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Home My WebLink AboutFP 2007-00041 Material & Test Certificate 7°'., /-- - CONTRACTOR'S MATERIAL&TEST CERTIFICATE FOR ABOVEGROUND PIPING PROCEDURE Upon completion of work,inspection and tests shell be made by the contractor's representative and witnessed by an owner's representative. All defects shall be corrected and system left In service before contractor's personnel finally leave the job. A oertlfl..te shell be filled out and 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 TY NAME DATE /A/i 6-r-,eavf (7--/I-X-'' fn. s C- 2- O ' PROPERbs O /1 -laf Jo CT e- / i1 r-w #73- l 3- /KW ACCEPTED SV APPRza .,UTHORITY('S)NAMES ADDRESS 7``+7/ PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS JES 0 NO EQUIPMENT USED IS APPROVED AYES 0 NO IF NO,EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT SEEN INSTRUCTED AS TO LOCATION tjLEg ONO OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT IF NO,EXPLAIN INSTRUCTIONS COPIESAPPROPRIATEuu ANDAVNOFEON INS IRU TIONS AND CARE ANO MAINTENANCE CHARTS GES"ONO IF NO,EXPLAIN LOCATION SUIPLI OF SYSTEM 1ST ^CTA/ I//% frjl_ MAKE MODEL YEAR OF ORIFICE QUANTITY TEMPERATURErvee RATING grit4 MANUFACT RE SJ[ rRATINGSPRINKLERS ^v 41 S -3 3� ` j� � �+ 173 I ( ! S PIPE CONFORMS TO v STANDARD 3'i' 0 NO PIPE AND FITTINGS CONFORM TO STANDARDEr 0 NO FITTINGS IF NO,EXPLAIN ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST PIPE ALARM VALVE91-e TYPE MAKE MODEL.. MIN, / S nof___w OW LG�I/ �w!�C 5rt af Dr INDICATOR _ Sw "S.- DRY VALVE O O.0 MAKE. MODEL , SERIAL NO. MAKE MODEL SERIAL NO. figiniATER TIME TO TRIP WATER AIR TRIP POINTALARM REACHED THRU TEST PIPE- PRESSURE PRESSURE AIR PRESSURE OPERATED TEST OUTLET' PROPERLY DRY PIPE MIN. SEC. PSI PSI PSI MIN. SEC. YES NO OPERA INO TO Without �/� O.O.D. �y 0. i�+1 O.O.O. IF NO,EXPLAIN •MEASURED FROM TIME INSPECTOR'S TEST PIPE IS OPENED. OSA EQgo) PRINTED IN USA (OVER) Contractor's Material&Test Certificate for Aboveground Piping 13-10 SPRINKLER SYSTFMS s_s--- OPERATION 0 PNEUMATIC 0 ELECTRIC 0 HYDRAULIC PIPING SUPERVISED ❑YES ONO 'DETECTING MEDIA SUPERVISED ❑YES ONO DOES VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL STATIONS OYES ONO DELUGE& IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR TESTING IF NO,EXPLAIN PREACT N ❑YES ❑NO VALV $ DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO MAKE MODEL SUPERVISION IOSS ALARM OPERATE VALVE RELEASE OPERATE RELEASE YES NO YES NO MIN. SEC. HYDROISTATIQ: Hydrostatic tests shall be made at not less then 200 psi(13.6 bars)for two hours or 50 psi(3.4 bars)above static pressure in excess of 150 psi(10.2 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 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 than 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(3785 L/min)for 8•Inch pipe,1500 GPM(5678 L/min)for 104nch 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 1-14,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•B psi(0.1 bars)in 24 hours. ALL PIPING HYDROSTATICALLY TESTED AT PSI FOR /RAS. IF NO,STATE REASON DRY PIPING PNEUMATICALLY TESTED ❑YES ❑NO 1/ Qy' (?...DEQUIPMENT OPERATES PROPERLY ❑YES ❑NO �1/ /' DRAIN READING OF GAGE LOCATE R SUPPLY TEST PIPE, RFSIDU E WITH VALVE IN TEST PIPE OPEN WIDE TESTS TEST STATIC PRESSURE: L ) PSI 1 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.11513 OYES ONO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDER- GROUND SPRINKLER PIPING ❑YES ONO BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED GASKETS r yf WELDED PIPING ❑YES (CJNV 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 00 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 DYES 0 N PIPING ARE NOT PENETRATED HYDRAULIC NAMEPLATE PROVIDED IF NO,EXPLAIN DATA Oleg- Is?YES ❑NO DATE LEFT IN SERVICE WITH ALL CONTROL VALVES 097: ' REMARKS (,/ // NAME OF SPRINK OTR/�CTOj{, / / F'4 L flp e.L 667 ' 7 t? 5) f/ ��((r+((////��r//�`�� TESTS WITNESSED BY C( •• SIGNATURES FOR PROPERTY OWNER(SIGNED) TIT h DAT FO•.•/RI/lIu.E11 ONTR OR(SIGNED) TITLE wrviYDAk- --7- �_ ffffss GGii • �^J /U� � / ADDITIONAL EXPLANATION AND NOTES ISA BACK Contractor's Material&Test Certificate for Aboveground Piping