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1301 L'ORIENT STREET <br /> ST. PAUL, MINNESOTA 55117 <br /> (651)558-3300 • (800)-229-6263 <br /> nulnMw11C SPRINKLER CO. FAX: (651)558-3310 <br /> SHEET 1 OF 2-Use separate sheet for each building inspection REPORT OF INSPECTION <br /> MINNESOTA LICENSE NO. C00005 WISCONSIN LICENSE NO. 265989 <br /> REPORT TO BUILDING OR LOCATION—i422 E <br /> STREET INSPECTOR <br /> CITY & STATE DATE <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 plpmg system last ctmeked for proper pitch? <br /> F. Are dry valves uatelglpro gcted om freezing? <br /> Signature Il( r r`'Zt t Title Date <br /> Inspector's Secti'(All responses reference current inspection) NA=NOT APPLICA LE <br /> 1. General <br /> a. Is the building occupieYes L-1No <br /> b. Are all systems in service, Yes ❑No <br /> c. Is there a minimum of 18 in. (457 mm)clearance between the top of the storage and the sprinkler deflectors�IOYes ❑No <br /> d. Does all electrical heat tape appear to be satisfactory?❑Yes ❑No/C;NA <br /> e. Does the hand hose on the sprinkler system(s) appear to be satisfactory?❑Yes ❑No./UA <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 positiow-1c)fes ❑No <br /> b. Are all control valves in the open position locked,sealed or equipped with a tamper switch es ❑No <br /> 3. Water Supplies(See Item 16.) —` <br /> a. Was a water flow test of main drain made at the sprinkler riser(s)'?�iYes ❑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 /Q:NA <br /> b. Are fire department connections in satisfactory condition,couplings free,caps in place, and check valves tight Yes ❑No ❑NA <br /> Are they accessible and visibletYes ❑No ❑NA <br /> 5. Wet Systems <br /> a. Are cold weather valves(O.S. &Y.)in the appropriate open or closed position?,l"Yes ❑No ❑NA <br /> b. Have antifreeze system solutions been tested?❑Yes ❑No CNA <br /> c. Were the antifreeze test results satisfactory?❑Yes ❑No ANA <br /> d. In areas protected by wet system(s),does the buildigQ app pe to be properly heated in all areas,including blind attics and perimeter areas <br /> where accessible? es ❑No ❑NA Do all exterior openings appear to be protected against freezing?J I'es [-]No ❑NA <br /> 6. Dry System(See Items 11 to 13.) f _ <br /> a. Are dry valve(s)in service es ❑No ❑NA <br /> b. Are the air pressu s an in ter levels in accordance with the manufacturer's instructions?❑Yes ❑No ❑NA <br /> c. Has the operation th air r-#r en supplies been tested?❑Yes ❑No ❑NA Are they in service?❑Yes ❑No ❑NA <br /> d. Were low points d n ins tion?❑Yes ❑No ❑NA <br /> e. Did quick-ope ' g ices op rat satisfactorily?❑Yes ❑No ❑NA <br /> f. Did the dry v e(s p o rly uring the trip pressure test?❑Yes Ll No L1 NA <br /> g. Did the heating equipm t int the dry-pipe value room(s)operate at time of inspection?❑Yes ❑No ❑NA <br /> 7. Special Systems(See 4tio <br /> a. Did the deluge or pe perate properly during testing?❑Yes ❑No ❑NA <br /> b. Did the heat-respone properly during testing?❑Yes ❑No ❑NA <br /> c. Did supervisory deve kng testing?❑Yes ❑No ❑NA <br /> 8. Alarms <br /> a.Did water motor(s)and gong(s)test satisfactorily?❑Yes ❑NojVA <br /> b.Did electric alarm(s)test satisfactory?XYes El No El NA <br /> c.Did supervisory alarm service test satisfactory? Yes El L1NA Ja J I <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) Yes ❑No <br /> c. Are quick response and residential spurs less than 20 years old?(Older sprinklers require sample testinvfZyes ❑No <br /> d. Is stock of spare sprinklers available?)Z"es ❑No <br /> e. Does the exterior condition of sprinkl r system appear to be satisfactory ?,�1�Yes El No <br /> E�Y <br /> f. Are sprinklers of proper temperature rating for their locations?, es ?,;Oyes <br /> 10.Explain any "No"answ comments: <br /> Signature: e 7 Date: <br />