HomeMy WebLinkAbout2010-10-04 Viking Automatic Sprinkler Co. Agreement & Report of Inspection 301 York Ave
It, NCit St. Paul, Minnesota 55130
MIrouanCafflant€aeco. RECEIVED (651) 558 -3300 • (800) 229 -6263
Setting The Standard... Fax: (651) 558 -3310
AGREFKENT 'AND REIDRT O INSPECTION 5
SHEET 1 of 2 - Use separate sheet for each building inspected #INSPECTION
MINNESOTA LICENSE NO. C005
REPORT TO e I • / ITY � OF OA? t CATION j ,t/
STREET (al `j C j O K &oo2 a i4 goa ly- l�CC� . ..m.� PECTOR , •7'" }
CITY & STATE Q a t et j(' hip i 5 /1.4 it ) DATE / 0 " L f - /6
Customer 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, customer agrees to the terms and conditions on rear of
form and will complete the Owner's Section of this document. Viking Automatic Sprinkler Company will not be held liable for incorrect or unknown
answers provided in the Owner's Section.
Owner's Section (To be answered by Owner, Occupant or Customer) RECEIVED
' mer) RE Y G
A. Explain any occupancy hazard changes since the previous inspection:
NOV 05 "310
B. Describe fire protection modifications made since last inspection: AJ Chi j 1t-
CITY OF OAK I'ARK Mew„ 1 b
C. Describe any fires since last inspection: �?
D. When was the system piping last checked for stoppage, corrosion or foreign material? -- 5 , J oe.? u )
E. When was the dry - piping system last checked for proper pitch? ` / ) /
F. Are dry valves adequately protected from freezing? t
G. Does the system contain any low point drains? o Yes o No If yes, please state how many and the general location of each:
Customer's Signature Title Date
Inspector's Section (All responses re nce curre r' .:. ection) N/A = NOT APPLICABLE
1 General
a. Is the building occupied? j tYes ❑ No
b. Are all systems in service. $c Yes ❑ 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? /isles o No
d. Does the valve hose on the sprinkler system(s) appear to be satisfactory? ❑ Yes o No N /A
2 Control Valves (See Item 15)
a- Do sprinkler system control valves appear to be in the appropriate open,or closed position? 7-Yes o No
b. Are control valves in the open position locked, sealed or equipped with a tamper switch ?p&Yes ❑ No
3 Water Supplies (See Item 16)
a. Was a water flow test of main drain made at the sprinkler riser(s)? Yes n No
4 Tanks, Pumps, Fire Department Connections
a. Do fire pumps, gravity tanks, reservoirs and pressure tanks appear in good condition and properly maintained? n Yes o No . v/A
b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight? ai..Yes n No o N/A
Are they accessible and visible? Byes o No ❑ N/A
5 Wet Systems
a. Are cold weather valves (O.S. & Y.) in the appropriate open or closed position? ❑ Yes n No 9IN /A
b. Have antifreeze system solutions been tested? n Yes o No )1, N/A
c. Were the antifreeze test results satisfactory? n Yes n No /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? to Yes o No o N/A Do all exterior openings appear to be protected against freezing? ;Yes ❑ No o N/A
6 Dry System (See Items 11 to 13)
a. Are dry valves (s) in service? Yes o No o N/A
b. Are the air pressures and prirWig water levels fn accordance with the manufacture's instructions? qiYes n No ❑ N/A
c. Has the operation of the air or nitrogen supplies been tested? ltYes n No n N/A Are they in service? c Kes ❑ No o N/A
d. Were all known low points drained during this inspection? n Yes ❑ No jt1l\l/ A
e. Did quick - opening devices operate satisfactorily? n Yes ❑ No 9►N /A
f. Did the dry valve(s) appear to trip properly during the trip pressure test? pies o No n N/A
g. Did the heating equipment in the dry -pipe valve room(s) appear to operate at time of inspection? )es ❑ No ❑ N/A
7 Special Systems (See Item 14)
a. Did the deluge or pre -action valves operate properly during testing? n Yes o No �I /A
AN
/A
Did the heat - responsive devices operate properly during testing? o Yes ❑ No /A
c. Did supervisory devices operate during testing? ❑ Yes o No otN/A
8 Alarms
a. Did water motor(s) and gorig(s) test satisfactorily? ❑ Yes ❑ No 0 iiI /A
b. Did electric alarm(s) test satisfactory ?Yes o No ❑ N/A
c Did supervisory alarm service test satisfactory? 6 4(es n No o N/A
9 Sprinklers
a. Do visible sprinklers appear to be free from corrosion, loading or obstruction to spray discharge? 0, Yes ❑ No
b. Do visible sprinklers appear to be less than 50 years old? (Older sprinklers require sample testing) kYes o No
c. Do quick response and residential sprinklers appear less than 20 years old? (Older sprinklers require sample testing) n Yes o No /p 1/A
• d. Is stock of spare sprinklers available? Ayes o No
e. Does the exterior condition of sprinkler system appear to be satisfactory? "(Yes ❑ No
f. Do visible sprinklers appear to be of proper temperature rating for their locations? cxyes o No
10 Explain any No answers and comments:
Inspector's Signature: r Date: `0 q
Inspection Form PI 2 -1 -10
TERMS AND CONDITIONS
The Report of Inspection, together with these Terms and Conditions, constitute the entire agreement ( "Agreement ") of the parties.
L This Agreement is for work performed on this Inspection only. If Customer wants Viking Automatic Sprinkler Co. ( "Company ") to
make any additional repairs, alterations or replacements as a result of the work performed, the Company will do so for additional
compensation to be agreed upon in writing by the parties.
2. The Company does not know and does not represent whether the current fire protection system on the property of Customer
( "Property ") was originally designed and installed in such a way that the system will perform as originally intended or is suitable and
sufficient for its intended purpose given the way in which the Property has been or will be used. In other words, the Property has been
or may be used in ways such that the configuration of partition walls, the location of and types of materials (including the presence of
hazardous materials) and other conditions of the Property's use are such that the fire protection system is inadequate, insufficient or
unsuitable for the Property. THIS AGREEMENT IS NOT A GUARANTEE OR WARRANTY THAT THE SYSTEM WILL IN
ALL CASES (A) PROVIDE THE LEVEL OF PROTECTION FOR WHICH IT WAS ORIGINALLY INTENDED, (B) IS FREE OF
ALL DEFECTS AND DEFICIENCIES, (C) AND IS IN COMPLIANCE WITH ALL APPLICABLE CODES. Customer agrees that
it has not retained Company to make these assessments unless otherwise specifically indicated.
3. The Company will be permitted, at all reasonable times, to enter the Property to conduct the work as outlined in this Agreement.
4. THE COMPANY'S POTENTIAL LIABILITY ARISING OUT OF ITS WORK IS HEREBY LIMITED. CUSTOMER
SPECIFICALLY AGREES TO ASSUME THE ENTIRE RESPONSIBILITY AND LIABILITY TO THE FULLEST
EXTENT PERMITTED BY LAW, FOR ALL DAMAGES OR INJURY TO ALL PERSONS, WHETHER EMPLOYEES,
OCCUPANTS, VISITORS, OR OTHERWISE, AND TO ALL PROPERTY, ARISING OUT OF, RESULTING FROM, OR
IN ANY MANNER RELATING TO OR CONNECTED WITH, THE EXECUTION OF THE COMPANY'S WORK
PROVIDED FOR IN THIS REPORT OF INSPECTION, AND ALL ACTIVITIES RELATED THERETO, OR
OCCURRING OR RESULTING FROM THE USE BY THE COMPANY OR ITS AGENTS OR EMPLOYEES OF
MATERIALS, EQUIPMENT, INSTRUMENTALITIES OR OTHER PROPERTY, IRRESPECTIVE OF WHETHER THE
SAME BE OWNED BY THE CUSTOMER, THE COMPANY OR THIRD PARTIES. THE CUSTOMER, TO THE
FULLEST EXTENT PERMITTED BY LAW, AGREES TO INDEMNIFY, DEFEND, AND SAVE HARMLESS THE
COMPANY, ITS AGENTS AND EMPLOYEES FROM ALL SUCH CLAIMS AND LIABILITIES INCLUDING, WITHOUT
LIMITING THE GENERALITY OF THE FOREGOING, CLAIMS AND LIABILITIES FOR WHICH THE COMPANY
MAY BE OR MAY BE CLAIMED TO BE LIABLE ARISING OUT OF THE COMPANY'S NEGLIGENT WORK, ACTS,
SERVICES, OR OMISSIONS, OR ANY CLAIMED BREACH OF THIS AGREEMENT BY COMPANY. CUSTOMER
SHALL INDEMNIFY COMPANY FOR COMPANY'S LEGAL FEES, COSTS, AND DISBURSEMENTS PAID OR
INCURRED TO ENFORCE THE PROVISIONS OF THIS PARAGRAPH. CUSTOMER FURTHER AGREES TO
OBTAIN, MAINTAIN AND PAY FOR SUCH GENERAL LIABILITY INSURANCE COVERAGE AND ENDORSEMENTS
AS WILL INSURE THE PROVISIONS OF THIS PARAGRAPH AND UPON REQUEST, PROVIDE COMPANY
EVIDENCE THEREOF.
IF THE ABOVE INDEMNIFICATION IS UNENFORCEABLE IN THE STATE IN WHICH THE WORK IS
PERFORMED, THEN THE FOLLOWING LIMITED LIABILITY LANGUAGE APPLIES.
CUSTOMER AGREES TO LIMIT THE LIABILITY OF COMPANY, ITS OFFICERS, DIRECTORS,
EMPLOYEES, PARENT COMPANY, SUBSIDIARIES, AFFILIATES, CONSULTANTS,
SUBCONTRACTORS AND VENDORS, TO A MAXIMUM OF $5,000 OR THE AMOUNT OF THE
CONTRACT /PRICE OF WORK TO BE PERFORMED, WHICHEVER IS LESS. THIS LIMITATION
OF LIABILITY SHALL APPLY TO ALL JUDGMENTS, CLAIMS, LIABILITY, COSTS, CLAIM
EXPENSES, LEGAL FEES AND ALL DAMAGES OR LOSSES OF ANY NATURE SUSTAINED BY
CUSTOMER, CONTRACTOR OR SUBCONTRACTORS OR ANY OTHER PARTY CLAIMING BY
OR THROUGH THEM.
5. Customer agrees to obtain and shall be solely responsible to maintain insurance for the Property, and contents therein, and/or
operations performed within or around the Property. Customer waives subrogation against, and releases Company from, any loss
covered under any such property insurance policies.
6. While the Company will make every reasonable effort to prevent the discharge of water into or onto areas of landscaping, decorative
pavement, etc., it is the Customer's responsibility to provide sufficient and readily accessible means to accept the full flow of water
that may be required by tests as determined by the type of inspection.
7. This Agreement may not be assigned by Customer without the written consent of the Company.
8. Neither party shall be liable to the other for indirect, incidental, consequential or punitive damages arising out of the work.
9. If payment for work provided in this Agreement is not received by the Company within 30 days from Customer's receipt of an invoice
for the work, Customer shall pay interest at the rate of 3% per annum on all past due sums, together with all costs of collection,
including attorney's fees.
10. This Agreement constitutes the entire agreement of the parties. If any provision hereof shall be invalid, the remaining provisions shall
survive and be enforceable against the parties. The law of the state where the work is performed will govern. This Agreement
supersedes all prior agreements. This Agreement may be modified only by a written instrument signed by both parties.
Customer T &C -INSP 2 -1 -10
1 � 301 York Ave
€11 6 1 N Q 1 r St. Paul, Minnesota 55130
TOMATIC SPRINKLER CO. R EC I e S • `� - ,- 00 • (800) 229 -6263
Setting The Standard... ! Y
ax: (651 558 -3310
SHEET 2 of 2 - Use separate sheet for each system inspected NOV tem N . or Description if multiple
CITY OF OAK PARK systems 1- 4) 4 i f /_ 14 `/ ,
Inspecti Report —� ._Alti I c -
No. ,a. 59 3 t/ --- __ .M
11 Date dry -pipe valve trip tested (control valve partially open) /0- y- /0 (See Trip Test Table which follows)
12 Date dry -pipe valve trip tested (control valve fully open) -- (See Trip Test Table which follows)
13 Date quick - opening device tested A) P (See Trip Test Table which follows)
DRY VALVE TRIP TEST TABLE Q.O.D.
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
Q
C iL a A (. k r./ n .._-
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 / V 0 O t T ( 2 2 -- C..---
With
Q.O.D
14 Date deluge or preaction valve tested / ) to (See Trip Test Table which follows)
TRIP TEST TABLE
Operation ❑ PNEUMATIC ❑ ELECTRIC ❑ HYDRAULIC
Piping Supervised ❑ YES ❑ NO (Detecting Media Supervised ❑ YES ❑ NO
DELUGE & Does valve operate from the manual trip and /or remote control stations ❑ YES ❑ NO
PREACTION Is there an accessible facility in each circuit for testing ❑ YES ❑ 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 Sins Condition
4 City Control Valves /- " 05 T , T? c VP 5 Y2S
Bypass Valves
Tank Control Valves
Pump Control Valves
Sectional Control Valves
System Control Valves a - Y ' ;t 1 f 1+ t + 11
-
Other Control Valves / - C " 4.16.4 afr- ' ` , t e /
Kitchen Control Valves
16 Water Flow Test at Sprinkler Riser
r"
Water Supply Source: City t !o Tank Pump
Residual
Test Pipe Size of Static (Flow)
Date Location Test Pipe Pressure Pressure
Last Water Flow Test p . „?i c'►9' /2 Q 5 .Z " 9 9 5' IT
This Water Flow Test /0 ,q,/e-, R , c ,p lz c 2 " 10 1 C °f
17 Explain any "No" answers and comments:
18 Adjustments 95 corrections made during this inspection: — 61,4 4 k o l c m ,.1 Ar re / ilia / U n r --
ritock ed/ A 1.v4'c 7 5, ---
'e 59N 4- t{R. (JALj
19 Although the comments are not the result of an engineering review, please see the attache Inspection Related Deficiencies
form for additional items and during the course of the inspection (only attached if applicable).
Inspector's Signature: G P Date: 7(3 - 9'
Inspection Form P2 2 -1 -10
•T t
TERMS AND CONDITIONS
The Report of Inspection, together with these Terms and Conditions, constitute the entire agreement ( "Agreement ") of the parties.
1. This Agreement is for work performed on this Inspection only. If Customer wants Viking Automatic Sprinkler Co. ( "Company ") to
make any additional repairs, alterations or replacements as a result of the work performed, the Company will do so for additional
compensation to be agreed upon in writing by the parties.
2. The Company does not know and does not represent whether the current fire protection system on the property of Customer
( "Property ") was originally designed and installed in such a way that the system will perform as originally intended or is suitable and
sufficient for its intended purpose given the way in which the Property has been or will be used. In other words, the Property has been
or may be used in ways such that the configuration of partition walls, the location of and types of materials (including the presence of
hazardous materials) and other conditions of the Property's use are such that the fire protection system is inadequate, insufficient or
unsuitable for the Property. THIS AGREEMENT IS NOT A GUARANTEE OR WARRANTY THAT THE SYSTEM WILL IN
ALL CASES (A) PROVIDE THE LEVEL OF PROTECTION FOR WHICH IT WAS ORIGINALLY INTENDED, (B) IS FREE OF
ALL DEFECTS AND DEFICIENCIES, (C) AND IS IN COMPLIANCE WITH ALL APPLICABLE CODES. Customer agrees that
it has not retained Company to make these assessments unless otherwise specifically indicated.
3. The Company will be permitted, at all reasonable times, to enter the Property to conduct the work as outlined in this Agreement.
4. THE COMPANY'S POTENTIAL LIABILITY ARISING OUT OF ITS WORK IS HEREBY LIMITED. CUSTOMER
SPECIFICALLY AGREES TO ASSUME THE ENTIRE RESPONSIBILITY AND LIABILITY TO THE FULLEST
EXTENT PERMITTED BY LAW, FOR ALL DAMAGES OR INJURY TO ALL PERSONS, WHETHER EMPLOYEES,
OCCUPANTS, VISITORS, OR OTHERWISE, AND TO ALL PROPERTY, ARISING OUT OF, RESULTING FROM, OR
IN ANY MANNER RELATING TO OR CONNECTED WITH, THE EXECUTION OF THE COMPANY'S WORK
PROVIDED FOR IN THIS REPORT OF INSPECTION, AND ALL ACTIVITIES RELATED THERETO, OR
OCCURRING OR RESULTING FROM THE USE BY THE COMPANY OR ITS AGENTS OR EMPLOYEES OF
MATERIALS, EQUIPMENT, INSTRUMENTALITIES OR OTHER PROPERTY, IRRESPECTIVE OF WHETHER THE
SAME BE OWNED BY THE CUSTOMER, THE COMPANY OR THIRD PARTIES. THE CUSTOMER, TO THE
FULLEST EXTENT PERMITTED BY LAW, AGREES TO INDEMNIFY, DEFEND, AND SAVE HARMLESS THE
COMPANY, ITS AGENTS AND EMPLOYEES FROM ALL SUCH CLAIMS AND LIABILITIES INCLUDING, WITHOUT
LIMITING THE GENERALITY OF THE FOREGOING, CLAIMS AND LIABILITIES FOR WHICH THE COMPANY
MAY BE OR MAY BE CLAIMED TO BE LIABLE ARISING OUT OF THE COMPANY'S NEGLIGENT WORK, ACTS,
SERVICES, OR OMISSIONS, OR ANY CLAIMED BREACH OF THIS AGREEMENT BY COMPANY. CUSTOMER
SHALL INDEMNIFY COMPANY FOR COMPANY'S LEGAL FEES, COSTS, AND DISBURSEMENTS PAID OR
INCURRED TO ENFORCE THE PROVISIONS OF THIS PARAGRAPH. CUSTOMER FURTHER AGREES TO
OBTAIN, MAINTAIN AND PAY FOR SUCH GENERAL LIABILITY INSURANCE COVERAGE AND ENDORSEMENTS
AS WILL INSURE THE PROVISIONS OF THIS PARAGRAPH AND UPON REQUEST, PROVIDE COMPANY
EVIDENCE THEREOF.
IF THE ABOVE INDEMNIFICATION IS UNENFORCEABLE IN THE STATE IN WHICH THE WORK IS
PERFORMED, THEN THE FOLLOWING LIMITED LIABILITY LANGUAGE APPLIES.
CUSTOMER AGREES TO LIMIT THE LIABILITY OF COMPANY, ITS OFFICERS, DIRECTORS,
EMPLOYEES, PARENT COMPANY, SUBSIDIARIES, AFFILIATES, CONSULTANTS,
SUBCONTRACTORS AND VENDORS, TO A MAXIMUM OF $5,000 OR THE AMOUNT OF THE
CONTRACT/PRICE OF WORK TO BE PERFORMED, WHICHEVER IS LESS. THIS LIMITATION
OF LIABILITY SHALL APPLY TO ALL JUDGMENTS, CLAIMS, LIABILITY, COSTS, CLAIM
EXPENSES, LEGAL FEES AND ALL DAMAGES OR LOSSES OF ANY NATURE SUSTAINED BY
CUSTOMER, CONTRACTOR OR SUBCONTRACTORS OR ANY OTHER PARTY CLAIMING BY
OR THROUGH THEM.
5. Customer agrees to obtain and shall be solely responsible to maintain insurance for the Property, and contents therein, and /or
operations performed within or around the Property. Customer waives subrogation against, and releases Company from, any loss
covered under any such property insurance policies.
6. While the Company will make every reasonable effort to prevent the discharge of water into or onto areas of landscaping, decorative
pavement, etc., it is the Customer's responsibility to provide sufficient and readily accessible means to accept the full flow of water
that may be required by tests as determined by the type of inspection.
7. This Agreement may not be assigned by Customer without the written consent of the Company.
8. Neither party shall be liable to the other for indirect, incidental, consequential or punitive damages arising out of the work.
9. If payment for work provided in this Agreement is not received by the Company within 30 days from Customer's receipt of an invoice
for the work, Customer shall pay interest at the rate of 3% per annum on all past due sums, together with all costs of collection,
including attorney's fees.
10. This Agreement constitutes the entire agreement of the parties. If any provision hereof shall be invalid, the remaining provisions shall
survive and be enforceable against the parties. The law of the state where the work is performed will govern. This Agreement
supersedes all prior agreements. This Agreement may be modified only by a written instrument signed by both parties.
Customer T &C -INSP 2 -1 -10