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<br /> 1301 L'ORIENT STREET
<br /> �. q ` I �' ISI G - y ST.PAUL,MINNESOTA 55117
<br /> 4 Y (651)558-3300• (800)-229-6263
<br /> AUTOMATIC SPRINKLER CO " FAX FAX: (651)558-3310'.,
<br /> SHEET 2 OF 2 - Use separate sheet for each system inspection , System No. or Description if multiple
<br /> 4.,.::::,,,7,..4,,, systems a) c /_'
<br /> „ r,' Inspection Report r R 1
<br /> 11. Date dry-pipe valve trip tested (control valve partially open) .. (See Trip Test Table which follows)
<br /> �
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<br /> `- 12. Date dry-pipe valve triptested (control valve fully open) (See Trip Test Table which follows) � .1p ,-
<br /> 13. Date quick-opening device tested (See Trip Test Table which follows)
<br /> DRY VALVE TRIP TEST TABLE Q.O.D.
<br /> ,.s ' MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
<br /> ,
<br /> DRY PIPE Time to Trip Water Air Trip Point Time Water Reached Alarm Operated
<br />'4 .,,X ,, OPERATING Thru Test Pipe Pressure pressure Air Pressure Test Outlet Properly
<br /> TEST MIN. SEC. PSI PSI PSI MIN. SEC. YES NO
<br /> Without c,4i '"'
<br /> t
<br /> '' • `
<br /> S With
<br /> O.O.D. ,g .e..
<br /> s."'E'4 ..' ' '' "mh r * ;..v 3 rv"r - =;: ?k :I '�`;.*:c• '` k,� `f '�-�y, ;._'> ` ' 'SYf_`g'-4 f ` x "'a�8• `,d
<br /> ': 14. Date deluge or preaction valve tested - (See Trip Test Table which follows) aF`.
<br /> TRIP TEST TABLE a
<br /> � ' - Operation ❑ PNEUMAT{6-++r9•'-ELECTRIC ❑ HYDRAULIC A x ' j
<br /> ,..,:, Piping Supervised 0 YES 0 NO i Detecting media supervised ❑ YES 0 NO '. --'�'��-' "" �'
<br /> '' k DELUGE& Does valve operate from the manual trip and/or remote control stations 0 YES 0 NO
<br /> 4 PREACTION Is there an accessible facility in each circuit for testing Method of testing-circuits
<br /> VALVES 0 YES 0 NO r
<br /> Does each circuit operate Does each circuit Maximum time to +r '�s
<br /> - if
<br /> MAKE MODEL supervision loss alarm operate valve release operate release .,
<br /> YES NO YES NO YES NOk 41 '
<br /> "xe 0t4-4'' �ft
<br /> 15. See Control Valve Maintenance Table,
<br /> Control Valve Maintenance Table N
<br /> "" e
<br /> J
<br /> , Explain 'i
<br /> ai' Abnormal ;>I
<br /> Control Valves Number Type Open Secured Closed Signs Condition * v ne
<br /> City Connection Control ` ,.
<br /> Valve
<br /> Tank Control Valves c
<br /> Pump Control Valves
<br />,.k.:.-,„ Sectional Control Valves r
<br /> System Control Valves y' g /� 1 ib,t L U; ,.t`� -
<br /> r, Other Control Valves Lv J7/—
<br /> Kitchen Control Valve / x
<br /> - 16. Water Flow Test at Sprinkler Riser1i .4,1-v,:: .'. 1
<br /> iic Water Supply Source: City Tank 4Pump {
<br /> Date Test Pipe Size of Static Residual `„
<br /> h
<br /> Location Test Pipe Pressure (Flow) F
<br /> �4, Pressure
<br /> Last Water Flow Test f .! - " y,'-.-:-5;7_.-- ©A..)
<br /> This Water Flow Test
<br /> 4-0
<br /> ./�, _ W; w � - ti#b,., � .7 '
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<br /> 17. Explain any "No" answers and comments:
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<br /> T, , }
<br /> 18. Adjustments or corrections� made during this inspection: "^ 'a,),„ 1 .1.._,A-7-..EirAJA(.__F c A'-� :� "L�f f'
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<br /> �%C�R4s t�t� Sa�� c
<br /> Ae.,,,.(24.,c
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<br /> 19. Although these comment.not the result of an engineering review, the following desirable improvements are recommended .
<br /> Maus -f A-PC, r 3 Tia/'. f-/�,fi".>S. 4,...1-;—.07-c7— (,^�`/�94. S!.-"Rte. 040, u
<br /> tt s p/ :` I i k- a
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<br /> Signatur . �v,� ' �` -� _ Date / ���/
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