HomeMy WebLinkAbout2007-07-18 Viking Automatic Sprinkler Agreement & Inspection Report 1301 L'Orient Street
St
17
. III4e. N� s� (651 -3300e(800)229-6263
UTONIATIC SPRINKLER CO. Fax: ?651)558-3310
Setting The Standard...
AGREEMENT AND REPORT OF INSPECTION r
SHEET 1 of 2-Use separate sheet for each building inspected #INSPECTION <2 Q J O G F.
MINNESOTA LICENSE NO.C005
REPORT TO fig„ j4 10 5 Q t/,to cj BUILDING OR LOCATION , 44.1 -,
STREET tae cc) M Q na 02 t AE A04. INSPECTOR 0x/47— Gie•4 fJ
CITY&STATE 1,4 pf e2 t Het y kis , 044 DATE /j_ /?- to 9
Owner hires Viking Automatic Sprinkler Company to conduct an inspection 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. Explain any occupancy hazard changes since the previous inspection: A.)04.)e
B. Describe fire protection modifications made since last inspection: *1)t)/,J Q
1'
C. Describe any fires since last inspection: , Alli3 4 1 2007 f t r(f
D.When was the system piping last checked for stoppage,corrosion or foreign material? _ r
E. When was the dry-piping system last checked for proper pitch? _� _
F. Are dry valves adequately protected from feting? N A-
Signature u- t / -r..2 / Title Date
Inspector's Section(All responses reference current inspection) N/A=NOT APPLICABLE
1 General
a. Is the building occupied?Ies o No
b. Are all systems in service. 'Q(�es o No
c. Does there appear to be a minimum of 18 in.(457 mm)clearance between the top of the storage and the sprinkler deflectors? Yes o No
d. Does the valve hose on the sprinkler system(s)appear to be satisfactory? ❑Yes ❑No OtN/A
2 Control Valves(See Icon l5) C'
a. `Do sprinkler system control valves appear to be in the appropriate open or closed position? Ip-r es ❑No
b. Are control valves in the open position or equipped with a tamper switch? s o No
3 Water Supplies(See Item 16)
a. Was a water flow test of main drain made at the sprinkler riser(s)?)(yes o No
4 Tanks,Pumps,Fire Department Connections
a. Are fire pumps,gravity tanks,reservoirs and pressure tanks in good condition and properly maintained? o Yes ❑No Al/A
b. Are fire department connections in satisfactory condition,couplings free,caps in place,and check valves tight? ,Yes ❑No ❑N/A
Are they accessible and visible?res a No o N/A
5 Wet Systems
a. Are cold weather valves(OS.&Y.)in the appropriate open or closed position? ❑Yes ❑No otN/A
b. Have antifreeze system solutions been tested? o Yes ❑No ON/A v
c. Were the antifreeze test results satisfactory? ❑Yes ❑No 141/A
d. In areas protected by wet system(s),does the building appear to be properly heated in all areas,including blind attics and perimeter areas
where accessible? (Yes o No o N/A Do all exterior openings appear to be protected against freezing?LYes o No ❑N/A
6 Dry System(See Items 11 to 13)
a. Are dry valves(s)in service? ❑Yes o NoVN/A
b. Are the air pressures and priming water lev in accordance with the manufacture's instructions? o Yes ❑No 34,N/A
c. Has the operation of the air or nitrogen supplies been tested? ❑Yes ❑N N/A Are they in service? ❑Yes ❑No (d�A1/A
d. Were all know low points drained during this inspection? ❑Yes ❑No N/A
e. Did quick-opening devices operate satisfactorily? o Yes ❑No tiAI/A
f. Did the dry valve(s)trip properly during the trip pressure test? o Yes ❑No .N/A
g. Did the heating equipment in the dry-pipe valve room(s)operate at time of inspection? o Yes o No ON/A
7 Special Systems(See Item 14)
a. Did the deluge or pre-action valves operate properly during testing? ❑Yes ❑No p•N/A
b. Did the heat-responsive devices operate properly during testing? ❑Yes ❑No /A
c. Did supervisory devices operate during testing? ❑Yes o No ON/A
8 Alarms
a. Did water motor(s)and gong(s)test satisfactorily? ❑Yes ❑No AN/A
b. Did electric alarm(s)test satisfactory? -Yes ❑No o N/A
c. Did supervisory alarm service test satisfactory? EYes o No ❑N/A
9 Sprinklers
a. Do visible sprinklers appear to be free from corrosion,loading or obstruction to spray discharge? $.Yes ❑No
b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing) of xes o No
c. Are quick response and residential sprinklers less than 20 years old? (Older sprinklers require sample testing)INYes ❑No ❑N/A
d. Is stock of spare sprinklers available? fiCes ❑No
e. Does the exterior condition of sprinkler system appear to be satisfactory?pi.Yes ❑No
f. Do visible sprinklers appear to be of proper temperature rating for their locations?pies o No
10 Explain any"No"answers and comments:
Signature: 1 f _SLDate: '7 4- 6 9
(Rev.2/8/06)
1301 L'Orient Street
NOV II 51611 - V '' \St Paul,Minnesota 55117
AUTOMATIC SPRINKLER co.. (651)558-3300 • (800)229-6263
Setting the Standard... Fax: (651)558-3310
SHEET 2 of 2-Use separate sheet for each system inspected System No.or Description if multiple
systems /-Lc)eV-
,
Inspection
as fig
,
11 Date thy-pipe valve trip tested(control valve partially open) Al (See Trip Test Table which follows)
12 Date dry-pipe valve trip tested(control valve fully open) /d._ (See Trip Test Table which follows)
13 Date quick-opening device tested iJ/9" ee Trip Test T le which follows)
DRY VALVE TRIP TEST TABLE Q.O.D.
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
DRY PIPE Time to Trip Water Air Trip Point Time Water Reached Alarm Operated
OPERATING Thru Test Pipe Pressure Pressure Air Pressure Test Outlet Properly
TEST MIN. SEC. PSI PSI PSI MIN. SEC. YES NO
Without
Q.O.D
With
Q.O.D
14 Date deluge or preaction valve testedii.-- (See Trip Test Table which follows)
r' TRIP TEST TABLE
Operation o PNEUMATIC o ELECTRIC o HYDRAULIC
Piping Supervised o YES o NO Detecting Media Supervised 0 YES o NO
DELUGE& Does valve operate from the manual trip and/or remote control stations o YES o NO
PREACTION Is there an accessible facility in each circuit for testing 0 YES 0 NO Method of Testing Circuits
VALVES Does each circuit operate Does each circuit Maximum time to
MAKE MODEL supervision loss alarm operate valve release operate release
YES NO YES NO YES NO
15 See Control Valve Maintenance Table
CONTROL VALVE MAINTENANCE TABLE
Explain
Abnormal
Control Valves Number Type Open _ Secured Closed Signs Condition
City Control Valves
Bypass Valves
Tank Control Valves
Pump Control Valves
Sectional Control Valves j
System Control Valves ? . q " A fC tio< y/Q,e 114 5
Other Control Valves
Kitchen Control Valves
•
16 Water Flow Test at Sprinlder Riser
Water Supply Source: Cip £ ' Tank Pump
Residual
Test Pipe Size of Static (Flow)
Date Location Test Pipe Pressure Pressure
Last Water Flow Test 7-2,/-Ot:, IL_ i 5Qit S."
LO 9s
This Water Flow Test /-/3`(�I) 2, Set '' to I 5' /
17 Explain any"No"answers and comments:
18 A4istments qr corrections made during this inspecti n: ---
19 Although these comments are not the result of an engineering review,the following desirable improvements are recommended:
Signature: 71 -11.41 Date: /7- Pr-- a 1
(Rev.2/8/06)