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1301 L'ORIENT STREET - X71 V r <br /> ST.PAUL,MINNESOTA 55117 <br /> (651)558-3300• (800)-229-626 v 2 2 1999 <br /> ,! AUTOMATIC SPRINKLER CO. FAX: (651)558-3310 p ��44 <br /> SHEET 1 OF 2.Use separate sheet for each building inspection REPORT OF INSPECTION o�rY®1"®R®IYO <br /> MINNESOTA LICENSE NO.C00005 ^ WISCONSIN LICENSE NO.265989 <br /> REPORT TO , �� `�'`=1 -'r'--HUILDING OR LOCATION <br /> STREET t= • v� 1,z,isni L INSPECTOR <br /> CITY & STATE �,f DATE /C. ) %pct <br /> Owner's Section(To be answered by Owner or Occupant) <br /> A. Explain any occupancy hazard changes since the previous inspection: ' <br /> B. Describe fire protection modifications made since last inspection. <br /> C. Describe any fires since last inspection. <br /> D. When was the system piping last checked for stoppage, corrosion or foreign material? <br /> E. When was the dry-piping system last checked for proper pitch? <br /> F. Are dry valves adequately protected from freezing? <br /> Title e <br /> Inspector's Seetton(All responses�eference current inspection) NA =NOT APPLICABLE <br /> 1. General <br /> a. Is the building occupied?4.,Yes ❑No <br /> b. Are all systems in service?l! Yes ❑No <br /> c. Is there a minimum of 18 in. (457 mm)clearance between the top of the storage and the sprinkler deflectors?flames ❑No <br /> d. Does all electrical heat tape appear to he satisfactory?❑Yes ❑No 'ItNA <br /> e. Does the hand hose on the sprinkler system(s) appear to be satisfactory?❑Yes ❑No. 6NA <br /> 2. Control Valves (See Item 15.) <br /> a. Are all sprinkler system control valves and all other valves in the appropriate open or closed position?tr7es ❑No <br /> b. Are all control valves in the open position locked, sealed or equipped with a tamper switch? `Yes ❑No <br /> 3. Water Supplies(See Item 16.) <br /> a. Was a water flow test of main drain made at the sprinkler riser(s)91;0 i'es ❑No <br /> 4. Tanks, Pumps,Fire Department Connections <br /> a. Are fire pumps, gravity tanks,reservoirs and pressure tanks in good condition and properly maintained?❑Yes ❑No 011*M <br /> b. Are fire department connections in satisfactory condition,couplings free,caps in place, and check valves tight?l$-Yes ❑No ❑NA <br /> Are they accessible and visible? -'es ❑No ❑NA <br /> 5. Wet Systems <br /> a. Are cold weather valves(O.S. &Y.)in the appropriate open or closed position?09-'fes ❑No ❑NA <br /> b. Have antifreeze system solutions been tested?O Yes ❑No ##;i--NA <br /> c. Were the antifreeze test results satisfactory?❑Yes ❑No SGA <br /> d. In areas protected by wet system(s),does the building appear to be properly heated in all areas, including blind attics and perimeter areas <br /> where accessible?jG Yes ❑No ❑NA Do all exterior openings appear to be protected against freezing?des ❑No ❑NA <br /> 6. Dry System(See Items 11 to 13.) <br /> a. Are dry valve(s)in service?❑Yes ❑No of_-_�'NA <br /> b. Are the air pressures and priming water levels in accordance with the manufacturer's instructions?❑Yes ❑No 105NA <br /> c. Has the operation of the air or nitrogen supplies been tested?❑Yes ❑No o"A Are they in service?❑Yes ❑No feNA <br /> d. Vkere low points drained during this inspection?❑Yes ❑No 'EBNA <br /> e. Did quick-opening devices operate satisfactorily?❑Yes ❑No 64NA <br /> f. Did the dry valve(s)trip properly during the trip pressure test?❑Yes ❑No/SIA <br /> g. Did the heating equipment in the dry-pipe value room(s)operate at time of inspection ?❑Yes ❑No A-NA <br /> 7. Special Systems(See Item 14.) <br /> a. Did the deluge or pre-action valves operate properly during testing?❑Yes ❑No ANA <br /> b. Did the heat-responsive devices operate properly during testing?❑Yes ❑No Jo;-NA <br /> c.Did supervisory devices operate during testing?❑Yes ❑No NA <br /> 8. Alarms <br /> a. Did water motor(s)and gong(s)test satisfactorily?❑Yes ❑No F!�MA <br /> b.Did electric alarm(s)test satisfactory' -Yes 05�No ❑NA -> <br /> c. Did supervisory alarm service test satisfactory?%C Yes ❑No ❑NA <br /> 9. Sprinklers <br /> a. Are all sprinklers free from corrosion,loading or obstruction to spray discharge ? Yes ❑No <br /> b. Are sprinklers less than 50 years old?(Older sprinklers require sample testing),i4-Yes ❑No <br /> c. Are quick response and residential sprinklers less than 20 years old?(Older sprinklers require sample testing)&�-Yes ❑No <br /> d. Is stock of spare sprinklers available?ce-Yes ❑No <br /> e. Does the exterior condition of sprinkler system appear to be satisfactory ?, Yes ❑No l A <br /> f. Are sprinklers of proper temperature rating for their locations?piLYes ❑No ;) 1 �: <br /> 10.Explain any"No;.-answer'a-n&.corpme�ts: 'Y _ J `f' r�,' / �' _, r 1`,yiJro y' <br /> L c' <br /> , <br /> 1 1 <br /> ILL <br /> Signature: -r f��� 'x'.' �g .. ��, 'J jC7-- r/� I <br /> Date: <br />