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Home My WebLink AboutFire Sprinkler Report 2005 .~.NG AUTOMATIC SPRINKLER CO. 1301 L'ORIENT STREET ST. PAUL, MINNESOTA 55117 (651) 558-3300 . (800)-229-6263 FAX: (651) 558-3310 SHEET 1 OF 2 - Use separate sheet for each building inspe<;tion AGREEMENT & REPORT OF INSPECTION INSPECTION # $/40'+91 REPORT TO STREET CITY & STATE BUILDING OR LOCATION ~\;.a INSPECTOR ~ ~ (r- DATE I 2. - 2.. "i -0 So 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: r'\ 0 V\...!1- B. Describe fire protection modifications made since last inspection. -r--- G-lA ~ y\ lCh"\. Q C. Describe any fires since last inspection. Title D. E. F. Inspector's Section ( II responses reference current inspection) 1. General a. Is the building occupied?0~ No b. Are all systems in service?;.."rYes No c. Does there appear to be a minimum of 18 in. (457 mm) clearance between the top of the storage and the sprinkler deflectors~es I I No d. Does the valve hose on the sprinkler system(s) appear to be satisfactory? Yes 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 No b. Are control valves in the open position locked, sealed or equipped with a tamper switch? res __ No 3. Water Supplies (See Item 16.) a. Was a water flow test of main drain made at the sprinkler riser(s)0'es 4. Tanks, Pumps, Fire Department Connections a. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? Yes No -f'fNA b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tigh~es I I No I I NA Are they accessible and visible?)..rYes No NA 5. Wet Systems a. Are cold weather valves (O.S. & Y.) in the appropriate open or closed position? Yes b. Have antifreeze system solutions been tested? I I Yes I No ~A c. Were the antifreeze test results satisfactory? I I Yes No ......r1NA d. In areas protected by yet system(s), does the building appear to be properly heated in all areas, inch!ding blind attic.s and perimeter areas where accessible?yYes UNo LI NA Do all exterior openings appear to be protected against freezing~es I I No I NA 6. Dry System (See Items 11 to 13.) a. Are dry valve(s) in service? 1-1 Yes 1-' No ~A b. Are the air pressures and priming water levels in accordance with the manufacturer's instructions? Yes No........rNA c. Has the operation of the air or nitrogen supplies been tested? Yes No?'1\fA Are they in service? Yes -1 No ~A d. Were all known low points drained during this inspection') Yes [1 No ~NA e. Did quick-opening devices operate satisfactorily? I Yes I No ~A f. Did the dry valve(s) trip properly during the trip pressure tesO Yes No 7!'JA g. Did the heating equipment in the dry-pipe valve room(s) operate at time of inspection ') I Yes I No k"'NA 7. Special Systems (See Item 14.) ./ a. Did the deluge or pre-action valves operate properly during testing') [ Yes [ No I/NA b. Did the heat-responsive devices operate properly during testing? l:2J:s No ftNA c. Did supervisory devices operate during testing? I Yes I No / NA 8. Alarms a. Did water motor(s) and gong(s) test satisfactorily?, Yes No /NA b. Did electric alarm(s) test satisfactory??, Yes :-, No ~ NA c. Did supervisory alarm service test satisfactory? n Yes No ~A 9. Sprinklers a. Do visible sprinklers appear to be free from corrosion, loading or obstruction to spray discharge/Yes No b. Are sprinklers less than 50 years old? (Older sprinklers require sample testin~ es No c. Are quick response and residential sprinklers less than 20 years old') (Older sprinklers require sample testing) Yes d. Is stock of spare sprinklers available~es - No e. Does the exterior condition of sprinkler system appear to be satisfactory 'l..P'Yes ' .1)It> f. Do visible sprinklers ap ear to be of proper temperature rating for their 10cations?0'es 111, Explain any "No" answer d comments: NA =NOT APPLICABLE (// No INo~A 'NoAA No Signature: 7 .. /2..-27-t2S- ._~ Ddte. ________~_ ~._____________.._ S-Q - L -Z -? , :gWG ~1Y $ :gmlllU~!S :pgpUgUlUlO:Jgl glll SIUgUlgAOldUl~ g\qlll!Sgp llU!MOnOJ ;:np 'Mg!Agl llu!-lggu!llug Ull JO l\nSgl glJl IOU glll SIUgUlUlm gSglJl lJ~nolJl\V .61 :uo!pgdsu! 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