HomeMy WebLinkAboutAnnual Wet Sprinkler Inspection - Inspection - 757 TURNPIKE STREET 10/28/2019 IMPACT FIRE SERVICESi LL.
26 HAMPSHIRE DRIVE
H Ds N NH 03051
0.603.2 3. 31
IM AC 1 .603.589.2051
WWW.GETFIREPROTECTION-COM
FIRCommonwealth of Mass Sprinkler Contractor C-210059
inspected to the State Adopted version of NFPA 25
ANNUALWET SPRINKLER INSPECTION
DATE: 1012312019 1 . m EDTCUSTOMER ID:
JOB :174993 4 TO:
SHIP TO: NAME C&VIA SERVICES
NAME STOP&SHOP#92 ADDRESS ATT l:A OLD ACCOUNTS PAYABLE,
ADDRESS 767 TURNPIKE STREET" � OITY DB�JR IDA�.� ST -w MA ZIP 02466
ZIP
CITY NORTH DOE STATE , 0'
CONTACT STORE Al A E R PHONE 9 ' 3-9 EMAIL
GUST PO
TypE OF SERVICE REGULAR 9 EMERGENCY C1
END TIME VALVEN:
�OATYO
STAR' TIMEVALVE SIZE ,f OF SYSTEMS
VALVE MAKE Star VALVE I ODEL F
FII E I. I PANEL MAKE MONITORING YES NO U NIA
YES 0 No ❑ N1IA
Al is FA P in normal at start of inspection? YES R1 NO f1 NIA LJ
A2 is the panel&riser accessible' YES Id NO U NIA LJ
A3 Flow switches operational' Total#of flow-switches tested.2 YES 0 NO Ll NIA Ll
A4 Tam er switches o erational?Total#of tamper switches tested.2
YES id NO Ll NIA
A5 Does inspector's test valve terminate in correct orifice NO N/A
A6 Alarm line valves in proper position? YES Q1 NO U NIA.G7
A7 is hydraulic or pipe schedule placard attached and legible? YESEf NOS NIA
AS System gauges In good condition? Date on Gauge:2018
yES Id
ro o Ll
/closed position's NO L NIAIA
A 9 Are all valves supervised and in the appropriate pen
10 Static Before psi Res
ideal 40 psi Static After 45 psi Time to Reach Static � Drain ix :
t` base of r Ll
iser t r above hydraulie demand or previous re
adiln YES NO NIA
All is residual main brain test read!
at yES � NO Cl NIA
A All control valves accessible and ex
erclsed through full range of motion? YES 9f NO L3 NSA C1
13 Alarm valve and trim free from damage's rs YES NO U NIA Ll
14 Fire Department Connection in compliance Hydrostatically tested in last 5 yea
alarm: elll V.11�l. Flow-switch 40} Dress-switch
15 T�rr1e to ail Y'LS NO 11 NIA C1
signs,valve chart,anti-freeze ia�card if a licabie in face' I NO Ll NIA
A I6 All system si P,
A 17 Alarm line valve sealed in open position All valves in normal condition? YES Ll N U NIA id
A iS Has the tank been assessed far obstructions In the last 5 years? YES Ej NO U N/A
1 Has
an obstruction asaassrrian�t been performed on piping in the last 5 years? Ll
sassed for obstructions in the last 5 years' YES NIA
20 Has the alarm valve and/or backflo�nr and FDD check been assessed YES O C1 NIAC3
I beads appear free of leafs and damage' YES U NOW NIA Ll
A Meads free of foreign material? N NIA
3 Minimum'18"clearance from deflector to obstruction? ES 14 Np Q NIAu
A 4 All proper escutcheon plates in place? � ���s "YES id NO Q NIA Ll
A Standard response sprinkler heads less than 50 dears aid'? Date.
Date: 'YES 0 NO Q NIA
6 Quick res once sprinkler heads less than 0 ears old' date: 2i��2 YES Ll NO 0 NIA.U
A 7 Dry sprinkler heads less than 10 years old? Date: E U O U NIAId
8 l�arstt environmentenvironment pritCler headsls less than 5 years o1d'? Date: Y C O IN A
9 Have any heads been tested?
S are sprinkler box pro erl su lied with heads wrenches YIDS Id NO Ll NIA.
A31 Exposed piping and hanger in good condi#ion1 YES Ll NO Q NIA ld
A32 Does#ire pump appear to be in good working order's yES Q NQU—NLAX
A33 at fire unY under one re ular churns as required r hIFP months YES 0 NO NIA Id
Astandpipe and Dose valves been ins acted and determined to be in earn lance in last YES U NO Ll NIA W
Has
A Has standpipe.been flow tested in last 5 ears'? Ii s ected today) YES Id NO 0 NIA L)
3 Has antifreeze been tested in last 1 months?{heck chart B'1 for results}M`f p YES id NO❑ NIA Ll
7 Did monitoring company recolve signal? YES � NO� I C7
FA P left in normal condition's YES W NO Ll NIA LI
Does customer awn a co of 1 FPA and understand his/her res ansiblities?
i
B 1 Antifreeze Test Results:
A L %at lir e e Point %at Base of Freeze Point at Antifreeze Antifreeze PSI Reading PSI Reading for o AFL.c
Location Vent at Vent Loopas of I_,�vp Type Quantity on Tank Loop Compliance?
1 Inspection results: Passed U Passed With Deficiencies 0 Critical Deficiencies Found CI System Inoperable
Ll
PLEAD SEE ELECTRONIC WORK ACKNC LE DGMENT, OR "ALERT TADS' OF
SERVICE LINK (ENTAILED TO CUSTOMER AT COMPLETION F THE INSPECTION}, FOR.
DETAILS ON ANY CURRIENT OR PREVIOUSLY REPORTED RECOMMENDATI N �
DEFICIENCIES,OR IMPAIRMENTS.**
D I General Comments:
f
b
E
E 1 List the changes in the occupancy hazard or fire protection equipinent,as advised by the owner,since last inspection
F:
` suggested irn rovernelE is �relre discussed with the undersigned owner or owner's Representative: YES CI NO
P I Inspection and P
"Custoiner signature may be found on eleetronic Work Acknowledgement in lieu of(his report.*�
101 8/ 9 THIS IS NOT AN INVOICE
C[ISTI1EIt'S SIGNATURE
DATE T ' PAIN## DESCRIPTION PRICE AIyi 'I~
Annual wet fire spriWer systeM inspection
i m uaiey
CUSTOMERS PRINTED NAME
c 101 8119
TECHNICIAN SIGNATURE DATE
Paul Rice, Dennis Chase 201 SPRINKLER SERVICE CALL
- TECHNICIAN PR.I-NTED NAME LICENSE#