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� <br /> �� Grinnel�° � <br /> � �`"^�^'�' FIRE PROTECTION SYSTEMS COMPANY <br /> INSPECTION CONTRACT - <br /> NO. :........__. :,�. .:.....::...: '' <br /> INSPECTION REPORT REPORT OF INSPECTION <br /> BUREAU FILE ........ ....... � <br /> No. ... .... .. .... .. _..... � <br /> NO. ........ : ._.-._ ............ . <br /> SET 2 OF 2 � <br /> i. DRY SYSTEMS Ya N.A.; No' <br /> a. No.of systems '� Make&Model <br /> Date last triptested � <br /> b. Is the air pressure and priming water levels normal2 <br /> c. Did the air compressor operate satisfactorily? <br /> d. Were all low points drained during this inspectiont <br /> e. Did all quick opening devices operate satisfactorily7 <br /> f. Did all the dry vaives operate satisfactorily during this inspection? <br /> g. Do dry valves appear to be protected from freezingt - <br /> h. Is the dry valve house heafed7 <br /> �. S/ECUL SYSTEMS �. <br /> a. No.of systems - Make&Model ��'`�`'� <br /> ry� � _... <br /> b. Were valves tested as requiredt �-�- ' <br /> c. Did all heat responsive systems operate satisfactorilyT <br /> d. Did the supervisory features operate during resting� - <br /> Heat Responsive Deyices: Type Type of test <br /> Valve No. 1...... 2...... 3......4...... 5...... 6...... Yalve No. 1...... 2...... 3......4......5......6...... <br /> Valve No. 1...... 2...... 3......4...... 5......6...... Yalve No. �...... 2...... 3......4...... 5......6...... , <br /> Valve No. 1...... 2...... 3......4...... 5...... 6...... Va�ve 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 L� "'' __ Y �„ <br /> location <br /> Test results <br /> i. AURMS Yes N.A.x No• <br /> a. Did the water motors and gong operete during testingt <br /> b. Did the electric alarms operate during testing� <br /> c. Did the supervisory alarms operate during testing� <br /> 9. S►RINKLERS—MPING <br /> a. Do sprinklers generally appear to be in good external condition� <br /> b. Do sprinklers generally appear ro be free of corrosion,paint,or loading and visible obstructions7 �..---'" <br /> t. 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 satisfadory? '-�--" <br /> e. Does the hand hose on the sprinkler system appear to be in satis(actory condition? � � <br /> 10. EXrLANATION Of"NO"ANSWERS(Fo�Sections 16 thru 9): <br /> _ - +. <br /> 11. THE INSPKTOR SUGGE5T5 THE FOLLOWING NECESSARY IMPROVEMEPITS.HOWEVER,THESE SUGGESTIONS ARE NOT THE RESULT OF AN ENGINEERING SURVEY: <br /> 12 ADJUSTMENTS OR CORRECTIONS MADE: <br /> � <br /> 13. U5T CHANCES IN THE OCCUPANCY HAZARD OR FIRE PROTKTION EQUI►MENT,AS ADVISED BY THE OWNER IN SECTiON 1A: <br /> �.u ,_ : - <br /> i.... <br /> 14. lNSrKT10N AND SUGGESTED iMPfiQVfMENTS WERE DISCUSSED WITH THE i;RDER�:GNED OWNER DR OWNER'S RErRESENTATIVEt <br /> Signature of owner or owner's representative Date <br /> DUPLICATE TO: <br /> STRfET <br /> CITY 6 STATE ZIP <br /> ATT. <br /> tNot Applic�ble <br /> G45�0-2 •Explain(No)Answers oe Back of Sheet <br /> INSURANCE BUREAU COPY <br />