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HomeMy WebLinkAbout2005-11-30 Viking Automatic Sprinkler Co. Agreement & Report of Inspection 1301 LQRIENT STREET ST. P MINNESOTA 55117 (651) a _ -3300 • (800 )-229 -6263 } Am AUTOMATIC SPRINKLER CO. FAX: (651) 558 -3310 s - SHEET 1 OF 2 - Use separate sheet for each building inspection AGREEMENT & REPORT OF INSPECTION MINNESOTA LICENSE NO. C005 INSPECTION # 5 / 39 q S/ REPORT TO 0 & k R s d G e PLia C a ti BUILDING OR LOCATION S'' ' F STREET 6Q G © 0 y g Q i p f J , ,c.) - INSPECTOR P117 &g ,4 A 1 CITY & STATE 0o k Pc ,ti LC /1Q f " 4 is. , A 0 DATE i/ - 3,-') -05'- Owner 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, owner agrees to term and conditions on rear of form and will complete the Owner's Section of this document. ' , Owner's Section (To be answered by Owner or Occupant) .) e v L� A. Explain any occupancy hazard changes since the previous inspection: - 1 - 5 B. Describe fire protection modifications made since last inspection. . P, DEC 3 0 2005 LU 3 UJ C. Describe any fires since last inspection. Aj vA.) ? D. When was the system piping las . hecked for stoppage, corrosion or foreign material? 26 Vs a /t < E. When was the a . ip • s ste last checked for proper pitch? I of r F. Are dry valve • ..t r u. y p ted from freezing? ya 5 Signature i e'f -." Title Date Inspector's Secti l (All ; -posses reference current inspection) NA =NOT APPLICABLE 1. General - �r a. Is the building occupied? es ❑ No b. Are all systems in service? Es ❑ 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? ceVes, ❑ No ,;: d Does themaive hose on the spri ystan(s) appearsto be satisfactory? ❑ Yes ❑ No. OI►1A _ . _ 2. Control Valves (See Item 15.) a. Do sprinkler system control valves appear to be in the appropriate open or closed position? / Yes ❑ No b. Are control valves in the open position locked, sealed or equipped with a tamper switch ?0,Yes ❑ No 3. Water Supplies (See Item 16.) a. Was a water flow test of main drain made at the sprinkler riser(s) ?Yes ❑ No 4. Tanks, Pumps, Fire Department Connections a. Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and properly maintained? ❑ Yes ❑ No A b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight ?.Yes gro ❑ NA Are they accessible and visible ?Yes ❑ No ❑ NA 5. Wet Systems a. Are cold weather valves (O.S. & Y.) in the appropriate open or cl sed position? ❑ Yes ❑ No 'NA b. Have antifreeze system solutions been tested? ❑ Yes ❑ No NA c. Were the antifreeze test results satisfactory? ❑ Yes ❑ No A d. In areas protected tox wet system(s), does the building appear to be properly heated in all areas, including blind attics and perimeter areas where accessible? Yes ❑ No ❑ NA Do all exterior openings appear to be protected against freezing ?.Yes ❑ No ❑ NA 6. Dry System (See Items 11 to 13.)) a. Are dry valve(s) in service? 4wYes ❑ No ❑ NA b. Are the air pressures and priming water levels in accordance with the manufacturer's instructions? gYes ❑ No ❑ NA c. Has the operation of the air or nitrogen supplies been tested? (..Yes ❑ No ❑ NA Are they in service ?.Yes ❑ No ❑ NA d. Were all known low points drained during this inspection? ❑ Yes • No YNA e. Did quick - opening devices operate satisfactorily? ❑ Yes ❑ No r. A f. Did the dry valve(s) trip properly during the trip pressure test? " es ❑ No ❑ NA g. Did the heating equipment in the dry-pipe valve room(s) operate at time of inspection 90--Yes ❑ No ❑ NA 7. Special Systems (See Item 14.) a. Did the deluge or pre-action valves operate properly during testing? ❑ Yes ❑ No CANA b. Did the heat - responsive devices operate properly during testing? ❑ Yes ❑ No ( NA c. Did supervisory devices operate during testing? ❑ Yes ❑ No iftlIA 8. Alarms a. Did water motor(s) and gong(s) test satisfactorily? ❑ Yes ❑ No tANA b. Did electric alarm(s) test satisfactory? C`Yes ❑ No ❑ NA c. Did supervisory alarm service test satisfactory? $.Yes ❑ No ❑ NA 9. Sprinklers a. Do visible sprinklers appear to be free from corrosion, loading or obstruction to s ray discharge ? A.-Yes ❑ No b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing) rIres ❑ No c. Are quick response and residential sprinkers less than 20 years old? (Older sprinklers require sample testing) ❑ Yes ❑ No OANIA d. Is stock of spare sprinklers available? Wes ❑ 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? Wes ❑ No 10. Explain any "No" answer and comments: AO Signature: ......--- 1 ! j Date: /f "" 3 0 'Q C t"■ • Terms and Limitations 1. This Agreement is for inspection services only. If Suhseriber wants the Company to make " any repairs, alterations or replacements as a result of this inspection, the Company will do so for additional compensation to be agreed upon in writing by the parties. 2. The Company not now and does not represent whether the current fire protection system_ on the Property was originally designed and installed it 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 l.. used in was such that the configuration of partition walls, the location of and types of materials,(includirigthe of hazardous materials) and other conditions of the Property's use are such that. the .tire protection system As inadequate, insufficient or unsuitable for the Property. THIS REPORT IS NOT A GUARANTEE OR WARRANTY THAT THE SYSTEM WILL L. i\ ALL CASES (A) PROVIDE THE LEVEL OF PROTECTION FOR WHICH IT WAS ORIGINALLY INTENDED . c , IS FREE OF AIL DEFECTS AND DEFICIENCIES (C) AND IS IN COMPLIANCE WITH ALI . APPLICABLE CODES. 3 The Company's inspection will not inci!de ever=; sprinkler head. pipe or other parts of the fire protection sprinkler svPtim; that currently exist and is limited to a yisoal inspection of ea:_ier ral ! c idab: accessible p ' is ef the system. The Company shall only be obligated. to inspect a representative number 01 sample oi.iite sprinkleP l eads pipes hangars, valves or of er i4... :a and equipment in their current position. 4. The Company will be permitted. at all reasonable times, to enter the Property indicated above to conduct the inspection as outlined in this Agreement. 5. The Company 's xate liability arising out of its inspection services must be limited. THEREFORE, THE LIABILITY, IF ANY, OF THE COMPANY TO THE SUBSCRIBER AND /OR OTHER OCCUPANTS OR VISITORS OF THE PROPERT', r RISIN<< OUT OF THE COMPANY'S INSPECTION, REPORT. ACT OR OMISSION OR FAILURE TO ACT, OR ANY CLAIMED BREACH OF THIS AGREEMENT BY THE COMPANY, SHALL IN NO EVENT EXCEED THL IUi :A_L TEE PAID BY THE SUBSCRIBER FOR THE INSPECTION SERVICES THAT GIVE RISE IC) rANY 6. The Company :, following each inspection, will provide to the Subscriber a_ written "Report of Inspection`' ( "Report "). If .,hired by t tc or local cedes, the Company=-will provide a copy of the Report to fire and /or building officials. If desired, a copy of the Rol ».r_ will also be forwarded to the Subscriber's insurance company. The Report and recommendations by the Company are onhy advisory visory in nature and are intended to assist the Subscriber in reducing the possibility of loss to the Property by indicating obvious defects or impairments to the fire protection system(s) which were discovered by the Company's inspection and which should 'receive prompt attention. 7. Subscriber agrees to obtain and shad be solely responsible to maintain insurance for the Property. all contents therein, and /or operations performed within or around the Property to be inspected. 8. The Subscriber agrees to assume the entire responsibility and liability, to the fullest extent permitted bylaw; for all damages or injury to all persons, whether employees or otherwise, and to all property, arising out of it, resulting'` from or tit y manner connected With, the execution of the wort.; provided for in this Inspection Agreement or occurring or resulting from the use by the Company or in ,.gents or employees or materials, equipment, instrumentalities or other property, whether the same be owned by the Subs fiber, the Company or 'bin] p arties, and the Subscriber. to the fullest extent permitted by law. ag . indemnify and save harmless the Company , its agents and employees from all sartICtibirris iiietuding •With€ttt limiting the generality of the toie:_ninv, claims for which the Company may be or may be claimed to be, liable and legal tee and disbursements ents paid or incurred to enforce the provisions of this paragraph and the Subscriber further agrees to (obtain, !maintain and pay for such general liability insurance coverage and endorsements as will insure the provisions of this paragraph. 9. While the Company will nrakc every reasonable effort to prevent the discharge of water into or onto areas of ' landscaping, decorative pavement, etc., it is the Subscriber'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. 10. This Agreement may not be assigned by Subscriber without the written consent of the Company. 11. This Agreement may be signed in counterparts; a signed facsimile, photocopy, and /or electronic mail of this Agreement shall be as binding on both parties just as though this Agreement were executed in its original, pre - printed form. 12. If payment for work provided in this agreement is not paid when due, Subscriber agrees to pay all costs of collection including attorney's fees. 1301 L'ORIENT STREET G A P ST._, MINNESOTA 55117 (651, .A -3300 • (800)- 229 -6263 so. UTOMATIC SPRINKLER CO. FAX: (651) 558 -3310 STET 2 OF 2 - Use separate sheet for each system inspection System No. or Description if mvitiple systems / q)L - q , j Inspection Report /- c A u 4 I O Edi No. S l 3 2 9S/ 11. Date dry-pipe valve trip tested (control valve partially open) 11- 36') 5 (See Trip Test Table which follows) 12. Date dry-pipe valve trip tested (control valve fully open) 11 - g - 0 3 (See Trip Test Table which follows) 13. Date quick - opening device tested N 4- (See Trip Test Table which follows) DRY VALVE TRIP TEST TABLE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. few /? I_ X q 1 DRY PIPE Tema to Trip Water Air Trb, Pant Time Water Reached Alarm Operated OPERATING Thiu Test Pipe Pressure Pressure Air P ressu re Test Outlet TEST MIN. SEC. PSI PSI PSI MIN. SEC. YES , NO O.O.D. Without ) 25 9r2 3 9 /G `' With O.O.D. 14. Date deluge or preaction valve tested A) �" (See Trip Test Table which follows) TRIP TEST TABLE Operation ❑ PNEUMATIC ❑ ELECTRIC ❑ HYDRAULIC Piping Supervised ❑ YES ❑ NO I 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 fa lhty in each circuit for testing Method of testing - circuits VALVES ❑ YES ❑ NO Does each circuit operate Does each circuit Mapmum time to MAKE MODEL supervision loss alarm operate valve release operate release YES NO YES NO YES NO r 15. See Control Valve Maintenance Table. Control Valve Maintenance Table Abnormal Control Valves Number Type Open Secured Closed Igns Condition City Control Valves / ,- 4 1 Ostg V C 5 -05 v c Bypass Valves \ C 1, -- balc.Control Valves 1— V ) 3 / Q [ ( I I 1 t' 1, limp Control Valves I .—) j_ 6 '' 4 F 1 I f t v t Sectional Control Valves 3. 1/ ^' gthehr g , t 1 t t t zd a .. - System Control Valves 1- y N / F f t / 1 r+ MO Other Control Valves 1_ Y t I r I 1 + Kitchen Contra Valves 1- Z apt( ' t / t I I 16. Water Flow Test at Sprinkler Riser n Water Supply Source: Tank Pump Date Test Pipe Size of Static Residual Location Test Pipe Pressure (Flow) Pressure Last Water Flow Test // 1 . t, s e 4 2 r+ O 7 S This Water Flow Test 1 /-�$O R t 5•2 R - 2.+ 9 J Fj 17. Explain any "No" answers and comments: 18. Adjustments or corrections made during this inspection!' V t o P 14 C tn.] *Rat JA L J Q S ►,e ► Q- 'e C V .+,o = t y C— 19. Although these comments are not the result of an engineering review, the following desirable improvements are recommended: if r aTW iLM/ 01 f,ilIFTIMTILYNTAIIVITANIZ. e . A. Signature: 7 t .c't<J ' Date: 3 6 - 01 /- ' - r Terms and Limitations 1. This Agreement is for inspection services only. If Subscriber wants the Company to make any repairs, alterations or replacements as a result of this inspection, the Company will do so for additional compensation to be agreed upon m writing by the parties. 2. The Company does not know and does not represent whether the current fire protection system on the 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 he 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 REPORT 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. 3. The Company's inspection will not include every sprinkler head, pipe or other parts of the fire protection sprinkier system that currently exist and is limited to a visual inspection of external readily accessible parr of the system. The Company shall othy tie obligated to inspect a tcpreseatative number or .sample. of the sprinkler heads, pipes, Hangars, valves or_other u.vices and equipment in their current position. 4. The Company will be permitted, at all reasonable times, to enter the Property indicated above to conduct the inspection as outlined in this Agreement. 5. The Company's potential liability arising out of its inspection services must be limited. THEREFORE, THE LIABILITY, IF ANY. OF THE COMPANY TO THE SUBSCRIBER AND /OR OTHER OCCUPANTS OR VISITORS OF THE PROPERTY ARISING OUT OF THE COMPANY'S INSPECTION, REPORT. ACT OR OMISSION OR FAILURE TO ACT, OR ANY CLAIMED BREACH OF THIS AGREEMENT BY THE COMPANY, SHALL IN NO EVENT EXCEED THE TOTAL FEE PAID BY THE SUBSCRIBER FOR THE INSPECTION SERVICES THAT GIVE RISE TO ANY SUCH LIABILITY. 6. The Company, following each inspection, will provide to the Subscriber a written "Report of Inspection" ("Report"). If required by state or local codes, the Company will provide a copy of the Report to fire and /or building officials. If desired. a copy of the Report will also be forwarded to the Subscriber's insurance company. The Report and recommendations by the Company are only advisory in nature and are intended to assist the Subscriber in reducing the possibility of loss to the Property by indicating obvious defects or impairments to the fire protection system(s) which were discovered by the Company's inspection and which should receive prompt attention. 7. Subscriber agrees to obtain and shad be solely responsible to maintain insurance for the Property, all contents therein, and /or operations performed within or around the Property to be inspected. 8. The Subscriber 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 or otherwise, and to all property, arising out of it, resulting from or in any manner connected with, the execution of the work provided for in this Inspection Agreement or occurring or resulting from the use by the Company or its agents or employees or materials, equipment, instruinentalities or other property, whether the same be owned by the Subscriber. the Company or third parties, and the Subscriber. to the fullest extent permitted by law. agrees . to indemnify and save harmless the Company , its agents and employees = from all-such claims including, without -limiting the =— generality of the foregoing, claims for which the Company may be or may be claimed to be, liable and legal fee and disbursements paid or incurred to enforce the provisions of this paragraph and the Subscriber further agrees to ohtvii., maintain and pay for such general liability insurance coverage and endorsements as will insure the provisions of this paragraph. 9. 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 Subscriber'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. 10. This Agreement may not be assigned by Subscriber without the written consent of the Company. 11. This Agreement may be signed in counterparts: a signed facsimile, photocopy, and /or electronic mail of this Agreement shall be as binding on both parties just although this Agreement were executed in its original, pre-printed form. 12. If payment for work provided in this agreement is not paid when due, Subscriber agrees to pay all costs of collection including attorney's fees.