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SUMMIT FIRE PROTECTION 575 Minnehaha Ave.W • St. Paul,MN 55103 • 651-251-1880 3026 40T"Ave.NW • Rochester,MN 55901 • 507-280-0622 418 Great Oak Dr. • Waite Park,MN 56387 • 320-257-6390 760 Liberty Way • North Liberty,IA 52317 • 319-665-4330 4208 Enterprise Circle • Duluth,MN 55811 • 218-740-4412 4353 NW Urbandale Dr. • Urbandale,IA 50322 • 515-867-2424 SHEET t OF 2-Use separate sheet for each building inspection REPORT OF INSPECTION ,. _ . ;;.,,, - MINNESOTA LICENSE NO.C0075/IOWA LICENSE NO. FP-036 JOB NUMBER � `� — INSPECTION NAME :.-- �; �u{ � BUILDING/LOCATION STREET :�— ��l:r '� P-..,%<, �, . •,:�:_� � `�. INSPECTOR � ;1;�„; ,�J�j�G.� CITY&STATE ' :' -`r� � * -- :f' DATE %�� > t j;i � . - _ Owner's Section(to be answered by Owner or Occ�pant) A. Explain any occupancy hazard changes since the previous inspection: 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 of fareign 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? �1'es 0 No a Is there a minimum of 18 in.(457 mm)clearance between the top of the storage and the sprinkler de�flectors? �1'es ❑No d.Does the hand hose or standpipe on the sprinkler system(s)appear to be satisfactory? ❑Yes ❑No�NA 2. Control Valves(See ltem I5.) r...,�� a.Are all sprinkler system control valves and a11 other valves in the appropriate open or closed osition? �i-Yes ❑No b.Are all control valves in the open position locked,sealed or equipped with a tamper switch?�Yes❑No 3. Tanks,Pumps,Fire Department Connections �S a.When was fire pump last tested for performance? ��Y b.Are fire pumps,gravity tanks,reservoirs and pressure tanks in good condition and properly maintained? ❑Yes 0�10�NA c.Are fire department connections in satisfactory condition,couplings free,caps in place,and check valves tight? 67`Xes ❑No ❑NA Are they accessible and visible?'�Yes❑No ❑NA 4. Wet Systems p a. Have antifreeze system solu�ions�en tested? ❑Yes ❑No C�1"NA b.What temp is antifreeze? '✓,t � � c. In areas protected by wet system(s),does the building appear to be properly heated in all areas? ❑Yes ❑No�1A 5. 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? l�'es No❑NA c.Has the operation of the air or nitrogen supplies been tested? �es 0 No ❑NA Are tt�ey in service? �'es 0 No ❑NA d.Were low points drained during this inspection?�Yes ❑No NA How many? p` e.Did quick-opening devices operate satisfactorily? �Yes ❑No J�NA � f.Did the dry valve(s)trip properly during the trip pressure test?�Yes ❑No 0 NA �I g.Did the heating equipment in the dry-pipe valve room(s)operate at time of inspection?,�'es ❑No ❑NA 6. Special Systems(See Item 14.) a.Did the deluge or pre-action vaLves operate properly during testing? ❑Yes 0 No ❑NA b.Did the heat-responsive devices operate�pkroper}y during testing? ❑Yes ❑No ONA c.Did supervisory devices operate during,testing? �Yes❑ No ❑NA d.Did flow for kitchen hood systetri shut off g�"s or electric? ❑Yes 0 No ❑NA 7. Alarms a.Did water motor(s)and gong(s)test satisfa�torily? ❑Yes ❑No C�NA , b.Did electric alarm(s)test satisfactorily? �Yes 0 Ng ❑NA *' f f;,,; a�y,:",•. f c.Did supervisory alarm service test satisfactorily? G1�Yes ❑No a�IA �;',,;, .� . r •� °�-� ' -�'=' d.Did tamper switches test satisfactorily? �Yes ❑No❑NA �� '' ��; `� ` � � � � 8. Sprinklers a.Are all sprinklers free from corrosion,paint,loading or obstruction to spray discharge? �Yes ❑No b.Are sprinklers less than 50 years old?(Older sprinklers require sample testing) CfYes ❑No c.Are quick response and residential sprinklers less than 20 years old?(Older sprinklers require sample testing) �Yes ❑No ❑NA d.Is stock of spare sprinklers available? ❑Yes �No e.Does the exterior condition of sprinkler system appear to be satisfactory? �lYes❑No f.Are sprinklers of proper temperature,�ating for their locations? �IYes❑No g.Is location free of recalled heads? �Yes ❑No � . ' � � � Signature: � � _ Date: �� �