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} tyco Fire & SimplexGrinnell <br /> ✓ INSPECTION CONTRACT <br /> Security NOJ....7. .P,.`f q:. ... <br /> INSPECTION REPORT REPORT OF INSPECTION BUREAU FILE ............._................... <br /> NO. ._. PER NFPA 13 & 25 No. _....._. <br /> SET 2 OF 2 <br /> 6.DRY SYSTEMS N.A.$ No` <br /> a. No.of systems ' Make&Model Wi /' I <br /> Date last trip tested -7—7—,a 5 - - <br /> b. Is the air pressure and priming water levels normal? EV_ <br /> C. Did the air compressor operate satisfactorily? ✓ <br /> d. Were all low points drained during this inspection? I/ <br /> e. Did all quick opening devices operate satisfactorily? ✓ <br /> f. Did all the dry valves operate satisfactorily during this inspection? ,..---- <br /> g. <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 systems —(4 Make&Model <br /> Type <br /> b. Were valves tested as required? „r <br /> c. Did all heat responsive systems operate satisfactorily? I <br /> d. Did the supervisory'features operate during testing? 1 <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 /> 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 /> c. <br /> c. Did the supervisory alarms operate during testing? f,/ <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 <br /> and strainers appear to be satisfactory? J <br /> e. Does the hand hose on the sprinkler system appear to be in satisfactory condition? ✓ <br /> 10.EXPLANATION OF"NO"ANSWERS(For Sections 1B thru 9): <br /> 11.THE INSPECTOR SUGGESTS THE FOLLOWING NECESSARY IMPROVEMENTS,HOWEVER;THESE SUGGESTIONS4ARE NOT THE RESULT OF AN ENGINEERING SURVEY: <br /> N-gl iC <br /> 12.ADJUSTMENTS OR CORRECTIONS MADE: <br /> 13.LIST CHANGES IN THE OCCUPANCY HAZARD OR FIRE PROTECTION EQUIPMENT,AS ADVISED BY THE OWNER IN SECTION 1A: <br /> 14 INSPECTION SUGGESTED MPROVE .E DSCSSED�YJTH THEGED OWNER OR OWNER'S EPR EN CATIVE? <br /> Signatureof owner orowner's representativee ( 41.// ( � jL Date <br /> DUPLICATE TO: <br /> STREET <br /> CITY&STATE ZIP <br /> , <br /> ATT. <br /> Not Applicable <br /> SG4550R2-2(04-05) 'Explain(No)Answers on Back of Sheet <br /> • INICI IDA Nlr'C DI IDCAI 1 r'r%r x, <br />