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Home My WebLink AboutSprinkler Report 2007 LID #: 3150134 ~-;o( 01 Page 1 of 3 >c,v --.... ,--.-.------,.--~-_...__...-._-_....__..._..-I !Annual Sprinkler I System Inspection Report Work Order #: 850649 For MonthlYear: August 2007 ~ Ahern Fire Protection 13705 26th Avenue, Suite 110 Minneapolis, j\1N 55441 (763) 268-0515 P . (763) 268-0516 f www.ahemfire.com . Since 1880 L_ !Invoice: PRIOR LAKE BAPTIST CHURCH iPhone #: :(952) 447-2824 Street: 15690 CREDIT RIVER ROAD iCity: PRIOR LAKE State: MN Zip: 55372 ~-- -------t----------------~-----.-- -+-----:-T--.--------.-- 'Location: iPrior Lake Baptist Church ,oept.: , 1-.---.-1---------.-- ---------------+- ~.--.-~---.-..-.--- 'Street: i5690 Credit River Road 'City: Prior Lake State: MN Zip: 55372 !' ----- ----+--_._--_.__.._--------,-----~--_._....__.._.__.__._~..._-_.--_.~-,._------------:._--------,----_..._._---_.._--- Phone #: . :(952) 447.2824 iFax: #: 1(952) 447.2837 .. _. . Eeman: i IDate:-- -. - - ---- iSignature:-- ---- -- - -P--- -------- -- , ---- - __nO ---_.---~ - --" -- ---..; wet-----l'-, :Fo~-'I lFireDo~;;----1 &ppression_P--- -_-: IDry---- i-i----tAlarm~----i Fi~ePu~- - ,Anti Freeze - -, pre~~ti~-___--n~ctors '-i iYlll~~~ ___ _.t-~_~a~~____ :D~luge~- _L_:Hydrant~_=__=----------_ ~and Pipe/H~____~ iIntemal Sprinkler ____~ Contacts: w;k Waddell------ Direct: (952) 447.2824 Ext L!~e~~___~~e~~-_- IALARM DEVICES TESTS 1. Did waterflow or pressure switches operate satisfactorily? 2. Did tamper switches operate satisfactorily? 3. Did water motor alarm gongs or electric bells operate satisfactorily? 4. Did alarm service or central station operate satisfactorily and receive proper signals? BFRP [BIDC _____- ~~- 'BF Generic r---.-------- --- --, BF Lincoln : ~.__.__"..___.__...._____i iBF Omaha ---_._._._,_.-._---~._'--_.--'--_.-- y N N/A '-; =: Cl LuJ ".f<.1 i7 l..-.. IALARM SIGNALS ~~ie~;~~ r-L, -- _-i__-==---I~---. ': ----==r=.-----=--'-----==-~--i-~-=~=~ .=~=-! ~~--- -~- _._---~----------~------- --_.-_.-- 15 YEAR INSPECTION Y N N/A 1. Was the 5 year Inspection performed on the following items? I ~ i n A. Alarm valves B. Check valves C. Gauges D. Internal Examination of Piping Date due: IS-YEAR TESTING I. Was the 5 year testing performed on the following items? A. Sprinkler heads in corrosive environments or rated 325" F or higher. B. Standard sprinklers in service for 75+ years. IIO-YEAR TESTING 1. Was the 10 year testing performed on the following items? A. Standard sprinklers in service for 50+ years. B. Quick response sprinklers in service for 20+ years. C. Dry pendant sprinklers. This document PROPERTY OF AHERN FIRE PROTECTION Copyright 2005 JF. Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT. rptInspection _Annual LID #: 3)50134 ICONfROL VALVE SERVICE'''..... .., I. Were the following service items performed on the control valve~ A. Fully opened and closed? B. Valve packing checked? C. Valve stem lubricated? D. Is the valve properly secured and locked in it's normal operating position? IBACKFLOW PREVENT OR TEST 1. Did the backflow preventor(s) pass the test of back flow and forward flow capabilities? y Page 2 of 3 N N/A ~J li._ IANTI-FREEZE TEST 1. Has the anti-freeze solution for each system below been tested by measuring specific gravity? Y N/A ,- " -I ~.." LI Y N N/A ~._J .r ~--' Y N N/A IHANGERS AND SEISMIC BRACING 1. Did hangers and seismic bracing appear to be in good condition, firmly attached, and free from corrosion, from a visual inspection performed from floor level? y N N/A W I IJ Y N N/A " " ~ . L ..J C IPIPING I. Was the exterior of exposed sprinkler piping in good condition, not subjected to external loads, free of mechanical damage? NOTE: Piping located in concealed spaqes, such as above a drop ceiling, are not required to be inspected. IFIRE DEPARTMENT CONNECTIONS I. Are fire department connections visible and in good condition? 2. Are caps and plugs in place? 3. Are automatic drain valves operating properly? 4. Do hose connections operate freely? HOSE RACKS PRESENT? eYes 0 No CONDITION: Bad y IMAIN DRAIN TEST i~~:::1~~:~~~-t-=---~ !I_d___ ---+----t---=f-- ---L-~+=~ l:~~~~=-=f- . 1 .....1 ... . I. ....:---- . , . ~_ . r ---=- _- I. Were all main drains tested at full flow? Ifno, explain: _____~__________ 2. Were test results similar to the last test? If no, explain: __._____n_____ __.__._________..____.....____________________...__.._-'-- ---..,---..-,--- 3. Was there any discharge of obstructive material, heavy discoloration of water, or plugging of the inspector's test connection? IGENERAL INFORMATION 1. Are all the sprinkler systems in service? 2. Is the building completely sprinklered? 3. Are all sprinklers in good condition? 4. Are all sprinklers free of obstruction? 5. Are spare sprinklers and wrenches available? 6. In spray coating area, are sprinklers free from accumulation? 7. Is hydraulic nameplate securely in place and legible? 8. Is emergency service contact information readily available? 9. Are alarm devices provided and in good condition? 10. Are all standard sprinklers dated 1920 or later? Y ~' lL- N N/A -~' /: i ,.f // ~ [~ Y N N/A I 0 Cj i7 fL., IOWNER QUESTIONS 1. Any changes in sprinkler system since last inspection? 2. Any fires since last inspection? This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2005 IF. Ahem Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT rptlnspection _Annual LID #: 3150134 / / ., A.1::ru~b;rofsprinklerheadsthatoperated. __~~-...... ~'--~----~ --- ----- B. How long was system out of service? -i-~~.- ------'-- , I C. Area where fire occured. -~'---2- "--- -- --------- I 3. Are all areas ofthe building properly heated to prevent freezing where wet pipe systems exist? 4. Do you have an outside alarm service? [[yes, name and phone number. ;' ~. , Note to Owner _ Our inspections will only report conditions as they exist at time of inspection and do not guarantee the operation of the System due to factors beyond our control. (i.e., potentially closed valves or depleted municipal water supply.) Per NFPA-25, this inspection is based on the assumption that the system has been installed in accordance with all applicable codes and standards. Page 3 of 3 Owner/Representative's Signature: Date __________________._~-----.------u-.-----.-- ____n___ ~ewDeficiencies foun~ du~ing this inspection? Yes No Customer receive copy of New Deficiency Report? Yes No _~ / / 1 _~____~~_,-!----L-.L..L-- 1'-\ '.. .'. /r ---.1LL__~~:__c:~l_j~...~-(' - I ---- -~'---1------ -~._-~-~~---_. -_...-----_._._-_.-._._----~--~-_..~.--_._.._--_._-- ---- -----..---.--.------------.-....---....-..--..--.-.------------"._- ---,"-- .--..------..---.-----------.--------------- SERVICES PERFORMED: C~;arm Test Drain Test Flow Test C).'Walk Through (=Y'Annual Inspection Other This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2005 JF. Ahem Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT rptlnspection _Annual ~..,.. Ahern Fire Protection ... 13705 26th Avenue, Suite 110 Dry /Preaction/ Date:-- - - Minneapolis, .MN 55441 Deluge Pipe L- (763) 268-0515 p . (763) 268-0516 f Work Order #: / ,.1-. www.ahemfire.com · Since 1880 Valve Trip Test ~ID #: =- = ___ ~ .HERN IILocation: I f---i-- Street: : ~h~~~l - , , : Date: 'D t.! u_~ __~ ep.. i - r-- ---- __--.L_ --- IFax: #: ISignature: /'1 --~.- F , /_.. System #: k'/ System Type: ,/ 4< j " ,. h-'\ Valve Serial #: ... i / '.t "":.::, /, Manufacturer Name: f (/'1 1-. t;! <-._ f'! . / Valve Model: ;,. i i ,.~ l " ,i i t.. p t i) L ,.f t:Ji c... I.,' L.- Valve Size: ( / Controlling Sprinklers Location:_ Controlling Sprinklers Number: Date of Last Full-Flow Trip Test: (Must be done every 3rd Year) Date Last Operated: Pressure Before Test - Air ~'. approx 'v /.'~ / ~+ Ibs. lbs. Pressure Before Test - Water Size and Location of Test Valve: /> S Was gate valve below dry valv~ (j~..wide.,~eS~? ~f~ot, how many turns?) Valve Tripped At . Air pressure; ':,.J Ibs. Valve Tripped At - Water Pressure I} ~'J' /,i: ,-;..... i .~. Valve Tripped At - Time ./ /.:';,' min. sec. If system flooded, list time wate?e/ac~djst opening. min. sec. PERFORMANCE Poor Fai,;/Good Poor'Fair.)Good Poor fair Good Poor /Fair' Good Poor -PairJGood lYes'" No N/A i~'"'I No N/A Interior of Body Moving Parts Rubber Facing Seats Reset? Did alarms operate at trip test? Have low point drains been emptied? # Water control valve left open and sealed? Are the valves accessible? Are the valve enclosures heated adaquately? Interior of pipe that passes through freezers free of ice blockage? Ouick OneninlJ Devices Device Serial #: "-Yes No 1ffJ(,() . '~ No N/A ~ No N/A f1"es ' No N/A -:'0" Yes No .~/A Device Manufacturer Name: Device Type and Model: Air pressure in upper chamber Ibs. Quick opening device tripped at sec. Ibs. ------.~ /=, .~- ---rForem~~~~ru-;- !-~---~-~_..:;//{~...I~ System #: System Type: .,;- (l. / (,1/ ~.",- . ;;~{q. ~ ManufacturerNameJl\j l U Valve Model: ~~,t/ V/v\ / ' "'~'1'~,,, Valve Serial #: ,. L " ......i - .:i _ .-.-;; I'-J ~_-\, approx Pressure Before Test - Water lbs. lbs. Size and Location of Test Valve: Was gate valve belowi1~lv;.~e~w~ at test? (if not, how many turns?) Valve Tripped At - Air pressure ;' '..-. J Ibs. Valve Tripped At - Water Pressure .... f L l~',,,,,,,! 7' / Ibs. Valve Tripped At . Time,./;::; I min. sec. If system flooded, list time waterle~eh'ctf~opening. min. sec. PERFORMANCE Interior of Body Moving Parts Rubber Facing Seats Reset? Did alarms operate at trip test? Have low point drains been emptied? # Water control valve left open and sealed? Are the valves accessible? Are the valve enclosures heated adaquately? Interior of pipe that passes through freezers free of ice blockage? Ouick Onenina Devices Device Serial #: Poor Fair ,.([00(1) Poor Fair Aoo& Poor Fair' .( ~oJ Poor Fair)'t'~ Poor Fai;.,.Jt~ ,'~ es ' Nor N/A ,;- es No N/A / ~ No N/A ,~'\ No N/A ;~- No N/A ".....Yes. No N/A ._- .", Yes No NIN Device Manufacturer Name: Device Type and Model: Air pressure in upper chamber Ibs. lbs. Quick opening device tripped at sec. Belt Conditions? Reset? Yes No Page 1 of 2 This document PROPERTY OF AHERN FIRE PROTECTION Copyright 2005lF. Ahern Co. 'REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT rptBlank_ ValveTripTest