HomeMy WebLinkAboutabove ground piping CUfJ 11tAC1 Ufs'S M/11 EfZIAL 8� 1 ES I CEFi 1 IFI(;A I E F=U�i �BUVEGFiVUNU F'IF'llvla
PFtOCEDURE
l�pon cornhle�lon d work��P��on and tesb shalt ba made br Iha conir�cto�e r��etaent�dlve And wltnessed by an ovmere reprssen1a11ve.All delecte ehall be ea►eeled and
system lefl in service belore rnnlrnctors personnol finally k,ave Ihe�ob.
A cerliflcate ShaA be f8�ed oul anA signed by bolh rePrnsenlbive�.Coplea shnA be prepared la:�pprovinp aulhorltbs owr»re,and tontractor.N b understood Ihe owner�rep-
resenldtiv9'S si9nature In no wTy pre�udices any claim�qainst conhaclor lor fautly maAerlal,poor wakrtwnship,or lai�uro Io corrpy w�h app�oving avlhally'e�equtremems oi
Iocat ord'inana�l.
PhOPEFi1Y NAME L DAiE
�►���7 .,L� ���� \/ J�-
PROPERTYADDRESS '�Q OQ�N� T� �jS�P�Z
_��k���£ --
ACCEPTED 8Y APPROVING AUTNORITIES�NAMES)
� G �t�+ e F v e.n�o
n�onEss
PLANS
INSTALIATION CONFORMS 10 ACCEPiEO PLIINS D VES O NO
EOUIPMENI USE�IS APPROVEO O YES O NO
IF NO.EXPLAIN DEVIATIONS
NAS PEHSON IN C1IARGE OF FII1F FOUICMENT BEEN INSTRUCIED AS iOIOCATION VES O NO
OF CnNiROI VALVES AND C�RE AND MAINTENANCF OF TNIS NEW EOUIPMENf�
IF NO.EXPUIIN
INSTRUCTIONS
NAVE COPIES OF iHE FOLLOW�NG BEEN lEF T ON TNE PREMISES: O VES O Np
1. SYSiFMCOMPONENISINSTRUCTIONS OYES ONO
2. CAREANDMAINfENANCFINSTRUC110NS O�ES ONO
3. NFPA 19A D VE3 O NO
LOCAiION SUPPLIES 9UIl�INGS
OF SYSTEM
YEAR OF ORIFICE TEMPERATURE
MAKE MODEI MANUfAC1URE SRE QUAN111Y RA11Nt3
GF..NTE�¢.�►` �'�'4----. 1�1'�O Z. ' �1 1 LS
•� SSI� � �g0 � + Z°� l�
SPRINKlEp3
VI�a.►�aLes�_ — _—_�__ Pr�►�1�t1Nb� —'
,
t
PIPE AND TYpe ol Pipe �Xa�► 1O � A�.1 t� ��... \
F11T1NGS jype ol Fftlings [��S 'Z{Zp�1
MAXIMUM TIME TOOPERATE
AUIpM AIARM DEVICE 1HROUGH TES1 CONNEC110N
VALVE IYPE MAKE MODEI MIN. SEC.
ORfLOW
INDICA10q V�N�. N�t�if�ft• W �' � 4��G�
���1 r1 b� o.O.D.
�Rr va�vE
MAKE MODEL SERIAL NO. MN(E MODEL SERIAL NO.
iIME lp TRIP ?IME WA1EA ALARM
TH1�UiESt WATFR A�FI iA1PPOINT REACNED OPERA1Ep
DRr PIPE CONNECitON' PRESSUf�E PIIESSURE AIR PRESSURE 1ESi OUILET' PiiOPERIY
OPERATiNO MIN. SEC. PSI PSI PSI MIN. SEC. YES NO
TE3T
Wilhout
O.O.b.
��� Wfth
O.O.O.
IF NO,EXPlA1N
I
'MEASUREO FROM TIME MSPECTOR S TEST CONNEC110N IS OPENEO.
85A�1b88) PiiINTEO IN U.S.A. (OVEA)
OPERATION
O PNEUMATIC O EIECTFIC O HYDRAUUC
PIPIN(3 SUPERVISED O YES O NO LDETECTING MEDIA SU'PERVISED O YES O NO
DOES VALVE OPERAiE fROM 1HE MANUAL TRIP AND/OR REMOTE CONTROL SIATIONS O YES O NO
DELUGE 8 IS TNEfiE AN ACCESSIBLE FACILITY IN EACN CIRCUIT FOR 1ESTING IF NO,EXPLAIN
PREACTION
VAlYE3 O YES O NO
DOES EAC'H CIRCUII OPERAIE DOES EAC CIRCUIT XIMU I O
``/� MAKE MODEL SUPEFiVISION LOSS ALARM OPERATE VALVE RELEASE OPERATE HELEASE
1� YES NO YES NO MIN. C.
kiY�B�IAII�:Hydroslatic teste shall be made at not lesa lhan 200 psl(13.6 bars)(or 1wo hours or 50 psi(3.4 bars)above slatk presa�re in eYcese
ol 150 ps (10.2 bars)lor two hours.Diflerential dry ppe valve dapperc ehall be leh ope�during test to pevenl damage.AII abovegrourd piping leakage
TEST shall be slopped.
DESCRIP110N �M�Eslab�ish 40 psl(2.7 bars)air pressure and moasure drop which shaA not exoeed 1•i/2 psi(0.1 bars)in 24 hours.Tesl pressure
tanla al normal waler level and air pressure and measure air ressure dr which shap nol ezceeA 1•1/2 si 0.1 bars in 24 houn.
ALL PIPING NYOROSTATICAIIY TESTED AT .�OID PSI FOfi Z� HRS. IF NO,STATE REASON
OFiY PIPINC3 PNEUMATICALLY TESTED O YES O NO
EQUIPMENT OPERAIES PROPEF�LY Cl YES O NO
p0 YOU CERTIFY AS THE SPRINKLER CONiRACTOR TNAi'ADOITIVES AND CORROSIVE CNEMICAIS,SOOIUM SIUCATE OR
OERIVATIVES OF SODIUM SILICAIE,BRINE,OFi OTIIER CORFIOSIVE CFIEMICALS WERE NOT USEO FOR TESTING SYSTEMS OR
TESTS STOPPING LEAKSt x YES O NO
DRAIN READINO OF GAGE LOCATED NEAR WATER FiESIDUAL PRESSURE WITH VALVE IN TEST ��
TEST SUPPLY TEST CONNECTION: �_�'S� CONNECTION OPEN WIDE �_PS�
UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSI�ED BEFO{iE CONNECTION MADE TO SPRINKLER PIPING.
VERIFIED 8Y COPY OF iHE U FORM NO.858 O YES O fJ0 OTNER EXPLAIN
FLUS�IED BY INSIALLER OF UNOEF�- F��t�1r� �"��1
(3ROUN0 SPRINKLER PIPING O YES O NO
BLANK TESi1NO
NUMBER USED LOCA110NS NUMBER REMOVED
(iASKEt9 �
WELOEO PIPIN(3 YES O NO ,
IFYES...
WITH TFIE REOUI EMENTS Of AT IEAST�AWS D10.9,LEVEI.AR�-�ING PROCEDURES COMPLY Q yES O NO
WELDING �ptiYip�jANCETWIT 1FTF E AEO�REMEN S OF ATLE�AST AWS DIOL9,lEV�UARI�IEO IN A YES O NO
p0 YOU CERTIFY THAT wEIDING WAS cARRIED Oui IN CUMPt IAr�CE wITH A
ROETRIEVEDE HAT OPE�I�STIN Plf'It G AREI SMWTHSTHAI SLAG ANU O F ERpE
WELOING RESIDUE ARE AEMOVED,AND TIIAT T11E INTERNAL OIAMEiERS OF b.YES O NO
PIPING ARE NOT PENETRATED __ _
CUTOUIS pp YOU CERTIFY iNAT YOU NAVE A CONTROL FEATURE TO ENSURE THAT ALL �p YES O NO
(DISCS� CUTOUTS(OISCS)ARE HETRIEVED7 __ ___
HY�RAUUC NAME PIATE PROV�DEO IF NO,EXPLAIN
DATA
NAIIAEPLATE O YES O NO
OATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN:
RENIAHKS
NAME OF SPRINKLER CONTRACTOR
OLSf-�t t' �¢.z ?un�t�oN —
TES1S WITNESSEO BY
SIGNATURES
FOR PRO RTY O Fi(SIGNED) TITLE DATE
- � ac.(J� �z���c,4-� � � z-3- �-
FOR SP ER C TiiACTOR(SIGNED) TITLE OATE ,
-3-g
AOUITIONAL EXPLANATtON ANO NOTES
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