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� -y � Simp/e�rGrinne// BE SAFE. <br /> INSPECTION CONTRACT � <br /> A business unit of Tyco Fire&Security Np j 4' : � <br /> ' INSPECTION REPORT REPORT OF INSPECTION BUREAU FILE <br /> No. �_ PER NFPA 25 rvo. � <br /> SET20F2 <br /> 6.DRY SYSTEMS Yes N.A.$ No <br /> a. No.of systems Make&Model <br /> Date last trip tested <br /> b. Is the air pressure and priming water levels normal? <br /> c. Did the air compressor operate satisfactorily? <br /> d. Were all low points drained during this inspection? <br /> e. Did all quick opening devices operate satisfactorily? <br />, f. Did all the dry valves operate satisfactorily during this inspection? <br /> g. Do dry valves appear to be protected from freezing? <br /> h. Is the dry valve house heated? <br /> 7.SPECIAL SYSTEMS <br /> a. No.of sys�ng,,...��Make&Model <br /> Type <br /> b. Were valves tested as required? <br /> c. Did all heat responsive systems operate satisfactorily? <br /> d. Did the superoisory features operate during testing? <br /> Heat Responsive Devices: Type Type of test <br /> Valve No.._ .. , �. 1......2......3......4......5......6...... Valve No. 1.:....2......3......4......5......6...... �c <br /> Valve No. 1......2......3......4......5......6...... Valve No. 1......2......3......4......5......6...... ;. <br /> ' Valve No. 1......2...:..3......4......5......6...... Valve No. 1......2......3......4......5......6...... <br /> � Valve No. 1......2......3......4......5......6...... Valve No. 1......2......3......4......5......6...... „ <br /> Auxiliary equipment: No. Type <br /> Location <br /> Test results <br /> 8.ALARMS Yes N.A. No <br /> a. Did the water motors and gong operate during testing? <br /> b. Did the electric alarms operate during testing? ! <br /> ' a Did the supervisory alarms operate during testing? /" <br /> y. <br /> 9.SPRINKLERS–PIPING <br /> a. Do sprinklers generally appear to be in good external condition? <br /> b. Do sprinklers generally appear to be free of corrosion,paint,or loading and visible obstructions? '' <br /> c. Are extra sprinklers available on the premises? <br /> d. Does the exterior condition of piping,drain valves,check valves, hangers,pressure gauges,open sprinklers j <br /> and strainers appear to be satisfactory? <br /> e. Does the hand hose on the sprinkler system appear to be in satisfactory condition? <br /> 10.EXPLANATION OF"NO"ANSWERS(For Sections 16 thru 9): <br /> r <br /> 11.THE INSPECTOR SUGGESTS THE FOLLOWING NECESSARY IMPROVEMENTS,HOWEVER,THESE SUGGESTIONS ARE NOT THE RESULT OF AN ENGINEERING SURVEY: <br /> .-� <br /> ' 12.ADJUSTMENTS OR CORRECTIONS MADE: � <br /> �- i� ,�.._ .It��- l� �.�` � ca �rZle.t�' �� <br /> ,; <br />" 13.LIST CHANGES IN THE OCCUPANCY HAZARD OR FIRE PROTECTION EQUIPMENT,AS ADVISED BY THE OWNER IN SECTION 1A: <br /> / <br /> .�, . <br /> 14.INSPECTION AND SUGGESTED IMPROVEMENTS,WfRE DISCUSSED W�H THE NDERSIGNED OWNER OR OWNER'S REPRESENTATtVE? <br /> i � <br /> Signature of owner or owner's representativ��- �--�`�=`�^-- �� -�-+:—�--- Date �_� <br /> , DUPLICATE TO: <br /> STREET <br /> CITY&STATE ZIP <br /> ATT. <br /> $Not Applicable <br /> ��. SG4550R22(04/O6)�D' ' � A' � <br /> INSURANCE BUREAU COPY <br />