HomeMy WebLinkAboutFire Sprinkler Report 2007
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AUTOMATIC SPRINKLER CO.
Setting The Standard...
1301 L'Orient Street
St. Paul, Minnesota 55117
(651) 558-3300 . (800) 229-6263
Fax: (651) 558-3310
SHEET] at 2. Use separate sheet for each building mspected
MINNESOTA LICENSE NO. COOS
AGREEMENT AND REPORT OF INSPECTION
III NSPECTION
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REPORT TO
STREET
CITY & STATE
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BUILDING OR LOCATION
! 'f vI "',. INSPECTOR
DATE
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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 (fo be answered by Owner or Occupant)
A. Explain any occupancy hazard changes since the previous inspection: J..} ,,-. .~I e
B. Describe fire protection modifications made since last inspection:
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C. Describe any fires since last inspection:
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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? V\.
F. Are dry valves adequately protected from freezing? (1'-"''';
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Signature Title
Inspector's Section (All responses reference current inspection)
1 General
a. Is the building occuPied?Nes 0 No
b. Are all systems in service. AYes 0 No ,
c. Does there appear to be a ininimum of 18 in. (457 rom) clearance between the top of the storage and the sprinkler deflectors? ~Yes r] No
d. Does the valve hose on the sprinkler system(s) appear to be satisfactory? u Yes 0 No ).eN/ A
2 Control Valves (See Item 15) ,
a. Do sprinkler system control valves appear to be in the appropriate open or closed position?p es n No
b. Are control valves in the open position locked, sealed or equipped with a tamper switch?)(Yes 0 No
3 Water Supplies (See Item 16)
a. Was a water flow test of main drain made at the sprinkler riser(s)?>tfes 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 tight? t>(Yes D No u N/ A
Are they accessible and visible?AYes D No D N/ A / '
5 Wet Systems
a. Are cold weather valves (OS. & Y.) in the appropriate open or closed position? u Yes n No)<€'N/ A
b. Have antifreeze system solutions been tested? 0 Yes D No ~/ A
c. Were the antifreeze test results satisfactory? [] Yes D No )d:J'J/ A
d. In areas protected by wet system(s), does the building appear to be properly heated in all areas, including blind attics and perimeter areas
where accessible?)d Yes D No D N/ A Do all exterior openings appear to be protected against freezing?;(:es D No D N/ A
6 Dry System (See Itend 1) to 13)
a. Aredryvalves(s)inservice?~eS DNo DN/A
b. Are the air pressures and priming water levels in accordance with the manufacture's instructions?AYes D No [J N/ A
c. Has the operation of the air or nitrogen supplies been tested? )e{Yes D No D N/ A Are they in service?~Yes D No D N/ A
d. Were all know low points drained during this inspection?AYes D No 0 N/ A
e. Did quick-opening devices operate satisfactorily?~s [] No n N/ A
f. Did the dry valve(s) trip properly during the trip pressure test?XYes uNo D N/ A
g. Did the heating equipment in the dry-pipe valve room(s) operate at time of inspection?){Yes D No D N/ A
7 Special Systems (See Item 14)
a. Did the deluge or pre-action valves operate properly during testing? u Yes D NoXN/ A
b. Did the heat-responsive devices operate properly during testing? DYes 0 No 'Jl\..1-J/A
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 XN/ A
b. Did electric alarm(s) test satisfactory?')(fYes [] No 0 N/ A '
c. Did supervisory alarm service test saflsfactory?j2 Yes D No D N/ 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 testing)ll1Y es 0 No
c. Are quick response and residential sprink1ers less than 20 years old? (Older sprinklers require sample testing) 'ji..'!es 0 No 0 N/ A
d. Is stock of spare sprinklers available?A Yes 0 No
e. Does the exterior condition of sprinkler system appear to be satisfactory? ~ Yes 0 No
f. Do visible sprinklers appear to be of proper temperature rating for their locations? )Q. Yes D No
10 Explain any "No" answers and corome~ts:
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Date
N/A = NOT APPLICABLE
Signature:
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Date:
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1301 L'Orient Street
St. Paul, Minnesota 55117
(651) 558-3300 . (800) 229-6263
Fax: (651) 558-3310
Inspection Report
No. ':( :5 ,:., Z L/
System No. or Description if multiple
systems Ii I ,'f :>
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SHEET 2 of 2 - Use separate sheet for each system inspected
11 Date dry-pipe valve trip tested (control valve partially open)
12 Date dry-pipe valve trip tested (control valve fully open)
13 Date quick-opening device tested
A
(See Trip Test Table which follows)
(See Trip Test Table which follaws)
(See Trip Test Table which follows)
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DRYV LVE TRIP TEST TABLE 0.0.0.
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
Time to Trip Water Air Trip Point Time Water Reached Alarm Operated
Thm Test Pipe Pressure Pressure Air Pressure Test Outlet Properly
MIN. SEe. PSI PSI PSI MIN. SEe. YES NO
Without
Q.OD
With
Q.O.D
DRY PIPE
OPERATING
TEST
14 Date deluge or preaction valve tested
(See Trip Test Table which follmvs)
TRIP TEST TABLE
DELUGE &
PREACTlON
V ALVES
;VIA
Operation D PNEUMATIC D ELECIRIC D HYDRAUUC
Piping Supervised DYES D NO IDetecting Media Supervised DYES D NO
Does valve operate from the manual trip and/ or remote control stations DYES D NO
Is there an accessible facility in each circuit for testing DYES D NO IMethod of Testing Circuits
Does each circuit operate Does each circuit Maximum time to
MAKE MODEL supervision loss alarm operate valve release operate release
YES I NO YES I NO YES I NO
I I I
15 See Control Valve Maintenance Table
Explain
Abnormal
Control Valves Number Tvpe Open Secured Closed Signs Condition
City Control Valves / f'J ~j -' --'~
Bvoass Valves
Tank Control Valves
Purno Control Valves
Sectional Control Valves 1- TI; C ':II r _. -. _.
System Control Valves I '-~ " I:; . l-
Other Control Valves ! - i.--' I>~ - -. ..
Kitchen Control Valves
CONTROL VALVE MAINTENANCE TABLE
16 Water Flow Test at Sprinkler Riser
Water Su I Source:
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Tank
Date
Test Pipe
Location
Size of
Test Pi e
Static
Pressure
Pum
Residual
(Flow)
Pressure
Last Water Flow Test
This Water Flow Test
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17 Explain any "No" answers and comments:
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:
'"~7 '," .J i-I..-' 7
(Rev. 2/8/06)
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AUTOMATIC SPRINKLER CO.
Setting The Standard...
1301 L'Orient Street
St. Paul, Minnesota 55117
(651) 558-3300 . (800) 229-6263
Fax: (651) 558-3310
Inspection Report
No.;< L5:;,2 '-1
11 Date dry-pipe valve trip tested (control valve partially open)
12 Date dry-pipe valve trip tested (control valve fully open)
13 Date quick-opening device tested / - , \ - l. 7
System No. or Description if multiple
systems If Z ~. .:::2
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SHEET 2 of 2 - Use separate sheet for each system inspected
7 - i I Co I (See Trip Test Table which follows)
(See Trip Test Table which follows)
(See Trip Test Table which follows)
DRY PIPE
OPERATING
TEST
DRY VALVE
MAKE
It;> ,,\ ','--.,1 s;
Time to Trip
Thru Test Pipe
MIN. SEe.
MODEL
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Water
Pressure
TRIP TEST TABLE
SERIAL NO. MAKE
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Air Trip Point
Pressure Air Pressure
PSI
0.0.0.
MODEL
? -)
Time Water Reached
Test Outlet
MIN. SEe.
SERIAL NO.
757Ul Ice
Alarm Operated
Properly
YES NO
PSI
PSI
Without
Q.o.D
With
Q.o.D
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14 Date deluge or preaction valve tested
(See Trip Test Table which follows)
TRIP TEST TABLE
DELUGE &
PREACTION
V ALVES
Operation D PNEUMATIC D ELEClRIC D HYDRAUliC
Piping Supervised DYES D NO I Detecting Media Supervised DYES D NO
Does valve operate from the manual trip and/ or remote control stations DYES D NO
Is there an accessible facility in each circuit for testing DYES D NO I Method of Testing Circuits
Does each circuit operate Does each circuit Maximum time to
MAKE MODEL supervision loss alarm operate valve release opera te release
YES I NO YES T NO YES I NO
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15 See Control Valve Maintenance Table
CONTROL VALVE MAINTENANCE TABLE
Explain
Abnormal
Control Valves Number Tvpe Open Secured Closed Signs Condition
City Control Valves
Bvpass Valves
Tank Control Valves
Pump Control Valves
Sectional Control Valves
System Control Valvcs I '-l .) '{ '1 - -.- -
Other Control Valves
Kitchcn Control Valves
16 Water Flow Test at Sprinkler Riser
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Water Su polv Source: ; Citv i Tank Pump
Residual
Test Pipe Size of Static (Flow)
Date Location Test Pipe Pressure Pressure
Last Water Flow Test
This Water Flow Test '7 - J I -c. 1 ~. , 4' ,',1 C",;'Ci 71.."
17 Explain any "No" answers and comments:
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:
/-11-(.,"7
(Rev. 2/8/06)