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1301 L'Orient Street Sir. De. N M St.Paul,Minnesota 55117 AUTOMATIC SPRINKLER CO. (651)558-3300 • (800)229-6263 Setting-The Standard... Fax: (651)558-3310 SHEET 2 of 2-Use separate sheet for each system inspected System No.or Description if multiple systems 3....L)p 7- Inspection Report No. g a 5, 11 Date dry-pipe valve trip tested(control valve partially open) ,/`A (See Trip Test Table which follows) 12 Date dry-pipe valve trip tested(control valve fully open) Ai 4- (See Trip Test Table which follows) 13 Date quick-opening device tested A.)4- (See Trip Test Table which follows) DRY VALVE TRIP TEST TABLE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. DRY PIPE Time to Trip Water Air Trip Point Time Water Reached Alarm Operated OPERATING Thru Test-Pipe Pressure Pressure Air Pressure Test Outlet Properly TEST MIN. SEC. PSI PSI PSI MIN. SEC. YES NO Without Q.O.D With Q.O.D 14 Date deluge or preaction valve tested Al A (See Trip Test Table which follows) TRIP TEST TABLE Operation ❑PNEUMATIC ❑ELECTRIC ❑HYDRAULIC Piping Supervised o YES ❑ NO Detecting Media Supervised ❑ YES ❑ NO DELUGE& Does valve operate from the manual trip and/or remote control stations ❑ YES El NO PREACTION Is there an accessible facility in each circuit for testing ❑ YES ❑ NO Method of Testing Circuits VALVES Does each circuit operate Does each circuit Maximum time to MAKE MODEL supervision loss alarm operate valve release operate release YES NO YES NO YES NO 15 See Control Valve Maintenance Table CONTROL VALVE MAINTENANCE TABLE Explain Abnormal Control Valves Number Type Open Secured Closed Signs Condition City Control Valves /— 3'- ()j J ,j� a c 17),a c P S �,}cpass Valves 2- (i " 05i t/ V4/I. :)4 S e 5 Tank Control Valves Pump Control Valves Sectional Control Valves System Control Valves 120/.. q/' 3 F f l c cti a � S s5 Other Control Valves Kitchen Control Valves 16 Water Flow Test at Sprinkler Riser Water Supply Source: dr q t 1 Tank Pump Residual Test Pipe Size of Static (Flow) Date Location Test Pipe Pressure Pressure Last Water Flow Test /D-1-09 R1 cQR 5 2" 5 .5- 'S"?This Water Flow Test /0-/ -OA i SPR 5 Z'' 5-5 .S/ 17 Explain any"No"answers and comments: 18 Adjustments corrections made during this inspection: -- A I ©„t (-oat) 3�k Q s� 91JPS-- --- Eie[t4P Ate4.,,4?5t 4raAmLS/ 19 Although these comments are not the result of an engineering review,the following desirable improvements are recommended: Signature: 4s cr•J Date: /6 . /6 . 0C (Rev.2/8/06)