HomeMy WebLinkAboutFire Sprinkler Report 12/27/2007
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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
SHFFl" I ot 2 - Use separate,sneri for each building inspected
MINNESOTA LICENSE N~.S;:OO$' .' i?
REPORTTO i./<.,.\ :.L;~ 0-..--::' Ii' i i ,',' BUILDING OR IDeATION .,
STREET <i.'J" '",; i :'t "[XI i \ l~ '\ : (' r. > ,'j. INSPECTOR . ,/ l '>Y~7.() :1
CITY & STATE 12~ -;.:- v '.. I . 1 \"_ DATE / '/,.' L -7 1
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Owner lures VIking Automatic Sprmkler Company to conduct an mspection 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. ~xplain any occupancy hazard changes since the previous inspection:
AGREEMENT AND REPORT OF INSPECnON
#INSPECTION
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D. When was the system piping last checked for stoppage, corrosion or foreign material?
j,. ~len wa~ the dry-piping system last checked for proper pitch?
r. Al\ drrt')~"C)> adequately prote~~ from freezmg?
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B. Describe fire protection modifications made since last inspection:
C Describe any fi res since last inspection:
Title
Date
Inspector's Se ion (All responses reference cutrent inspection)
1 General "
a, Is the building oCCUpied?~ [J No
b. Are all systems in servicejP"l"es n No -;t'
c. Does there appear to be a minimum of 18 in. (457 mm) clearance between the top of the stora,gs:.and the sprinkler deflectors? y'fes I I No
U. Does the valve hose on the sprinkler system(s) appear to be satisfactory? LJ Yes LJ No ...,.1\1/ A
2 Control Valves (See Item1S)
a. Do sprinkler system control valves appear to be in the appropriate open or closed position? _~s 0 No
b. ^re control valves in the open position locked, sealed or equipped with a tamper switch? g~ n No
3 Water Supplies (See Item 16) .-..-
a. Was a water flow test of main drain made at the sprinkler riser(s)~es LJ No
4 Tanks, Pumps, Fire Department Connections
a. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? LJ Yes [] No
b, Are fire dq,)artment connections in satisfa:)0ry condition, couplings free, caps in place, and check valves tight? y'Yes
Are they accessible and visible? LJ Yes 'J'?No u N/ A
5 Wet Systems
a. Are cold weather valves (OS. & Y.) in the appropriate open or clos~sition? Il Yes [J N()_~
b. Ilave antifreeze system solutions been tested? DYes 0 No .-er-N/..b--.
Co Were the antifreeze test results satisfactory? n Yes n No _-RoMlA
d. In areas protected by ~-system(s), does the building appear to be properly heated in all areas, including blind ~cs and perimeter areas
where accessible?~es n No n N/ A Do all exterior openings appear to be protected af,ainst freezinf,~s Il No [] N/ A
6 Dry System (See Items 11 to 13)
a. Are dry valves (s) in service? u Yes lJ No 0 N/ A
b. Ale the alr pressures and pnmmg watR levels m accordaj1.ce With the manufacture's mstructions? I I Yes lJ No u N/ A
Co Has the operatIon of the air or mtTOf,emUPPlies been sted? u Yes LJ No [] N/ A Are they m servlcP? II Yes II No LJ N/ A
d. WPf(' all know low pomts dramed du is msp on? n Yes II No II N/ A
e, Old qUlck-openmg deVIces operateati ctonly? [] Yes Cl No Il N/ A
f. Old the dry valve(s) tnp properly qu g the t' pressure test? 11 Yes 0 No 0 N/ A
g. Old the heatinf, eqUIpment l.11 the dW-I Ipe v. ve room(s) operate at time of mspL'CtIon? u Yes LJ No n N/ A
7 Special Systems (See Item 14) '\
a. Did the deluge or pre-action valves on 'ate properly during testing? lJ Yes 0 No 0 N/ A
b. Did the lwat-responsive devices op ate properly during testing? lJ Yes 0 No 0 N/ A
Co Did supervisory devices operate uring testing? 0 Yes 0 No [] N/ A
8 Alarms
a. Did water motor(s) and gong(s) test satisfactorily? [J Yes u No ,~N/ A
b. Did electric alarm(s) test satisfactoryZ-1fY es 0 No 0 N/ A
Co Did supervisory alarm service test satisfactory?'; Yes II No II N/ A
9 Sprinklers ....-
a. Do visible sprinklers appear to be free from corrosion, loading or obstruction Lo spraYodischarge?/6'Yes uNo
b. Are sprinklers less than 50 years old? (Older sprinklers require sample testinf,) p'fes 0 No /' //
c. Are quick response and residential S~rinkle less than 20 years old? (Older sp~inklers require sample testing)A'Yes "P-No u N/ A
d. Is stock of spare sprinklers available? - es [J No ____
e. Does the exterior condition of sprin er system appear to be satisfactory?A'1l'es 0 No
f. Do visible sprinklers appear to be of proper temperature rating for their locations~es LJ No
10 Explain any "No" answers and conmlents:
N/A = NOT APPLICABLE
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..rN / A
II No II N/ A
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Signature:
(Rpv.l/X/Ob)
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Date:
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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
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System No. oi;Description ii~ultiplc
systems / - , ! ( ! / ,I
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SHEET 2 of 2 - Use separate sheet for each system ~.:,cted
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lnspc~on R-"J791
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Date dry-pipe valve trip tested (control valve partially open)
Date dry-pipe valve trip tested (control valve fully open)
Date quick-opening device tested
11
12
13
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(See Trip Test Table which follows)
(See Trip Test Table which follows)
(See Trip Test Table whicllfollows)
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DRY VALVE TRIP TEST TABLE xr.O,D,
MAKE MODEL SERIAL NO, MAKE MODEL SERIAL NO,
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Time to Trip Water ~ir Trip p'dnt Time \lVater Reached Alarm Operated
Thru Test Pipe Pressure Prdsl.lre Aiyr';essure Test Outlet Properly
MIN, SEe. PSI /\AI / , PSI MIN. SEe. YES NO
Without ~1" I
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With ; i ///
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14 Date deluge or pre action valve tested
Operation LJ PNEUMA TIC ;6 ELECTRIC o HYDRAULIC
Piping Supervised DYES /' 'J NO I Detecting Media Supervised ::J YES !e NO
Does valve operate from the manual trip and/oyfemote control stations -.J YES iJ NO
Is there an accessible facility in each circuit f,Pftesting DYES c: NO IMethod of Testing Circuits
_~/ MODEL Does each circuit operate Does each circuit Maximum time to J
MAKE supervision loss alarm operate valve release operate release
YES I NO YES I NO YES I NO J
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DRY PIPE
OPERATING
TEST
DELUGE &
PRE ACTION
V ALVES
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(See Trip Test Table which follows)
TRIP TEST TABLE
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15 See Control Valve Maintenance Table
CONTROL VALVE MAINTENANCE TABLE
Secured
Explain
Abnormal
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CO,n tion
Closed Signs
Control Valves
Cit Control Valves
B ass Valves
Tank Control Valves
Pum Control Valves
Sectional Control Valves
Svstem Control Valves
,CDther Control Valves
<~~ReR-.control Valves
"i6 Water Flow Test at Sprinkler Riser
Water Su 1 Source:
Explain any "No" answers and comme?t-s.;:',. ",. ,/:"
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Adjustments or corrections made duringthii(jnspection:
Last Water Flow Test
This Water Flow Test
17
18
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Tank
Pum
Residual
(Flow)
ressure
Test Pipe
Location
Size of
Test Pi e
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19 Although these comments are not the result of an engineering review, the following desirable improvements are recommended:
Date:
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Signature: I
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