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� <br /> tyCO Fi�e& Grinnell <br /> lSecurity <br /> � FIRE PROTECI'ION INSPECTION CONTRACT <br /> INSPECTION RE�RT NO. ___ <br /> No. REPORT OF INSPECTION BUREau Fi�E ___ <br /> CONFERRED WITH NO. <br /> SET 1 OF 2 _ <br /> REPORT TO BUILDING OR LOCATION INSPECTED <br /> STREET INSPECTOR <br /> CITY&STATE ZIP GRINNELL OFFICE PHONE NO. <br /> ATT. DATE <br /> 1.GENERAL Yes N.A.$ No' <br /> A. (To be answered by the Owner or Owner's representative) <br /> a. Have there been any changes in the occupancy classification, machinery or operations since the last inspection? <br /> b. Have there been any changes or repairs to the fire protection systems since the last inspection? <br /> c. If a fire has occurred since the last inspection,have all damaged sprinkler system components been replaced? <br /> d. Has the piping in all dry systems been checked for proper pitch within the past five years? <br /> Date last checked (checking is recommended at least every 5 years) <br /> e. Has the piping in all systems been checked for obstructive materials? <br /> Date last checked (checking is recommended at least every 5 years) <br /> f. Have all fire pumps been tested to their full capacity through the use of hose streams or flow meters within the past 12 months? <br /> g. Are gravity,surface or pressure tanks protected from freezing? <br /> h. Are any of the sprinklers 50 years old or older? (testing and/or replacement is recommended for such sprinklers) <br /> i. Are any extra high temperature solder sprinklers regularly exposed to temperatures near 300°F? <br /> B. (To be answered by the inspector) <br /> a. Have the sprinkler systems been extended to all visible areas of the building? <br /> b. Does there appear to be proper clearance between the top of all storage and the sprinkler deflector7 <br /> c. Are the building areas protected by a wet system,heated, including its blind attics and perimeter areas,where accessible� <br /> d. Are all visible exterior o enin s rotected a ainst the entrance of cold air? <br /> 2.CONTROL VALVES <br /> a. Are all sprinkler system main control valves and all other valves in the appropriate open or closed position? <br /> b. Are all control valves sealed or supervised in the open position? <br /> No. Easily Valve Secured? Supervision <br /> Control of Type Accessible Signs Open If es, how? (Sealed?) Operational <br /> Valves Valves y (Locked?) <br /> Yes No Yes No Yes No Yes No (Supvd.?) Yes No <br /> CITY CONNECTION <br /> TANK <br /> PUMP <br /> SECTIONAL <br /> SYSTEM <br /> ALARM LINE <br /> 3.WATER SUPPLIES Pressure Fire Pump&Tank <br /> a. Water supply source? City Gravity Tank Pressure Fire Pump&City <br /> Waterflow Test Results Made During This Inspection Pressure Fire Pump&Pond <br /> Test Size Static Static Test Size Static Static <br /> Pipe Test Pressure Flow Pressure Pipe Test Pressure Flow Pressure <br /> Located Pipe Before Pressure After Location Pipe Before Pressure After <br /> 4.TANKS,PUMPS,FIRE DEPT.CONNECTIONS Yes N.A.$ No' <br /> a. Do fire pumps,gravity,surface or pressure tanks appear to be in good external condition? <br /> b. Are gravity,surface and pressure tanks atthe proper pressure and/or waterlevels? <br /> c. Are fire dept.connections in satisfactory condition,couplings free,caps or plugs in place and check valves tight? <br /> d. Are fire dept.connections visible and accessible? <br /> 5.WET SYSTEMS <br /> a. No.of systems Make&Model <br /> b. Are cold weather valves in the appropriate open or closed position7 <br /> If closed, has piping been drained? <br /> c. Has the owner or owner's representative been advised that cold weather valves are not recommended by NFPA? <br /> ' d. Have all the antifreeze systems been tested? <br /> e. Date antifreeze systems were tested <br /> f. The antifreeze tests indicate protection to: <br /> system 1 2 3 4 5 temperature <br /> g. Did alarm valves,watertlow alarm indicators and retards test satisfactorily? <br /> � G4550-R1-1 INSURANCE BUREAU COPY $Explan(No)Answers on Back of Sheet 2 .� <br />