
c. Does there appear to be a minimum of 18 in. (457 mm) clearance between the top of the storage and the sprinkler deflectorsUd"fes D No
d. Does the valve hose on the sprinkler system(s) appear to be satisfactory? 0 Yes D No. ~A
2. Control Valves (See Item 15.)
a. Do sprinkler system control valves appear to be in the appropriate open or closed position?~es D No
b. Are control valves in the open position locked, sealed or equipped with a tamper switch~es 0 No
3. Water Supplies (See Item 16.)
a. Was a water flow test of main drain made' at the sprinkler riser(s)?~es 0 No
4. Tanks, Pumps, Fire Department Connections
a. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? ::J Yes CJ No ~NA
b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight?~es LJ No 0 NA
Are they accessible and visible?)2"Yes C No [J NA
S. Wet 'Systems
a. Are cold weather valves (O.S. & Y.) in the appropriate open or closed position? n Yes C No ~A
b. Have antifreeze system solutions been tested? 0 Yes 0 No ~A
c. Were the antifreeze test results satisfactory? 0 Yes 0 No ~NA
d. In areas protected by wet system(s), does the building appear to be properly heated in all areas, inch!.ding blind attics and perimeter areas
where accessible?,,0'Yes D No [J NA Do all exterior openings appear to be protected against freezing~es 0 No 0 NA
6. Dry System (See Items 11 to 13.)
a. Are dry valve(s) in service? DYes 0 No ~ .
b. Are the air pressures and priming water levels in accordance with the manufacturer's instructions? 0 Yes [] No ~A
c. Has the operation of the air or nitrogen supplies been tested? 0 Yes 0 No E:'1fA Are they in service? 0 Yes C No ;?rNA
d. Were all known low points drained during this inspection? 0 Yes C No E1NA
e. Did quick-opening devices operate satisfactorily? 0 Yes [j No .0"NA
f. Did the dry valve(s) trip properly durlng the trip pressure test? 0 Yes 0 No ~A
g. Did the heating equipment in the dry-pipe valve room(s) operate at ti~e of inspection? :=J Yes 0 No ~A
7. Special Systems (See Item 14.)
a. Did the deluge or pre-action valves operate properly during testing? 0 Yes [J No ~A
b. Did the heat.responsive devices operate properly during testing? 0 Yes D No ...0"'NA
c. Did supervisory devices operate during testing? DYes D No $NA
8. Alarms ~.-<':
a. Did water motor(s) and gong(s) test satisfactorily? 0 Yes 0 No ,J.6"NA
b. Did electric alarm(s) test satisfact<;>ry,%Yes 0 No 0 NA _
c. Did supervisory alarm service test satisfactory? [J Yes [] No ~A
9. Sprinklers ~ ../
a. Do visible sprinklers appear to be free from corrosion, loading or obstruction to spray discharge ? L.J""Yes 0 No
b. Are sprinklers less than 50 years old? (Older sprinklers reqnire sample tesling).I"fYes [j No ./
c. Are quick response and reSidential spn~kl9s less than 20 years old? (Older sprinklers reqUlre sample testmg) n Yes D No~ N/A
d. Is stock of spare sprinklers available?~es C No
e. Does the exterior condition of spnnkler system appear to be satisfactory ~es Cj'{o
f. Do visible sprinklers appear to be of proper temperature rating for their locations? j2!"Yes :::J No
10. Explain any "No" answeqpd cQmments: 3 ~~ s.~\ ~~ ':,~\1 ~- y.I\".~ >11,-,,_
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NA =NOT APPLICABLE
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Signature:
1..tING
AUTOMATIC Sl'IlJNKl.ER CO.
SHijE'F 2.0F 2 - Use separate sheet for each system inspection
1301 L'ORIENT STREET
ST. PAUL, MINNESOTA 55117
(651) 558-3300 . (800)-229-6263
FAX: (651) 558-3310
Inspection Report
No.
System No. or Description if multiple
systems ~'1. I.)~
11. Date dry-pipe valve trip tested (control valve partially open) (See Trip Test Table which follows)
12. Date dry-pipe valve trip tested (control valve fully open) (See Trip Test Table which follows)
13. Date quick-opening device tested (See Trip Test Table which follows)
DRY VALVE TRIP TEST TABLE Q.O.D.
14. Date
MAKE MODEL I SERIAL NO. I MAKE I MODEL SERIAL NO.
I T I
DRY PIPE llme to Trip Water Air Tri~ Point lime Water Reached Alarm Operated
OPERATING Thru T esl Pipe Pressure p"""",,, Air rassure TestOuUel Properly
TEST MIN. SEC. PSI PSI PSI MIN. SEC. YES NO
Without
Q.O.D.
With
Q.O.D.
deluge or preaction valve tested (See Trip Test Table which follows)
TRIP TEST TABLE
Operation o PNEUMATIC o ELECTRIC o HYDRAULIC
Piping Supervised DYES o NO I Detecting media supervised DYES o NO
DELUGE & Does valve operate from the manual trip and/or remote control stations DYES o NO
PREACTION Is Ihere an accessible facility in each circuil for lesting Method of testing-circuits
VALVES DYES o NO
~~":::i~~ ~=~I=ate I ~:a:I;:;~~ase ~...~imum time 10
MAKE MODEL o erale release
YES NO YES NO YES I NO
1 I I
ontrol Valve Maintenance Table.
Control Valve Mamtenance Table
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15. See C
Explain
Abnonnal
Contror Valves Number Type Open Secured Closed Signs Condltton
Citv Control Valves
~ss Valves
Tank Control Valves
Pump Control Valves
Sectional Control Valves
System Control Valves '_ U,\ - 1<:"_'-10.__ -
Other Control Valves
Kitchen Control Valves
16. Water Flow Test at Sprinkler Riser
Water Su t Source:
Date
Cit
Test Pipe
Location
Tank
Size of
Test Pipe
Static
Pressure
Residual
(Flow)
Pressure
Last Water Flow Test
This Water Flow Test
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17. Explain any "No" answers and comments: l\f'1"....
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18. Adjustments or corrections made during this inspection:
19. Although these comments are not the result of an engineering review, the following desirable improvements are recommended:
Signature:
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Date: .;;l.. - \ ~-O<:'
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