HomeMy WebLinkAbout6001 SCHIRRA COURT25 -78 INSPECTION, TESTING, AND MAINTENANCE OF WATER -BASED FIRE PROTECTION SYSTEMS
Inspection, Testing, and, Maintenance Cover Sheet
NFPA 25 as amended by CCR, Title 19
Property Information:
F A`,A,0Name: S Occupancy /Use:
Address: %'aol S:-"141 ee Construction Type: rD
City: j Fj f.4i No. Stories:
ZIP: Year Constructed:
E MPQ
Contact:
Telephone:
Contractor Information: Number of System Risers
Jorgensen Company
Copy sent to:
2345 S. Fruitvale Ave., #1
x Owner Date
Bakersfield
ra:Fire AHJ Date
CA 93306
Contractor Date
661- 327 -4352
NOTES:
262995. 1) For specific inspection, testing, and
maintenance requirements and information,
see NFPA 25, 2002 Edition as amended by
Job # h' California Code of Regulations, Title 19, §901
to §906.
2) Inspection Items may be performed by the
Performed by:
Print)
Owner in accordance with California Code of
Regulations Title 19 §904.1(a)
Forms included with this report NFPA 25
Chapter Number of Forms NIA FAIL* PASS
Automatic Sprinkler System 5 7
Standpipe and Hose Systems 6
Private Water Supply System 7
Fire Pump g
Water Storage Tank 9
Water Spray System 10
Foam Water Sprinkler System 11
See "Deficiencies and Comments" section at end of each respective form.
State Fire Marshal AES 1 March 21, 2006
ANNEX B 25 -79
Main Drain Test Results:
Inspection, Testing, and Maintenance Fire Sprinkler System
NFPA 25, Chapter 5*as amended b CCR, Titie 19
Page 1 of 4
Date of Inspection, Testing, Maintenance: System Riser ID: ls j
Property Information:
E
M = Maintenance
Residual Pressure: (psi)
Name: i DS Type of System:
LB Wet Pipe
Dry PipeDPie
o -[i, .
0/ Address: 0 S/-/ Y C/` l 11 Preaction N
Description NFPA 25
Reverence
Deluge
ARE MP
City: 226
1.1 1 Daily Preaction /Deluge Valves - Enclosure
Main Drain Test Results: Abbreviation Key:
I = Inspection
Initial Static Pressure: (psi) T = Test
E
M = Maintenance
Residual Pressure: (psi) A -O = After Operation
MI =Per Manufacturer's Instructions
Restored Static Pressure: (psi)
Item Activity Frequency Description NFPA 25
Reverence Fail N/A Pass
1.1 1 Daily Preaction /Deluge Valves - Enclosure 12.4.3.1Weeklytemperature
1.2 1 Daily Dry Pipe Valves - Enclosure 12.4.4.1.1 NC` Weekly temperature
1.3 1 Quarterly Gauges (Dry, Preaction, Deluge 5.2.4.2
Systems) 5.2.4.3
1.4 1 Quarterly Control Valves 12.3.2:1
1.5 1 Quarterly Alarm Devices 5.2.6
1.6 1 Quarterly Gauges (Wet Pipe Systems) 5.2.4.1
1.7 1 Quarterly Hydraulic nameplate 5.2.7
1.8 1 Quarterly Pipe and Fittings 5.2.2
1.9 1 Quarterly Sprinklers 5.2.1
1.10 1 Quarterly Spare Sprinklers 5.2.1.3
1.11 1 Quarterly Fire Department Connections 12.7.1
1.12 1 Quarterly Alarm Valves - Exterior Inspection 12.4.1.1 y
1.13 1 Quarterly Preaction /Deluge Valves - Exterior 12.4.3.1.6Inspection
1.14 1 Quarterly Pressure Reducing Valves 12.5.1.1 X
1.15 1 Quarterly Dry Pipe Valves- Exterior Inspection 12.4.4.1.4
1.16 1 Quarterly Backflow Preventers 12.6.1 Y
1.17 1 Annually Buildings 5.2.5
State Fire Marshal AES 2 March 21, 2006
25 -80 INSPECTION, TESTING, AND MAINTENANCE OF WATER -BASED FIRE PROTECTION SYSTEMS
Inspection, 'testing, and Maintenance Fire Sprinkler System Page 2 of 4
NFPA 25, Chapter 5 as amended b CCR, TItie '19
Date of Inspection, Testing, Maintenance: -- _ System Riser ID: L j
Property Information:
Name: /
Type of System: o
Wet Pipe ,.Q
Address: yf _S , f / /'0 Dry Pipe iPreaction
Deluge
City:
Item Activity Frequency Description NFPA 25
Reference Fail N/A Pass
1.18 1 Annually Hangers 5.2.3 X
1.19 1 Annually Seismic Braces 5.2.3
1.20 1 5 Years Hangers (Accessible concealed spaces) 5.2.3.3
1.21 1 5 Years Seismic Braces (Accessible concealed 5.2.3.3spaces)
1.22 1 5 Years Pipe and Fittings (Accessible concealed 5.2.2.3spaces)
1.23 1 5 Years Sprinklers (Accessible concealed spaces) 5.2.1.1.4
1.24 1 5 Years Alarm Valves — Interior Inspection 12.4.1.2
1.25 1 5 Years Alarm Valves - Strainers, filters, orifices 12.4.1.2
1.26 1 5 Years Check Valves — Interior Inspection 12.4.2.1
1.27 1 5 Years Preaction /Deluge Valves — Interior 12.4.3.1.7Inspection
1.28 1 5 Years Preaction/Deluge Valves - Strainers, 12.4.3.1.8filters, orifices
1.29 1 5 Years Dry Pipe Valves — Interior Inspection 12.4.4.1.5
1.30 1 5 Years Dry Pipe Valves - Strainers, filters, orifices 12.4.4.1.6 x
2.1 T Annually Alarm Devices (90 Sec) 5.3.3
12.2.7
12.2.6
2.2 T Annually Main Drain Test (Enterdata on Page 1) 12.2.6.1
12.3.3.4
2.3 T Annually Antifreeze Test 5.3.4
2.4 T Annually Control Valve - Position 12.3.3.1
2.5 T Annually Control Valve— Operation 12.3.3.1
2.6 T Annually Supervisory 12.3.3.5
2.7 T Annually Preaction Valve — Priming Water 12.4.3.2.1
2.8 T Annually Preaction Valve — Low Air Pressure Alarm 12.4.3.2.10
2.9 T Annually Preaction Valve — Full Flow Trip Test 12.4.3.2.2 7C
State Fire Marshal AES 2 March 21, 2006
ANNEX .B 25 -81
Inspection, Testing, and Maintenance Fire Sprinkler System Page 3 of 4
NFPA 25, Chapter 6 as amended h CCR, Title 19
Date of Inspection, Testing, Maintenance: — y—r/ System Riser ID:
Property Information:
Name:
Type of System: oV: C c oarWetPipe r (j'
Ij, \
op
Dry PipeAddress: e;cx / J f j'G'y Preaction
Deluge 4F`, i5Xq
City:IGESh
Item Activity Frequency Description NFPA 25
Reference Fail NIA Pass
2.10 T Annually Dry Pipe Valve — Priming Water 12.4.4.2.1
2.11 T Annually Valve — Low Air Pressure 12.4.4.2.6Aarm'
pe
C
2.12 T Annual) y Dry Pipe Valve — Quick - Opening 12.4.4.2.4Device
2.13 T Annually Dry Pipe Valve — Trip Test 12.4.4.2.2
2.14 T Annually Back-flow Preventer Assemblies 12.6.2
2.15 T 3 Years Dry Pipe Valve — Full Flow Trip Test 12.4.4.2.2.2
2.16 T 5 Years Gauges 5.3.2'
2.17 T 5 Years Pressure Reducing Valve 12.5.1.2 js
2.18 T 5 Years Fire Department Connection Backflush 12.7.4
2.19 T 5 Years Sprinklers — Extra High Temperature 5.3.1.1.1.3
2.20 T 5 Years Sprinklers — Corrosive environment or 5.3.1.1.2corrosivewater
2.21 T 10 Years Sprinklers - Dry 5.3.1.1.1.5
2.22 T 20 Years Sprinklers - Fast Response 5.3.1.1.1.2-
2.23 T 50 Years Sprinklers 5.3.1.1.1
2.24 T 75 Years Sprinklers 75 years in service 5.3.1.1.1.4
2.25 T Sprinklers manufactured prior to 1920 5.3.1.1.1.1Replace
3.1 M Annually Control Valves 12.3.4
3.2 M Annually Preaction /Deluge Valves 12.4.3.3.2
3.3 M Annually Valves/Quick-Opening 12.4.4.3.2Devices
3.4 M Annually Dry Pipe Valve — Low Point Drains 12.4.4.3.3
3.5 M 5 Years Obstruction Investigation Chapter 13
State Fire Marshal AES 2 March 21, 2006
25 -82 INSPECTION, TESTING, AND MAINTENANCE OF WATER-BASED FIRE PROTECTION SYSTEMS
Item
inspection, Testing, and Maintenance Fire Sprinkler System Page 4 of 4
NFPA 25, Chapter 5 as amended b CCR, Title 19
Date of Inspection, Testing, Maintenance: System Riser ID: 1X.17.
Property information:
Name:
Type of System:
lglwet Pipe
0F < <,
Address: fC C' Dry Pipe co `p
Deluge
City: ins
Item
Deficiencies and Comments:
Deficiencies and Comments Item number must correspond to the Item number
of the Activity listed above:
i
See Continuation Page(s) (Indicate the number of continuation pages)
p, -PASS
Cl FAIL
Signature Date
J
State Fire Marshal AES 2 March 21, 2006
ANNEX B 25 -79
Inspection, Testing, and Maintenance Fire Sprinkler System Page 1 of 4
NFPA 25, Chapter 5 as amended b CCR, Title '19
Date of Inspection, Testing, Maintenance: System Riser ID:. °r/ -3
Property Information:
Initial Static Pressure: (psi)
Name: --
Address: / G j -rr C
Type of System: .01
N-Wet
Dry PPfipe
y
P
Preaction •,.
M = Maintenance
Deluge
F /RE MPS''
A -O = After Operation
Restored Static Pressure:i
Main Drain Test Results: Abbreviation Key:
I = Inspection
Initial Static Pressure: (psi) T = Test
M = Maintenance
Residual Pressure: -S (psi) A -O = After Operation
Restored Static Pressure:i
MI = Per Manufacturer's Instructions
psi)
Item Activity Frequency Description NFPA 25
Reference Fail N/A Pass
1.1 1 Daily Preaction /Deluge. Valves - Enclosure 12.4.3.1Weeklytemperature
1.2 1 Daily Dry Pipe Valves - Enclosure 12.4.4.1.1Weeklytemperature
1.3 1 Quarterly Gauges (Dry, Preaction, Deluge 5.2.4.2
Systems) 5.2.4.3-
1.4 1 Quarterly Control Valves 12.3.2.1
1.5 1 Quarterly Alarm Devices 5.2.6 jr
1.6 1 Quarterly Gauges (Wet Pipe Systems) 5.2.4.1
1.7 1 Quarterly Hydraulic nameplate 5.2.7
1.8 1 Quarterly Pipe and Fittings 5.2.2
1.9 1 Quarterly Sprinklers 5.2.1
1.10 1 Quarterly Spare Sprinklers 5.2.1.3
1.11 1 Quarterly Fire Department Connections 12.7.1
1.12 1 Quarterly Alarm Valves - Exterior Inspection 12.4.1.1 Y
1.13 1 Quarterly Preaction /Deluge Valves - Exterior 12.4.3.1.6Inspection
1.14 1 Quarterly Pressure Reducing Valves 12.5.1.1
1.15 1 Quarterly Dry Pipe Valves - Exterior Inspection 12.4.4.1.4
1.16 1 Quarterly Backflow Preventers 12.6.1
1.17 1 Annually Buildings 5.2.5
State Fire Marshal AES 2 March 21, 2006
25 -80 INSPECTION, TESTING, AND MAINTENANCE OF WATER -BASED FIRE PROTECTION SYSTEMS
Inspection, Testing, and Maintenance Fire Sprinkler System Page 2 of 4
NFPA 25, Chapter 5 as amended by CCR, Title 19
Date of Inspection, Testing, Maintenance: System Riser ID:G' -3
Property Information:
Type of System:
Name: , et Pipe rAF'i °92
Address: 46a 1' SGf rJ G Dry P co;' D Pie
1PreactionN„\.,
13 Deluge 9TF'._' Fil?E MP4'
City: lrrry c
Item Activity Frequency Description NFPA 25
Reference Fail N/A Pass
1.18 1 Annually Hangers 5.2.3
1.19 1 Annually Seismic Braces 5.2.3
1.20 1 5 Years Hangers (Accessible concealed spaces) 5.2.3.3
1.21 1 5 Years Seismic Braces (Accessible concealed 5.2.3.3
spaces)
1.22 1 5 Years Pipe and Fittings (Accessible concealed 5.2.2.3spaces)
1.23 1 5 Years Sprinklers (Accessible concealed spaces) 5.2.1.1.4-
1.24 1 5 Years Alarm Valves - Interior Inspection 12.4.1.2
1.25 1 5 Years Alarm Valves - Strainers, filters, orifices 12.4.1.2
1.26 I 5 Years Check Valves - Interior Inspection 12.4.2.1 Nc-
1.27 1 5 Years Preaction/Deluge Valves - Interior 12.4.3.1.7Insection Y"
1.28 1 5 Years Preaction/Deluge Valves - Strainers, 12.4.3.1.8filters, orifices
1.29 1 5 Years Dry Pipe Valves - Interior Inspection 12.4.4.1.5 c,
1.30 1 5 Years Dry Pipe Valves - Strainers, filters, orifices 12.4.4.1.6
2.1 T Annually Alarm Devices (90 Sec) 5.3.3
12.2.7
12.2.6
2.2 T Annually Main Drain Test (Enterdata on Page 1) 12.2.6.1
12.3.3.4
2.3 T Annually Antifreeze Test 5.3.4
2.4 T Annually Control Valve - Position 12.3.3.1
2.5 T Annually Control Valve - Operation 12.3.3.1-
2.6 T Annually Supervisory 12.3.3.5 j-
2.7 T Annually Preaction Valve - Priming Water 12.4.3.2.1
2.8 T Annually Preaction Valve - Low Air Pressure Alarm 12.4.3.2.10
2.9 T Annually Preaction Valve - Full Flow Trip Test 12.4.3.2.2
State Fire Marshal AES 2 March 21, 2006
113r 1217.`f 25 -81
Inspection, Testing, and Maintenance Fire Sprinkler System Page 3 of 4
NFPA 25, Chapter 5 as amended by CCR, Title 19
Date of Inspection, Testing, Maintenance: 02 _5_11 System Riser ID: "0 -3
Property Information:
Name:
Type of System: o
V-Wet Pipe Q/ °9 jtej'
Dry Pipe ' InAddress: Preaction
Deluge
ARE MPQ
City:
Item Activity Frequency Description NFPA 25
Reference Fail N/A Pass
2.10 T Annually Dry Pipe Valve — Priming Water 12.4.4.2.1
2.11 T Annually Dry Pipe Valve — Low Air Pressure 12.4.4.2.6Alarm
2.12 T Annuallyy ry Pipe Valve — Quick - Opening 12.4.4.2.4Device
2.13 T Annually Dry Pipe Valve — Trip Test 12.4.4.2.2
2.14 T Annually Backflow Preventer Assemblies 12.6.2
2.15 T 3 Years Dry Pipe Valve — Full Flow Trip Test 12.4.4.2.2.2
2.16 T 5 Years Gauges 5.3.2
2.17 T 5 Years Pressure Reducing Valve 12.5.1.2
2.18 T 5 Years Fire Department Connection Backflush 12.7.4
2.19 T 5 Years Sprinklers — Extra High Temperature 5.3.1.1.1.3
2.20 T 5 Years Sprinklers — Corrosive environment or 5.3.1.1.2corrosivewater
2.21 T 10 Years Sprinklers - Dry 5.3.1.1.1.5
2.22 T 20 Years Sprinklers - Fast Response 5.3.1.1.1.2
2.23 T 50 Years Sprinklers 5.3.1.1.1
2.24 T 75 Years Sprinklers 75 years in service 5.3.1.1.1.4
2.25 _ T Sri manufactured prior to 1920 5.3.1.1.1.1lace
3.1 M Annually Control Valves 12.3.4
3.2 M Annually Preaction /Deluge Valves 12.4.3.3.2
3.3 M Annually Dry Pipe Valves /Quick- Opening 12.4.4.3.2Devices
3.4 M Annually Dry Pipe Valve — Low Point Drains 12.4.4.3.3
3.5 M 5 Years Obstruction Investigation Chapter 13'
State Fire Marshal AES 2 March 21, 2006
25 -82 INSPECTION, TESTING, AND MAINTENANCE OF WATER -BASED FIRE PROTECTION SYSTEMS
Inspection, Testing, and Maintenance Fire Sprinkler System
NFPA 26, Chapter 5 as amended b CCR, Title 19
Page 4 of 4
Date of Inspection, Testing, Maintenance: System Riser ID:
Property Information:
Name:'
Type of System:
Wet Pipe
c
F- 'Q
09
Address: r/ J ' /v'N a Cj Dry Pipe
Preaction
Deluge
City:
Item
Deficiencies and Comments:
Deficiencies and Comments Item number must correspond to the Item number
of the Activity listed above:
i LF1
See Continuation Page(s) c.) (indicate the number of continuation pages)
ePASS
FAIL
Si nature Date
State Fire Marshal AES 2 March 21, 2006
ANNEX B 25 -79
Inspection, Testing, and Maintenance Fire Sprinkler System Page I of 4
NFPA 25, Chapter 5' as amended b CCR, Title 19
Abbreviation Key:
System Riser ID:
I = Inspection
Date of Inspection, Testing, Maintenance:
T = Test
Property Information:
Name: , S- Type of System:
o9 ?J
Address:
1Net Pipe
Dry Pipe
QCQ,
Preaction
Frequency
Deluge
ARE MPF'
City:
N/A Pass
1.1 1 Daily
Main Drain Test Results: Abbreviation Key:
I = Inspection
Initial Static Pressure: (psi) T = Test
M = Maintenance
Residual Pressure: .z (psi) A -0 = After Operation
MI =Per Manufacturer's Instructions
Restored Static Pressure: (psi)
Item Activity Frequency Description NFPA 25
Reference Fail N/A Pass
1.1 1 Daily Preaction /Deluge Valves — Enclosure 12.4.3.1Weeklytemperature
1.2 1 Daily Dry Pipe Valves — Enclosure 12.4.4.1.1Weeklytemperature
1.3 I Quarterly Gauges (Dry, Preaction, Deluge 5.2.4.2
Systems) 5.2.4.3
1.4 1 Quarterly Control Valves 12.3.2.1
1.5 1 Quarterly Alarm Devices 5.2.6
1.6 1 Quarterly Gauges (Wet Pipe Systems) 5.2.4.1
1.7 1 Quarterly Hydraulic nameplate 5.2.7 X
1.8 1 Quarterly Pipe and Fittings 5.2.2
1.9 1 Quarterly Sprinklers 5.2.1
1.10 1 Quarterly Spare Sprinklers 5.2.1.3
1.11 1 Quarterly Fire Department Connections 12.7.1
1.12 1 Quarterly Alarm Valves — Exterior Inspection 12.4.1.1
1.13 1 Quarter) Quarterly
Preaction /Deluge Valves — Exterior 12.4.3.1.6Inspection
1.14 1 Quarterly Pressure Reducing Valves 12.5.1.1
1.15 1 Quarterly Dry Pipe Valves — Exterior Inspection 12.4.4.1.4
1.16 1 Quarterly Backflow Preventers 12.6.1
1.17 1 Annually Buildings 5.2.5
State Fire Marshal AES 2 March 21, 2006
25 -80 INSPECTION, TESTING, AND MAINTENANCE OF WATER -BASED FIRE PROTECTION SYSTEMS
Inspection, Vesting, and Maintenance Fire Sprinkler System Page 2 of 4
NFPA 25, Chapter 5 as amended b CCR, Title 19
Date of Inspection, Testing, Maintenance:1 System Riser ID:
Property Information:
F-- Type of System:
Name: Wet Pipe
CO!,
Address: 66 11 Dry Pipe
Preaction NT \9JAte•, IV
Deluge
p
City: X1 J
Item Activity Frequency Description NFPA 25
Reference Fail N/A Pass
1.18 1 Annually Hangers 5.2.3
1.19 1 Annually Seismic Braces 5.2.3
1.20 1 5 Years Hangers (Accessible concealed spaces) 5.2.3.3
1.21 1 5 Years Seismic Braces (Accessible concealed 5.2.3.3spaces)
1.22 1 5 Years Pipe and Fittings (Accessible concealed 5.2.2.3spaces)
1.23 1 5 Years Sprinklers (Accessible concealed spaces) 5.2.1.1.4
1.24 1 5 Years Alarm Valves — Interior Inspection 12.4.1.2
1.25 1 5 Years Alarm Valves - Strainers, filters, orifices 12.4.1.2
1.26 1 5 Years Check Valves— Interior Inspection 12.4.2.1
1.27 1 5 Years Preaction/Deluge Valves — Interior 12.4.3.1.7Inspection
1.28 1 5 Years Preaction/Deluge Valves - Strainers, 12.4.3.1.8filters, orifices
1.29 1 5 Years Dry Pipe Valves — Interior Inspection 12.4.4.1.5 A
1.30 1 5 Years Dry Pipe Valves - Strainers, filters, orifices 12.4.4.1.6
2.1 T Annually Alarm Devices (90 Sec) 5.3.3
12.2.7
12.2.6
2.2 T Annually Main Drain Test (Enter data on Page 1) 12.2.6.1
12.3.3.4
2.3 T Annually Antifreeze Test 5.3.4
2.4 T Annually Control Valve - Position 12.3.3.1
2.5 T Annually Control Valve — Operation 12.3.3.1 j(
2.6 T Annually Supervisory 12.3.3.5
2.7 T Annually Preaction Valve — Priming Water 12.4.3.2.1
2.8 T Annually Preaction Valve — Low Air Pressure Alarrn 12.4.3.2.10
2.9 T Annually Preaction Valve — Full Flow Trip Test . 12.4.3.2.2
State Fire Marshal AES 2 March 21, 2006
ANNEX B 25 -81
Inspection, Testing, and Maintenance Fire Sprinkler System Page 3 of 4
NFPA 25, Chapter 5 as amended by CCR, Title 19
Date of Inspection, Testing, Maintenance: —
Property Information:
f
Name:
Address: 116 S C —
City:s = =-,
System Riser ID:
Type of System: 1
Wet Pipe h
Dry Pipe ,
i '` .
Preaction
Deluge
RE MP
Item Activity Frequency Description NFPA 25
Reference Fail N/A Pass
2.10 T Annually Dry Pipe Valve — Priming Water 12.4.4.2.1
2.11 T Annuallyy ry Pipe Valve — Low Air Pressure
Alarm 12.4.4.2.6
2.12 T Annuallyy ry Pipe Valve — Quick - Opening
Device 12.4.4.2.4
2.13 T Annually Dry Pipe Valve — Trip Test 12.4.4.2.2
2.14 T Annually Backflow Preventer Assemblies 12.6.2
2.15 T 3 Years Dry Pipe Valve — Full Flow Trip Test 12.4.4.2.2.2
2.16 T 5 Years Gauges 5.3.2
2.17 T 5 Years Pressure Reducing Valve 12.5.1.2
2.18 T 5 Years Fire Department Connection Backflush 12.7.4
2.19 T 5 Years Sprinklers — Extra High Temperature 5.3.1.1.1.3
2.20 T 5 Years Sprinklers — Corrosive environment or
corrosive water 5.3.1.1.2
2.21 T 10 Years Sprinklers - Dry 53.1.1.1.5
2.22 T 20 Years Sprinklers - Fast Response 5.3.1.1.1.2 x
2.23 T 5b Years Sprinklers 5.3.1.1.1
2.24 T 75 Years Sprinklers 75 years in service 5.3.1.1.1.4
2.25 T Sprinklers manufactured prior to 1920
Replace 5.3.1.1.1.1
3.1 M Annually Control Valves 12.3.4
3.2 M Annually Preaction /Deluge Valves 12.4.3.3.2
3.3 M Annually Dry Pipe Valves /Quick- Opening
Devices 12.4.4.3.2
3.4 M Annually Dry Pipe Valve — Low Point Drains 12.4.4.3.3
3.5 M 5 Years Obstruction Investigation Chapter 13
State Fire Marshal AES 2 March 21, 2006
25 -32 INSPECTION, TESTING, AND MAINTENANCE OF WATER -BASED FIRE PROTECTION SYSTEMS
Inspection, Testing, and Maintenance Fire Sprinkler System
NFPA 25, Chap-ter 5 as by CCR, Title 19
Page 4 of 4
amended
Date of Inspection, Testing, Maintenance: <
ol
System Riser ID:
Property Information:
Type of System:
Name: Wet Pipe
oF
Address: OCR( f}- Dry Pipe is j1: Preaction N,. , ')
Deluge
city:
Item
Deficiencies and Comments:
Deficiencies and Comments Item number must correspond to the Item number
of the Activity listed above:
See Continuation Page(s) ndicate the number of continuation pages)
ASS
FAIL .._.
Si nature Date
State Fire Marshal AES 2 March 21, 2006
ANNEX B 25 -79
Inspection, Testing, and Maintenance Fire Sprinkler System
NFPA 25, Chapter 5-as b CCR, 'title 19
Page 1 of 4
amended
Date of Inspection, Testing, Maintenance: l `l System Riser ID:
Initial Static Pressure: lJ (psi)
Property Information:
Type of System:
M = Maintenance
Name: /-57(4 Wet Pipe
Dry Pipe aAddress: tom! SV 12, 2 1
Restored Static Pressure: (psi)
Preaction
pc
Activity
Deluge
RE M
City:
Fail N/A
Main Drain Test Results: Abbreviation Key:
nn I = Inspection
Initial Static Pressure: lJ (psi) T = Test
M = Maintenance
Residual Pressure: (psi) A -O = After Operation
77 MI =Per Manufacturer's Instructions
Restored Static Pressure: (psi)
Item Activity Frequency Description NFPA 25
Reference Fail N/A Pass
1.1 I Daily Preaction /Deluge Valves – Enclosure 12.4.3.1Weeklytemperature
1.2 1 Daily Dry Pipe Valves – Enclosure 12.4.4.1.1Weeklytemperature
1.3 1 Quarterly Gauges (Dry, Preaction, Deluge 5.2.4.2
Systems) 5.2.4.3 J
1.4 1 Quarterly Control Valves 12.3.2.1
1.5 1 Quarterly Alarm Devices 5.2.6
1.6 1 Quarterly Gauges (Wet Pipe Systems) 5.2.4.1
1.7 1 Quarterly Hydraulic nameplate 5.2.7
1.8 1 Quarterly Pipe and Fittings 5.2.2
1.9 1 Quarterly Sprinklers 5.2.1
1.10 1 Quarterly Spare Sprinklers 5.2.1.3
1.11 1 Quarterly Fire Department Connections 12.7.1
1.12 1 Quarterly Alarm Valves – Exterior Inspection 12.4.1.1
1.13 1 Quarterly Preaction /Deluge Valves – Exterior 12.4.3.1.6Inspection
1.14 1 Quarterly Pressure Reducing Valves 12.5.1.1
1.15 1 Quarterly Dry Pipe Valves – Exterior Inspection 12.4.4.1.4
1.16 1 Quarterly Backflow Preventers 12.6.1
1.17 1 Annually Buildings 5.2.5
State Fire Marshal AES 2 March 21, 2006
25 -80 INSPECTION, TESTING, AND MAINTENANCE OF WATER -BASED FIRE PROTECTION SYSTEMS
Inspection, Testing, and Maintenance Fire Sprinkler System page 2 of4
NFPA 25, Chapter 5 as amended by CCR, Title 19
Date of Inspection, Testing, Maintenance: System Riser ID:
Property Information:
hh
Name: J.
Type System: °— c— A,
co 1, Wet Pipe
Address: Dry Pipe rr #n.
Preaction .,,T``aDeluge
n
City: 6K F IE(J)
Item Activity Frequency Description NFPA 25
Reference Fail N/A Pass
1.18 1 Annually Hangers 5.2.3
1.19 1 Annually Seismic Braces 5.2.3
1.20 1 5 Years Hangers (Accessible concealed spaces) 5.2.3.3
1.21 1 5 Years Seismic Braces (Accessible concealed 5.2.3.3spaces)
1.22 1 5 Years Pipe and Fittings (Accessible concealed 5.2.2.3spaces)
1.23 1 5 Years Sprinklers (Accessible concealed spaces) 5.2.1.1.4
1.24 1 5 Years Alarm Valves — Interior Inspection 12.4.1.2
1.25 1 5 Years Alarm Valves - Strainers, filters, orifices 12.4.1.2
1.26 1 5 Years Check Valves — Interior Inspection 12.4.2.1
1.27 1 5 Years Preaction/Deluge Valves — Interior 12.4.3.1.7Inspection
1.28 1 5 Years Preaction/Deluge Valves - Strainers, 12.4.3.1.8filters, orifices
1.29 1 5 Years Dry Pipe Valves — Interior Inspection 12.4.4.1.5
1.30 1 5 Years Dry Pipe Valves - Strainers, filters, orifices 12.4.4.1.6 x
2.1 T Annually Alarm Devices (90 Sec) 5.3.3
12.2.7
2.2 T Annually Main Drain Test (Enterdata on Page 7)
12.2.6
12.2.6.1
12.3.3.4
2.3 T Annually Antifreeze Test 5.3.4
2.4 T Annually Control Valve - Position 12.3.3.1
2.5 T Annually Control Valve— Operation 12.3.3.1
2.6 T Annually Supervisory 12.3.3.5
2.7 T Annually Preaction Valve — Priming Water 12.4.3.2.1
2.8 T Annually Preaction Valve — Low Air Pressure Alarm 12.4.3.2.10
2.9 T Annually Preaction Valve — Full Flow Trip Test . 12.4.3.2.2
State Fire Marshal AES 2 March 21, 2006
ANNEX B 25 -81
Inspection, Testing, and Maintenance Fire Sprinkler System Page 3 of 4
NFPA 25, Chapter 5 as amended b CCR, 'Tit9e 19
Date of Inspection, Testing, Maintenance: 6 — System Riser ID: C7 -l
Property Information:
Type f System:?
Name: 0 •
7
Wet Pipe
Address: y i l . /
Dry Pipe
Preaction V,.
k1
f
J
9Deluge MPpS
City: A
E
Item Activity Frequency Description NFPA 25
Reference Fail N/A Pass
2.10 T Annually Dry Pipe Valve — Priming Water 12.4.4.2.1
2.11 T Annuallyy ry Pipe Valve — Low Air Pressure 12.4.4.2.6Alarm
2.12 T Annually Dry Pipe Valve — Quick- Opening 12,4.4.2.4Device
2.13 T Annually Dry Pipe Valve — Trip Test 12.4.4.2.2
2.14 T Annually Backflow Preventer Assemblies 12.6.2
2.15 T 3 Years Dry Pipe Valve — Full Flow Trip Test 12 4.4.2.2.2
2.16 T 5 Years Gauges 5.3.2
2.17 T 5 Years Pressure Reducing Valve 12.5.1.2
2.18 T 5 Years Fire Department Connection Backflush 12.7.4
2.19 T 5 Years Sprinklers — Extra High Temperature 5.3.1.1.1.3
2.20 T 5 Years Sprinklers — Corrosive environment or 5.3.1.1.2corrosivewater
2.21 T 10 Years Sprinklers - Dry 5.3.1.1.1.5
2.22 T 20 Years Sprinklers - Fast Response 5.3.1.1.1.2
2.23 T 50 Years Sprinklers 5.3.1.1.1
2.24 T 75 Years Sprinklers 75 years in service 5.3.1.1.1.4
2.25 T Sprinklers manufactured prior to 1920 5.3.1.1.1.1Replace
3.1 M Annually Control Valves 12.3.4
3.2 M Annually Preaction /Deluge Valves 12.4.3.3.2
3.3 M Annually Dry Pipe Valves /Quick- Opening 12.4.4.3.2Devices
3.4 M Annually Dry Pipe Valve — Low Point Drains 12.4.4.3.3
3.5 M 5 Years Obstruction Investigation Chapter 13
State Fire Marshal AES 2 March 21, 2006
25 -82 INSPECTION, TESTING, AND MAINTENANCE OF WATER -BASED FIRE PROTECTION SYSTEMS
Inspection, Testing, and Maintenance Fire Sprinkler System
NFPA 25, Chapter 5 as amended by CCR, Title 19
Gage 4 of 4
Date of Inspection, Testing, Maintenance:
r
0
System Riser ID:
Property Information:
x1 61 Type of System:
Name: 7""D' ,/J ' Wet Pipe
gr Azl'
j ° ?
Address: SI"
Dry Pipe
Preaction
iaj,
Deluge TFFIPE V!P
T
City: & z F_ y A
Item
Deficiencies and Comments:
Deficiencies and Comments Item number must correspond to the Item number
of the Activit sted above:
0 U
See Continuation Page(s) (indicate th number of continuation pages)
PASS Q
FAIL R— / ! < _
Si nature Date
State Fire Marshal AES 2 March 21, 2006