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S E N T It Y FIRE PROTECTION INC. 4439 Hwy_12 SW, P.O. Box 69 Waverly, Minnesota 55390 763-658-4483 Fax#: 763-658-4921 B.Tett C.Msintenaect Sheet 2 of 2 The fallowing tests we to be performed at the noted intervals. Report 1.Regular Maintenance Items my tam on Part III of this form. A.If sprinklers have been nplaccd,wee they proper rc0W nents? 1.Quarterly Tesla O Yes O No WN/A A. Sprinkler system main 1.Record Static Ptessnte� t and Residual Pressure � B.Air ��-��m pre�ae ba mere than P6 psi• psitw repaired? O Yes O No Wl/A Rias flow observed'! RrYes O No (3 N/A C.Dry-pipe systems being maintained in dry condition? 2.An results comparable to previous test? , Yes O No O N/A O Yes O NoQTI/A B.Waterflow alum devices passed tests? OCes O No O N/A D.If any of the following were discovered,was an obstruction 1.)orpectors test connection opened?(wet-pi)e when not in investigation conducted and the system flushed?O Yes O No)EN/A fi wzipg weatber) Yes O No O N/A Fxplain reason(s)and obstruction imwestigadm findings in Part III 2.Bypass connection opened?(wet-pipe systems in f wzing 1.Defective intake screen for pumps talking suction fian open sources. weather,dry-pipe,preaction.or deluge). O Yes O No Wl/A 2.Obstructive material discharged during waterflow tests. 3.Alamos actuated? AfYes O No O N/A 3.Foreign materials found in dry-pipe valves.check valves or pumps. 4.Was flow observed? A*Yes O No O N/A 4.Heavy discoloration of water during drain test or plugging of C Comad Valves(except OS&Y and gear-operated indicating inspectors test eomnectiom butterfly valves)opened until spring or torsion is felt in the rod, 5.Plugging of sprinkles found during activation or alteration. thea closed back one-quarter turn? Yes O No O N/A 6.Plugging found in piping dismantled during alteatians. D.Priming water level passed test in dry-pipe and preacdon systems? 7.Faihre to flush yard piping or surrounding public mains following O Yes O NoA N/A new installation or repairs. E Low air pressure signal an dry-pipe and preaction systems passed 8.Record of brokem mains in the vicinity. test? O Yes O No WN/A 9.Abnormally frequent false-tripping of dry-pipe valves. L Semiannual Test 10.System is retmmed to service after an extended period out of Quick opening devices passed test? O Yes O No RNA service(greater than one yew). 3.Anand Tests 11.There is reason to believe the system contains sodium silicate A.Are all sprinkles in service dated 1920 or later%dVcs O No O N/A or its derivatives. B.Fast Response sprinklers in service for less than 20 years? 2.Annual Maintenance Items If'no'test scrapie now and everyl0 years. O Yes O No jl N/A A.Operating stem of all OS&Y valves lubricated,completely closed, C Standard sprb*kn in service for less than 50 years? and reopened? O Yes O No WN/A If'no'test sample now and every IO years. .dYes O No O N/A B.Interior of dry-pipe,preaction and deluge valves cleaned? D.Specific gravity of antifreeae correct? ArYes O No O N/A O Yes O No RMA E All control valves operated through full range and returned to C.Low points draimcd in dry-pipe.preaCbon and deluge systems prior normal position? Q(Yes O No O N/A to the onset of frorzing weather? O Yes O No.AW A F.Preaction and deluge valves full flow trip test:(except deluge valves D.Sprinklers and spray nodes protecting commercial cooking when water can't be dischaged) egnipmeu and ventilating systans replaced except for bulb-type (Be sure to test all systans at the some time which arIdesigned which show no signs of grease buildup? O Yes O Nop'N/A apowe surrtdWnaoasly in case of fire.) Part III-Comments (Any-bw answers,test failures or other 1.Water Som all nozzles unimpeded? O YN/A problems foul with the sprinkler system must be explained here.) 2 Ptesare at hydraulically most remote nozz3.Residual reading at valve psi. Was flow ❑Y /A 4.Are above oompaabk to design values. N/A 5.Manual activation passed test? es O No O N/A 6.Automatic air aintenance devices ed test? ❑Yes O No O N/A G.Dry-pipe valve partial flo trip test: 1.Record initial air pressure ps' water pressure psi. 2 Record tripping air pressure psi and tripping times(sec.). 3.Are above results oornpaatile previous tests?OYes OrioON/A H.Automatic aQ maintenance derv' on dry-pipe and pmaction systems passed test? O Yes O No O N/A I. Backflow devices passed ow ? O Yes O No O N/A L Backflow devices full flow test O Yes O No O N/A K Allsprinkler pressure g control ves passed frill flow est? O Yes O No O N/A 4.Dry-pipe fbB trip test to be done eve third year. 1.Record initial pr ssere psi and water ssure psi. N t IV-:pedO 'S fol'mum n 2 R000rd air posture psi and tripp' time ' 3.Was water to inspectors test connection Yes Olio ON/A baps' Compa< 4.An above co mpwable to previous tests?O es O No O N/A Company's Address: S.Tests b dome every flRh year. I state that the informatuan on this farm is correct at the time and place A.Extra Very Extra High and Ultra High Tem sprinkles of my inspection.and that all equipment tested at this time was left in O Yes No Ll N/A operaional condition upon completion of this inspection except as B.Ganges checked against calibrated gauge or replaced? \ noted in Part III O Yes O No O N/A Signature of Dau: