32C-104 (22) .,
M .P.E
ma
Fire Protection Services
10 Pendleton Drive Hebron,CT RISER# j OF 2
(Phone)860-228-3636 (Fax) 860-228-8574
ispection Location l.J W'IT C 1 l7 e. _.5-U Cr Du Z LV Pr N xi OR- (?/vv1 p-r-o„(_) "IA-
). Date dry-pipe valve trip tested(control valve partially open) ,(JA- (See Trip Test table which follows.)
I, Date dry-pipe valve trip tested(control valve fully open) .0A- (See Trip Test Table which follows.)
!. Date quick-opening device tested itjik- (See Trip Test Table which folkrnrs.)
TRIP TEST TABLE
DRY VALVE QUICK OPENING DEVICE
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. —
DRY PIPE Thru pipe Water Pressure Air Pressure Pressure Test u Dip Point Time Water ulet Properly
OPERATING MIN SEC I PSI PSI MIN SEC YES NO
TEST Without _
Q.O.D. �l J.
Q.O.D.
WET VALVE
3. MAKE MODEL SERIAL NO. INSPECTORS TEST ALARMS EPR
S &Fi\-Se /J A. AJ A 30 SECONDS es ❑No
I., Control Valve Maintenance Table:
CONTROL VALVES Number Type Open Secured Closed Signs Explain Abnormal Condition
aty Conn.Control Valve / Gr i9/ 3 ye j Am-
ark
Control Valves �J
'ump Control Valves
lectional Control Valves
lystem Control Valves
lackflow Valves p2 3 - s ✓4S
5. Water Flow Test at Sprinkler Riser:
Water Supply Source: lunicipal ❑ Tank ❑ Pump _
Date Test Pipe Location Size of Test Pipe Static Pressure Residual Flow Pressure
1st Water Flow Test 7i 2_ST ?NS feCT7O
his Water Flow Test JO/ i �vs e"2 13b ? 5
8. Adjustments,Con'ecions Made,or Remarks
7. Parts Replaced
8. The Inspector suggests the following necessary improvements,repairs or replacements. These suggestions are not the result of an
Engineering Survey.
9. Inspector suggested improvements,repairs,replacements were discussed with the undersigned owner or owners representative
❑YES ❑NO ❑N.A.
•
0. Explanation of No Answers(For Sections 1B through 9)
i _ i�� / / /i CONTINUED PAGE 3 ❑YES ❑NO ❑N.A.
31G' INSPECTO e "
A7/44—Pli-la,oc2-- - 5 /5,-*-2_2"---/- 4/71,-22-,9Ai/.. /6/r .//6.3--
>IGNA OWNER OR OWNER'S REPRESENTATIVE (PRINT NAME) DATE
st
M•P•E
-160
mow
Fire Protection Services
10 Pendleton Drive Hebron,CT
3: (Phone) 860-228-3636 (Fai) 86!-28-8574 _ 17
SPRINKLER ALARM INSPECTION REPORT PAGE#1 OF
): f/1( - c l iii INSPECTION__ <'/v
LOCATION AJA-
J1/d 0%/-1,9 p ..c1 44— /244,114 AufrioAY 14—
Arn L3 CE2////// ig DATE /0)3//D (
Nner's Section(To be answered by Owner or Occupant)
A Explain any occupancy hazard changes since the previous inspection.
B. Describe fire protection modifications made since last inspection.
C. Describe any fires since last Inspection. (2$�J- �° s,
D. When was the system piping last checked for stoppage,corrosion or foreign material? A T.L/U5 Zr I I-d Ti'_-'._.-
E. When was the dry-piping system last checked for proper pitch? ./( -/Q
F. Are dry valves adequately protected from freezing? _.jfif-}-
•pector's Section(Alt responses reference current inspection)NA=NOT APPLICABLE
3eneral
a. Is the building occupied? .Yes ❑No
b. Are all systems in service? Cg-Yes ❑No
c. Is there a minimum of 18 in.(457 mm)clearance between the top of the storage and the sprinkler deflectors? 'es -❑No
J. Does all electrical heat tape appear to be satisfactory? ❑Yes ❑No [ NA �
e. Does the hand hose on the sprinkler system(s)appear to be satisfactory? ❑Yes ❑No I4
Control Valves(See Item 14)
3. Are all sprinkler system 6ontrol valves and all other valves in the appropriate open or closed position? fli.yes ❑No
)• Are all control valves in the open position locked,sealed or equipped with a tamper switch? EYes ❑No
Water Supplies(See item 15)
L Was a water flow test of main drain made at the sprinkler riser(s)? (,1�
Tanks,Pumps,Fire Department Connections �J
L Are fire pumps,gravity tanks,reservoirs and pressure tanks in good condition and properly maintained? ❑Yes ❑No VJNA
r. Are fire department connections irsatisfactory condition,couplings free,caps in place,and check valves tight?123,Yes ❑No DNA
Are they accessible and visible? Yes ❑No DNA
Wet Systems •
Was inspectors test performed?Oyes ❑No ❑NA •
L Are cold weather valves(O.S.&Y.)In the appropriate open or closed ition? ❑Yes ❑No [v NA
. Have antifreeze systems solutions been tested? ❑Yes 0 No �4 A
Were the antifreeze test results satisfactory? ❑Yes ❑No ONA
. In areas protected by wet system(s)does the building appa rt rto be properly heated In all areas,including blind attics and
re
perimeter areas whe accessible? es No
. Do all exterior openings appear to be protected against freezing? :'S Yes ❑No DNA
Ave aia r�r valves,waterflow indicators and retards in satisfactory condition? J 'es ❑No DNA
Iry Systems ❑Yes (If yes see items 10 to 12.)
. - - in service? ❑Yes ❑No DNA
Are the air pressures: • • • • •rr er levels In a ,• _ . .-. - _: . . i Yes ❑No DNA
Has the operation of the air or ni ••_- ••. •::n tested? ❑Yes ❑No ❑NA Are they in service? ❑Yes ❑No DNA
Were low points drain:. •. • g this inspection? ❑Yes- . • DNA
Did quick-o.,:.'-• •evices operate satisfactorily? ❑Yes ❑ o r A
Did t = • valve(s)trip properly during the trip pressure test? ❑Yes • . •NA
.the heating equipment In the dry-pipe valve room(s)operate at the time of Ins.: Yes ❑No DNA
ipecial Systems Cl Yes NA If yes(see items 13.) \.
Did the deluge or pre-action valves operate properly during testing? ❑Yes ❑No KNA
Did the heat responsive devices operate properly during testing? ❑Yes ❑No EllsiA
Did the supervisory devices operate during testing? ❑Yes 0 No k54A •
alarms
Did water motors)and gong(s)test satisfactorily? El Yes ❑No (Oh4A
Did electric alarm(s)test satisfactorily? ❑Yes ❑No [INA
Did supervisory alarm service test satisfactorily? s- ❑No ❑NA
prinklers
Are all sprinklers free from corrosion,loading or obstruction to spray discharge?yam s ❑No
Are sprinklers less than 50 years old?(Oder sprinklers require sample testing) /9--Yes ❑No
Is stock of spare sprinklers available? a-Yes ❑No
Does the exterior condition of sprinkler system appear to be satisfactory? 51.Yes ❑No
Are sprinklers of proper temperature ratings for their locations? Yes ❑No
WHITE-OFFICE COPY YELLOW-SUBSCRIBERS COPY PINK-INSPECTOR'S COPY