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.;; � <br /> �ycr� Fire $r � Simp/exGrinne// <br /> ., Security INSPECTION CONTRACT <br /> NO. !_ ,. <br /> INSPECTION REPORT REPORT OF INSPECTION BUREAU FILE _ __ <br /> No. __ -__ P�R NFPA 13 & 25 Na . <br /> SET20F2 <br /> 6. DRY SYSTEMS Yes N.A.$ No' <br /> a. No.of systems —Make&Model <br /> Date last trip tested <br /> b. Is the air pressure and primin3 water levels normal? <br /> c. Did the air compressor opera e satisfactorily? <br />�: d. Were all low points drained during this inspection7 <br /> 4 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 piotected from freezing7 <br /> h. Is the dry valve house heated? <br /> 7.SPECIAL SYSTEMS <br /> a. No.of systems Make&Model <br /> Type <br /> b. Were valves tested as required? <br /> c. Did all heat responsive systems operate satisfactorily? <br /> d. Did the supervisory 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...... <br /> Valve No. 1......2......3......4......5......6...... Valve No. 1......2......3......4......5......6...... ; <br /> i 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 /> Y,. <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 /> c. Did the supervisory alarms operate during testing? � <br /> 9.SPRINKLERS–PIPING <br /> ._� t a. Do sprinklers generally appear to be in gopd external condition? ' <br /> ��'' b. Do sprinklers generally appear to be free of cotre�ion, paint,or loading and visible obstructions? " <br /> - c. Are extra sprinklers available on the premises? <br /> d. Does the exterior condition of pipir�q,cUair�v�lves,check valves, hangers,pressure gauges,open sprinklers <br /> and strainers appear to be satisfactory? 7 <br /> e. Does the hand hose on the sprinkler system appear to be in satisfactory condition? <br /> 10.EXPLANATION OF"NO"ANSWERS(Por Sections 1 B thru 9): <br /> � � <br /> � <br /> 11.THE INSPECTOR SUGGESTS THE FOLLOWING NECESSARY IMPROVEMENTS,HOWEVER,THESE SUGGESTIONS ARE NOT THE RESULT OF AN ENGINEERING SURVEY: <br /> . ��--. - . �.. <br /> � <br /> 12.ADJUSTMENTS OR CORRECTIONS MADE: <br /> i <br /> 73.LIST CHANGES IN THE OCCUPANCY HAZARD OR FIRE PROTECTION EQUIPMENT,AS ADVISED BY THE OWNER IN SECTION 1A: <br /> " 14.INSPECTION AND SUGGESTED IMPROVEMENTS WERE DISCUSSED WITH THE UNDERSIGNED OWNER OR OWNER'S REPRESENTATIVE? <br /> Signature of owner or owner's representative - Date <br /> DUPLICATE TO: <br /> STREET <br /> CITY&STATE ZIP <br /> ATT. <br /> $Not Applicable <br /> '� SG4550R2-2(04-05) 'Explain(No)Answers on Back of Shee' <br /> iNSURAf�CE BUREAU COP.Y <br /> �.. <br />