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., VIKING AUTOMATIC SPRINKLER COMPANY . -� 1301 L'ORIENT STREET• ST.PAUL,MINNESOTA 55117 • (651)558-3300 • 1-800-229-6263 •FAX: (651) 558-3310 r'; � � SHEET 1 OF 2-Use separate sheet for each building inspection '�,�`` REPORT OF INSPECTION _ ,�, .�- MINNESOTA LICENSE NO. CO0005 WISCONSIN LICENSE NO. SC0000115 _ ;� REPORT TO BUILDING OR LOCATION STREET INSPECTOR CITY & STATE DATE �;', Owner's Section(To be answered by Owner or Occupant) �' :� A. Explain any occupancy hazard changes since the previous inspection: ;�: . -3' •>, s>,; B. Describe fire protection modifications made since last inspection. �- C. Describe any fires since last inspection. -- D. When was the system piping last checked for stoppage, corrosion or foreign material? E. When was the dry-piping system last checked for proper pitch? F. Are dry valves adequately protected from freezing? - Signature � Title � � Date �� _ ;. Inspector's Section (All responses reference current inspection) NA =NOT APPLICABLE - 1. General ' a. Is the building occupied?�Yes � No �� ;� b. Are all systems in service?p Yes ❑No ��'"' � c. Is there a minimum of 18 in. (457 mm)cleazance between the top of the storage and the sprinkler deflectors?6�--Yes ❑No '- ' d. Does all electrical heat tape appear to be satisfactory?�Yes ❑No !�-�VA �y +� e. Does the hand hose on the sprinkler system(s) appear to be satisfactory? - Yes �Na �NA �� 2. Control Valves(See Item I5.) a. Are all sprinkler system control valves and all other valves in the appropriate open or closed position?�-Yes ❑No + ��- b. Are all control valves in the open position locked, sealed or equipped with a tamper switch?�Yes ❑No 3. Water Supplies (See Item 16.) a. Was a water flow test of main drain made at the sprinkler riser(s)?�Yes u No � �% 4. Tanks, Pumps, Fire Department Connections a. Are fire pumps, gravity tanks,reservoirs and pressure tanks in good condition and properly maintained?❑Yes ❑No C�AfA � � b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight?�r3Yes ❑No ❑NA '" Are they accessible and visible?{�J_Yes ❑No ❑NA � 5. Wet Systems ti� a. Are cold weather valves (O.S. & Y.) in the appropriate open or closed position?��'es ❑No ❑NA "��x" b. Have antifreeze system solutions been tested?❑Yes '�No �--AIA � �� c. Were the antifreeze test results satisfactory?- Yes ` No �-NA �� } a, d. In areas protected by wet system(s), does the building appear to be properly heated in all areas, including blind attics and perimeter areas � �� " °" where accessible?t_.�Yes ❑No ❑NA Do all exterior openings appear to be protected against freezing?G�..yes ❑No ❑NA 6. Dry System(See Items 11 to 13.) a. Are dry valve(s) in service?❑Yes ❑No �NA - b. Are the air pressures and priming water levels in accordance with the manufacturer's instructions?❑Yes ❑No @-NA , x �:°, c. Has the operation of the air or nitrogen supplies been tested?❑Yes ❑No 'r�NA Are they in service?❑Yes ❑No �-�TA •_� d. Were low points drained during this inspection?❑Yes - No ;NA ' - e. Did quick-opening devices operate satisfactorily?'` Yes �No �-NA f. Did the dry valve(s) trip properly during the trip pressure test?❑ Yes �No �-NA g. Did the heating equipment in the dry-pipe value room(s) operate at time of inspection ?❑Yes ❑No 0 NA '� f 7. Special Systems (See Item 14.) �." a. Did the deluge or pre-action valves operate properly during testing?� Yes �'No C�'�AIt� ' b. Did the heat-responsive devices operate properly during testing?U Yes �No �NA �•�, c. Did supervisory devices operate during testing? J Yes ❑No C3-Ia1A _ 8. Alarms � a. Did water motor(s) and gong(s)test satisfactorily?CI Yes �J No �1-�IA b. Did electric alarm(s) test satisfactory?C✓1_Yes r No ❑NA � - c. Did supervisory alarm service test satisfactory?�Yes `No �J NA , :. ; ; 9. Sprinklers Y � a. Are all sprinklers free from corrosion, loading or obstruction to spray discharge ?�Yes ❑No - b. Are sprinklers less than 50 years old? (Older sprinklers require sample testing) �'Yes ❑No T" c. Are quick response and residential sprinklers less than 20 years old?(Older sprinklers require sample testing)[�Yes ❑No d. Is stock of spare sprinklers available?�Yes -No ` ' ' e. Does the exterior condition of sprinkler system appear to be satisfactory ?�Yes C No f. Are sprinklers of proper temperature rating for their locations?�Yes -No ,; ' 10.Explain any "No" answer and comments: Signature: � Date: