HomeMy WebLinkAboutFP 2006-00348 Material & Test Certificate CONTRACTOR'S MATERIAL&TEST CERTIFICATE FOR ABOVEGROUND PIPING
PROCEDURE
Upon completion of work,Inspection end tests shall be made by the contractor's rapresentatlw and witnessed by an owner's representative, All
defects shell be corrected end system left In service before contractor's personnel finally Neve the job,
A certlfl.:ete shell be filled out and signed by both repreeentatives. Copies shell be prepared for approving authorities,owners end contractor.
It Is understood the owner's representative's signature in no way preludlces any claim against contractor for Nulty material,poor workmanship,
or failure to comply with approving authority's requirements or local ordinances.
PROPERTY NAMEDATE
fiu6 6"/40 E, 642240 et-,S //-/
PROPERTY ADDRESS
.5236 Z 64 a- 604‘.ry 6.T.
ACCEPTED SY APPROVING AUTHORITY 'SI NAMES
Cri g � 3
ADDRESS
PLANS
INSTALLATION CONFORMS TO ACCEPTED PLANS YES 0 NO
EQUIPMENT USED IS APPROVED ES 0 NO
IF NO,EXPLAIN DEVIATIONS
OHAS P CONTROL VALVESCHARGE
ANDFFIRE CARE ANDMAINTENANCEOINSTRUCTED
THIS NEW EQAS UIPMENT ❑YES NO
IF NO,EXPLAIN
INSTRUCTIONS
HAVE c OAHU OF APPROPRIATE INSTRUCTIONS AND CARE AND MAINTENANCE CHARTS ❑YES 0 NO
AND N.PA 13A BEEN LEFT ON PREMISES
NLOCATION SUPPLIES.LDOS'LOOS, �y� Vha f , Ai ��+ - ,� 1
OF SYSTEM S�'p L, �/tue
MAKE MODELFEAR OF ORIFICE QUANTITY TEMPERATURE
MANUFACTURE SIZE RATING
2..006 /5"5--
SPRINKLERS 7-'/� Ori il�
( /r' &aO. �v" l Z /,55—
PIPE CONFORMS TO / STANDARD hE ES D NO
PIPE AND FITTINGS CONFORM TO / O STANDARD Lt. ❑NO
FITTINGS IF NO,EXPLAIN
ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST PIPE
ALARM -E TypE MAKE MODEL MIN.
OR F L. ries,SRo1"reit _511 7 X fig V 33"
INDICATOR
DRY_YALVE 0.0.0,
�� `�E MODEL I SERIAL NO MAKE MODEL SERIAL N0.
TIME TOT . WATER AIR TRIP POI ALARM
REACHED OPERATED
THRU TEST PIPE- SURE PRESSURE AI RE TEST OUTLET PROPERLY
DRY PIPE MIN. SEC, PSI PSI /'— PSI MIN. SEC. YES NO
OPERATING
TEST Without
O.O.O.
With
O.O.D.
IF NO,EXP `____"_________`
'MEASURED FROM TIME INSPECTOR'S TEST PIPE IS OPENED.
(OVER)
SSA 00401 PRINTED IN USA
Contractor's Material&Test Certificate i' ; Aboveground Piping
13-10 SPRINKLER SY(AP.-fS
OPERATION
• • - - •TIC DELECTRIC OHYDRAULIC
PIPING SUPERVISED AYES it, • DETECTING MEDIA S '- ED AYES ONO
DOES VALVE OPERATE FROM THE MANUAL TRIP ANO/OR RE • •. • STATIONS ❑YES ONO
DELUGE& IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUI -- - STING IF NO, •- •
PREACTION DYES ii .•
VALVES
DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAX •• . ME
T
MA MODEL SUPERVISION LOSS ALARM OPERATE VALVE RELEASE OPERATE Ru•--
YES NO YES NO MIN, riz.
HYDROSTATIC: Hydrostatic tests shell be mode at not less than 200 psi)13.6 bars)for two hours or 50 psi 13.4 bars)above static
pressure,n excess of 150 psi(10.2 bars)for two hours. Differential dry-pipe valve clappers shell be left open during test to prevent damage.
All aboveground piping leakage shall be stopped.
TEST FL SN(NG: 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,
760 GPM(2839 Llmin)for 6-inch P8(34,1000 GPM(3785 L/min)for 8-inch pipe,1500 GPI(15678 L/min)for 10-Inch pipe end 2000
GPM(7570 L/min)for 12-inch pipe. When supply cannot produce stipulated flow rates,obtain maximum available.
PNEUMATIC:Establish 40 psi 12.7 bars)air pressure end 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 1-14 psi(0.)bars)In 24 hours.
ALL PIPING HYDROSTATICALLY TESTED
jA PSI FOR HRS. IF NO,STATE REASON
��
DRY PIPING PNEUMATICALLY TESTED ❑YES ONO J4s[
EQUIPMENT OPERATES PROPERLY ,v i D YES ❑NO !/
READING OF GAGE LDRAINOCATED EA WATER SUPPLY TEST PIPE, RESIDUAL PR ITH VALVE IN TEST PIPE OPEN WIDE
TESTS TEST STATIC PRESSURE: PSI J 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,a5B DYES ONO OTHER EXPLAIN
FLUSHED BY INSTALLER OF UNDER•
GROUND SPRINKLER PIPING DYES ONO
BLANK TESTING NUMBER ED LOCATIONS NUMBER REMOVED
GASKETS
WEL ED PIPING ❑YES pirQO
IFYES..-
DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY
WITH THE REQUIREMENTS OF AT LEAST AWS 010.9,LEVEL AR-3 0 YES [ANO
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 D YES D NO
00 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 ONO
PIPING ARE NOT PENETRATED
HYDRAULIC NAMEPLATE PROVIDED IF NO,EXPLAIN
DATA
NAMEPLATE YES ONO
DATE LEFT INS RVI WITH AL NTrj.LyALVVS'�O EN:
REMARKS (I _f/'/'�
NAME OF SPRINKLER CO=j•RACTORr
/1-7,- -- 6egieo .�Pe'V•UL6)L
TESTS WITNESSED BY
SIGNATURES F PROPERTY OWNER(51O CO 1A.14 TITLA,�, DATE
FOR SPRI CONTR CTOR (SIGNED) TITLE DATE
5 cD t n-e� j o�iE� 'y14/h4l I f/ ?C3 .
ADDITIONAL EXPLANA ION AND NOTES
e5A BACK
(gilts.-toy's Matt-dal& Tcci fCcrtific. for Abovcgraund r'ipLIg