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Home My WebLink AboutFire Sprinkler Inspection 2/8/2006 I~ING 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 inspection AGREEMENT & REPORT OF INSPECTION MINNESOTA LICENSE NO. C005 REPORT TO <;-+- , \"V\ I (l.,l-\ e \ \l.,'?'RO DuL\-i., yr \ or INSPECTION # C; I L) Cj 3 :2 STREET CITY & STATE r: , . CL..JV('Ltl..,,{"'\t/1 Av~. f. . I- c \ V... , ]/vl VI . C''-''\\'r BUILDING OR LOCATION ~c,...,.,-<C.. "$ J E:. INSPECTOR Pc.~, \ \-k ,.., ''-1 ? -~ t-::. - 0 L, sc, ?''7 < DATE 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: ./'.-.J () ~..., ~ B. Describe fire protection modifications made since last inspection. V\O'-4--€ C. Describe any fires since last inspection. Ii" D \-., i:'~ 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? /-.J I A F. Are dry valves. . dequa~~l protected from freezing? ,(/ IA- Signature C'..~- Title l. "-' p \ '::> '1 '-:->'~"">-) Date-?l-;Y"o ('":) Inspector's Section (All responses reference current inspection) 1. General a. Is the building occupied? YI ~s U No b. Are all systems in service?,YJ Yes [I 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'0'es d. Does the valve hose on the sprinkler system(s) appear to be satisfactory? Il Yes 11 No. ,Vr-NA 2. Control Valves (See Item 15.) a. Do sprinkler system control valves appear to be in the appropriate open or closed position?m-es I No b. Are control valves in the open position locked. sealed or equipped with a tamper switch0es II No 3. Water Supplies (See Item 16.) a. Was a water flow test of main drain made at the sprinkler riser(s)'~Yes 4. Tanks. Pumps, Fire Department Connections a. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? Yes L.. No ~A b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight'0'es I No 'I NA Are they accessible and visible? j)-"fes [] No UNA 5. Wet Systems a. Are cold weather valves (O.S. & Y.) in the appropriate open or c1g;;ed position? Yes 1.1 No XNA b. Have antifreeze system solutions been tested? I I Yes [..! No ,).;-fNA c. Were the antifreeze test results satisfactory? II Yes UNo fiJ NA 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? res IJ No [] NA Do all exterior openings appear to be protected against freezing0es I j No NA 6. Dry System (See Items II to 13.) a. Are dry valve(s) in service? [J Yes LJ No )-6NA b. Are the air pressures and priming water levels in accordance. with the manufa~tur 's instructions? [ [Yes I ,I No c. Has the operation of the air or nitrogen supplies been tested? LJ Yes UNo l A Are they III service? J Yes d. Were all known low points drained during this inspection? [J Yes D No I. A e. Did quick-opening devices operate satisfactorily? [J Yes LJ No )6NA . f. Did the dry valve(s) trip properly during the trip pressure test? II Yes II No IfiA g. Did the heating equipment in the dry-pipe valve room(s) operate at time of inspection? 1'1 Yes II No ..vrNA 7. Special Systems (See Item 14.) a. Did the deluge or pre-action valves operate properly during testing? [J Yes I I No ~A b. Did the heat-responsive devices operate properly during testing? LJ Yes [J No )2rNA c. Did supervisory devices operate during testing? [J Yes I J No j,J"NA 8. Alarms a. Did water motor(s) and gong(s) test satisfactorily? [J Yes [J No g.,x'A b. Did electric alarm(s) test satisfactory? 9"Yes [J No [J NA c. Did supervisory alarm service test satisfactory? ~es [J No [] NA 9. Sprinklers a. Do visible sprinklers appear to be free from corrosion, loading or obstruction to spray discharge? 7es LJ No b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing) [)Xes [J No c. Are quick response and residential sprinklers less than 20 years old? (Older sprinklers require sample testing) ~es U No II N/A d. Is stock of spare sprinklers available? y.v es n No e. Does the exterior condition of sprinkler system appear to be satisfactory ? g-f"es U~.o f. Do visible sprinklers appear to be of proper temperature rating for their locations? y..'fes I I No 10. Explain any "No" answK and comments: j, b ) ~/~'>l - NA =NOT APPLICABLE No No ~A LJ No ~A Signature: ( Date: ,;1.-F'-OG... AUTOMATIC SPRINKLER CO. 1301 L'ORIENT STREET ST. PAUL, MINNESOTA 55117 (651) 558-3300 . (800)-229-6263 FAX: (651) 558-3310 SHEET 2 OF 2 - Use separate sheet for each system inspection System No. or Description if multiple systems 1- t.-J ' . l.ve +- Inspection Report No. r:, 1 L~ Cj ~ c.. 11. Date dry-pipe valve trip tested (control valve partially open) (See Trip Test Table which follows) 12. Date dry-pipe valve trip tested (control valve fully open) (See Trip Test Table which follows) 13. Date quick-opening device tested (See Trip Test Table which follows) DRY VALVE TRIP TEST TABLE 0.0.0. 1'-'1,4 MAKE MODEL SERIAL NO. I MAKE I MODEL SERIAL NO. I I DRY PIPE Time to Trip Water Air Trip Point Time Water Reached Alarm Operated OPERATING Thru Test Pipe Pressure Pressure Air Pressure Test Outlet Properly TEST MIN. SEC. PSI PSI PSI MIN. SEC. YES NO Without 0.0.0. With 0.0.0. deluge or preaction valve tested (See Trip Test Table which follows) TRIP TEST TABLE Operation o PNEUMATIC o ELECTRIC o HYDRAULIC Piping Supervised DYES o NO I Detecting media supervised DYES o NO DELUGE & Does valve operate from the manual trip and/or remote control stations DYES o NO PREACTION Is there an accessible facility in each circuit for testing Method of testing-circuits VALVES DYES o NO Does each circuit operate Does each circuit Maximum time to MAKE MODEL suoervision loss alarm ooerate valve release one rate release YES I NO YES I NO YES I NO I I I ontrol Valve Maintenance Table. Control Valve Mamtenance Table 14. Date rv/A 15. See C Explain Abnormal Control Valves Number Type Open Secured Closed Signs Condition City Control Valves I 15'.\J -, -- -.. Bvpass Valves Tank Control Valves -li!IIillP Control Valves I - L-I" VS<J''''( -- -- - Sectional Control Valves I-Y" e c - -- - System Control Valves 1- Lt" i2..,1-' - - - Other Control Valves , ~ I"~ ~ ,f:- - -_. -' Kitchen Control Valves Date Tank Size of Test Pipe S tati c Pressure Pump Residual (Flow) Pressure 16. Water Flow Test at Sprinkler Riser Water Supply Source: Last Water Flow Test This Water Flow Test )-OL ,. < \ r L...j~ C,;ll 4 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: j /~~ ~~ Date: /") D ~-O-O(p