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<br /> � 1301 L'ORIENT STREET �� ���
<br />� � � V� �I N G ��� ' ST. PAUL, MINNESOTA 55117 ���'�''
<br />��_ � ,� �* '��� ��•,°� (651)558-3300 • (800)-229-6263 � �`-� �� '
<br />�� = AUTOMATIC SPRINKLER CO.
<br />�� �� FAX: (651) 558-3310 � 4 �y
<br /> SHEET 2 OF 2 - Use separate sheet for each system inspection System No. or Descr�tion if multiple �.�
<br /> ` ,�� : i - systems i .,�� � �.
<br /> , ,._ �� . R � s;�p��c t�c� L �,�t-
<br />„ Inspection Re�ort , _ ' .-n,-!l,
<br /> Np '%;'i �`.s 4: .�.3 � ti S H.es�Q c�.�n i �. %'',�'; �J ��.
<br /> �..!�(i,�' FY,�', �.. ,y; .�J �r�
<br /> :"�._ �r 11. Date dry-pipe valve trip tested (control valve partially open) .�'�i� (See Trip Test Tab/e which follows) .,��„�� � �
<br /> 12. Date dry-pipe valve trip tested (control valve fully open) ti�`� (See Trip Test Table which follows) ''�" a
<br />� 13. Date quick-opening device tested � �,� (See Trip Tesf Table which follows) „ ti ' ,� ..�
<br /> y,,. DRY VALVE TRIP TEST TABLE Q.O.D. � _
<br /> ,r° MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. �,.' �
<br /> .�..,.;��.-* . ���'� �" k .�
<br /> x# :. �";� DRY PIPE Time to Trip Water Air Trip Point Time Water Reached Alarm Operated ' ' �� ���"" �'
<br /> i Thru Test Pipe Pressure pressure Air Pressure Test Outlet Properly �
<br />��# OPERATING -`� � ��
<br /> �+` TEST
<br /> MIN. SEC. PSI PSI PSI MIN. SEC. YES NO
<br />��� �t Without ; ,�;, �.`'�
<br /> � Q.O.D. �„s
<br /> � � �� With , ; � � �
<br /> Q.O.D. �
<br /> � �
<br /> r � � � T
<br /> �_„� .�� ,�
<br />� ` ,:: � x
<br /> t `' 14. Date deluge or preaction valve tested ��- (See Trip Test Tab/e which follows) 4, � '�
<br />� �
<br />`��'�'w' TRIP TEST TABLE ' -�
<br /> � r� ; K
<br /> � - Operation ❑ PNEUMATIC ❑ ELECTRIC ❑ HYDRAULIC ��, � "�
<br /> � _
<br /> � Piping Supervised ❑ YES ❑ NO Detecting media supewised ❑ YES ❑ NO � `-'
<br /> -'�r � - DELUGE& Does valve operate from the manual trip and/or remote control stations � ❑ YES ❑ NO '� �'�
<br />" a��,� PREACTION Is there an accessible faal�ty in each circmt for testing Method of testing-circuits ; `;���'�
<br /> �- " ���
<br /> � VALVES ❑ YES ❑ NO . ;�.;, "�
<br /> �,-�`'* Does each circuit operate Does each circuit Maximum time to �" � w a;
<br /> 'xs r �,,` MAKE MODEL su ervision loss alarm o erate valve release o erate release - �
<br /> ���r;. - YES NO YES NO YES NO
<br /> x �+�i w�
<br /> F� ,.
<br /> 15. See Control Valve Maintenance Table.
<br />�.' � r
<br />�� Control Valve Maintenance Table �,.
<br /> Explain � �'^�
<br /> # Abnormal
<br /> ,�,� , Control Valves Number Type Open Secured Closed Signs Condition �
<br /> City Connection Control ��"'
<br /> �t
<br /> �:a Valve _ _
<br /> Tank Control Valves -
<br /> �� ' Pump Control Valves ,�
<br />��� ��
<br /> „� Sectional Control Valves �.
<br /> � J �` :�;'i
<br />����', System Control Valves _ �f f�(Z .� 4� �
<br /> Other Control Valves
<br /> � Kitchen Control Valve R S . ' �-;�; �� : -J p s
<br />�'`��` 16. Water Flow Test at Sprinkler Riser �
<br /> -•:: :.
<br /> { Water Supply Source: City �,,�'" Tank ,�,i,.=� Pump �,f�
<br />�, Date `. Test Pipe Size of Static Residual
<br /> Location Test Pipe Pressure (Flow)
<br />��:::_ . _
<br /> Pressure
<br />�.= Last Water Flow Test � 1 ' � �-f� I ,� , _ %::_ �,' (G�s- �-'"- ��
<br /> This Wate Flow Test �� /d— Q { e/Z 2 '' � �`�"' ��`
<br />�" .. �_
<br />� 17. Explain any "No" answers and comments:
<br />��
<br />�_ �s�
<br />�r�;' 18. Adjustments or corrections made during this inspection:
<br />�:
<br /> �., ��.
<br /> , 19. Although these comments are not the result of an engineering review, the following desirable improvements are recommended:
<br />��j �..
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<br />� � ��;�
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<br /> Si nature: ��, � � ��-f i/* f J �'�'�
<br /> g �tl�' Date: �—'!�,��
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