HomeMy WebLinkAboutINSP FIRE PROTECTION SYSTEM 9/16/2011 (COPY)25 -78 INSPEC'T'ION, TESTING ANd- K1AINfENAN i, OFC WATER -BASED FIRE PRO`I'L'C`fION SYSTEMS
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Inspection, Testing, and Maintenance Cover Sheet
NFPA 25 as amended by CCR, Title 19
Property Infolrmatiqn:
Name:
PG-
Occu anc /Use: pF c IA Occupancy/Use: Y / Ea 1 - , w p
Address: %p"
A~,, .6oristruction Type: co `-s. 52JLiEiC
city: No. P v v r1Q
ZIP: /-3 Year Constructed:
FE MPP
Contact:
Telephone:
Contractor Information:
44
Number of System Risers
Name: - J S Copy sent to:
Address: smm S• ,)aAV j U- Owner Date
City:
n
GL.d/ Fire AHJ Date
State: L11" ' ontractor Date
Telephone: ` v NOTES:
1) For specific inspection, testing, and
CA License# maintenance requirements and information,
see NFPA 25, 2002 Edition as amended by
Job # i A California Code of Regulations, Title 19, §901
to §906.
Performed by: '
Print) 2) Inspection Items may be performed by the
Owner in accordance with California Code of
Note: Contractor information may be pre - printed Regulations Title 19 §904.1(a
F s included with this report NFPA 25
Chapter Number of Forms NIA FAIL* PASS
Automatic Sprinkler System 5
Standpipe and Hose Systems 6
Private Water Supply System 7
Fire Pump S
Water Storage Tank 9
Water Spray System 10
Foam Water Sprinkler System 11
I`See "Deficiencies and Comments" section at end of each respective form.
State Fire Marshal AES 1 March 21, 2006
Inspection, Testing, and Maintenance Fire Sprinkler System Page 1 of 4
NFPA 25 Cha ter 5 as amended b CCR Title 19
Date of Inspection, Testing, Maintenance: i(0 / System Riser ID:
Property Informatjpn:
y / .JQName. L I
Type of ystem: oA t1
Address:
et Pipe °•,obi
Dry Pipe .
Preaction
M = Maintenance
Deluge
A -O = After Operation
City:
Restored Static Pressure: (psi)
Main Drain Test Results: Abbreviation Key:
1 = Inspection
Initial Static Pressure: 75- (psi) T = Test
M = Maintenance
Residual Pressure: (psi) A -O = After Operation
MI = Per Manufacturer's Instructions
Restored Static Pressure: (psi)
Item Activity Frequency Description NFPA 25 Fail N/A PassReferenceReference
1.1 I Daily Preaction /Deluge Valves — Enclosure 12.4.3.1Weeklytemperature
1.2 1 Daily
Weekly Dry Pipe Valves — Enclosure temperature 12.4.4.1.1
1.3 1 Quarterly Gauges (Dry, Preaction, Deluge Systems) 5.2.4.2
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 Sprinklers 5.2.1
1.9 1 Quarterly Spare Sprinklers 5.2.1.3
1.10 1 Quarterly Fire Department Connections 12.7.1
1.11 1 Quarterly Alarm Valves — Exterior Inspection 12.4.1.1
1.12 1 Quarterly Preaction /Deluge Valves — Exterior Inspection 12.4.3.1.6
1.13 1 Quarterly Pressure Reducing Valves 12.5.1.1
1.14 1 Quarterly Dry Pipe Valves — Exterior Inspection 12.4.4.1.4
1.15 1 Quarterly Backflow Preventers 12.6.1
1.16 I Annually Pipe and Fittings 5.2.2
1.17 I Annually Buildings 5.2.5
State Fire Marshal AES 2 June 17, 2008
Inspection, Testing, and Maintenance Fire Sprinkler System
NFPA 25 Chawter,5 as amended bv CCR Title 19
Page 2 of 4
Date of Inspection, Testing, Maintenance: System Riser ID:
NFPA 25
Reference
Property Information:
yName: U7
Address: — i—'
Type stem:
Wet Pipe
Dry Pipe
Preaction
o_CA< t
4
1.18
Deluge`•
A
5°
City:
5.2.3
EcM
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 5 Years Hangers (Accessible concealed spaces) 5.2.3.3F1.21 I 5 Years Seismic Braces (Accessible concealed
s aces 5.2.3.3
l 5 Years Pipe and Fittings (Accessible concealed
s aces
5.2.2.3
1.23 1 5 Years Sprinklers (Accessible concealed spaces) 5211.4
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 Inspection 12.4.3.1.7
1.28 1 5 Years
Preaction /Deluge Valves - Strainers, filters,
orifices
12.4.3.1.8
1.29 I 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 l
2.1 T Annually Alarm Devices (90 Sec) 5.3.3
12.2.7
2.2 T Annually Main Drain Test (Enter data on Page 1)
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
State Fire Marshal AES 2 June 17, 2008
Inspection, Testing, and Maintenance Fire Sprinkler System
NFPA 25 Cha ter as amended by CCR, Title 19
Page 3 of 4
Date of Inspection, Testing, Maintenance:
Description
System Riser ID:
Fail
Property for ation:
Pass
2.9 T
Name: L ( Type of stem: or Cq</ II,
Wet Pipe
Dry PipeAddress: (130o mr
Dry Pipe Valve — Priming Water
Preaction
Delugeq
T
City: ! .
Dry Pipe Valve — Low Air Pressure Alarm 12.4.4.2.6
Item Activity Frequency Description NFPA 25
Reference Fail N/A Pass
2.9 T Annually Preaction Valve — Full Flow Trip Test 12.4,3.2.2
2.10 T Annually Dry Pipe Valve — Priming Water 12.4.4.2.1
2.11 T Annually Dry Pipe Valve — Low Air Pressure Alarm 12.4.4.2.6
2.12 T Annually Dry 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 f
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 manufactuyed prior to 1920 —
Replace
5.3.1.1.1.1
3.1 M Annually Control Valves 12.3.4 l
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 Jum t 1, e-UVU
Inspection, Testing, and Maintenance Fire Sprinkler System
NFPA 25, Ch ter 5 as amended by CCR Title 19
Page 4 of 4
Date of Inspection, Testing, Maintenance: 44 4L
V
System Riser ID:
Property Infor ation:
Name: Type g>iSystem: o CpFcA Z III
Address: c/%G
Z Wet Pipe
Dry Pipe
T`' o
Preaction
Deluge 1
E- MPP
City:
Item
Deficiencies and Comments:
Deficiencies and Comments Item number must correspond to the Item number
of the Activity listed above:
V
Se Continuation Page(s) _ (Indica th umber f continuation pages)
ASS
FAIL
Signature ate
State Fire Marshal AES 2 June 17, 2008