HomeMy WebLinkAbout2011-08-31 Ahern Fire Protection Annual Fire Protection Systems Inspection Report LID #: 3150313 ;1. Page 1 of 3
Ahern Fire Protection r
Annual S p Work Order #:
Sprinkler
13705 26th Avenue, Suite 110
w wapolis, MN 55441 System Ins inkle 854162
(763) 268 -0515 p • (763) 268 -0516 f w. rn p For M 4162 ear:
ER �/ w ahefire.com •Since 1880 Report July 2011
Invoice: SHILO AUTOMATIC SPRINKLER EAST COAST OFFICE Phone #: (208) 466 -0006
Street: 2362 SPARTA ROAD (City: NORTH WILKESBORO State: NC Zip: 28659-
Location: Lowe's #2315 Dept.: 1
Street: 5888 Nova Scotia Ave N City: Oak Park Heights State: MN Zip: 55082
Phone #: (651) 275 -9910 Fax #: (651) 275 -9911 Foreman: Andy Zarbok
Date: Signature: - ., _- = -;_----
!Wet 4 Foam FireDoors Suppression BF RP
i
Dry 2 Alarms FirePumps 1 Anti_Freeze , BF DC
Preaction Detectors VaIveTT 2 Water Spray BF Generic
Deluge Hydrants BF Lincoln
Stand Pipe/Hose Internal Sprinkler BF Omaha
Contacts: Mark Holey Direct: (208) 466 -0006 Ext:
Deficiency Cell/Pager:
(ALARM DEVICES TESTS Y N N/A I
1. Did waterflow or pressure switches operate satisfactorily? '❑ ]
2. Did tamper switches operate satisfactorily? ]
3. Did water motor alarm gongs or electric bells operate satisfactorily? .I-.- ] ]
4. Did alarm service or central station operate satisfactorily and receive proper signals? r E E
ALARM SIGNALS I
System # '
C r ; .t ."-."--- 1 I
a
Test Times f .' I , . ' C _ - , i t ` _
15 YEAR INSPECTION Y N N/A I
1. Was the 5 year Inspection performed on the following items? ❑ ❑. E
A. Alarm valves
B. Check valves
C. Gauges
D. Internal Examination of Piping Date due: ', ] ]
15 -YEAR TESTING Y N N /r, I
1. Was the 5 year testing performed on the following items? ❑ ❑ a
A. Sprinkler heads in corrosive environments or rated 325° F or higher. Date Due: ] ] 11
B. Standard sprinklers in service for 75+ years. Date Due: ] ] t
110 -YEAR TESTING Y N N/
1. Was the 10 year testing performed on the following items? ] Ell
A. Standard sprinklers in service for 50+ years. Date Due: ] ❑
B. Quick response sprinklers in service for 20+ years. Date Due: ] ❑ 1
C. Dry pendant sprinklers. Date Due: ]
RECEIVED NOV 141011
This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2005 J.F. Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT. rptlnspection_Annual
LID #: 3150313 Page 2 of 3
`'CONTROL VALVE SERVICE"" " Y N N/A
1. Were the following service items performed on all control valves? ❑ ❑,
A. Fully opened and closed? 7
r✓ u,
B. Valve packing checked? ❑ '❑
C. Valve stem lubricated? , ❑
J
D. Is the valve properly secured and locked in its normal operating position? ❑ ❑
IBACKFLOW PREVENTOR TEST Y N N/A I
1. Did the backflow preventor(s) pass the test of backflow and forward flow capabilities? ❑, ❑
(ANTI- FREEZE TEST Y N N/A I
1. Has the anti -freeze solution for each system below been tested by measuring specific gravity? ❑ ❑ '
'HANGERS AND SEISMIC BRACING Y N N/A I
1. Did hangers and seismic bracing appear to be in good condition, firmly attached, and free from corrosion, from a visual inspection
performed from floor level? N,.
IPIPING Y ' N N/A I
1. Was the exterior of exposed sprinkler piping in good condition, not subjected to external Toads, free of mechanical damage? -. L
NOTE: Piping located in concealed spaces, such as above a drop ceiling, are not required to be inspected
'FIRE DEPARTMENT CONNECTIONS Y N N/A I
1. Are fire department connections visible and in good condition? ''� ❑ ❑
2. Are caps and plugs in place? I ❑
3. Are automatic drain valves operating properly? i ❑ TE
4. Do hose connections operate freely? ,1-" ❑ ❑
I HOSE RACKS PRESENT? ❑ Yes 0 No CONDITION: 0 Good 0 Fair 0 Bad Y N N/A I
(MAIN DRAIN TEST .
'System Number I A 1
J �..
'Static Pressure / (. f ' 7)
'Residual Pressure > , 1 4,,,:e:,;
Size of drain r -�% - vim"
1. Were all main drains tested at full flow? 2 El ❑
If no, explain:
2. Were test results similar to the last test? ,� ❑ ❑
If no, explain:
3. Was there any discharge of obstructive material, heavy discoloration of water, or plugging of the inspector's test connection? ❑ ..- ❑
'GENERAL INFORMATION Y N N/A I
1. Are all the sprinkler systems in service? n n
2. Is the building completely sprinklered? .'•
3. Are all sprinklers in good condition? ,kr- ❑ ❑
4. Are all sprinklers free of obstruction? ,- ❑ ^'
5. Are spare sprinklers and wrenches available? ' o
6. In spray coating area, are sprinklers free from accumulation? ❑ ❑ , c
7. Is hydraulic nameplate and information sign securely in place and legible? X' ❑ ❑
8. Is emergency service contact information readily available? ,t' ❑ ❑
9. Are alarm devices provided and in good condition? • P' ❑,
10. Are all standard sprinklers dated 1920 or later ?_ E
'OWNER QUESTIONS Y N N/A I
1. Any changes in sprinkler system since last inspection? ❑ 'U ❑
2. Any fires since last inspection? ❑ :. ❑
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LID #: 3150313 Page 3 of 3
A. Number of sprinkler heads that opeiatea'
B. How long was system out of service?
C. Area where fire occured.
3. Are all areas of the building properly heated to prevent freezing where wet pipe systems exist? LI ❑ C
4. Do you have a n outside alarm service? - _ . - Vi C
If yes, name and phone number. ' '' ; `. i''> ! r
Note to Owner - Our inspections will only report conditions as they exist at time of inspection and do not guarantee the operation of the
System due to factors beyond our control. (i.e., potentially closed valves or depleted municipal water supply.) Per NFPA -25, this inspection is
based on the assumption that the system has been installed in accordance with all applicable codes and standards.
Owner /Representative's Signature: Date F::: -., / ( �
/
l .'
New Deficiencies found during this inspection? Yes No Customer receive copy of New Deficiency Report? Yes No
A previous inspection for your facility revealed the following deficiency in your Fire Protection System:
Def`Bate: /21/2008 System # Quote: _�.,,...Quaa4itYr _
. �
Def #: 3157399 --- .,_ `' rte^
Casing rel el'v°aTvrpipe4s- plugged to floor d i -
IF THIS DEFICIENCY HAS BEEN REPAIRED, PLEASE$ILL' r • ' e • ' AIR: FOREMAN'S INITIALS: .
AHERN FIRE PROTECTION willperfon rdriMpair per your verbal or written approv.. - .. • • elect to proceed with this work, please call or sign and
fax or mail a copy oLtivs -page We will call to set up an appointment. Thank you.
ACCEPTED BY: DATE:
A previous inspection for your facility revealed the following deficiency in your Fire Protection System:
Def Date: 7/16/2010 System # Quote: Quantity:
Def#: 31501621 k1 r —. f: ,
dry system air maintenance device has a bad valve for the bypass. ( ' - \ 1 . ��-
The 6" ry y YP
IF THIS DEFICIENCY HAS BEEN REPAIRED, PLEASE FILL IN DATE OF REPAIR: FOREMAN'S INITIALS: .
AHERN FIRE PROTECTION will perform this repair per your verbal or written approval. Should you elect to proceed with this work, please call or sign and i
fax or mail a copy of this page. We will call to set up an appointment. Thank you.
ACCEPTED BY: DATE:
A previous inspection for your facility revealed the following deficiency in your Fire Protection System:
Def Date: 7/16/2010 System # Quote: ‘ Quantity
Def #: 31501622 ; 4 ; r\ i
\ ` f �,.
''
eed to pipe casing relief to the floor drain. It currently has plastic sleeving to direct the water to the drain:
ra n
IF THIS DEFICIENCY HAS BEEN REPAIRED, PLEASE FILL IN DATE OF REPAIR: FOREMAN'S INITIALS: .
AHERN FIRE PROTECTION will perform this repair per your verbal or written approval. Should you elect to proceed with this work, please call or sign and
fax or mail a copy of this page. We will call to set up an appointment. Thank you.
ACCEPTED BY: DATE:
A previous inspection for your facility revealed the following deficiency in your Fire Protection System:
Def Date: 7/16/2010 System # , Quote: Entity:
Def #: 31501623 } ' ^ 4 f
The suction gauge on the fire pump is broken. ..' �,
IF THIS DEFICIENCY .HAS BEEN REPAIRED, PLEASE FILL IN DATE OF REPAIR: FOREMAN'S INITIALS: .
AHERN FIRE PROTECTION will perform this repair per your verbal or written approval. Should you elect to proceed with this work, please call or sign and
fax or mail a copy of this page. We will call to set up an appointment. Thank you.
ACCEPTED BY: DATE:
INOTES I
SERVICES PERFORMED: ® Alarm Test . Drain Test ow Test ' O Walk Through ,,,' Annual Inspection 0 Other
This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 2005 J.F. Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT. rptlnspection_Anrural
6 v
.•leetric /Diesel Ahern Fire Protection
13705 26th Avenue, Suite 110
Fire Pump Test Minneapolis, MN 55441
HERN (763) 268 -0515 p • (763) 268 -0516 f
www.ahernfire.com • Since 1880
Invoice To: SHILO AUTOMATIC SPRINKLER EAST COAST OFFICE Phone #: (208) 466 -0006
- -- - - - - -- - - -- - - -- -_ -_ _ -
Street 2362 SPARTA ROAD City: NORTH WILKESBORO State: NC Zip: 28659-
LID: 3150313
Location: Lowe's #2315 Dept.:
- - -- - -- Work Order #: 854162
Street: 5888 Nova Scotia Ave N City: Oak Park Heights State: MN Zip: 55082
Phone #: (651) 275 -9910 Fax #: (651) 275 -9911 Foreman: Andy Zarbok Total Fire Pumps: 1
Date t Signature: ,
Electric Motor, and I Electric Motor I Diesel Engine I Pump Pressure Nozzlg /Size Pressure - gpm I a° I Total
Diesel Engine Rating Flow
TIME RPM VOLTS AMPS WATER OIL PRESS SUCT DISC NET F L OW
TEMP
1
f - Churn
2
t ;
3
:.
4
5
Are the values in the above table acceptable? .Yes ❑ No
Page 2 of 2 This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 1998 J.F. Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT. rptFirePump
. -- - .EleetrDiesel Ahern Fire Protection
13705 26th Avenue, Suite 110
Fire -sump Test Minneapolis, MN 55441
HERN (763) 268 -0515 p • (763) 268 -0516 f
www.ahernfire.com • Since 1880
Invoice To: SHILO AUTOMATIC SPRINKLER EAST COAST OFFICE Phone #: (208) 466 -0006
R
T
Street: 2362 SPARTA ROAD City: NORTH WILKESBORO State: NC Zip: 28659-
LID: 3150313
Location: Lowe's #2315 Dept.:
— _- Work Order #: 854162
-„
Street: 5888 Nova Scotia Ave N City: Oak Park Heights State: MN Zip: 55082
Phone #: (651) 275 -9910 Fax #: (651) 275 -9911 Foreman: Andy Zarbok Total Fire Pumps: 1
Date:: 1 -- r ' Signature: ,' - o.. --L __ _" .,
PUMP JOCKEY PUMP CONTROLLER J.P. CONTROLLER -
Manufacturer: - . __ - ---
Model: Manufacturer: _ •
Witnessed by: r • p. �.- Serial #: 0 , Model:
Capacity gpm Serial #:
Date: - ) ! ' psi
. -
S.O. gpm . `' : — Vol ta e:
PIPING __ _ _ _ p / f Elec H.P.: 1
Sensing Lines per NFPA 20? Size suction in.
Check Valves Suction Discharge Bypass} discharge in
In in In ELECTRIC MOTOR/DIESEL ENGINE J.P. ELECTRIC MOTOR i
OS Y Valves Suction Discharge Bypass' f
Manufacturer:
in in in .. Jockey Pump Cut in Pressure: Cut opt Pressure:
RPM: If J - / /1, l
Test Header: in. with e - - 2 1/2" Hose Valves Serial #: �; .T�T
Roof Manifold: 1 in Voltage: `tom / Fire Pump: Cut in Pressure: Cut out Pressure:
Elec Pump Casing Relief Valve in HP / rej f
Diesel Main Relief Valve NI \ in AMP: f �` Manual Stop: (:
Auto Air Release in Cycles: \ ry ) /" - 0
Gauges Phase: t f�_. l A uto Stop: ' . Timer ,-�'`" min
Suction Discharge System Model:
F. P. Electric Motor F. P. Diesel Engine - 10 Manual Starts and 10 Auto Starts required during initial setup.
•
Page 1 of 2 This document PROPERTY OF AHERN FIRE PROTECTION. Copyright 1998 J F Ahern Co. REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT. rptFirePump
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1 of 1 This document PROPERTY OF Ali ERN FIRE l'Itif fl Copyright 1998 1 F Ahem Co REPRODUCTIONS IN ANY FORM VIOLATES COPYRIGHT rptBlank Deficiency
Ahern Fire Protection DrylPreaction/
HERN
13'1'I�ii5'26t1rAvenue, Suite 110 Date:
Minneapolis, MN 55441 7/1/20854162 11
Work Order #:
(763) 268 -0515 p • (763) 268 -0516 f
www.ahernfire.com •Since 1880 Deluge Pipe
Valve Trip Test LID #: 3150313
Location: Lowe's #2315 Dept.:
Street: 5888 Nova Scotia Ave N City: Oak Park Heights State: MN Zip: 55082 1
Phone #: (651) 275 -9910 Fax #: 651) 275 -9911 Foreman: Andy Zarbok
Date: Signature:
System #: System #: System 6'
System Type: D System Type: Dry
Valve Serial #: Valve Serial #:
Manufacturer Name: `, ; ,, j Manufacturer Name: Tyco
Valve Model: Valve Model:
Valve' Size: - � te Valve Size: ' te' '
Controlling Sprinklers Location: t .n- Controlling Sprinklers Location: , '
i x� ! ' /.-1'� r -.VI 1 . 7'
Controlling Sprinklers Number: approx. Controlling S Number: approx
Date of Last System Pressure Test: Date of Last System Pressure Test:
(Must be done every 3rd Year) / , (Must be done every 3rd Year) .A,.
Date of Last Full -Flow Trip Test: Date of Last Full -Flow Trip Test:
(Must be done every 3rd Year) / , (Must be done every 3rd Year) — - --/
Date Last Operated: Date Last Operated:
Pressure Before Test - Air ^ 7% Ibs Pressure Before Test - Air .(--/ 0 lbs.
Pressure Before Test - Water j ; Ibs. Pressure Before Test - Water .' � e"""' lbs.
Size and Location of Test Valve: ' 1 r t /l ; Size and Location of Test Valve: L ; 2,r '
Was gate valve below dry valve open wide a'Ttest? (if not, how many turns ?) Was gate valve below dry valve open wide at test? (if not, how many turns ?)
Valve Tripped At - Air pressure / lbs. Valve Tripped At - Air pressure' J lbs.
Valve Tripped At - Water Pressure /, ! Ibs. Valve Tripped At - Water Pressure / ' �" -- lbs.
Valve Tripped At - Time min. e Aec. Valve Tripped At - Time min. /.:Sec.
If system flooded, list time water reached test opening. min. sec. If system flooded, list time water reached test opening. min. sec.
PERFORMANCE Poor Fair Nock, PERFORMANCE Poor Fair
Interior of Body Poor Fair Groo Inter of Body Poor Fair oo aIr Coed
Moving Parts Poor Fair Gc ' Moving Parts Poor Fair Goad`
Rubber Facing - ---, Fair QOd Rubber Facing . Fair G6d'
Seats i . 1 Poor Fair Ooci 6 \ Poor Fair G •
Reset? Ye "s - ; No N/A j Reset? ; No N/A i
Did alarms operate at trip test? Yes No N/A Did alarms operate at trip test? Yes.- No N/A
Have low point drains been emptied? # Yes , No N/A Have low point drains been emptied? # S( i No N/A
Water control valve left open and sealed? Yes No N/A Water control valve left open and sealed? No No N/A
Are the valves accessible? Yes) No N/A Are the valves accessible? (S
.y�,ggs_ No N/A
Are the valve enclosures heated adaquately? Yes _; No N/A Are the valve enclosures heated adaquately? 'Yee,---' No N/A
Interior of pipe that passes through freezers , .. .
Interior of pipe that passes through freezers ""
Yes No N /A / Yes No : N/A
free of ice blockage? - free of ice blockage?
Quick Opening Devices Quick Opening Devices
Device Serial #: Device Serial #:
Device Manufacturer Name: Y y t - Device Manufacturer Name:
Device Type and Model: °` _ � Device Type and Model: _ /
Air pressure in upper chamber / j ( lbs. Air pressure in upper chamber ( i r e) Ibs.
Quick opening device tripped at t sec. lbs. Quick opening device tripped at ,'(sec. lbs.
Quick opening device left in service, and control open aryl- sealed? Quick opening device left in service, and control open and sealed?
Yes. ` No N/A Yes No N/A
AIR COMPRESSOR 0 Plant 0 System O Manual 0 Automatic
Oil Level? Add Oil? Belt Tight? Belt Conditions?
Cuts In? lbs. Cuts Out? lbs. Tested? Reset? Yes No N/A
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