HomeMy WebLinkAboutMIS98-00151 Automatic Sprinkler Systems - MIS Inspections - 6/14/2004 000
EKERAID FM
CONFIDENCE TESTING
AUTOMATIC SPRINKLER SYSTEMS
► � ..
ddress �{l/vP� Nam. S1' Q'i", 3 P`�o,r �c� �rSo"Z-�j'
iccupied as
:uilding Owner Phoned
idress City Zip Code
ate of inspection Type of inspection: Annual_�_O Other
ester's Name (PLEASE PRINT) _ cL a�:j SFD Certification No.__r-4-oD(,R/
DRY SYSTEM:
1. Trip test (dry trip) conducted: . . . . . . . . . . . . . . . . . . . . Yes ❑ No ❑
System tripped in seconds.
2. All flow switches, supervisory switches
and alarm bells tested: . . . . . . . . . . . . . . . . . . . . . . . . . . Yes o ❑ N/A ❑
Static Pressure: psi
3. Alarm bell operates: . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes ❑ No ❑ N/A ❑
4. Flow tests conducted: . . . . . . . . . . . . . . . . . . . . . . . . . Yes ❑ No ❑
Flow pressure: psi
2-inch drain? . . . . . . . . . . . . . . . . . . . . . . . Yes ❑ No ❑
5. Systems inspected and I ridated: . . . . . . . . . . . . . . . . . Yes ❑ No ❑
6. Air compressor re ' system in 30 minutes: . . . . . . . . . . Yes ❑ No ❑
7. System dr i ed and restored to normal operation: . . . . . Yes ❑ No ❑
8. Were a heat actuation devices tested on
-action and deluge systems? . . . . . . . . . . . . . . . . . . . Yes ❑ No ❑
WET SYSTEM:
1. Flow test conducted: . . . . . . . . . . . . . . . . . . . . . . . . . . . Yes f0 No ❑
Static pressure: _psi
Flow pressure: _ _psi
2-inch drain? . . . . . . . Yes P No ❑ Other ❑
. . . . . . . . . . . . . . . . . . . . . . . . . .
2. Flow switches, supervisory switches
and alarm bells tested: . . . . . . . . . . . . . . . . . . . . . . . . . . Yes i No ❑ N/A ❑
3. Alarm bell operates: . . . . . . . . . . . . . . . . . . . . . Yes ( No ❑ N/A ❑
4. Systems inspected and lubricated Yes / No (.
5 Pressure regulating valves tested. IJ Yes ) No
RE: Automatic Sprinkler Svstems (continued):
General:
1 . Central Station monitoring? . . . . . . . . . . . . . . . . . ./. . . Yes No ❑
Name of Company
2. Location of sprinklers:
Basement Hallways 100%_Other
3. Pumper connections and clapper valves unobstructed: . Yes po No ❑
4. Sprinkler heads less than 50 years old: . . . . . . . . . . . . . Yes �a No ❑
5. Sprinkler coverage is acceptable: . . . . . . . . . . . . . . . . Yes � No ❑
6. Spare sprinkler heads are available: . . . . . . . . . . . . . . . . Yes 2 No ❑
7. Systems left in service: . . . . . . . . . . . . . . . . . . . . . . . . . . Ycs 5a No ❑
8. Valves are sealed or supervised: . . . . . . . . . . . . . . . . . . Yes �. No ❑
9. Signs are provided on valves: . . . . . . . . . . . . . . . . . . . . Yes No ❑
10. City static water pressure psi.
Problems found:
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dz • a D�i1 B �¢�lr✓ S 3 r� �rv�` � 3p/i4 �P� /1<'ac��
Corrections made:
Date corrected By
THIS IS TO CERTIFY THAT THE AUTOMATIC SPRINKLER SYSTEM HAS BEEN PROPERLY
TESTED AND INSPECTED FOR RELIABILITY TO COVER THE ITEMS LISTED IN THIS REPORT,
IS CONSISTENT WITH MANUFACTURER'S REQUIREMENTS, AND ALL CORRECTIONS HAVE
BEEN MADE.
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