HomeMy WebLinkAboutAnnual Wet Sprinkler Inspection - Inspection - 150 FLAGSHIP DRIVE 6/30/2020 { IMPACT FIRE SERVICES, LL
26 HAMPSHIRE DRIVE
I PA M CT 0 4 HUDS N NH 03051
603.293.7531
FIREWWW.GETFIREPROTECTION.COM
Commonwealth of Klass Sprinkler Contractor SS 219959
Inspected to the State Adopted Version of NFPA 25
ANN A MTT SPRINKLER NSPECTI I
J J #: `l 9 DATE:9 /3 2 2 11:00am EDT CUSTOMER ID:
Sx T : BILL T :
NAMT FLAGSHIP PRESS NAME FLAGSHIP PRESS
ADDRESS 150 FLAGSHIP DRIVE ADDRESS 150 FLAGSHIP DRIVE
CITY NORTH AND OVER STATE MA ZIP 01845 CITY NORTH AND OVER STATEMAZIP01845
CONTACT JIM DEBURRO PHONE 3) 560-1679 EMAIL jdeburro@flagshippress.com
CUST P
TYPE OF SERVICE REGULAR EMERGENCY L7
START TIME END T1W VALVE LOCATION: Middle riser
VALVE MACE Central VALVE MODEL vAL T stm 4 ##of SYSTEMS
FIRE ALARM M PANE, MAST MONIT01UNG YTS id NO Ll NIA C1
l is FA P In normal at start of Inspection? YES El NO Ll NIA p
A.2 Is the panel&riser accessible? YTS R1 NO Ll NIA Ll
A 3 Flow switches operational?Total#of flow-switches tested:I YTS Id NO❑ N/ Q
4 -Tamper switches operational?Total#of tamper switches tested:3 YTS W NO L7 N/A LI
AS Does Inspector's test valve terminate In correctorifice? YTS id NO L7 NIA fl
A6 Alarm line valves In proper position YTS Id NOD NIA U
A.7 is hydraulic or Pipe schedule placard attached and legible' YTS 16 NO Ll NIA❑
System gauges In good condition' Date on Gauge:201.5 YBS d NO Ll NIA C1
A9 Are all valves supervised and in the appropriate open/closed position? YES E! NO Q NIA C7
10 Static Before 60 1 psi Residual 35 psi Static After 50 psi Time t leach Static 2 Drain Size: 2 -
All is residual main drain test reading at base of riser at or above hydraulic demand or previous beading? YTS Ef NO U /A L)
A.12 All control valves accessible and exercised through full range of motion YTS Id NO Ll NIA❑
13 Alarm valve and trim free from damage?e YTS id NO Q NIA.Cj
14 Fire Department Connection in compliance Hydrostatically tested in last 5 years YES id NO U N/A El
15 Time to alarm: Belil l.M. . Flow-switch 190 Press-switch
16 All system sl nsx valve chart,anti-frees placard.,11fa licable in lace? YES Ef NO U NIA Ll
17 Alarm line valve sealed In open position' All valves in normal condition? YTS ld NO Ll NIA El
18 Has the tank been assessed for obstructions in the last 5 years? YTS L1 NO❑ N/ ld
A 19 Has an obstruction assessment been performed on piping In the last 5 years' YTS El NO Ll NIA Ll
A 20 Has the alarm valve and/or backflow and FDC check been assessed for obstructions in the last 5 years? YTS Ed NO C1 NIA LJ
A21 Heads appear free of leafs and damage? YTS id NO 0 NIAC]
2 Heads free of foreign material? YTS 0 NO Ll N/A Lt
A23 Minimum 1 "clearance from deflector to obstruction? YES Id NO Ll NIA Ll
A24 All proper escutcheon plates in place? YTS 0 NOU NIA Ll
A25 Standard response sprinkler leads less than 50 years old' Date: 2007 YES W NO Q NIA Ll
A26 Quick res onse s rinkler heads less than 20 years old' Date; YES L7 NO Ll N/A ki
2 D rinkler heads lass than 1 O.years old? Date: YTS C1 NO Ll NIA id
A28 Harsh environment sprinkler heads less than 5 gears old? Date: 'ITS LJ NO 0 NIA Id
A29 Have any heads been tested? Date: YES Ll NOD
A 0 Sparo s rinkler box proper1 su ppiled with heads&wrenches?
A31 Exposed piping and hangers in ood condition? YTS Ef NO C) NIA Ll
A 2 Does fire pump appear to be In goon working order YTS U NO ❑ N/A 16
A33 Has fire pump undergone re afar churns as r ulred er NFPA YES A 0
A34 Has standpipe and hose valves been inspected and determined to be in coral lance in last 12 months? YTS Ll NO Q NIA.i
A35 Has standpipe been flow tested in last 5 years? YES U NO Ll NIA id
36 Has antifreeze been tested In last 12 months heck chart 131 for results,if inspected today YES Ll NO p NIA U
37 Did monitoring company receive signals Erg Ef NO ❑ NIA LJ
A 38 FADP left in normal condition? YTS id NO El NIA❑
A 39 Does customer own a copy of NFPA 25 and understand hislher re onslblitles YTS 1A NO LJ NIA LJ
B I Antifreeze Test Results:
:
AFL ° t Freese %at Base Of Freeze Point at Antifreeze Antifteeze PSI leading PSI Reading for Is AFL in
Location Vent t Vent
4 r(>40G) p Base of Loop Type Quantity on Tank Loop Compliance?
ee
I Inspection results: Passed W Passed With DeficienciesCritical Deficiencies Found Ll System Inoperable U
PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, OR "ALERT TAB" OF
SERVICE LINK EMAIL D TO CUSTOMER AT COWLETION OF THF, INSPECTION), FOR
DETAILS N ANY CURRENT OR PREVIOUSLY REPORTED RECOMMENDATIONS,
DEFICIENCIES, R I IPA RMIEN S."
I General Comments:
I List the changes in the occupancy hazard or fire protection equipment,as advised by the owner,since last inspection
F I Inspection and suggested j mprovements were discussed with the undersigned Owner or Owner's Representative: YES Ll NO U
** ustomer signa ure may b e found on electronic Work Acknowledge ment in lieu of this report.**
6130/20 THIS IS NOT AN INVOICE
CUSTOMER'S SIGNATURE DATE QTY PART# DESCRIPTION PRICE AMOUNT
Annual wet sprinkler inspecUon
CUSTOMER'S PRINTED NAME
1010
TECHNICIAN SIGNATURE DATE
Torn FrIn , 150250
TECHNICIANPRINTED NAME LICENSE�# � i SPRINKLER SERVICE CALL
S 11S0125I7
IMPACT FIRE SERVICES, LL
26 HAMPSHI E DRIVE
HUDSON NCI 03051
O : 63. 3. 531
IM ACT
F : 603.589.2051
FIREVM.GET I=I ICE P I OTECTI O N.COAT
cmmonvwrealth of Ma s Sprinkler Contractor S -210 0 9
Inspected to the State Adopted Verslan of NFPA 2
ANNUAL VMT SPRINKLER INSPECTION
JOB##;1 3 5 5 DATE:0 13 / 1 1:00am EDT CUSTOMER ID:
SHIP TO: BILL T :
NAmE FLAGSHIP PRESS NA E FLAGSHIP PLEBS
ADDREss 150 FLAGSHIP DRIVE ADDRESS 150 FLAGSHIP DRIVE
clTY NORTH AND OVER STATE MA ap 01845 cITY NORTH ANDOVER STATEMAzIP01845
CONTACT JIM DE BURRO PION 03) 560-1679 EmAm ideburro@flagshippress.com
ST P
TYPE OF SERVICE REGULAR Id EMERGENCY ❑
START TIME ENS]TIME VALVE LOCATION: Riaht riser
VALVE MAKE Central VALVE MODEL VALVE E OF SYSTEMS
FIRE ALARM PANEL MAKE MONITORING YES V NO ❑ NIA.0
Al Is FADP in normal at start of inspection? YES d NO ❑ NIA❑
2 Is the panel&riser accesslble? YES Ef NO ❑ NIA❑
A3 Flow switches operational?Total#of flow-switches tested: t YES Id NO❑ NIA❑
A4 Tamper switches operational?Total#of tamper switches tested:3 YES JA NO❑ NIA❑
5 Does inspector's test valve terminate in correct on#ice? YES Id NO❑ NIA❑
A6 Alarm line valves In proper position? YIDS id NO❑ NIA❑
A 7 is hydraulic or pipe schedule placard attached and legible? 'YES id NO❑ NIA.❑
System gauges in good condition? Date on Gauge:2018 YES Id NO❑ NIA❑
A 9 Are all valves supervised and in the appropriate openlclosed position? YES Id NO U NIA❑
A10 Static Before 50 psi Residual 35 psi Static After 60 psi Time to Reach Static 2 Drain Silo: 2
All is residual main drain test reading t base of riser at or move hydraulic demand oryre lous reading? YES E! NO❑ NIA❑
A 12 All control valves accessible and exercised through full range of motion? YES id NO C1 MIA❑
A 13 Alarm valve and trim free from damage? YES Id N ❑ NIA❑
14 Fire Department Connection In compliance?Hydrostatically tested in last 5 years? YES Ef NO❑ NIA❑
A 15 Time to alarm: l3elifl .M. . Flow-switch 45 Press-switch
A 16 All system si ns#yalve chart,anti-freeze lacard if applicable)in lance? YE.S Id NO U NIA(J
A 17 Alarm line valve sealed in open position? All valves In normal condition? YES id NO❑ NIA❑
.A 18 Has the tank been assessed for obstructions in the last 5 gears? YES ❑ NO U NIA Id
19 Has are obstruction assessment been performed on piping in the last 5 years? YES id NO❑ N/A
A 0 Has the alarm valve and/or backflovwr and FDC check been assessed for obstructions In the last 5 years? YES Ed N ❑ NIA❑
21 Meads appear free of leaks and damage? YES Ef NO❑ NIA❑
A2 Heads free of foreign material? YES 0 NO❑ N/A❑
A23 Minimum 1 "clearance from deflector to obstruction? YES id NO Ll NIA.U
4 All proper escutcheon plates in dace? YES 91 NO U N/A❑
A25 Standard response sprinkler heads less than 50 years old? Date: 2007 YES id NO❑ MIA❑
A26 Quick response sprinkler heads less than 20 yeaLs old? Date: 'YES Ll NO❑ NIA Id
A27 Dry..s prinkler heads less than IO ears old? Date: YES C) NO❑ NIA Id
Harsh environment sprinkler heads less than 5 years old? Date: YES ❑ NO❑ NIA Id
A29 Have any heads been tested? Date: NO❑ NIA ed
A30 Spare sprinkler.box properly supplied with heads&wrenches?
Al Exposed p1ping and hangers in good condition? YES El NO❑ NIA❑
A32 Does fire pump appear to be in mood working order? YES ❑ NO U NIA
A33 Has fire pump undergone regular churns as regulred per NFPA 257 YES ❑ ld
34 Has standpipe and hose valves been inspected and determined to be in cow lance in last 12 months? YES L) NO ❑ NIA ld
A35 Has standpipe been flow tested in last 6 years? YES ❑ NO ❑ NIA.W
36 Has antifreeze been tested in last 12 months Check chart 131 for results,if inspected today) YES ❑ NO ❑ N/A❑
A,37 Did monitoring company receive signal? YES 16 NO ❑ NIA❑
38 FADP left in normal condition? YES Id NO❑ NIA❑
A 39 Does customer own a copy of NFPA and understand his/her res onslblitles? YES id NO❑ NIA❑
E
B 1 Antifreeze TestResults:
AFL %at Freeze Point %at Base of Freeze Point at Antifreeze Antifreeze PSI Reading PSI Reading for Is AFL in
Location Vent at Vent Loop
0 0G fins of Loop Type Quantityon Tank Loop Compliance?
C 1 Inspection results: Passed W" Passed With Deficiencies U Critical Deficiencies Pound U System Inoperable C
PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, OR "ALERT TAB" OF
SERVICE LINK EMI AILED TO CUST MIER AT COMPLETION OF THE INSPECTION), FOR
DETAILS ON ANY CURRENT OR PREVIOUSLY REPORTED RECOMMENDATIONS,
DEFICIENCIES,CAR IMPAIRMENTS."
D 1 General Comments:
1 List the changes in the occupancy hazard or fire protection equipment,as advised by the owner,shire last inspection
1 Inspection and suggested improvements were discussed With the undersigned Owner or Owner's Representative-, YES C3 NO Q
"Customer signature may be found on electronic Work Acknowledgement In Hen of this report."
6/30/20 TFUS IS NOT AN INVOICE
CUSTOMER'S SIGNATURE DATE QTY PAS T# DESCRIPTION PRICE AmoUNT
1 Annual wet sprinkler inspection
CUSTOMER'S PRINTED NAME
6/30/20
TECHNICIAN SIGNATURE E DATE
Tory Frink, 150250
TECHNICIAN PRINTED liME LICENSE 1 ..........
SPRILR SERVICE CALL
S11SI 5I7
IMPACT FIRE SERVICES, LL
26 HAMPSHIRE ]RIVE
L
HUDS N NH 03051
n
. 603.293.7531
PA
IM CT
F. 603.589.2051
FIR1M.G T'I=REPROTECTIOff#iCOIF
ommonvweaith of mass sprinkier contractor Fc- 1005
rape ted to the State Adopted version of NFPA 25
ANNUAL NWT SPRIINKLER INSPECTION
j B .. 18834595 ELATE:o / / 20 1 1:00am EDT CUSTOMER ID:
EU To: BH L TO:
NAw FLAGSHIP PRESS NA E FLAGSHIP PRESS
ADDRESS 150 FLAGSHIP DRIVE ADDPBSS 150 FLAGSHIP DRIVE
clTY NORTH ANDOVER STATE MA zip 01845 cITY NORTH ANDOVER sT TE VIA z1P 01845
CONTACT JIM DEBURRO PHONE (603) 560-1679 EMAIL jdeburro@flagshippress.com
CUST P
TYPE OF SERVICE REGULAR Id EMERGENCY ❑
STAIR'S'TWE END THE VALVE LOCATION: Left riser
VALVE MAKE S I VALVE MODEL Shot n ALvE 11 #�of SYSTEMS
FIRE ALARM PANED KkKE MONITORING YES U NO U NIA 0
Al Is FAP in normal at start of inspection? YES Id No ❑ NIA❑
A.2 Is the panel&riser accessible? YES Ef NO ❑ NIA❑
,,3 Flow switches operational?Total#of flow-switches tested:I YES 16 NO❑ NIA❑
A 4 Tamper switches operational?Total#of tam leer switches tested:3 YES W No❑ NIA❑
A 5 Does Inspector's test valve terminate In correct orifice? YES Id No❑ NIA❑
A 6 Alarm line valves In proper position? YES id No❑ NIA❑
A 7 Is hydraulic or pipe schedule placard attached and legible? YES 0 NOD NIA❑
A 8 System gauges In good condition? Date on Gauge:2018 YES El NO❑ NIA Q
A 9 Are all valves supervised and in the appropriate openfclosed position? YES 16 No 0 NIA❑
A 10 Static Before 50si esidual 3 psi static After �� psi Time to leach Static Drain Size:
All Is residual main drain test reading t base of riser at or above hydraulic demand or previous reading? YES Id NO❑ NIA
A 12 All control valves accessible and exercised through full range of motion? YES W No Ll NIA❑
13 Alarm valve and trim free from daTa e? YES Id No❑ NIA❑
14 Fire Department Connection In compliance?Hydrostatically tested In last 5 years? YES Id No❑ NIA❑
15 Time to alarm: Bell/W.M.G. Flow-switch 30 Press-switch
A 16 All stern signs,valve chart,anti-freeze placard if applicable)In lace? YES Id No Q NIA.U
A 17 Alarm line valve sealed In open position? All valves In normal condition? YES 9 No❑ NIA❑
A18 Has the tank been assessed for obstructions in the last 6 gears? YES ❑ NO❑ NIA id
A 19 Has an obstruction assessment been performed on piping In the last 5 years? YES ❑ NO❑ NIA
A20 Has the alarm valve and/or backflow and FDD check been assessed for obstructions in the last 5 years? YES C3 NO Q NIA
A 21 Heads appear free of leaks and damage? YES El No❑ NIA❑
A.22 Heads free of foreign material? YES NO❑ NIA❑
A23 Minimum 1 "clearance from deflector to obstruction? YES NO Ll NIA
A24 All proper escutcheon dates in place? YES 04 No U NIA Cl
A25 Standard response sprinkler heads less than 50 gears aid? Date: 2007 YES Id No E3 NIA C3
A26 (wick response sprinkler heads less than 20 years old? Date: YES Ll No L3 N/A id
A27 Dy s prinler heads less than 10 years old' Date: YES Q No Q MIA 0
A28 Harsh environment sprinkler heads less than 5 years old? Date: YES ❑ NO Q NIA Id
29 Have any heads been tested? Date; 0 N A
A 30 Spare.sprinkler box properly supplied with heads&wrenches?
A1 Exposed piping and hangers in good condition? YES Ed No❑ NIA Q
A32 Does fire pump appear to be In good working order? YES ❑ NO LJ NIA id
A33 Has fire pump undergone regular churns as required per NFPA 2 ? YES ❑
34 Has standpipe and hose valves been inspected and determined to be in corn lance In last 12 months? YES ❑ No ❑ NIA id
Has standpipe been flow tested In last 5 years? YES ❑ NO ❑ NIA id
Has antifreeze been tested in last 12 months?(Check chart BI for results,If Inspected today) YES Q No L3 N/A id
A 37 Did monitoring company receive signal? YES Id No ❑ NIA❑
A38 FADP left in normal condition? YES Id No Q NIA 0
A 39 Does customer own a copy of NFPA 25 and understand his/her res onsibl[ties? YES 1A No U NIA Q
r
t
B 1 Antifreeze Test Results:
AFL °�at Freeze Paint %at Base of Freeze Point at Antifreeze Antifreeze PSI Reading PSI Reading for Is AFL in
Location e�nt at e t Loop Base of Loop Type Quantity on Tarok LoopCompliance?
0 (>406)
I Inspection results: passed W Passed With Deficiencies L1 Critical Deficiencies Found C3 Systein Inoperable U
PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, OR "ALERT TAB" O
SERVICE LINK (EMAILED TO CUSTOMER AT COMPLETION OF THE INSPECTION , FOR
DETAILS ON ANY CURRENT OR PREVIOUSLY REPORTED RECOMMENDATIONS,
DEFICIENCIES,OR IMPAIRMENTS."
D 1 General Comments:
E I List the changes in the occupancy hazard or fire protection equipment,as advised by the owner,since last inspection
F I Inspection and suggested improvements were discussed with the undersigned Owner or Oivnei's Representative: YES C3 NO L)
"Customer signature may be found on electronic Work Acknowledgement In lieu of this report."
6/30120 THIS IS NOT AN INVOICE
TtSTOMEWS SIGNATURE DATE T PART# DESCRIPTION PRICE AMOUNT
CUSTOMER'S PRINTED NAME
l /2
TECHNICIAN SIGNATURF, DATE
Tom Fri , 150250
2031 E ALL
TECHNICIAN PRINTED NAB LIC NS ## SPRINKLER SERVICE
SWS012517