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HomeMy WebLinkAboutFire Sprinkler Inspection 11.6.15 People.Integrity.Professionalism.Excellence. �' Job Number:SV1510061303 ICI NIG Job Name:Shepherds Path AUTOMATIC SPRINKLER CO. Inspector:Kevin Strandberg Date:11/6/15 Monthly ❑ Semi-Annual 0 AGREEMENT & REPORT OF INSPECTION Quarterly El Annual ❑x Five Year 0 Site Information Customer Information Building Name Shepherds Path Name Same Address 3611 N.Berens Road NW Address City,State ZIP Prior Lake MN 55379-5899 City,State ZIP Site Contact Lewis Hanson Customer Contact Telephone 952-230-2925 Telephone Customer hires Viking Automatic Sprinkler Company to conduct an inspection of the fire suppression system at the above location or building and to prepare a written report of that inspection for the agreed upon fee. As a part of this agreement,customer agrees to Terms And Conditions found on Report of Inspection and will complete the Owner's Section of this document. Viking Automatic Sprinkler Company will not be held liable for incorrect or unknown answers provided in the Owner's Section. PRIOR TO TESTING NOTIFICATIONS YES PHONE NUMBER CONTACT NOTES BUILDING MANAGEMENT MONITORING ENTITY ❑x 2ND MONITORING ENTITY 0 AHJ ❑ NOTES OWNER'S SECTION (To be answered by the Owner,Occupant,or Customer) 1.Is the building occupied? Yes❑x No El 2.Are all systems in service? Yes❑x No El 3.Was the system(s)free of actuation of devices or alarms since the last inspection? Yes x❑ No D 4.Explain any occupancy hazard changes since the previous inspection: None 5.Describe any fire protection modifications made since the last inspection: None 6.Describe any fires since the last inspection: None 7.When was the system last checked for stoppage,corrosion,or foreign material? Unknown 8.When was the dry-piping system last checked for proper pitch? N/A 9.Are Dry valves adequately protected from freezing? N/A 10.Does the system contain any low points? Yes ❑ No El General Locations: If yes,how many? Owner's Signature Printed Name: Lewis Hanson Title: Maintenance XE-mail: Date Signed:11/6/15 Form Revision Date:08-05-2014 301 York Avenue•St.Paul MN 55130•651.558.3300•800.229.6263 AMINEMIE1111 TERMS AND CONDITIONS The Report of Inspection,together with these Terms and Conditions,constitute the entire agreement("Agreement")of the parties. 1. This Agreement is for work performed on this Inspection only. If Customer wants Viking Automatic Sprinkler Company("Company")to make any additional repairs,alterations or replacements as a result of the work performed,the Company will do so for additional compensation to be agreed upon in writing by the parties. 2. The Company does not know and does not represent whether the current fire protection system on the property of Customer("Property")was originally designed and installed in such a way that the system will perform as originally intended or is suitable and sufficient for its intended purpose given the way in which the Property has been or will be used. In other words,the Property has been or may be used in ways such that the configuration of partition walls,the location of and types of materials(including the presence of hazardous materials)and other conditions of the Property's use are such that the fire protection system is inadequate, insufficient or unsuitable for the Property. The Company is NOT responsible for any damages due to:(1)incompatibility of materials within a CPVC piping system,or,(2)corrosion or deterioration of piping due to Customer's water supply,atmospheric conditions,soil quality,or any other condition at Customer's facility that adversely affects the integrity of the fire protection system. THIS AGREEMENT IS NOT A GUARANTEE OR WARRANTY THAT THE SYSTEM WILL IN ALL CASES (A) PROVIDE THE LEVEL OF PROTECTION FOR WHICH IT WAS ORIGINALLY INTENDED, (B) IS FREE OF ALL DEFECTS AND DEFICIENCIES,(C)AND IS IN COMPLIANCE WITH ALL APPLICABLE CODES. Customer agrees that it has not retained Company to make these assessments unless otherwise specifically indicated. 3. The Company will be permitted,at all reasonable times,to enter the Property to conduct the work as outlined in this Agreement. 4. TO THE FULLEST EXTENT PERMITTED BY LAW, CUSTOMER AGREES TO DEFEND, INDEMNIFY AND HOLD HARMLESS COMPANY AND ITS OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, PARENT COMPANY, SUBSIDIARIES AND AFFILIATES, (HEREINUNDER REFERRED TO AS "INDEMNIFIED PARTIES") FROM AND AGAINST ANY AND ALL CLAIMS, DEMANDS, LOSSES, EXPENSES OR LIABILITIES OF ANY KIND,INCLUDING ATTORNEY'S FEES, (HEREINUNDER REFERRED TO AS"DAMAGES"),ARISING OUT OF OR IN ANY WAY RELATING TO OR CONNECTED WITH THE WORK PERFORMED BY THE COMPANY UNDER THIS AGREEMENT (WHETHER ARISING DURING OR FOLLOWING THE PERFORMANCE OF THE WORK). THE FOREGOING OBLIGATIONS TO DEFEND, INDEMNIFY AND HOLD HARMLESS SHALL BE ENFORCEABLE REGARDLESS OF WHETHER SUCH "DAMAGES"ARE ACTUALLY OR ALLEGEDLY CAUSED BY THE NEGLIGENCE, PRODUCT LIABILITY, BREACH OF CONTRACT, BREACH OF WARRANTY, BREACH OR VIOLATION OF A STATUTE, ORDINANCE, GOVERNMENTAL REGULATION, STANDARD OR RULE OR OTHER FAULT OF ANY OF THE "INDEMNIFIED PARTIES", IT BEING THE EXPRESS INTENT OF CUSTOMER TO DEFEND INDEMNIFY AND HOLD HARMLESS THE "INDEMNIFIED PARTIES" FROM THE CONSEQUENCES OF THE "INDEMNIFIED PARTIES" OWN NEGLIGENCE, PRODUCT LIABILITY, BREACH OF CONTRACT, BREACH OF WARRANTY, BREACH OR VIOLATION OF A STATUTE, ORDINANCE, GOVERNMENTAL REGULATION, STANDARD OR RULE OR OTHER FAULT. SHOULD THE "DAMAGES"ASSERTED AGAINST THE "INDEMNIFIED PARTIES" ARISE OUT OF THE SOLE NEGLIGENCE OF THE "INDEMNIFIED PARTIES" CUSTOMER'S INDEMNIFICATION OBLIGATIONS HEREUNDER SHALL BE ONLY FOR THE AMOUNT OF THE "DAMAGES" THAT EXCEEDS THE LESSER OF$5,000 OR THE CONTRACT AMOUNT. CUSTOMER FURTHER AGREES TO INDEMNIFY THE"INDEMNIFIED PARTIES" FOR THEIR LEGAL FEES, COSTS AND DISBURSEMENTS PAID OR INCURRED TO ENFORCE THE PROVISIONS OF THIS PARAGRAPH AND TO OBTAIN, MAINTAIN AND PAY FOR SUCH INSURANCE COVERAGE AND ENDORSEMENTS, INCLUDING COMPLETED OPERATIONS COVERAGE,AS WILL INSURE THE PROVISIONS OF THIS PARAGRAPH,AND UPON REQUEST,SHALL PROVIDE COMPANY WITH EVIDENCE THEREOF. 5. IT IS UNDERSTOOD AND AGREED BY CUSTOMER THAT COMPANY IS NOT AN INSURER, THAT CUSTOMER SHALL OBTAIN THE TYPE AND AMOUNT OF INSURANCE COVERAGE WHICH IT DETERMINES NECESSARY,AND THAT THE AMOUNTS PAYABLE TO THE COMPANY HEREUNDER ARE BASED UPON THE VALUE OF THE SERVICES RENDERED AND ARE UNRELATED TO THE VALUE OF CUSTOMER'S PROPERTY,THE PROPERTY OF OTHERS LOCATED ON CUSTOMER'S PREMISES,OR ANY POTENTIAL LIABILITY OR DAMAGE TO CUSTOMER ARISING OUT OF THE WORK PERFORMED BY COMPANY. CUSTOMER ACCORDINGLY AGREES THAT THE LIABILITY OF COMPANY,ITS OFFICERS, DIRECTORS, EMPLOYEES,PARENT COMPANIES,SUBSIDIARIES,AFFILIATES AND AGENTS ARISING OUT OF OR IN ANY WAY RELATING TO OR CONNECTED WITH THE WORK PERFORMED BY THE COMPANY SHALL BE LIMITED TO THE LESSER OF$5,000 OR THE PRICE OF THE WORK PERFORMED BY THE COMPANY. THIS LIMITATION OF LIABILITY SHALL APPLY TO ALL CLAIMS, DEMANDS, LOSSES, EXPENSES OR LIABILITIES OF ANY KIND, INCLUDING ATTORNEY'S FEES, (HEREINAFTER REFERRED TO AS "DAMAGES"), SUSTAINED BY CUSTOMER OR ANY OTHER PARTY CLAIMING BY OR THROUGH CUSTOMER,AND SHALL APPLY REGARDLESS OF WHETHER SUCH"DAMAGES"ARE ACTUALLY OR ALLEGEDLY CAUSED BY THE NEGLIGENCE, PRODUCT LIABILITY, BREACH OF CONTRACT, BREACH OF WARRANTY, BREACH OR VIOLATION OF A STATUTE, ORDINANCE, GOVERNMENTAL REGULATION STANDARD OR RULE OR OTHER FAULT OF COMPANY,ITS OFFICERS,DIRECTORS,EMPLOYEES,AGENTS,PARENT COMPANIES,SUBSIDIARIES AND AFFILIATES. 6. CUSTOMER AGREES TO REQUIRE ITS INSURANCE POLICIES TO BE ENDORSED SO AS TO WAIVE ALL RIGHTS OF SUBROGATION AGAINST COMPANY. 7. While the Company will make every reasonable effort to prevent the discharge of water into or onto areas of landscaping,decorative pavement, etc.,it is the Customer's responsibility to provide sufficient and readily accessible means to accept the full flow of water that may be required by tests as determined by the type of inspection. 8. This Agreement may not be assigned by Customer without the written consent of the Company. 9. Neither party shall be liable to the other for indirect,incidental,consequential or punitive damages arising out of the work. 10. If payment for work provided in this Agreement is not received by the Company within 30 days from Customer's receipt of an invoice for the work, Customer shall pay interest at the rate of 3%per annum on all past due sums,together with all costs of collection, including attorney's fees. 11. This Agreement constitutes the entire agreement of the parties. If any provision hereof shall be invalid,the remaining provisions shall survive and be enforceable against the parties. The law of the state where the work is performed will govern. This Agreement supersedes all prior agreements. This Agreement may be modified only by a written instrument signed by both parties. T&C Revision Date:04-24-2014 © � People.Integrity.Professionalism.Excellence. I ICI Job Number:SV1510061303 Job Name:Shepherds Path AUTOMATIC SPRINKLER CO. Inspector:Kevin Strandberg Date:11/6/15 Report of Inspection Complete System Wet system Description 1.General Yes No N/A a. Is the building occupied? 0 0 0 b.Are all systems in service? 0 0 0 c. Does there appear to be a minimum of 18 inches (457 mm)clearance between the top of storage and the sprinkler deflectors? CI 1:1 d. Does the hand hose on the sprinkler system(s)appear to be satisfactory? ❑ El 0 2. Control Valves(see item 14) a. Do sprinkler system control valves appear to be in the appropriate open or closed position? 0 El ❑ b.Are control valves in the open position locked, sealed or equipped with a tamper switch? p ❑ ❑ 3.Water Supplies(see item 15) a. Was a waterflow test of the main drain made at the sprinkler riser(s)? 0 ❑ El 4.Tanks, Pumps, Fire Department Connections a.Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? ❑ ❑ 0 b.Are fire department connections in satisfactory condition, couplings free, caps in place and check valves tight? 0 ❑ ❑ c.Are they accessible and visible? 0 El ❑ 5.Wet Systems a.Are cold weather valves(OS&Y) in the appropriate open or closed position? ❑ El 0 b. Have anti-freeze solutions been tested? El ❑ 0 c.Antifreeze test result: Type of solution: ❑Glycerin El Propylene Glycol d. In areas protected by the wet system(s), does the building appear to be properly heated in all areas, including blind attics and perimeter areas where accessible? 0 El El e. Do all exterior openings appear to be protected against freezing? 0 ❑ El 6. Dry System (see items 10 thru 12) a.Are dry valve(s) in service? ❑ ❑ 0 b.Are the air pressures and priming water levels in accordance with the manufacturer's instructions? El El El c. Has the operation of the air or nitrogen supplies been tested? El ❑ 0 Are they in service? ❑ ❑ 0 d. Were all known low points drained during this inspection? El ❑ 0 e. Did quick opening devices operate satisfactorily? El ❑ 0 f. Did the dry valve(s)trip properly during the trip pressure test? ❑ El 0 g. Did the heating equipment in the dry pipe valve room(s)operate at the time of the inspection? El El 0 7.Special Systems(see item 13) a. Did the deluge or pre-action valves operate properly during testing? El El 0 b. Did the heat responsive devices operate properly during testing? ❑ ❑ 0 c. Did the supervisory devices operate properly during testing? ❑ ❑ 0 8.Alarms a. Did water motor(s)and gong(s)test satisfactory? ❑ ❑ 0 b. Did electric alarm(s)test satisfactory? 0 ❑ ❑ 9.Sprinklers a. Do visible sprinklers appear to be free from corrosion, loading or obstruction to spray discharge? 0 El ❑ b. Do sprinklers appear to be less than 50 years old? (Older sprinklers require sample testing) 0 El El c. Do quick response and residential sprinklers appear to be less than 20 years old? (Older sprinklers require sample testing) 0 ❑ d. Do dry sprinklers appear to be less than 10 years old?(Older sprinklers require sample testing) 0 ❑ ❑ e. Is stock of spare sprinklers available? 0 ❑ f. Does the exterior condition of sprinkler system appear to be satisfactory? 0 El g. Do visible sprinklers appear to be of proper temperature rating for their location? 0 El ❑ Form Revision Date:05-19-2014 301 York Avenue•St.Paul MN 55130•651.558.3300•800.229.6263 www . vikingsprinkler. com People.Integrity.Professionalism.Excellence. V, a Job Number:SV1510061303 Job Name:Shepherds Path AUTOMATIC SPRINKLER CO. Inspector:Kevin Strandberg Date:11/6/15 Report of Inspection 10.Date dry pipe valve tested(control valve partially open) N/A (see trip test table which follows) See Additional Pages for Multiple Dry,Deluge,or 11.Date dry pipe valve tested(control valve fully open) N/A (see trip test table which follows) Preaction Systems. 12.Date quick opening device tested N/A (see trip test table which follows) TRIP TEST TABLE Valve System# Quick Opening Device(If Applicable) MAKE MODEL SIZE SERIAL NO. MAKE MODEL SERIAL NO. DRY PIPE OPERATING Time to trip Water Air Trip Point Air Time water Reached Alarm Operated TEST though test pipe Pressure Pressure Pressure Test Outlet Properly? Minutes Seconds PSI PSI PSI Minutes Seconds Yes No Without Q.O.D. ❑ ❑ With Q.O.D. ❑ ❑ 13.Date deluge or preaction valve tested (see trip test table which follows) See Additional Pages for Multiple Dry,Deluge,or TRIP TEST TABLE Valve System# Preactionsystems. MAKE SIZE Piping Supervised? Yes❑ No ❑ Detecting Media Supervised? Yes❑ No El DELUGE& MODEL Does Valve Operate from the Manual Trip/or Remote Control Station? Yes❑ No PRE-ACTION Is there an Accessible Facility in each Circuit for Testing? Yes E] No ❑ TEST OPERATION Method of Testing Circuits PNUEMATIC Does Each Circuit Operate Supervision loss Alarm? Yes❑ No ❑ ELECTRIC ❑ Does Each Circuit Operate Valves Release? Yes❑ No ❑ HYDRAULIC Maximum Time to Operate Release? Yes❑ No ❑ 14.See Control Valve Maintenance Table Control Valves Number Type Open Secured Closed Signs Explain Abnormal Conditions City Valves 1 Yard Post YE] N ❑ YD N❑ Y❑ N II YE] N ❑ System Valves 2 OS Y YE] N ❑ YID N❑ Y❑ ND YE] N ❑ Y❑ N ❑ Y❑ N ❑ Y❑ N ❑ Y❑ N ❑ Y❑ N ❑ Y❑ NO Y❑ N ❑ Y❑ N ❑ Y❑ N ❑ Y❑ N ❑ Y❑ NO Y❑ N ❑ Y❑ N ❑ Y❑ NO Y❑ NO Y❑ ND Y❑ N ❑ Y❑ N❑ Y❑ N ❑ Y❑ N ❑ Y❑ N ❑ Y❑ NO Y❑ N ❑ Y❑ N ❑ 15.Water Flow Test at Sprinkler Riser Source: City Q Tank ❑ Pump Date Test Pipe Location Size of Test Pipe Static Pressure Residual(Flow)Pressure Last Flow Test 11/24/14 Riser 2" 115 102 This Flow Test 11/6/15 Riser 2" 114 102 16.Explain any"No"Answers and Comments: 17.Adjustments or corrections made during this inspection: 18.Although the comments are not the result of an engineering review,please see the attached Non-Inspection Related Deficiencies form for additional items found during the course of the inspection.(Only attached if applicable) Inspector's Signature g-1(--Obe4Date Signed 11/6/15 Form Revision Date:05-19-2014 301 York Avenue•St.Paul MN 55130•651.558.3300•800.229.6263