HomeMy WebLinkAboutFP 2010-00300 Contractors Material & Test Certificate for Above Ground Piping (04-11-11) Contractor's Material and Test Certificate for Aboveground Piping
PROCEDURE
Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representitive. All defects shal be
corrected and system left in service before contractors personnel finally leave the job. A certificate shall be filled out
and signed by both representitives. 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, of failure to comply with approving authority's requirement- o
local ordinances.
Property name ALDI Date
Property address 13747 - 60TH STREET OAK PARK HEIGHTS, MN P 2C0- e CXJ
Accepted by approving authorities (names)
Address
Plans 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 U Yes U No
control valves and care and maintenance of this new equipment?
If no, explain?
Instructions Have copies of the following been left on the premises? ❑ Yes LI No
1. System components instructions ❑ Yes [] No
2. Care and maintenance instructions ❑ Yes 0 No
3. NFPA 25 ❑ Yes D No
Location of Supplies buildings RETAIL BLDG.
system
Year of Temperature
Make Model Manufacture Orifice size Quantity rating
TYCO EC -14 2010 3/4" 82 286
TYCO TY -FRB 2010 1/2" 20 155
•
Sprinklers TYCO DS -1 2010 1/2" 22 286
Type of pipe XL THREADED , SCH. 10 & SCH. 7 GROOVED
Pipe and fittings
Type of fittings THREADED & GROOVED
Alarm device Maximum time to operate through test connection
Alarm valve or Type Make Model Minutes Seconds
flow indicator VANE POTTER VSF -R .3a
Dry valve Quick Opening Device (Q.O.D.)
Make Model Serial no. Make Model a no.
Time to trip Alarm
through test Trip poi operated
Dry pipe operating connection* Water pressure it pressure ressure Time water reached test outlet* properly
test
Minutes Seconds psi psi psi Minutes Seconds Yes No
Without
Q.O.D.
With \
Q.O.D.
If no, ex I 'ate
*Measure ime inspector's test connection is opened
Operation ❑ Pneumatic ❑ Electric ❑ Hydraulic
Piping supervised? ❑ Yes ❑ No 'Detecting media supervised? (Detecting media supervised?
Does valve operate from the manual trip, remote, or both control stations? ❑ Yes ❑ No
Is there an accessible facility in each If no, explain
Deluge and circuit for testing? ❑ Yes ❑ No
preaction valve
Does each circuit operate Does each circuit operate Maximum time to operate
supervision loss alarm? valve release? release
Make Model Yes No Yes No Minutes Seconds
Residual pressure
Pressure reducing Location and floor Make and model Setting Static pressure (flowing) Flow rate
valve test Inlet (psi) Outlet (psi) Inlet (psi) Outlet (psi) Flow (gpm)
Hydrostatic: Hydrostatic tests shall be made at not less than 200 psi (13.6 bar) for 2 hours or 50 psi (3.4 bar) above static pressu s in
excess of 150 psi (10.2 bar) for 2 hours. Differential dry -pipe valve clappers shall be left open during the test to prevent damage. _II
Test description
aboveground piping leakage shall be stopped.
Pneumatic: Establish 40 psi (2.7 bar) air pressure and measure drop, which shall not exceed 1.5 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 1.5 psi (0.1 bar) in 2i
hours.
All piping hydrostatically tested at psi for hours. If no, state reason
Dry piping pneumatically tested ❑ Yes ❑ No
Equipment operates properly ❑ Yes ❑ No
Do you certify as the sprinkler contractor that additives and corrosive chemicals, sodium silcate or derivatives of sodium silicate, brine, or
• other corrosive chemicals were not used for testing systems or stopping leaks?
❑ Yes ❑ No
Tests Re ' gauge located near water supply test connection: Residual pr with valve in test connection open
Drain test psi wide: 3u 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. 85B Yes ME No Other Explain
Flushed by installer of underground sprinkler piping Yes _ No
If powder -driven fasteners are used in concrete, has ❑ Yes ❑ No If no, explain
Blank testing Number used !Locations Number removed
gaskets
Welded piping U Yes U No
If yes...
• Do you certify as the sprinkler contractor that welding procedures comply with
the requirements of at least AWS B2.1? ❑ Yes ❑ No
Welding Do you certify that the welding was performed by welders qualified in
compliance with the requirements of at least AWS B2.1? ❑ Yes El No
Do you certify that the welding was carried out in compliance with a documented quality •
control procedure to ensure 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? El Yes El No
Cutouts (discs) Do you certify that you have a control feature to ensure that all cutouts (discs) ❑ Yes ❑ No
are retrieved?
Hydraulic data Nameplate provided If no, explain
nameplate ❑ Yes ❑ No
Remarks
Date left in service with all control valves open
Name of sprinkler contractor National Automatic Sprinkler Co. 10351 Jamestown St. #100
Blaine. MN 55449
Tests witnessed by
For prop= 'r, owner (signed) Title Date
F. r'" ler cy act (si Title Da e
itoo
Additional explanations and n•• s C
/4 D, 4 . • '1w/A
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