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Home My WebLink AboutSprinkler Inspection Report (2) 1301 L'ORIENT STREET ST. PAUL, MINNESOTA 55117 (651) 558-3300 . (800)-229-6263 FAX: (651) 558-3310 SHEi'T 1 OF 2 - Use separate sheet for each building inspection AGREEMENT & REPORT OF INSPECTION MINNESOTA LICENSE NO. COOS REPORT TO L-iH-l-c / 'l-~S ~...+~ ~So"'t STREET 413 C> ~ ~.... -k. 'S+- CITY & STATF ,t), \~r L",.. k".. : 1M,., INSPECTION # S/b90; BUILDING OR LOCATION .~.....~ INSPECTOR~ \ - \... \.... DATE l....- , \;. -0 \. J'oo,J t Owner hires Viking Automatic Sprinkler Company to conduct an inspection of the 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 terms and conditions on rear of form and will complete the Owner's Section of this document. Owner's Section (To be answered by Owner or Occupant) A. Explain any occupancy hazard changes since the previous inspection: V\ ~ ..Q. B. Describe fire protection modifications made since last inspection. r~ < lOt I , 'S-P--kj I'""S. '~p b r-c-l C. Describe any fires since last inspection. "'. ~ D. When was the system piping last checked for stoppage, corrosion or foreign material? ~~-b j i...J E. When was the dry-piping system last checked for proper pitch? Y1 t"\ ..p..t d {.,. .... <. F. Are dry valve~ adequately prote.cte~_ from freezing? ~ Signature~~ 0-.-~d!/, Tith'~" "". Datp , ." ~ Inspector's Section (All responses reference current inspection) 1. General a. Is the building occupie~ ~ D No b. Are all systems in service~es D No c. Does there appear to be a minimum of 18 in. (457 nun) clearance between the top of the storage and the sprinkler deflector~es D No d. Does the valve hose on the sprinkler system(s) appear to be satisfactory? DYes 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?ris D No b. Are control valves in the open position locked, sealed or equipped with a tamper switch~es D No 3. Water Supplies (See Item 16.) a. Was a water flow test of main drain made at the sprinkler riser(s)?~s D No 4. Tanks, Pumps, Fire Department Connections a. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? DYes D No ~A b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tightJo!""l"'Yes D No DNA Are they accessible and visible~es D No DNA 5. Wet Systems a. Are cold weather valves (O.S. & Y.) in the at't',vt',:ate open~r clos d position? DYes D No ~A b. Have antifreeze system solutions been tested? DYes D No A c. Were the antifreeze test results satisfactory? DYes D No NA d. In areas protected by wet system(s).:..d~s the building appear to be properly heated in all areas, including blind attics and perimeter areas where accessible? DYes D No ~A Do all exterior openings appear to be protected against freezing~es D No DNA 6. Dry System (See Items 11 to 13.) a. Are dry valve(s) in service?~es D No DNA b. Are the air pressures and priming water levels in accordance with the manufacturer's instructions~es D No DNA c. Has the operation of the air or nitrogen supplies been tested? ~ es D No D NA Are they in service? ~ es D No D NA d. Were all known low points drained during this inspection?~es D No DNA e. Did quick-opening devices operate satisfactorily? DYes D No ~A f. Did the dry valve(s) trip properly during the trip pressure test? J;l-lYes D No DNA g. Did the heating equipment in the dry-pipe valve room(s) operate at time of inspection ~s D No DNA 7. Special Systems (See Item 14.) a. Did the deluge or pre-action valves operate properly during testing? DYes D No ~A b. Did the heat-responsive devices operate t',vt'".ly during testing? DYes D No A"11fA c. Did supervisory devices operate during testing? DYes D No ~A 8. Alarms a. Did water motor(s) and gong(s) test satisfactorily? DYes D No ~ b. Did electric alann(s) test satisfactory?~es D No DNA c. Did supervisory alann service test satisfactory? DYes D No ~ 9. Sprinklers . a. Do visible sprinklers appear to be free from corrosion, loading or obstruction to sJ2.Ply dischargeA"'lJ Yes 0 No b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing)~es D No c. Are quick response and residential sprinIg,ers less than 20 years old? (Older sprinklers require sample testing~es D No ~ d. Is stock of spare sprinklers available?~es D No _ ~ e. Does the exterior condition of sprinkler system appear to be satisfactory ~ es D No f. Do visible sprinklers appear to be of proper temperature rating for their locations~s D No 10. Explain any "No" answer ~ comments: '-.) C / ~ {J- I NA =NOT APPLICABLE Signature: Date: h-/b"O b ".~. ..ca AUTOMATIC SPRINKLER CO. Setting The Standard... , 1301 L'Orient Street St. Paul, Minnesota 55117 (651) 558-3300 . (800) 229-6263 Fax: (651) 558-3310 System No. or Descripti~ if multiple """'"' /- 2' &1 j., -I to . t> \:) (See Trip Test Table which follaws) .- (See Trip Test Table which follO'ws) (See Trip Test Table which follows) TRIP TEST TABLE a.a.D. SERIAL NO. MAKE MODEL 2:.!S ... /I ~ Air SHEET 2 of 2 - Use separate sheet for each system ifuyc'-~cJ Inspection R.or~' ~ No. .5 I b G () ( 11 Date dry-pipe valve trip tested (control valv{! partially open) 12 Date dry-pipe valve trip tested (control valve fully open) 13 . Date quick-opening device tested DRY VALVE DRY PIPE vr~KATING Jtt>J Ce~ Time to Trip Thru Test Pipe MIN. SEe. PSI PSI MIN. SEe. MvunL .oAF 'C;" S Water Pressure Pressure Trip Point Air Pressure Time Water Reached Test Oudet PSI Without Q.O.D With Q.O.D 6S 3'-1 J3 ".- ".... ,-' /' 14 (See Trip Test Table which follaws) TRIP TEST TABLE Operation 0 PNEUMATIC 0 ELECIRIC 0 HYDRAUUC PipinK Supervised 0 YFS 0 NO IDetecting Media Supervised 0 YFS ~s ~alve operate from the manual trip and/ or remote control stations 0 YFS Is there an accessible facility in each circuit for testing 0 YFS 0 NO IMethod of Testing Cimrits Does each circuit operate Does each circuit supervision loss alarm operate valve release YES NO YES NO Date deluge or preaction valve tested DELUGE & PREACfION VALVES ;1/4 MAKE MODEL 15 See Control Valve Maintenance Table CONTROLVALVENUUNTENANCETABLE Number Open Secured Closed Signs Type Control Valves City Control Valves Bypass Valves Tank Control Valves Pump Control Valves Sectional Control Valves System C~..;"vl Valves Other Control Valves Kitchen Control Valves 16 Water Flow Test at Sprinkler Riser ~ Water Suvvlv Source: Citv .... Test Pipe Location 1_ c.J tI i - t-' ~ f?W .( g.F - - Tank Size of Test Pipe Static Pressure Date Last Water Flow Test This Water Flow Test K\-V ~I' 1"'-1 '1"' 5 b. I \;. #0 1.0 17 Explain any "No" answers and comments: 18 Adjustments or corrections made during this inspection: SERIAL NO. Alarm Operated Properly YES NO ,." o NO o NO Maximum time to operate release YES NO Explain Abnormal Condition Pump Residual (Flow) Pressure t::,..., 19 Although these comments are not the result ot an engineering review, the tOllowing desirable improvements are recommended: 1\ Signahm< /.-J --6 h Da"" b - ) b ~ 0 Ie (Rev. 2/8/06)