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Home My WebLink AboutFP 2007-00039 Materials & Test Certificate CONTRACTOR'S MATERIAL&TEST CERTIFICATE FOR ABOVEGROUND PIPING PROCEDURE Upon Completlon of work,Inspection and tests shall be made by the contractor's representative and witnessed by en owner's representative. All defects shell be corrected end system left In service before contractor's personnel finally leave the job, A certifloate shall be filled out end signed by both representatives. Copies shall be prepared for approving authorities,owners and contractor. It Is understood the owner's representative's signature In no way prejudices any claim against contractor for faulty material,poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PROP YNAME DAT /alt 6040 6-"P/Al S - 22-O 7--- PROP T5 R o'AL 7- it,d Cr. e /?ft4 tin ACCEPTED SY APPROVIN UTHOR T ('S►NAMES 'j r v` ADDRESS PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS 9'rES 0 NO EQUIPMENT USED IS APPROVED 9-YES 0 NO IP NO,EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT SEEN INSTRUCTED AS TO LOCATION ErES 0 NO OF CONTROL VALVES AND CARE ANO MAINTENANCE OF THIS NEW EQUIPMENT IF NO,EXPLAIN INSTRUCTIONS ccOPIEss OFAPRpPR APPROPRIATE TIONS ANO CARE AND MAINTENANCE CHARTS YES 0 NO AND HAVE SEENPREMISESIF NO,EXPLAIN LOFSYS EM ATION surPLl J! }1� /� y� `” 4� �i'�� C ��(`MAKE MODEL YEAR OF ORIFICE QUANTITY TEMPERATURE MANUFACTURE 8 RATING SPRINKLERS -rif gfS r 223, , l j� LSz� `To! itis I 3 3 7oflz(' ( 7. j5, ' PIPE CONFORMS TO ip,C44PArSTANDARD YES ONO f2�PIPE AND FITTINGS CONFORM TO /jSTANDARD -EVES ONO PITTINGS IF NO,EXPLAIN ALARM DEVICE MAXIMUM TIME'IL/OPERATE THROUGH TEST PIPE AVALVE LARM r TYPE / M-rs� Mint MIN. R� OR FLOW ��/ S� I (LII . INDICATORS re. IA,Slit' DRY VALVE 00.0. MAKE. MODEL SERIAL NO. MAKE MODEL SERIAL NO, TIME TO TRIP WATER AIR TRIP POINT TI E WATER ALARM THRU TEST PIPE' PRESSURE PRESSURE Al"PRESSURE REACHED OPERATED TEST OUTLET' PROPERLY DRY PIPE MIN. SEC. PSI PSI PSI MIN. SEC. YES NO OPERATING EST Without O.O.D. With Ay O.O.D. IF NO,EXPLAIN •MEASURED FROM TIME INSPECTOR'S TEST PIPE IS OPENED. SSA IMO) PRINTED IN USA (OVER) Contractor's Material&Teat Certificate for Aboveground Piping 13-10 SPRINKLER SYSTFMS OPERATION ❑PNEUMATIC 0 ELECTRIC ❑HYDRAULIC PIPING SUPERVISED OYES ONO 'DETECTING MEDIA SUPERVISED OYES ONO DOES VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL STATIONS ❑YES ONO DELUGE 8 IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR TESTING IF NO,EXPLAIN PREACTION ❑YES ❑NO V L ES DOES EACH CIRCUIT OPERATE DOES EACHCIRCUIT MAXIMUM TIME TO MAKE MODEL SUPERVISION ALARM OPERATE VALVE RELEASE OPERATE RELEASE YES 1 NO YES NO MIN. SEC. HYDROtSTATIC: Hydrostatic tests shall be mode et not less than 200 psi 113.6 bars)for two hours or 50 psi(3.4 bars)above statie pressure in excess of 150 psi(10.2 Bert)for two hours. Differential dry.pipe valve clappers shall be left open during test to prevent damage. All aboveground piping leakage shall be stopped. TEST FLUSHING: Flow the required rate until water is clear as Indicated by no collection of foreign materiel in burlap bags at outlets such as DESCRIPTION hydrants and blow-offs. Flush at flows not less then 400 GPM(1514 L/min)for 4•inch pipe 600 GPM(2271 L/min)for 5-Inch pipe, 750 GPM(2839 L/min)for 6-inch pipe,1000 GPM 13785 L/min)for 8-inch pipe,1500 GPM(5678 L/min)for 10-Inch pipe and 2000 GPM(7570 L/min)for 12-Inch pipe. When supply cannot produce stipulated flow rates,obtain maximum available. PNEUMATIC:Establish 40 psi(2.7 bars)air pressure and measure drop which shall not exceed 1.B psi(0.1 bars)in 24 hours. Test pressure tanks at normal water level and air pressure and measure air pressure drop which shall not exceed 1.51 psi(0.1 bars)in 24 hours. ALL PIPING HYDROSTATICALLY TESTED A PSI FOR HRS. IF NO,STATE DRY PIPING PNEUMATICALLY TESTED � YES 0 NO EQUIPMENT OPERATES PROPERLY ❑YES 0N GRAIN READING OF GAGE LOCATE ATER SUPPLY TEST PIPET RESIDUA - :,'„VE WITH VALVE IN TEST PIPE OPEN WIDE TESTS TEST STATIC PRESSURE: PSI PSI Underground mains and lead In connections to system risers flushed before connection made to sprinkler piping. VERIFIED BY COPY OF THE U FORM NO,eSB DYES 0N OTHER EXPLAIN ks FLUSHED BY INSTALLER OF UNDER• GROUND SPRINKLER PIPING OYES ONO BLANK TESTIWCi NUMBER USED LOCATIONS NUMBER REMOVED GASKETS WELDED PIPING ❑YES IF YES... DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9,LEVEL AR•3 ❑YES ONO DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN WELDING COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS 010.9,LEVEL AR.3 ❑YES 0 NO DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS ARE RETRIEVED,THAT OPENINGS IN PIPING ARE SMOOTH.THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED,AND THAT THE INTERNAL DIAMETERS OF ❑YES El NO PIPING ARE NOT PENETRATED HYDRAULIC NAMEPLATE PROVIDED IF NO,EXPLAIN DATA ,�/� NAMEPLATE l�YES 0 NO DATE LEFT IN SERVICE WITH ALL CON OL VAl.MESDN: REMARKS {J/L NAME OF SPRINSOuTRAC� cr!" P -r y_c 11 �(' t tra ,,yy//t1ll TESTS WITNESSED BY //(�/ SIGNATURES FOR ROPERTY OWNER( GNED) TITLE DA E FOR SPR 40 4S ,TRAC O•SIQNED)�o TITLE ou/LA4 Yfri / DATE ^Z2'0 ADDITIONAL EXPLANA ION AND NOTES ��C(JJ//rJ�J �Al��,�"/ ISA BACK Contractor's Material&Test Certificate for Aboveground Piping J