The URL can be used to link to this page

Home My WebLink Aboutmaterial/test certificate/aboveground piping � � P 1 of 3 Contractor's Materiai and Test Certificate for Aboveground Piping PROCEDURE Upon completion of work,inspedion and tests shall be made by tl�e contractor's represer�tative and witnessed by an oMmers representative. All defects shall be cort�ected and systern left in servioe before c�ntradors personnel finally leave the job. A certificate shall be filled out and signed by both representatives_ Copies shall be prepared fw approving authorities,owners,and contrador. it is understood the owners representative's signature in no way prejudices any dain�ainst coMractor for faultp material; poor workmanship,or failure to wmply with approving authority's requiremerrts or bcal ordinances. PROPERTY NAME Minn�onka Center for tl�e Arts DATE "Z_'z2..p'L PROPERTY ADDRESS 2240 N.Shore Drive,Orono,MN 55391 ACCEPTED BY�APPROVING AUTHORITIES(NAMES) ADDRESS PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS �YES ❑NO EQUIPMENT USED IS APPROVED �YES ❑NO IF NO,EXPLAIN DEVIATIONS: HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN �YES ❑NO INSTRUCTED AS TO LOCATION OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS I�W EQUIPMENT? IF NO, EXPLAIN: INSTRUCTIONS HqVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES? �YES ❑NO 1. SYSTEM COMPONENTS INSTRUCTIONS �YES ❑NO 2. CARE AND MAINTENANCE INSTRUCTIONS �YES ❑NO 3. NFPA 25 �YES ❑NO LOCATION SUPPUES BUILDINGS: OF SYSTEM YEAR OF ORIFICE TEMPERATURE MAKE MODEL �UFACTURE SIZE QVA��N RATING Reliable F1FR 2001 1/2" 222 155/200 SPRINKLERS Reliable G4FR 2001 1/2" 37 155 PIPE AND TYPE OF PIPE: S10,S40,Aqied Dynaflow and AINed E�ccel FITTINGS NpE�FIITINGS: Cast Iron-Scxewed,Dudile Iron-Grooved ` ALARM VALVE MAXIMUM TIME TO OPERATE OR FLOW ALARM DEVICE THROUGH TEST CONNECTION INDICATOR N� MAKE MODEL MiN SEC � " WA DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. NIAKE MODEL SERIAL NO. DRY PIPE -�E TO TRIP TIME WATER AIARM OPERATING T}�ROUGH TEST WATER AIR TRIP POINT REACHED TEST OPERATED TEST CONNECTION' PRESSURE PRESSURE AIR PRESSURE OUTLET' PROPERLY without . U.O.D. � Q.O.D. N/A IF NO,EXPLAIN: 'MEASURED FROM TIME INSPECTOR'S TEST CONNECTION IS OPENED. 1996 Edition s 2of3 OPERATION ❑ PNEUMATIC ❑ ELECTRIC ❑ HYDRAULIC PIPING SUPERVISED ❑ YES ❑ NO DETECTING MEDIA � YES ❑ NO SUPERVISED DOES VALVE OPERATE FROM THE MANUAL TRIP,REMOTE,OR BOTH CONTROL STATIONS? ❑ YES ❑ NO DELUGE AND �S THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR �F NO,EXPLAiN: PREACTION TESTING? VAWES ❑ YES ❑ NO DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO MAKE MODEL SUPERVISON LOSS ALARM? OPERATE VALVE RELEASE? OPERATE RELEASE WA YES NO YES NO MIN SEC ,.,�. PRESSURE LOCATION MAKE SETTING �AT1C PRESSURE RESIDUAL PRESSURE FLOW RATE REDUCING &FLOOR 8 MODEL (FLOWING) VALVE TEST INLET OUTLET INLET oUTLET FLOW RATE PS SI PSI PSI N/A HYDROSTATIC: Hydrostatic tesfs shali be made at not less than 200 psi(13.6 bars)for 2 hours or 50 psi(3.4 bars) above static pressure in excess if 15Q psi(10.2 bars)for 2 hours. DiffereMial dry-pipe vaAre dappers shall be left TEST �n during the test to pre�rent damage. All aboveground piping leakage shall be stopped. DESCRIPTION pNEUMATIC: EstaWish 40 � 2.7 bars air ps'( ) pressure and measure drop,which shall not exoeed 1'/z psi(0.1 bars) in 24 hours. Test p�essure tanks at normat water level and air pressure and measure air pressure drop,which shall not exceed 1'r4 psi(0.1 bars)in 24 hours. ALL PIPING HYDROSTATICALLY TESTED AT: 1F NO,STATE REASON: 20o PSI ( BARS ) FOR 2 HOURS DRY PIPING PNEUMATICA�LY TESTED � YES ❑ NO EQUIPMENT OPERATES PROPERLY � YES ❑ NO DO YOU CERTIFY AS THE SPRlNKLER CONTRACTOR THAT ADDITNES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OF SODIUM SIUCATE,BRINE,OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? �YES ❑ NO TESTS READING OF GAUGE IOCATED NEAR RESIDUAL PRESSURE WtTH VALVE IN TEST DRAIN WATER SUPPLY TEST CONNECTION: CONNECTION OPEN WIDE: TEST � pSl ( BARS ) PSI ( BARS ) UNDERGROUND MAINS AND I.EAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING VERIFIED BY COPY OF THE U FORM NO.858 ❑ YES � NO OTHER,EXPLAIN: FLUSHED BY INSTALLER OF UNDERGROUND � yES �.NO WA-P�ssure Tank SPRINKLER PIPING � BLANK NUMBER USED LOCATIONS NUMBER REMOVED TESTING GASKETS WELDED PIPING � YES ❑ NO IF YES... DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING � � PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9,LEVEL AR-3? YES NO WELDING �YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS � � QUALIFIED IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST YES NO AWS D10.9,LEVEL AR-3? DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIAMCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO � � ENSURE THAT ALL DISCS ARE RETRIEVED,THAT OPENINGS IN PIPING ARE YES NO SMOOTH,THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED? CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO � ❑ (DISCS) ENSURE THAT ALL CUTQUTS(DISCS}ARE RETRIEVED? YES NO 1996 Edition ra o��o HYDRAULIC NAMEPLATE PROVIDED IF NO,EXPLAIN: DATA NAMEPLATE � YES ❑ NO DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: REMARKS NAME OF SPRINKLER CONTRACTOR SKYLiNE FIRE PROTECTION,INC. TESTS WITNESSED BY SIGNATURES " � �� ~• ��`r S �"Q"� �( �a�02 PROPERTIG OWNER(SIGNED) TITLE DATE 2 �Z SPRINKLER CONTRACTOR(SIGNED) TITLE DATE ADDITIONAL EXPLANATION AND NOTES: Y�� t n�,h -T�e5-�-- L�e c.o J�L c�-�' �rt s��. -t�,,� k 1996 Edition , , � t� �coo�r�a�w �,s�or u s�.�+.� �� ss�2s �� tm+�� F'��P.0..1gc- FAx(mt)2�5oe9 FAX(�1)483-89�5 www.nardinifire.com www.nardinifire.carn DAY WORKS$EET � n,�,.�„r21,� � --------------- �� 1 OFFlCE USE�WLY Co�ct With: SIC1fLNiE RRE PF�IECT�N � CUSTOMER�: �� pddress: l0000-73rd wVE,�to#108 ; DATE: ��y: �GRa►Y�.�. _ ; �RV{CED BY: Sta�te: M�i � � Conta� J�i1 WROBEt. � � - 1 DIVISI4N: P�1e� �� '- � SERVICE ID: JOB STrE l��w�� MILEAGE: Job Name: i�ETONKA�ITER FOR THE ARTS a�r8ss: rt4o aa�st�o�t�wvE � TRUCK: �tty; O� i LABOR SYS: State: �tN Zp: 5�91- i P.O.#: Corrta� STEVE B. With: YORTENSON p�; l�dct'1�^s: � FREIGHT: _ � _.� __._.�' �ow �u�By: DAVE'TflOYAS �11YAL.iCER •' �� _ Job Nwnber: i000RES01340 � l.abot: gc�e�ed For: O2l2'JJ�12 Tane: 01:30 DAM 0PM W�k Type: KT rawei Time: � Woric To Be P�omned: FfRE 7EST RlOQ,3�3AL SYS7'EN. BIU.MEYER.OR�FY. TEST IS�1:30 P7N Work Con�leted/Notes. / - .s' , � � m�'-/ � � p ' 3, oat ` !h $ v� �A�s [ � p� QT1f: 9er EacM Sar Tolak Coet Each: � � � � �, .., - . �,vv��vr YavvL i•uu.�. ��r r�aoivi� ��1 r,iv��cr vn� � Na�Flre Equ�me�+Co:,Mc. � Nardt�d Are Equtp�s�Ca..+uc. O �5 Cly Rd E 1N 33i8 RedMnsr Dr. �.PaW,1�1551L6 �� 90,liD 5310! �)'�'� F'�e � co., t�'�1� �� tr��saaea Name of Fadlity: MINNETONKA CEN7ER FOR THE ART �'�0n�oe�art Da�� /G:�D2 Tine p�c 1�� AM PM' S� 2240 NORTl�1 SI�RE�tNE .�� PM � � _ , 3e�ri-11�nue1 ❑ � ❑ �p9� ❑ � �- - --��= � � � p � p T� p_...-... nuu�ac� st�yE B. � �oa�r�oN �c�,��o� � � �� a, � ��ba er• ��i��-- w�: � D_"- ,� ❑ `�°�` ❑ ❑ ��: �'�—� ,� (�oro�b�S„� Ye� � � ❑ ��= 3 w�cn� � � c�uae�,o�a [�--��S'�1 C l 3� — ��.�x �.-�,� �: � �►�.�x�roo �� y��d�- �a� c� � � c � � tv"�t �� c s r-� c � � c � up-e� c � a� �.u��r�c� � � c � � c � � c � � F � � � �eor�a�a..vawsc�.w s�.(s� -r� �oat�a�s v�a�,s�r. Mra�el f�sst Re�ry: Yss No �'� � �•s'�T� rr �id ve / �� Y N w� Y N O 1)Hazard Puq��Y c�oMe�ed wl cwte�t no¢�Jes �p��a�'"'�.�'a s-noa� �0�tioodlD��ct Penetra5on ee�ed wl weid ar lA.dsvioe ��[]i'��q�COndiit eeGweN bradae�ed �Cl s��'w'�'�� C�t3'��.nooas.ana au�c�.w�n►sae�s�,qa�e �7C�4�c��,�uar►,r�oz.d�a� C�[��F"e�s�a+t c� 18�eeclric sh�Eort aompiels �O'��`�'esc�� ,��a��o� �OG��+'� C��O aa��e�i a�a��s�r�ti a� �CIC�'f�',y�"°sc�c'�cpe�naa �p��s�►a�s��v�+e�►er�a�� Oa�� ro�n,t�d r.�c ana pia s�on C✓�Ci��)°�°�•a°�'ar"�d'�'� �'�0 9�� 2�P�nnel in�ed d nrerw�ap�on d� 1�p�ecic ope�a4on d mia+ce�wildl �JD,�)a��o��s�_ C+�C��)�+��,00dar�a� �fl(7��"�o�s�,aa��v�oo�s C�O��acw+wa�aora�� w�i:�«�� C,�C�.��o�s u.�oo�� 2'�(�x�d�g af t�ara wilh repod Tt�e sysfiem�s�n�wnn��e oodes�!sta�dards Y� C—}-'�0' ❑ �f�,a nOMD01n�1�8flC@�19 81�1Ad% Yes � N� e.__-- � X �T� .s- Qrato■�erJA�oiri�eedA�ea�P+i�dM� AuWoefaedAge� Schindler Elevator Corporation =inal Acceptance Date -�- � � 'n� Contract# U 7 L �� 1 �Dear Sirs: We have examined the r f�5 �+,✓ � � !� elevator Mo. � installed by you in the y�J r�v�.r,,��,� �,��,�-1 r ,,c ,�R 1 � Building. r��J �m c a L :J�u�Ct � • ��t If�-��'.w 1� /�°�Ir/ Street - - ,�. CiEY State and find same satisfactory and in accordance with the contract and we accept the elevator under the terms and guarantee of said contract. ,��+�Z"7�` � �� ^4" � . .,x..:�. '. .. .' _ . . "`�'. . t>. S� , �. : j � '� .' ' . -. ' ,_ '`J ELEVATORS OR ESCALATORS ARE BEING TURNED OVER WITH THE FOLLOWING EXCEPTIONS: � (Damage to the equipment—other than noted balow—wip not be the responsibility of Schindler Elevator Corporation.) L � � � � �� Furthermore, in accepting this equipment, I agre�hat the architecturai finishes on ihe cabs, entrances and fixtures are v acceptable. Finally,please understand that we wiA accept no further°punch lists". (n � - :I,acknowledge receipt of the following: :`' � Car Station Keys ��d � Special Keys for Corridor&Car Station Fixtures Door Release Keys Side Exit Door Keys � Set of Cab Protective Pads Emergency Power Keys j Firemen's Retum Keys r ;'�5�� : + ..�,�._ - P rchaser � SuperintendenUSales Rep. ��I� �. �� .'��- :.,'�—'��.��.`' � ?�,,_., `�� l� � �-a�C�'� a i '�� F,: � 'i'�`�` E� v cs�a,i vr Our Contract includes �4�- morrths of New Product Service. This service is"�eff�i�e"�'��' '��'�n�v�ezpi"t��e�`'��;'��"�"� �'�� 'W� .Our Service Technician will make periodic examinations and will perform all necessary adjustments,greasing, oiling and replacement of parts necessary to keep the elevator equipment in operation.Replacement of parts due to accident, misuse or negligence by parties other than Schindler is not included.All work will be performed during regular working hours of regular working days of the trade.In add'+tian, � hour Emergency Minor Adjustment Callback service is included FOR SERVICE ' DIAL 1-800-225-3123 Yourbuilding IdentifiicaUon number is ""� � � �� Notice: Providing a reliable and trouble-free installation is importarrt to us. However,as you complete the remaining building construction work,elevator misoperations or shutdowns may occur that are caused by job site conditions beyond our control. These conditions include construction dust or debris, vandalism or misuse, voltage fluctuations and equipment room `° .#emperature below 55 degrees F or above 90 degrees F.We wil{respond to your requests for service as quickly as possible. �: :ank you for your understanding and patience. 4.., -CRDT.APP. �cz��2o(REv.vss> White:H�nance Copy Yellow:Field Copy Pink:CustomerGopy - . . �� :; � DATE TIME CITY OF ORONO cn�o�N INSPECTION NQj� SCHEDULED � "a �-r ' ?U �� PERMIT NO. Y S` �O COMP/I.ETED ''? G ADDRESS a�o� LIC� �` S/'�0/� C. � OWNER CONTR. �O� �Pr��S urt ,,\ TELEPHONENO. `o�� a �3 y� , � �.�� r�., ��t y� , �- �,; � DESCRIPTIOM ��,l L��' ' ;J -..-� �_--�. /�' � tV 01 FOOTING 11 MECkIANICAL RI 18 EXCAV/GRADINC/ftLLING Q02 FRAMING 13 MECHANICAL FlNAL 19 LAICESFIORE/I�VETLANDS � h 03 INSULATION 24l25 WOOD BUHNER/FIREPLACE 34 TREE REMOVAI �Z 04 WALL BD. 12 WATER HOOK-UP 17 SRE INSPECTION Q 05 FINAL 14 SEWER hI00K-t!P O6 PROGRESS � 07 DEMO-SITE 27 SEPTIC MAINT. 21 COMPL/uNT � 07 DEMO-FINAt 15 SEPTIC iNSTALL. 22 FOLLONt-UP i09 PLUMBING RI 23 SEPTIC FlNAL 35 HARD COVER REMOVAL J 10 PLUMBING FlNAL 36 FOUNDATIOWRENIOVAL � OWNERfCONTRA TQMEETYOU: YES NO O �� % t-� ��MM ,.�,� . - W � �/�J '"'� ' ��, ��Q ;.� f. a- �L> �` �. �' I�'��(/l '' t ��. � � 'i , - � J � �• f �� !, �l Z�= i'f�F_,L;�1 i.�j--� O `'. , � �'', � �` '� � .��: �'1. !�/�� °�l �it t,�ve � � -�C �� y_- Q � � , /' S c (��,:�fP�e� �;'/�Unc�. �' 1�� " � , �u < < t �- � �" --L� � . I -�� c � ,ot.�- � �c 2— �-f 7" rti�s� a W ❑WORKSATISFACTORIFPROCEED O PROJECTCOMPLEfE W �CORRECT WORK 8 PROCEED ❑ISSUE CERTIFICATE OF OCCUPANCY � 0 ❑CORRECT WoORK,CALL FOR HEINSPECf10N TEMPORARY V BEFORE COVERtNG PERMANENT ❑CORRECTUNSAFECONDITIONWITHIN HOURS. p pHOTOTAKEN INSPECTOR WILL REfURN ❑STOP ORDER POSTED.CALL INSPECTOR 0 GTATION ISSUED ❑INSPECTIOP!REQUIRED.CALLTO ARRANGE ACCESS. Cail forthe next inspection 24 hours in advance. (952) 249-46�� OwnertCon r on sit� Inspector,,' �`t � � White Copyflnspector's Rle Canary CopylSite Notice