HomeMy WebLinkAbout2011-11-07 Summit Fire Protection Report of Inspection SUMMIT FIRE PROTECTION
1 575 MINNEHAHAAVE. W • ST. PAUL, MN 55103 • (651) 251 -1880 3 40TH AVE. NW • ROCHESTER, IMN'55901 • (507) 280 -0622
418 GREAT OAK DR., WAITE PARK, MN 56387 • (320) 257 -6390 760. LIBERTY WAY, NORTH LIBERTY, IA 52317 • (319) 665 -4330
4208 ENTERPRISE CIRCLE •DULUTH, MN 55811 • (218) 740 -4412 RECEIV i 6
SHE 1 OF 2 - u se se parate sheet for e ach buildin inspection REPORT OF INSPECTION p
MINNESOTA LICENSE NO. C0075 JOB NUMBER - ! 6 ? _ t
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( INSPECTION fC I BU ILDING&OCATION €
s $ Q/n 4 ac_ C INSPECTOR D ,r i
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OarratwIrSection (td be answered by Owner or Occupant) _
A. Explain any occupancy hazard changes since the previous inspection:
Y 4
B. Describe fire protection modifications made since last inspection: fA+.JTs y'A.tJs ',Lo'P -�
C. Describe any fires since last inspection:
D. When was the system piping last checked for stoppage, corrosion of foreign material?
E. When was the • i .in _ . tem last checked for14 per, pitch?
Signature Title Date
Inspector's Section (All responses reference current inspection) NA =NOT APPLICABLE
1. General
a. Is the building occupied ?PYes ❑ No
b. Are all systems in service'? Wes ❑ No
c. Is there a minimum of 18 in. (457 mm) clearance between the top of the storage and the sprinkler deflectors? Wes ❑ No
d. Does all electrical heat tape appear to be satisfactory? ❑Yes ❑ No 02.1A
e.. Does the hand hose or standpipe on the sprinkler system(s) appear to be satisfactory? ❑Yes ❑ No VPl:A
2. Control Valves (See Item 15.)
a. Are all sprinkler system control valves and all other valves in the appropriate open . closed lion? AaYes ❑. No
b. Are all control valves in the open - position locked, sealed or equipped with a rr ; . * es .C3 No
3. Tanks, Pumps, Fire Depat# ti+Con torus -
a. When was fire pump last tested for performance?
b. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition. and plrmaintained? Wes C} NoNA
k c. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight?- 'Ores ❑ No U NA
F Are they accessible and visible? p'i'es ❑ No ❑ NA
4. Wet Systems
a. Are cold weathe (O.S. & Y.) in the appropriate open or closed position? ❑Yes ❑ No WallA
4 b. Have an.' ze . s . solutions
, been tested? ❑Yes ❑ No j�NA
c. What tem. f . ... - +• .
d. In areas p . .. X47 wet system(s), does the building appear to be properly heated in all areas, including blind attics and perimeter areas
where acces ible Li es ❑ No 0 NA
5. Dry System (See Items 11 to 13)
a. Are dry valve(s) in service? pp/es ❑ No ❑ NA
b. Are the air pressures and priming water levels in accordance with the manufacturer's instructions ? ❑ NoU NA
c.,Has the operation of the air or nitrogen supplies been tested? es O No la NA Are they m service?Alrfes CI No ❑ NA
e. Did quick - opening devices operate satisfactorily? ❑Yes ❑ o A
f. Did the dry valve(s) trip properly during the trip pressure test? s El No ❑ NA
lit
g. Did the heating equipment in the dry-pipe valve room(s) opera at time of inspection ? Saes ❑ No ❑ NA
6. Special Systems (See Item 14.) ,
a. Did the deluge or pre-action v. ves .. -rate properly during testing? ❑Yes No 0 NA
b. Did the heat- responsive devi• s o. - , s 1'ro . ly during testing? ❑Yes ❑1N ONA
c. Did supervisory devices o. -, - *F (- sting? ❑Yes ❑ No ❑ NA
aw d. Did flow for kitchen hood s . " /s 11 .ff gas or electric? ❑Yes ❑ No ❑ NA
7. Alarms
a. Did water motor(s) and gong(s) test satisfactorily? ❑Yes ❑ NoiA
ilik b. Did electric alarm(s) test satisfactorily? Wiles ❑ No - 0 NA
c. Did supervisory alarm service test satisfactorily? OYes .0 No ❑ NA
d. Did'tamper switches test satisfactorily? , Yes .Q No ❑ NA
t: 8. Sprinklers - , ° _
..a.AAreallsprinklers free fronrsa ,)pp� uct to:sppa ?<ides CI No
b. Are Sprinklers less than 50 years old'? (Older sprinklers require sample testing)es ONO w Y ,
,, a Are quick response and residential sprinklers less than 20 years old? (Older sprinklers require -Sample testing) es: LINO .
d. Is stock of spare sp . ers available? Yes O No
e. Does the exteri. on' , on of sp ' system appear to be satisf tory? J es ❑ No
f. Are s .. of pro . - temperature rating for their locations? )es ❑ No
g. Are . - prinkler h- .. s . a recall list? ❑YesTo
Sign. .. -.: .' � - A sc J Date: �! / //
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SUIT FIRE PROTECTION
575 Minnehaha Ave. W. • St. Paul, MN 55103 651-251-1880 = 3026 40th Ave. NW • Rochester, MN 55901 • 507- 280 -0622
41$ Great Oak Dr. • Waite Park, MN 56387 • 320- 257 -6390 760 Liberty Way • North Liberty, IA 52317. 319- 665 -4330
4208 Enterprise Circle • Duluth, MN 55811 • 218 - 740 -4412 •
I�
;S IEET 2 OF 2 - U pa
rate s pste sheet or each system i coon tr Type of System �) / 4
poll Name &Pr f ` 11°Y' Many?
�/Q .J
iPectionWca Order ? J q what Size? -
- / - -Flow Switch.or Aiat Qherk with -
`_' 9. 1 va ve trip t este d. ( c ontrol vatve°pattially • open)' s •1 /;'"' 1 F _ Y ec:'Irtp T yisE Ta which fo i
0. I ctr valve trip tested (austral valve fully c e en) - ""'�' _ (ace` Tahleivhici: falio
,U3. Dt q ui c k- openin device tested wk **Trip Test Table which follows) }
DRY VALVE TRIP TEST TABLE Q.O.D. "
MAKE MODEL SERIAL NO. /1/i1/4(----
s� MODEL SERIAL NO.
5 "i a Z_ . 14- .---- f
DRY PIPE Time to Trip Water Pressure Air Pressure Reached Properly to
OPERATING Thru Test e Air P _ ressure Test Outlet
TEST Min sec. PSI PSI PSI Mtn. Sec. Yes o
Without
yr— 6 y iz ......0.............
With
12. Date deluge or preaclion valve tested AJ/ (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 1 stations? ' +U Yes ❑ No
VilLINES
Is there an eccessibk facility in each circuit for testing? No Method of Testing. Circuits:
T :.- M Loot OpC
M , �„� ^ D ch Circuit Operate Uee®' Circuit l to
won tate aive Release? ! ?
..; Yrs - No i . , }Yes
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3. See Control Valve 1 Lida ... n -:, T able : ; , r
o CONTROL VALVE MAINTENANCE TABLE
S i7.F. & OPEN SECURED CLOSED SIGNS EXPLAIN ABNORMAL CONDITIONS
4. CONTROL VALVES NUMBER City Connection Control Valve
4ockey Control Valve
Pump Control Valves
Additional Pump Control Valves
Test Header
Sectional . r ,1 Valves
— system Odor 'S ve3 y -.... .....- --' -- — ti r e- f - /
Other Control Valves
Kitchen Control Valve t. . _
Water Flow Teel a t / •
Water Supply Well Tank Pump
idoilp ,/
C ' ' v RESIDUAL; (51.UVfT
DATE TEST PIPE LOCATION Si7E OF TESL' P v PR& URE DIFFERENTIAL
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water Flow Test /O' ' ' s . '. K � . 'ltd - ..',
il t a
!:- 44, w aur Fl ow Test
/ / -- <. _ , ....
,.... t, , x , x - S P S �r
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Print Name , Signa ve !w Date / # � /