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Home My WebLink AboutFire Inspection Report (2) INSPECTION CONTRACT No.3oY~7..Q.,.~.~,.,.. BUREAU FILE NO. ~ INSPECTION REPORT "NO. CONFERRED WITH tqeD/Fire &: / Simp/exSrinne// SeCUrity REPORT OF INSPECTION per NFPA 13 & 25 REPORT Tn ",()L U f" f ~"'2" ~TFl!;!;T . CITY & STATE ILl DaIt. ATT H e I ~l"\\ s F ~JI'-IU\1 T L\c.- VVJ 1\ e-t ') (l BUILDING OR LOC~ON INSPECTED )NSP~CTOR r\. d ':::- ~: SG OFFICE ----y"'1/) I'> DATF / / ! 7 ,. LJ <) PHONE NO-S 67" -;;..JUQ ^"' ZIP ---..S'S""s 1'2 1. GENERAL A. (To be answered by the Owner or Owner's representative) a. Have there been any changes in the occupancy classification, machinery or operations since the last inspection? b. Have there been any changes or repairs to the fire protection systems since the last inspection? c. If a fire has occurred since the last inspection, have all damaged sprinkler system components been replaced? d. Has the piping in all dry systems been checked for proper pitch within the past five years? Date last checked (checking is recommended at least every 5 years) e. Has the piping in all systems been checked for obstructive materials? Date last checked (checking is recommended at least every 5 years) f. Have all fire pumps been tElsted to their full capacity through the use of h~se streams or flow meters within the past 12 months? g. Are gravity, surface or pressure tanks protected from freezing? h. Are any of the sprinklers 50 years old or older? (testing and/or replacement is recommended for such sprinklers) Are any extra high temperature solder sprinklers regularly exposed to temperatures near 3000F? B. (To be answered by the inspector) a. Have the sprinkler systems been extended to all visible areas of the building? b. Does there appear to be proper clearance between the top of all storage and the sprinkler deflector? c. Are the building areas protected by a wet system, heated, including its blind attics and perimeter areas, where accessible? d. Are all visible exterior openinas protected aaainst the entrance of cold air? 2. CONTROL VALVES a. Are all sprinkler system main control valves and all other valves in the appropriate open or closed position? b. Are all control valves sealed or supervised in the open position? SET 1 OF 2 ~A~c, Ves N.A.:j: No' /./ V V"" l..,.oo L,/ V ......... L./' ....... '"" t./ \./ ....... V V" Control Valves No. Easily Valve Secured? Supervision of Type Accessible Signs Open If yes, how? (Sealed?) Operational (Locked?) Valves /1 j Ves No Ves No Ves No Ves No 3Supvd.?\ Ves No ;..,t- ,...., i V 10 '. l1 V .......... ........ \.../ S t.JL7V ~ ./" CITY CONNECTION TANK PUMP SECTIONAL SvSTEM ALARM LINE "" I ~f //)'-;(1 I v ..s i/ v v <;vflld 3. WATER SUPPLIES a. Water supply source? City Waterflow Test Results Made During This Inspection Test Size Static Pipe Test Pressure Located Pipe Before Pressure Fire Pump & Tan" Pressure Fire Pump & City Pressure Fire Pump & Ponr' v Gravity Tank Static Pressure After Test Pipe Location Size Test Pipe Static Pressure Before Flow Pressure //'<.lJrvlS ')'\) ./ 'it, I U).p ..1 .;t (o) I -O.f'1 ~~ :..1.1, ..../< (.p..O -//J , - 4. TANKS, PUMPS, FIRE DEPT. CONNECTIONS a. Do fire pumps, gravity, surface or pressure tanks appear to be in good external condition? b. Are gravity, surface and pressure tanks at the proper pressure and/or water level~? c. Are fire depl. connections in satisfactory condition, couplings free, caps or plugs in place and check valves tight? d. Are fire depl. connections visible and accessible? 5. WET SYSTEMS a. No. of system~ 'J 4"//1/ I < j . t- o Make & Model b. Are cold weather valves in the appropriate open or closed position? If closed, has piping been drained? c. Has the owner or owner's representative been advised that cold weather valves are not recommended by NFPA? d. Have all the antifreeze systems been tested? e. Date antifreeze systems were tested f. The antifreeze tests indicate protection tn' system 1 ? ~. 4 <;. temperature g. Did alarm valves, waterflow alarm indicators and retards test satisfactorily? v Flow Pressure Static Pressure After Ves N.A.:j: No' 1./ U' V 1./ 1.../ l SG4550.R1.1 (2/05) INSURANCE BUREAU COpy *Not Applicable "Explain (No) Answers on Back of Sheet 2 INSPECTION CONTRACT No:3Q'f61f./2 BUREAU FILE NO. ~ I~~CTION REPORT NO 'mm mmm ...... -tqeD/Fire &. / SimplexGrinnel1 Secunty REPORT OF INSPECTION 6. DRY SYSTEMS a. No. ot systems 'f I, -r'-l C () ( (1 ,{2'V - \ I Make & Model Date last trip testeri b. Is the air pressure and priming water levels normal? c, Did the air compressor operate satisfactorily? d. Were all low points drained during this inspection? e. Did all quick opening devices operate satisfactorily? f. Did all the dry valves operate satisfactorily during this inspection? g. Do dry valves appear to be protected from freezing? h. Is the dry valve house heated? --8' 7. SPECIAL SYSTEMS a. No. of systemc TypE' b. Were valves tested as required? c. Did all heat responsive systems operate satisfactorily? d."Dld"tHe 5upervisBry 'feiltures Opimite dLil-ing' festing? Heat Responsive Devices: Typp Type of tp"t Valve No 1 . . . , . . 2 . . . . . . 3 . . . . . . 4 . . . . . . 5 . . . . . . 6 . . . . . . Valve Nr, Valve Nn 1 . . . . . .2. . . . . .3. . . . . .4. . . . . .5. . . . . .6. . . . . . Valve Np Valve No 1 . . . . . .2 . . . . . .3. . . . . .4. . . . . . 5 . . . . . .6. . . . . . Valve No. Valve No 1 . . .. . .2. . . . . .3. . . . . .4. . . . . .5. . . . . .6.. .. . . Valve No. Make & Model .. 1......2......3......4......5......6...... 1......2......3......4......5......6...... 1......2......3......4......5......6...... 1......2......3......4......5......6...... Auxiliary equipment: No TypE' Location Test resultc 8. ALARMS a. Did the water motors and gong operate during testing? b. Did the electric alarms operate during testing? c. Did the supervisory alarms operate during testing? 9. SPRINKLERS - PIPING a. Do sprinklers generally appear to be in good external condition? b. Do sprinklers generally appear to be free of corrosion, paint, or loading and visible obstructions? c, Are extra sprinklers available on the premises? d. Does the exterior condition ot piping, drain valves, check valves, hangers, pressure gauges, open sprinklers and strainers appear to be satisfactory? "-e. Does the hand hose on the sprinkler system appear to be in satisfactory condition? 10. EXPLANATION OF "NO" ANSWERS (For Sections 1B thru 9): fiJ/ .t.\ SET 2 OF 2 I Yes NA* No' \ V L/ ':!" l/ . ./ "." V \ I l Yes NA:j: No' V' l./ ./ V i/' ./ ../ \../ /(/ tfV) L 11. THE INSPECTOR SUGGESTS THE FOLLOWING NECESSARY IMPROVEMENTS, HOWEVER, THESE SUGGESTIONS ARE NOT THE RESULT OF AN ENGINEERING SURVEY: 12. ADJUSTMENTS OR CORRECTIONS MADE: Iv'(O AI 17~' ,,' 13. LIST CHANGES IN THE OCCUPANCY HAZARD OR FIRE PROTECTION EQUIPMENT, AS ADVISED BY THE OWNER IN SECTION 1A: ;' /l J(}y1L 14. INSPECTION AND SUGGESTED IMPROVEMENTt:laE DISC"SS"~~'lrH TUE: "i,nERSIGNED OWNER OR OWNER'S REPRESENTATIVE? Signature of owner or owner's representative x: X~~ Date~/ -7 - a-:- DUPLICATE TO' STREET CITY & STATE' ATT SG4550R 1.2 ZIP lNot Applicable 'Explain (No) Answers on Back of Sheet INSURANCE BUREAU COPY tileD /t~,l~ <~r1~~~~\~) '~:~::F~!~!r\~ _~~ i;::~~ NOTE: BEFORE ANY DRY PIPE VALVE IS TRIP TESTED, THE WATER SUPPL.Y LINe 10 IT eHOut.D.. THE VALVE SHOULD BE OPENED WIDE. AND WATER AT FULL PRESSURE! SHOULD E111! Dleo ACCUMULATION OF SCALE OR FOREIGN MATERIAL IF THERE IS A HYDRANT ON THE SUPPLYUNII, '!'HI. THE TWO INCH DRAIN IS OPENED, THE DRIP VALVE ON THE DRY PIPE VALVE SHOUL.D BE CHECl<RO UFOAfl TfIlI THAT IT IS IN OPERATING CONDITION. DRY PIPE VALVES VALVE SERIAL NUMBER MANUFACTURER (NAME) VALVE MODEL VALVE SIZE CONTROLLING SPRINKLERS I (LOCATION) I (NUMBER) DATE LAST TRIP TESTED? DATE LAST OPERATED? AIR PRESSURE BEFORE TEST WATER SIZE AND LOCATION OF TEST V~~ _ WAS GATE VALVE BELOW DRY VALVE OPEN WIDE AT TEST? (IF NOT, HOW MANY TURNS?) I AIR PRESSURE VALVE TRIPPED AT I WATER PRESSUREI I TIME IF SYSTEM FLOODED, LIST TIME WATER REACHED TEST OPENING PERFORMANCE jlNTERIOR OF BODY I MOVING PARTS VALVE CONDITION I RUBBER FACING I SEATS I RESET? DID ALARMS OPERATE AT TRIP TEST? ALL LOW POINT DRAINS BLOWN OUT? WATER CONTROL VALVE LEFT OPEN AND SEALED? ALARM CONTROL VALVE LEFT OPEN AND SEALED? OUICK OPENING DEVICES DEVICE SERIAL NUMBER MANUFACTURER (NAME) TYPE AND MODEL AIR PRESSURE IN UPPER CHAMBER QUICK OPENING DEVICE TRIPPED AT PERFORMANCE QUICK OPENING DEVICE LEFT IN SERVICE AND CONTROL OPEN AND SEAI.ED? LIST ANY UNSATISFACTORY CONDITIONS: REMARKS t:"'r- An..,." n... -,......,....,.,....... SYSTEM NO. ( , 'iCe fJP4 -IINCH A rtk_/C~d.~l s . _ (APPROX) -" -" ~ () LBS 7 0 LBS 13 LBS '70 LBS MIN SEC MIN SEC (?Of.)~ , I I ~ YlC; ) /,; -~ SYSTEM NO. ,1,,1 A SEe LBS LBS ~'1'O;1- .'::';~'_,,:;1~: ....-:". t 'r-, ',' " ': :'." ~'.,'';. 'S:, .. ~.'." ,'<:' .:.,.. '.' ISYSTEM' NO, ( ~;" "A NO. SYSTEM NO. ( INCH INCH INCH (APPROX) (APPROX) (APPROX) LBS LBS LBS LBS LBS LBS LBS LBSI LBSI SEC SEC LBS LBS LBS MIN SEC MIN MIN MIN SEe SEC MIN SEC MIN SYSTEM NO. ( SYSTEM NO. SYSTEM NO. LBS LBS LBS SEC SEe LBS LBS SEe LBS