HomeMy WebLinkAboutFP 2006-00346 Material & Test Certificate r-.., /1
CONTRACTOR'S MATERIAL&TEST CERTIFICATE FOR ABOVEGROUND PIPING
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PROCEDURE
Upon completion of work,Inspection and tests shat be made by the contractor's representative and witnessed by an owner's representative, All
defects shad be corrected and system left In service before contractor's personnel finally leave the job.
A oertlfi.ate shell be filled out end signed by both representatives. Copies shell be prepared for approving authorities,owners and contractor,
It Is understood the owner's representative's signature In no way prejudices any claim egainat contractor for faulty material,poor workmanship,
or failure to comply with approving authority's requirements or local ordinances.
PROPERTY NAME DATE
9NE tevE 64e406--JuS //-17"--61.6
PROPERTY ADDRESS
SRSS 4,q& 6,1-e---,Li Cr.
ACCEPTED BY APPROVING AUTHOORIITYI'S NAMES p�Q
er/ .fit /,'f'�.p_ 6
ADDRESS
PLANS
INSTALLATION CONFORMS TO ACCEPTED PLANS OYES 0 NO
EQUIPMENT USED IS APPROVED SZYES 0 NO
IF NO,EXPLAIN DEVIATIONS �`
HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION 0 YES ONO
OF CONTROL VALVES ANO CARE AND MAINTENANCE OF THIS NEW EQUIPMENT
IF NO,EXPLAIN
INSTRUCTIONS
HAVE COPIES OF APPROPRIATE INSTRUCTIONS AND CARE AND MAINTENANCE CHARTS 0 YES 0 NO
IF FFEPXPLAINBEEN LEFT ON PREMISES
OF SYt EM SUPPLIES SLOGS. ‘i,l1/7 1 —v,
� �� ' ,T V ae-5tve4--ft-0(
MAKE MODELFEAR OF ORIFICE QUANTITY TEMPERATURE
y MANUFACTURE. SIZE RATING
7—I GO //j L ?•G r L4 i
SPRINKLERS .7.y�� . / F£L Lr 2. 5c. 4/" 1-/0 /,¶_
PIPE CONFORMS TO N�I'* (-2,, D STANDARD YES 0 NO
PIPE AND FITTINGS CONFORM TO '•f f 13 N STANDARD YES 0 NO
FITTINGS IF NO,EXPLAIN
ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST PIPE
ALARM TYPE ,, MAKE MODE MIN, SEC.
VALVE
OR FLOW I/my SbGi Te!! S y's Ssµ ,4 FATrr- 30::::::1
INDICATOR sf�
�_ DR�YALV E 0.0.0.
MAKE, MODEL SERIAL NO. MAKE MODEL $bRfAL
Tliu �ER ALARM
TIME P WATER AIR T T REACHED OPERATED
THRU TEST M PRESSURE PRESSOR PRESSURE TEST OUTLET PROPERLY
DRY PIPE MIN. SEC. —1911_ 1 PSI MIN, SEC. YES NO
OPERATING
TEST Without
O.O.D.
With
O.O.O.
IF NO. IN �\\
r.--•MEASUREO FROM TIME INSPECTOR'S TEST PIPE IS OPENED. (OVER)
ISA BOit1) PRINTED IN USA
Contractor's Material &Tett Certificate for Aboveground Piping
13-10 SPRINKLER SYS1 F`1S
OPE RATION
OPNEUMATIC DELECTRIC DHYDRAULIC
PIPING SUPERVISED OYES DNO 'DETECTING MEDIA SUPERVISEO OM •NO
DOES VALVE OPERATE FROM THE MANUAL TRIP A .. a• ;EMOTE CONTROL STATIO. ❑YES ONO
DELUGE& IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR TESTINe '0. EXPLAIN
PREACTION ❑YES ONO
VALVES _
DOES EACH CI RCUiT OPERATE 1 DOES EACI4 CIRCUIT • IMUM TIME TO
MAKE a DEL SUPERVISION LC6S ALARM OPERATE VALVE RELEASE e• -• RELEASE
YES NO YES NO
HYDROtSTATIC: Hydrostatic tests shall be made at not less than 200 psi 113.6 bars)for two hours or 50 psi(3.4 bars)above static
pressure In excess of 150 psi 110.2 bars)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 FL STING: Flow the required rate until water is clear as Indicated by no collection of foreign material in burlap bags at outlets such es
DESCRIPTION hydrants and blow-offs. Flush at flows not lass than 400 GPM 11514 L/mint for 4-Inch pipe 600 GPM(2271 L/min)for 6-Inch pipe,
750 GPM(2839 L/min)(or 6-inch pipe,1000 GPM(3785 L/min)for 8-inch pipe,1500 GPM(5678 L/min)for 10-inch pipe and 2000
GPM(7570 L/min)for 12-1nch pipe. (0.1 When supply cannot produce stipulated flow rates,obtain maximum available.
PNEUMATIC:Esteblish 40 psi 12.7 bars)air pressure and measure drop which shell not exceed 1.%psi bars)in 24 hours. Test
pressure tanks at normal water level and air pressure end measure air pressure drop which shall not exceed 1-K psi(0.1 bars)in 24 hours.
ALL PIPING HYDROSTATICALLY TESTED AT PSI FOR HRS. IF NO,STATE REASON
��
DRY PIPING PNEUMATICALLY TESTEDilL, OYES DNO / / '
EQUIPMENT OPERATES PROPERLY Itr D VES DNO G I/
DRAIN READING OF GAGE LOCATE TER SUPPLY TEST PIPE, RESIDUAL PR E 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,55B DYES ❑NO OTHER EXPLAIN
FLUSHED BY INSTALLER OF UNDER-
GROUND SPRINKLER PIPING DYES DNO
BLANK TESTING NUMBER )SED LOCATIONS NUMBER REMOVED
GASKETS
WELDED PIPING ❑YES /25.40
IF YES...
DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY r—�
WITH THE REQUIREMENTS OF AT LEAST AWS 010.9,LEVEL AR-3 D YES ONO
DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN
WELDING COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9,LEVEL AR-3 AYES D 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 DYES D NO
PIPING ARE NOT PENETRATED
HYDRAULIC NAMEPLATE PROVIDED IF NO,EXPLAIN
DATA �y
NAMEPLATE I J YES D NO
DATE LEFT IN SERVICE WITH ALt�ONTROL VA`]LESgPEN,
REMARKS ((//// ✓ ZZ u
NAME OF SPRINKLER CONTRACTOR
/// TESTS WITNESSEDe�SEBY `._ (rte
SIGNATURES FO ROP V OWD t(SIGMA")�(�NX �TITt :I p4,, /f IOAT I ,. `,- A�`
FOR SP I KL R CONT ACTOR(SIGNED) TITLE j~// DATE �J !J
ADDITIONAL EXPLANATION AND NOTES
SSA RACK __
Conlracta=.-'s Mazcrial& "fps, Cie tifp_aic o: Aboveg ound Piping