HomeMy WebLinkAboutFP 2011-00139 Above Ground Fire Piping Certification (10-03-11) CONTRACTORS MATERIAL & TEST CERTIFICATE FOR ABOVEGROUND PIPING pJ nei
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PROCEDURE:
Upon completion or work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall
be left in service before contractor's personnel finally leave the job.
A certificate shall 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 for faulty material, poor workmanship, or failure to comply with approving authority's
requirements or local ordinances.
PROPERTY NAME: Pine G QDI/4_ ,4 1 9/30/2011
PROPERTY ADDRESS58I7Oak Green Court
ACCEPTED BY APPROVING AUTHORITIES ( NAMES)
City of bAl' P// . /4
PLANS ADDRESS:
INSTALLATION CONFORMS TO ACCEPTED PLANS • YES ❑ NO
EQUIPMENT USED IS APPROVED • YES ❑ NO
IF NO, EXPLAIN DEVIATIONS
HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION
OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT ® YES ❑ NO
IF NO, EXPLAIN
INSTRUCTIONS
HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: El YES ❑ NO
1. SYSTEM COMPONENTS INSTRUCTIONS • YES ❑ NO
2. CARE AND MAINTENANCE INSTRUCTIONS U YES ❑ NO
3. NFPA 25 U YES ❑ NO
LOCATION OF SUPPLIES BUILDINGS
SYSTEM ENTIRE BUILDING
DESCRIPTION MODEL YEAR ORIFICE SIZE TEMPERATURE QUANTITY
Reliable Residential Sidewall RES-44 2007 1/2" 155° 11 ea
Reliable Upright F1FR 2007 1/2" 200° 1 ea
SPRINKLERS
CPVC Pipe with CPVC Slip Fittings
PIPE & FITTINGS Allied XL with 2501b Class Ductile Iron Screwed Fittings
ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST
ALARM VALVE CONNECTION
OR FLOW TYPE MAKE MODEL MINUTES SECOp1pS
INDICATOR Vane Potter VFS -R , /
DRY VALVE Q.O.D.
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
TIME TO TRIP WATER AIR TRIP POINT TIME WATER REACHED ALARM OPERATED
THROUGH TEST CONNECTION PRESSURE PRESSURE AIR PRESSURE TEST OUTLET PROPERLY
MINUTES SECONDS PSI PSI PSI MINUTES SECONDS YES NO
DRY PIPE WITHOUT
OPERATING Q.O.D.
TEST WITH
Q.O.D.
IF NO, EXPLAIN
MEASURED FROM THE TIME THE INSPECTOR'S TEST CONNECTION IS OPENED.
OPERATION
= PNEUMATIC i❑ ELECTRIC 0 HYDRAULIC
PIPING SUPERVISED El YES El NO DETECTING MEDIA SUPERVISED = YES 0 NO
DELUGE
& PREATION DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE CONTROL STATIONS El YES 0 NO
VALVES IS THERE AN ACCESSIBLE FACILITY IN EACH CURCUIT FOR TESTING IF NO EXPLAIN
0 YES El NO
MAKE MODEL DOES EACH CURCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO OPERATE
SUPERVISION LOSS ALARM OPERATE VALVE RELEASE RELEASE
YES NO YES NO MINUTES SECONDS
HYDROSTATIC: HYDROSTATIC TEST SHALL BE MADE AT NOT LESS THAN 200 PSI (13.6 BAR) FOR TWO HOURS OR 50 PSI (3.4 BAR) ABOVE
STATIC PRESSURE IN EXCESS OF 150 PSI (10.2 BAR) FOR TWO HOURS. DIFFERENTIAL DRY -PIPE VALVE CLAPPERS SHALL BE LEFT OPEN DURING TEST TO
TEST PREVENT DAMAGE. All ABOVEGROUND PIPING LEAKAGE SHALL BE STOPPED.
DESCRIPTION PNEUMATIC: ESTABLISH 40 PSI (2.7BAR) AIR PRESSURE AND MEASURE DROP WHICH SHALL NOT EXCEED 1 -1/2 PSI (0.1 BAR) IN 24 HOURS.
TEST PRESSURE TANKS AT NORMAL WATER LEVEL AND AIR PRESSURE AND MEASURE AIR PRESSURE DROP WHICH SHALL NOT EXCEED 1 -1/2 PSI (0.1 BAR)
IN 24 HOURS.
ALL PIPING HYDROSTATICALLY TESTED AT PSI FOR HRS. IF NO, STATE REASON
DRY PIPING PNEUMATICALLY TESTED I] YES 0 NO
EQUIPMENT OPERATES PROPERLY El YES 0 NO
TESTS DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OR
SODIUM SILICATES, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS?
0 YES 0 NO
DRAIN TEST READING OF GAUGE LOCATED NEAR WATER SUPPLY TEST PIPE: RESIDUAL PRESSURE WITH VALVE IN TEST PIPE OPEN WIDE
STATIC PRESSURE: PSI PSI
UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFOR CONNECTION MADE TO SPRINKLER PIPING.
VERIFIED BY COPY OF THE U FORM NO. 85B 0 YES 0 NO OTHER EXPLAIN:
FLUSHED BY INSTALLATER OF UNDERGROUND El YES 0 NO
SPRINKLER PIPING
BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED
GASKETS
WELDED PIPING El YES 0 NO
IF YES........
DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY 0 YES 0 NO
WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3
WELDING
DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED El YES El NO
IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3
DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A El YES Q NO
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
PIPING ARE NOT PENETRATED.
CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL CUTOUTS El YES 0 NO
(DISKS) (DISKS) ARE RETRIEVED
HYDRAULIC NAMEPLATE PROVIDED IF NO, EXPLAIN
DATA
NAMEPLATES YES J NO
REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN:
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NAME OF SPRINKLER CONTRACTOR: SUMMIT FIRE PROTECTION
SIGNATURES
TEST WITNESSED BY
FOR PROPERTY OWNER ( SIGNED) TITLE DATE:
SUMMIT,
FI PE PPOTECTl7n
FOR SPRINKLER CONTRACTOR SI NED) TITLE DATE:
4-1.e4‘4 /a - 3 -//
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