HomeMy WebLinkAboutBP 2001-00009 Contractors Material & Test Certification for Above Ground Piping 13-66 INSTALLATION OF SPRINKLER SYSTEMS
P_
CONTRACTOR'S MATERIAL & TEST CERTIFICATE FOR ABOVEGROUND PIPING 0600
•
PROCEDURE
upon system left i is before contractors and tests shall be made by the contractors representative and witnessed by an owners representative. All defects shall be corrected and
rAntractors personnel finally leave the job.
A certificate shall be Idled out and signed by both representatives. Copies shall be prepared for approvirtg authorities. owners. and contractor. It is understood the owner's rep-
resentative's signature In no way pre((udicss any claim against contractor for faulty material. poor warbrrnship, or failure to s
local ordinances. comply with approving authority's requirements or
PROPERTY NAME a / r i i LA, / `r OATE�r, 2 ® -0/
PROPERTY ADDRESS r 7 7
ACCEP D BY APP OVI AUTHO IES (NAMES)
ADDRESS
PLANS
INSTALLATION CONFORMS TO ACCEPTED PLANS IVES O NO
EQUIPMENT USED IS APPROVED
IF NO. EXPLAIN DEVIATIONS ?YES ONO
HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION O YES O NO
OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT?
IF NO, EXPLAIN
INSTRUCTIONS
HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: 41•YES O NO
1. SYSTEM COMPONENTS INSTRUCTIONS tR YES O NO
2. CARE AND MAINTENANCE INSTRUCTIONS YES O NO
3. NFPA 13A If YES ONO
LOCATION SUPPLIES BUILDINGS
OF SYSTEM
YEAR OF ORIFICE TEMPERATURE
MAKE MODEL MANUFACTURE SIZE QUANTITY RATING
ReLit'%4 Fl Pr a 000 S 1 5 S
SPRINKLERS ` `. 4 � � A 6 ® /1 O
cc ; 4 1 1 1 J ' ,`elr.ti& 20 ' A. 3 / �'�
PIPE AND Type of Ppe � C Ri id / D X L
FITTINGS Type of Fittings /-
MAXIMUM TIME TO OPERATE
ALARM ALARM DEVICE THROUGH TEST CONNECTION
•
VALVE TYPE MAKE MODEL MIN. SEC.
OR FLOW / Q
INDICATOR /O Iv PO h-�e v J R- G
DRY VALVE O.O.D.
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
TIME TO TRIP TIME WATER ALARM
THRU TEST WATER AIR TRIP POINT REACHED OPERATED
DRY PIPE CONNECTION' PRESSURE PRESSURE AIR PRESSURE TEST OUTLET' PROPERLY •
OPERATING MIN. SEC. PSI PSI PSI MIN. SEC. YES NO
TEST
Without
O.O.D.
With
O.O.D.
•
IF NO, EXPLAIN
•
• MEASURED FROM TIME INSPECTOR'S TEST CONNECTION IS OPENED.
85A (10.88) PRINTED IN U.S.A. (OVER)
Figure 8 -1(a).
•
•
1991 Edition
SYSTEM ACCEPTANCE 13-67
OPERATION
O PNEUMATIC O ELECTRIC O HYDRAULIC
PIPING SUPERVISED 0 YES Cl NO 1 DETECTING MEDIA SUPERVISED O YES D NO
DOES VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL STATIONS O YES O NO
DELUGE & @ 4' I:A IL IN A '•' • - I I •, X• IN
PREACTION
VALVES 0 YES 0 NO
WES CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM I II-+ E
MAKE MODEL SUPERVISION LOSS ALARM OPERATE VALVE RELEASE OPERATE RELEASE
YES t NO YES NO MIN- SEC.
HYIIROSTATIC: Hydrostatic tests shall be lade at not less than 200 psi (13.8 bars) for two hours or 50 psi (3.4 bars) above static pressure in excess
o1150 pea (102 bars) to two tours. Differential dry -pipe valve dappere shall be left open during test to prevent damage. An aboveground piping leakage
TEST shall be slapped.
DESCRIPTION
pNF1 IMATX:• Estabish 40 psi (2.7 bars) all pressure and pleasure drop which shall not awed 1.1/2 psi (0.1 bars) in 24 hours. Test pressure
tanks at normal water level and as pressure and measure all pressure drop which shall not exceed 1 -1/2 psi (0.1 bars) in 24 hours.
ALL PIPING HYDROSTATICALLY TESTED ATaQOPSI FOR HRS. IF NO, STATE REASON
DRY PIPING PNEUMATICALLY TESTED 0 YES 0 NO
EQUIPMENT OPERATES PROPERLY O YES 0 NO
DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS. SODIUM SILICATE OR
DERIVATIVES OF SODIUM SILICATE. BRINE. OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR
TESTS STOPPING LEAKS? O YES O NO
DRAIN READING OF GAGE LOCATED NEAR WATER RESIDUAL PRESSURE WITH VALVE IN TEST
TEST SUPPLY TEST CONNECTION: PSI CONNECTION OPEN WIDE 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. 858 O YES O NO OTHER EXPLAIN
FLUSHED BY INSTALLER OF UNDER-
. GROUND SPRINKLER PIPING O YES 0 NO
BLANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED
GASKETS
WELDED PIPING O YES O NO
IF YES ...
DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES COMPLY
WITH THE REQUIREMENTS OF AT LEAST AWS 010.9, LEVEL AR -3 O YES O NO
DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN
WELDING COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS 010.9. LEVEL AR -3 O YES O NO
DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A
DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS ARE
RETRIEVED. THAT OPENINGS IN PIPING ARE SMOOTH. THAT SLOG AND OTHER
WELDING RESIDUE ARE REMOVED. AND THAT THE INTERNAL DIAMETERS OF
PIPING ARE NOT PENETRATED 0 YES 0 NO
CUTOUTS - DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL
(DISCS) CUTOUTS (DISCS) ARE RETRIEVED? Cl YES 0 NO
HYDRAULIC NAME PLATE PROVIDED IF NO. EXPLAIN
DATA
NAMEPLATE Fr YES 0 NO
DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: '..
REMARKS
NAME OF SPRINKLER CONTRACTOR
TESTS WITNESSED BY
SIGNATURES FO PER WNER (SIGN ).► I T 49 , D
I i�
6 ( � /f �IN ( KLERCONTR (SIGNED) _� TITLE (y � TE
ADDITIONAL EXPLANATION AND NOTES
85A BACK
Figure 8 -1(a) (cont.).
1991 Edition