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/ <br /> � Cf:NF:RAI. INFORA�inT1UN 13-c <br /> CONTRACT�R'S MATERIAL&7EST CERTIFICATE FOR �BOVEQROUND PIPING <br /> PROCEOURE <br /> Upon complstion ol work,In�p�ctian�nd ttrt��h�ll b�m�d�bY th�contf�ctor'�nPnwntatlw�nd witntiwd by�n own�r'�npnNnt�tlw, All <br /> de(�etr�h�ll b�cpmctsd�nd�y�tsm I�ft in Nrv{a b�(orr eontnetor'�p�rsonnN fln�lly bw�tA�Job. <br /> A drtlflpU�h�li bA tlll�d Out�nd�Ipn�d by both nprtqnLdvti.'CopFq q�all D�php�ryd fpr�pp�pvinp wtAorltlM,own�n�nd contnctor. � <br /> It I�und�ntood th�own�r'�npn��nuciw'�t{p��tur�In no r�y pn�udipi�ny ddm pNrot oontnetor fa Iwiry mn�rld,poor workm�nthlP. <br /> or f�ilun to eomply with�pprovinp wthorlly'�rpulnrrMnU or loeal ordinanpt, <br /> PROPEqTV NqME <br /> C��ar�; , �� „�;%_ -� : .� - ��' v `/ <br /> PROPERTY ADORESS <br />. �7Co � � <br /> ACCEPTEO BY qPPqOVINa AUTHORITY( N ES � <br /> % <br /> ADORE55 <br /> PIANS <br /> INSTALWTION CONFORMS i�ACCEPTEO PU1NS YES �NO <br /> EqU1PMENT USEO IS AVPROVED � <br /> �F NO,EXPLAIN DEVIATIONS �YES �NO <br /> HAS PERSON IN CHAqGE OF FIRE EQVIPMENT BEEN INSTRUCTEO AS TO LOCATION <br /> OF CONTROL VALVES ANO CARE AND MAINTENANGE OF THIS NEW EQUIPMENT �YES �NO <br /> IF NO,EXPLAIN ' <br /> INSTRUCTIONS <br /> HAVE COPIES OF APPROPq1qTE INSTRVCTIONS ANO CARE ANO MAINTEN/�NCE CMARTS YES �NO <br /> AND NFPA�3A BEEN LEFT ON PqEMISES <br /> IF NO,EXP(.AIN - <br /> LOCATION SUPPLIES BLOGS. <br /> OF SYSTEM �� � • <br /> �' _ C{;��C <br /> MAKE M�pE� YEA F ORIfICE pUANTITY TEMPERATURE <br /> M<WUFA�TUqE SIZE RATING <br /> SPRIIVK�EflS d /� �..7 <br /> / <br /> /62. <br /> � (.�� � <br /> / '? �'- <br /> PIPE COtVFOHMS TO - STANDARD YES �NO <br /> PIPE ANO F�TTINGS CONFORM TO /�1�PfF"� �3 STANOARO �YES �NO <br /> FITTINGS �F NO,EXPLAIN , <br /> AIARM OE V ICE M/1XIMUM TiME Tp OPERATE 7NRp(X',H 7ESf p�pE <br /> AI.ARM TVPE MAh;: <br /> VALVG MOOEL MIN, SEC. <br /> OR FLOW <br /> INOICATOR � F _ ) " <br /> Y V I.VE p <br /> MAKE MODEL SERIALNO. MAKE MOOEI SERIALNO. <br /> k� <br /> I TIME TO TRIP ' WATEH AIR TRIP POINT TIME WA EH A ARM <br /> THRU TEST PIPE� PRESSURE PRESSURE AlR PRESSUHE REACHED OPERATED <br /> 7ESTOUTLET� PFiOPERLY <br /> DRYPIVE MIN, SEC. P51 v5� P5� M�N. SEG VES NO <br /> OPERATING <br /> TEST Witho�t <br /> O.O.D. <br /> w��� <br /> a.O.D. � <br /> s �'�� > �� .� -3� �C <br /> IF NO.EXPLqIN . �`��'+`.f�,^ ���`/ <br /> , I 'MEASURED FROM TIME INSPECTOH'S TEST PIPE IS OPENED. <br /> esq ppep� PRINTEO IN VSA (OVER) <br /> Conlraclo�'�Material 6� Tcs� Ccrtificaie for Abovcaround Piping <br /> FORM li-4 <br />