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8 <br /> n Grinnell �������� <br /> `"^��'` FIRE PROTECTION SYSTEMS COMPANY 41997 <br /> INSPECTION REPORT SF� INSPECTION CONTRACT ; <br /> No. ....,�-.....:...:�.............. REPORT OF INSPECTION No._;�'�:. ,.�...% .:.:.�' ? : <br /> CONFERRED WITH �,�j'; U�- ��ONO BUREAU FILE ................ ' <br /> - N0. ................................ ', <br /> ..................................................................... PHONE N0. ........................................... SET 1 OF 2 :, <br /> REPORT TO ' � '� � �-��2 X BUILDING OR IOCATION INSPECTED � ^ - <br /> STREET ,L7DO �UX �� T INSPECTOR ��r�""�� �=-%'�' ='��?f/Z <br /> CITY&STATE _����/� %� /3'Z 1-- ZIP S`�� GRINNELL OFfICE_ -�`fCl` PHONE NO.���'�� . <br /> 11TT. DATE � "— �—`�� <br /> 1. GENERAL Yes N.A. No• <br /> A. (To be answered by the Owner or Owner's representative) <br /> a. Have there been any changes in the occupancy classification,machinery or operations since the last inspectionT - <br /> b. Have there been any changes or repairs to the fire protection systems since the last inspectiont ` <br /> c. If a fire has occurred since the last i�spection,have all damagea sprinkler system components been replacedt <br /> d. Has the � in �n all dr s stems been checked for ro er itch within the ast five ears7 � � <br /> P�P B� Y Y P P P P Y <br /> Date last checked (checking is recommended at least every 5 years) <br /> e. Has the piping in all systems been checked for obstructive materialst ✓r <br /> Date last checked (checking is recommended at least every 5 years) <br /> f. Have all fire pumps been tested to their fuil capacity through the use of hose streams or fiow meters within the past 12 monthst <br /> g. Are gnvity,surface or pressure tanks protected trom freezing7 �n - <br /> h. Are any of the sprinklers 50 years old or olderT (testing and/or replacement is recommended for such sprinklers) <br /> i. Are�ny extre hig}�temperature solder sprinklers regularly exposed to termperotures near 300°Ft <br /> B. (To be answered by the inspector) <br /> a. Have the sprinkler systems been extended to all visible areas of the buildingt ' !` <br /> b. Dces there appear to be proper clearance between the top of al)storage and the sprinkler deflectorT <br /> c. Are the building areas protected by a wet system,heated,including its blind attia and perimeter areas,where accessiblei <br /> d. Are all visible exterior openings protected against the entrance of cold air� <br /> Y. CONTROL VALVES <br /> a. Are all sprinkler system main control valves and all dther valves in the appropriate open or closed positiont <br /> b. Are all control valves sealed or supervised in the open positiont <br /> Control No. Easily Valve Securedt Supervision <br /> Valves of Type Accessible Signs Open If yes,howT (�aledt) Operational <br /> Valves (Locked�) <br /> Yes No Yes No Yes No Yes No (Su vd.�) Yes No <br /> CITY CONNECTION <br /> TANK�ui Ac� i�teiw�li1/ - r,� 1,./" <br /> PUMP <br /> SECTIONAL ! •t - <br /> �.M>i / (�,.i`- <br /> SYSTEM C,,�„� '7" (�5 +... %+ 1 <br /> ALARM LINE =� <br /> 3. WATER SU►rLlES !� f'`�:' _;'<.:rr PressuraFiw.euwp.&Tank <br /> a. Water supply sourceP City ,,GcavitYTank ����1� r7�t�s<- `� Pressure Fire Pump&Ciry <br /> Waterflow Tat Resu�ts Made During This Inspedion Pressure Fire Pump&Pond <br /> Test Size Static Static Test Size Static Static <br /> Pipe Test Pressure Flow Pressure Pipe Test Pressure Flow Pressure <br /> Located Pi e Before Pressure Aher Location Pi e Before Prasure Aher <br /> K ' <br /> ` � .T ` l <br /> :! <br /> �. TANKS,rUM►S,fIRE DE►T.CONNECTIONS Yes N.A.� No• <br /> a. Do fire pumps,gravity,surface or pressure tanks appear to be in good external condition? <br /> b. Are gnviry,surface and pressure tanks at the proper pressure and/or water levels7 , <br /> c. Are fire dept.rnnnedions in satisfadory condition,couplings free,caps or plugs in place and check valves tightt <br /> d. Are fire dept.connections visible and accessiblet <br /> S. WET SYSTEMS f <br /> a. No.of systems�Make d Model �- � <br /> � �c..-=_�-. . ,�.� r' <br /> b. Are cold weathcr valves in the appropriate open or closed positiont <br /> If closed,hu piping been drained� <br /> c. Has the owner or owner's representative been advised that cold weather valves are not recommended by NFPAt <br /> d. Have all the antifreeze systems been tested? <br /> �„ <br /> e. Date antiheeze syitems were testtd ' <br /> f. The antifreeze tests indicateprotectlon to: <br /> system 1 � 3 4 S temperature <br /> g. Did alarm valves,waterflow alarm ind�cators and retards test satisfadorilyt <br /> tNot AppUcable <br /> G4550-1 •Explain(No)Answers on Cack of SAa�t 2 <br />� <br /> INSURANC� BUREAU COPY <br />