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Home My WebLink AboutQuarterly Wet Sprinkler Inspection - Inspection - 351 HOLT ROAD 6/22/2020 IMPACT FIFE SERVICES, L.L 0 HAMPSHIRE DRIVE HUDS N NH 03051 IMP : 00 . 9 . '1 AC F: 603.589,2051 FIREWWII.G ETFI RE P RTECTI N.c Ili Commonwealth of Mass Sprinkler Contractor Sc- 10059 Inspected to the State Adopted Version of NFPA 25 QUARTERLY WET SPRINKLE.INSPECTION joB#.18834646 DATE:0 2 2 2 08:00am EDT CUSTOMER SHIP TO: BILL TO: NAME L.IF AI I INDUSTRIES - NORTH AND OVER NAmE LIFOAM INDUSTRIES LLC ADDRESS 351 HOLT RD ADDRESS PO BOX 774, ATTN: ACCOUNTS PA` A cITY NORTH AND OVER STATE MA zip 01845 ciT FREEP RT STATE IL. z1P 61032 INTACT L N BARTOLI PHONE 775) 316-0016 EmAIL L N.KART L.I @N E IVELL.c .c I+ CU T P 'HYPE OF SERVICE REGULAR id EMERGENCY CI TART TIME END TIME, VALVE LOCATION: Riser# VALVE MAM Firematic VALVE MODEL F VALVE SIZE 811 # E SYSTEMS I FIRE ALARM PANEL MAKE N tiff r MONITORING YES L3 NO U /A 0.0 is FA P In normal at start of Inspection"? 'YES NO Ll N/A Ll A.0.1 is the panel&riser accessible? YES NO ❑ N/A L1 A 0.2 Alarm line valves in properposition? YES Ef NO Ll N/A❑ A 1.0 Is hydraulicor pipe schedule placard attached and legible? YES If NO L3 NIA Cl 1.1 System gauges in good condition? Date on a e: 2019 YES d NO Ll N/A LJ 1.2 Static Before psi Residual 130 psi Static After 155 psi Time to Reach Static instant brain Size: " 1.3 is residual main drain test reading t base of riser at or above hydraulic demand or previous reading? YES Ef NO Ll N/A Cl A 2.0 Are all valves supervised and In the approprIato o en/closed ositlon YES d NO,U N/A U A .1 Alarm valve and trim free from damage? 'YES Q NO Id N/A LJ .0 Fire Department Connection In compliance?Hydrostatically tested In last 5 years? YES Ll NO WN/A L1 4.0 Time to alarm: 30 Bell[W.M. . Time to alarm When flowed via 1T A, .0 All system signs,valve chant,anti-freeze placard(if applicable)In place? YES W NO U N/A A.6.0 Alarm line valve sealed In open position All valves In normal condition? YES WINTO U N/A L3 .1 FAP left in normal condition? 'YES W N/A Q .2 laid monitoring company receive signal? YES id NO Ll N/A CJ 6.3 Has the tank been assessed for obstructions in the last 5 years? YES Q NO C] N/A A.6.4 Has an obstruction assessment been performed on piping in the last 5 years? YES If NO UN/A CJ A.6.5 Has the alarm valve and/or back flow and FDC check been assessed for obstructions in the last 5 years? YES 9 NO LJ N/A Il A.?.I Has antifreeze been tested in last 12 months?(Check chart BI for results,if inspected today) YES Ll NO U /A ld A. .0 Does fire pump appear to be in good Working order? YES U NO LJ N/Aid A. .1 Has tire pump undergone regular churns as required per NFPA 5? YIDS U NO U N/A i A. .o Does customer own a copy of NFPA 25 and understand his/her responsibilities? YES 0 NO EJ NIAQ QWS012517 k Antifreeze Test Results: AFL Vo at Freeze Vent ie Point � % t Base o Freeze Point at Antifreeze Antifreeze PSI Reading PSI Reading for Is AFL in Location I.oa r 4 p Base of Loop Type Quantity on Tank Loop Compliance? C I Inspection results: passed Ll Passed With Deficiencies W Critical Deficiencies Found Ll Systein Inoperable L PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, OR "ALERT TAB OF SERVICE LINK (EMAILED TO CUSTOMER ER AT COMPLETION OF THE INSPECTION), FOR DETAILS ON ANY CURRENT OR PREVIOUSLY REPORTED RECOMMENDATIONS DEFICIENCIES,OR IMPAIRMENTS." D 1 General Comments: 1 List the changes in the occupancy ha zard or frre protection equipment,a s advised by the owner,since last iuspeehon 1 inspection and suggested improvements were discussed with the undersigned Owner or Ownees Representative: YES id NO U **Customer signature may be found on electronic Work Acknowledgement In Heu of this report.** 6lf20 TIIS IS NOT AN INVOICE CUST ER"S SIGNATURE DATE QTY PART# DESCRIPTION PRICE AMOUNT Quarterly Bret CIS R'S PRINTED NAME 6/22 2 x DATE Chris Toro, .Joshua WhitneyS0 81 TECHNICIAN PRINTED NAME LICENSE 2031 SPRIT LER SERVICE CALL QWS012517 IMPACT FIRE SERVICES, LL 26 HAMPSHIRE DRIVE HUDSON NH 03051 603.293. 31 IMPACT F:603.589.2051 IRWM.GETFIREPROTECTION.COM Commonwealth of Mass sprinkler contractor S - 10059 Inspected to the State Adopted Version of NFPA 25 QUARTERLY WE'D' SPRINKLER]INSPECTION j i3 :18834646 DATE: 2 / 0 08:00am EDT CUSTOMER ID- SHIP TO: BILL TO: NAME LIFOAM INDUSTRIES - NORTH ANDOVER NAym LIFOAM INDUSTRIES LLC ADDRESS 351 H LT RD ADD ADDREss PO BOX 774,ATTIC: ACCOUNTS PAYA clTy NORTH AND V E R STATE MA zip 0 1845 ciTY F R E E P RT STATE IL zrP61032 CONTACT L N BA TOLI PHONE (775) 316-0016 EmArL L N.BART LI @N EWELLC .0 I STP TYPE OF SERVICE REGULAR id EMERGENCY U START TIME END TIME E 'SALVE LOCATION: Riser#2 VALVE MAKE Firematic VALVE MODEL F VALVE SIZE " OF SYSTEMS 1 FIRE ALARM PANEL MAKE No ifier MONITORING YES id NO Q N/A LJ A.0.0 Is FA P In normal at start of inspection? YES If NO L) NIA U A .1 Is the panel&risen accessible? YES Mf No LJ N/A 0 .2 Alarm line valves in ro erposition? 'DES tf NO Ll N/A LJ 1.0 i h d±aulic or i e schedule placard attached and legible? YES af NO Ll N/A A.1.1 System gauges In good condition? Date on Guage: 019 YES Ef NO LJ N/A0 A 1.2 Static Before 1 psi Residual�psi Static Afke�r 15 psi Time t Reach Static instant Brain Silo: 2` 1.3 Is residual main drain test reading at base of riser at or above hydraulic demand or revious reading? YES Ef NO Ll N/A U A2.0 Are all valves supervised and In the appropriate o eniclosedposition? YES tf NO Ll NIA Ll 2.1 Alarm valve and trim free from damage? YES IJ NO Id N/A ft 3.0 Fire Department Connection in compliance Hydrostatically tested in last 5 years? YES U NO W N/A G7 A 4.0 Time to alarm: 30 Bell/W.M.G. Time to alarm when flowed via 1TV A5.0 All system signs,valve chart,anti-freeze placard(if applicable)In place? YES 19 NO Ll N/A❑ A 6.0 Alarm line valve sealed In open position All values in normal condition? YES W NO Ll N/A LJ .1 FA P left in normal condition? YES 10 NO C) N/A0 6.2 Did monitoring company receive signal? YES Id NO LJ N/A .3 Has the tank been assessed for obstructions In the last 5 years? YES Ll NO 1 N/A A 6.4 Has an obstruction assessment been per-formed on piping in the last 5 years' YES Id NO L) N/A Ll A.6.5 Has the alarm value and/or bac #low and FDC check been assessed for obstructions in the last 5 years? YES Id NO U N/A U ..7.1 Has antifreeze been tested in last 12 months?(Check chart 131 for results,if inspected today) YES Q NO Ll N/A Id A. ,O Does fire pump appear t be in good working order'? YES El O U N/A . .1 Has fire pump undergone regular churns as required per NFPA 5? YES L) NO LJ N/A id A.9.0 Does customer own a copy of NFPA 25 and understand his/her responsibilities? YES W NO Ll N/ LJ WS01 17 { 1 Ant 1freeze'Test Results: AFL %at Freeze Point %at B ase,of Freeze Point at Antifreeze Antifreeze PSI Reading PSI Reading for Is AFL in Location Tent at Vent Loop Base of Loop 'Type Quantity on Tank Loop Compliance? 0 40 I Inspection results: Passed Ll Passed With Deficiencies W Critical Deficiencies Fount} 0 System Inoperable U PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, R "ALERT TAB OF SERVICE LINK (EMAILED TO CUSTOMER AT COMPLETION OF THE INSPECTION), FOR DETAILS ON ANY CURRE,NT OR PREVIOUSLY REPORTED RECOMMENDATIONS, DEFICIENCIES,OR IMPAIRMENTS. ' D I General Comments: I List the changes in the ece pancy 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 Owner's Representative: YES 46 NO U "Customer signature may be found on electronic Work Acknowledgement in lieu of this report,** 6/22/20 THIS IS NOT AN INVOICE CUSTOMER'S SIGNATURE DATE QTY PART## DESCRIPTION PRICE AM01UNT I Quartedy wet D ER'S PRINTED NAME 6/22/20 EDIT Ti ICIAN SIGNATURE DATE Chris Toro,Joshua WhitneySj 1 08 4- i SPR.�L�R.SERVICE .L TECHNICIAN PRINTED NAM LICENSE�# Q S I I7 i IMPACT FIRE SERVICES, LLC 26 HA11 PSH RE DRIVE DS N NH 03051 . 603.293.7531 PA IM CT F: 603.589.2051 FIRWWW.GETFIREPROTECTION.COM Comm of Mass Sprinkler Contractor S C-210059 Inspected to the State Adopted Verelon of NFPA 2 QUARTERLY WET SPRINKLER INSPECTION JOB :18834646 DATE: 122/2 m EDT CUSTOMER SHIP T : BILL TO: NAB LIF AM INDUSTRIES - NORTH ANDOVER NAB LIFOAM INDUSTRIES LLC ADDMS 351 MOLT RIB ADD ADDuss PO BOX 774, ATT I: ACCOUNTS I AYA I Y NORTH AND ER STATE A IP 01845 � REP RT STATE 1L iP 1032 CONTACT L N BARTOLI PHONE 5 316-0016 EMAM L N.BART LI@NENELLC .0 I CUST `HYPE OF SERVICE REGULAR id EMERGENCY L) START TIME END TIME VALVE LO ATt N: Riser##1 VALVE MAKE Firematic VALVE MODEL F vALVE s'zE 811 ##OF SYSTEMS 1 FM ALARM PANEL MAKE N tifi r MONITORING YES id NO ❑ NIA.U A0.0 Is FACIA In normal at start of Inspection YES tf NO Q NIA Cl .1 Is the panel&riser accessible? YES ef NO 0 NIA Ll 0.2 Alarm lime valves In properposition? YES Id NO 0 N/A LJ A 1.0 Is hydraulic or pipe schedule placard attached and legible? YES NO C) NIA Ll 1.1 System gauges in good condition [carte on cage: 2019 YES , NO LJ N/A U 1.2 Static Before 155 psi Residual 130 psI Static After 1 psi Time to Reach Static Instant Drain Size: 20' - A 1.3 Is residual main drain test r adian at base of riser at or above h raulic demand or pLevious reading? YES Id NO 0 N/A Ll A 10 Are all values supervised and In the appropriate, enlciosed osltion? YES El NO Q NIA.U A.2.1 Alarm valve and trim free from damage? YES Q NO Id NIA Ll A 3.0 Fire Department Connection in compliance?Hydrostatically tested in last 5 years? YES C.7 NO d N/A LJ A 4.0 Time to alarm: 30 BallN.1 . Tlrne to alarm when flowed via 1TV 5.0 All system signs,valve chart,anti-freeze placard(if applicable)in place's YES W NO U NIA .0 Alarm lime valve sealed in open position All valves in normal condition? YES V NO U N/A LJ A 6.1 FA P left In normal condition? YES " NO LJ N/A D A 6.2 Did monitoring company receive signal? YES W NO L) NIA A 6.3 Has the tank been assessed for obstructions in the last 5 years? YES Q NO LJ NIA.W .4 Has an obstruction assessment been performed on piping In the last 6 years? YES Id NO U N/AQ A 6.5 Has the alarm valve and/or backflow and FDC check been assessed for obstructions in the last 5 years? YES Id NO C) N/A La .7.1 Has antifreeze been tested in last 12 months?(Check chart 131 for results,If inspected today) YES U NO GI N/Ald A.8.0 Does fire pump appear to be In good working order? YES U NO U N/A 14 A.8.1 Has fire pump undergone regular churns as rewired per NFPA ? YES Cl NO Cl N/A.0 . .0 Does customer own a copy of NFPA 25 and understand hlslher responsibilities? YB Id NO Ll NIA U QWS012517 13 I Antifreeze Test Results: API Flo Freeze Point %at Base of Freeze Point at Antifreeze Antifr e e PSI Reading PSI Reading for Is AFC,in Vert at Vent Location 40 Loop base of Loop Type quantity on Talc Loop Compliance? 4r C I Inspection results: Passed Q Passed With Deficiencies id Critical Deficiencies Pound LJ System Inoperable Ll PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, OR "ALERT TAB" OF SERVICE LINK (EMAILED TO CUSTOMER T COMPLETION OF THE INSPECTION), FOR DETAILS ON ANY CURRENT OR PREVIOUSLY REPORTED RECOMMENDATIONS,, DEFICIENCIES,OR IMPAIRMENTS." D I General Comments: I List the changes in the occupancy hazard or fire protection equipment,as advised by the owner,since last inspection P I Inspection and su gested improvements were discussed with the undersigned 0 caner or Own is Representative: YES 46 NO Ll **Customer s!gnature m ay be found on el ectronic Work A cknowled gement in lieu of lh!s report.'* 1 0 THIS IS NOT AN INVOICE JST0ME SI 1 AT RE DATE 'I V PA T# DESCRIPTION PRICE AMOUNT I Quarkedy Bret B CUS�P?IEWS PRINTED NAME 11 TgreflNICIAN 916NAWRE DATE Chris Toro,Joshua WhitneyS1150081 TECHNICIAN PRINTED NAME LICENSE 90 1 SPRINKLER SERVICE CALL WS 12 1 4 IMPACT FIRE SERVICES, LLC r' 26 HAMPSHI E DRIVE HUDSON NH 03051 IMPACT 603.293.7531 F :603.589.2051 FIREWWW.GETFIREPROTECTION.COM Commonwealth of Mass Sprinkler contractor SC-210059 Inspected to the state Adopted Veralon of N FPA 25 QUARTERLY WET SPRINKLE.INSPECTION JOB :18834646 DATE:0 1 020 08:00am EDT CUSTOME R ID: SFU T : BILL TO- NAME LIF AI I INDUSTRIES IES - FORTH ANDOVER NAB LIF A I INDUSTRIES LLC ADDuss 351 H LT RD ADDRESS PO BOX 774,ATTIC: ACCOUNTS I A A CITY NORTH ANDOVER STATE MA zip 01845 ciTyFIEEPT STATE IL ziP61032 :. NTAOT L N BARTOLI PHONE 775)316-0016 EmAIL L I. AFT LI@ E1 ELLCO-CO v GUST P TYPE OF SERVICE REGULAR id EMERGENCY U START T1W END TIME VALVE LOCATION: Riser# 'IAL�11iA�E lull VALVE MODEL 717VALVE SIZE # SYSTBis 1 FM ALARM PANEL MAXE Notofier MONITORING YB id NO U NIA Ll 0.0 is FADP In normal at start of Inspection? YES Ef NO U N/A Ll o.1 is the panel&riser accessible? YES Ef NO El N/A Ll A 0.2 Alarm line valves In roperposition? YES Ef NO El NIA U 1.0 is h d arufic or i schedule fecard attached and le ible? YES &f N U N/ A L3 1.1 System gauges In good condition? Date on a e: 2017 YES d NO U NIA 1.2 Static Before 1.55 psi Residual 125 1 psi Static After 155 psi Time to Reach Static instant Grain Size: 0' A 1.3 Is residual main drain test reading at Base of riser at or above hydraulic demand or previous reading? YES Ef N N/A CJ A 2.0 Are all valves supervised and In the appropriate open/closed osition YES Id NO Lj NIA Q A,2.1 Alarm valve and trim free from damage? YES Id NO Ll N/A A 3.0 Fire Department Connection in compliance Hydrostatically all tested in last 5 years? YES L) NO VJ NIA Cl .0 Tir o to alarm; Bell[w.M. . Time to alarm when flowed via 1TV A .0 All system signs,valve chart,anti-freeze placard if applicable)in place? YIDS id NO Ll N/ AU A 6.0 Alarm line valve sealed in open position All valves in normal condition YES W NO L) NIA Ll 6.1 F DP left In normal condition? YES W NO L7 N/A. A►6.2 Did monitoring company receive signal? YES 9 NO Ll NIA A.6.3 Has the tank been assessed for obstructions In the last.5 years? YES U NO Ll N/A W 6.4 Has an obstruction assessment been performed on piping In the last 5 years? YES Ll NO id NIA Ll 6.5 Has the alarm valve and/or backflow and FCC check been assessed for obstructions in the last 5 gears? YES Ll NO Id N/A l A.7,1 Has antifreeze been tested in last 12 months?(Check chart 131 for results,if inspected today) YES Ll NO U N/A Ef A. .0 Dees fire pump appear to be in good working order? YES Ll NO U N/A id A.. .I Has fire pump undergone regular churns as required per NFPA YES ❑ NO L) NIA .9.0 Does customer own a copy of NFPA 25 and understand hi 1her responsibilities? YES W NO Ll NIA U i f € yk f y� S I. 'i e 5 B Antifreeze Test Results: A L %at Freese Point %at Base of Freeze point t Antifreeze Antif�ree PSI heading PSI Readingfor Is AFL in Location dent at a Loop Base of Loop Type Quantity on TankLoop Compliance? O 40G C I Inspection results: Passed Q Passed With Deficiencies id Critical Deficiencies Found L] System Inoperable 0 PLEASE SEE ELECTRONIC 'CORK ACKNOWLEDGMENT R "ALERT TAB" OF SERVICE LINE (EMAILED TO CUSTOMER AT COMPLETION THE INSPECTION), FOR DETAILS ON ANY CUNT OR PREVIOUSLY REPORTED RECOMMENDATIONS, DEFICIENCIES,OR IMPAHLMENTS." D I General Comments: E I List the changes in the occupancy hazard or fire protection equipment,as advised by the owner,since last inspection E I Inspection and suggested improvements were discussed vAth the undersigned Owner or Owner's Representative: YES ill NO U "Customer signature may be found on electronic Work Acknowledgement in lleu of this report." FO)j,-, /22/20 THIS IS NOT AN INVOICE VUSTOMERTSIGNATURE DATE QTY PARTA DESCRIPTION PRICE AMOUNT Quar#etly Bret CUS JER'S PRINTED NAME 5/22/20 UCHNICIANSIGNATURE DATE Chris Toro,Joshua Whitney S0 5 0 1 TECHNICIAN PRINTED NAME LICENSE 2031 PRE I LE SERVICE CALL IMPACT FIFE SERVICES, LL 26 HAMPSHIRE DRIVE H DS NNH 03051 0 . 603,293.7531 IMPACT F : 603.589.2051 FIRM. ETF I ICE P FTEGTi N.C Com monwea€lth of Mass s Prinkler Contractor S - 10059 Inspected to the State Adopted Version of NFPA 2 QUARTERLY WET SPRINKLER INSPECTION j ..18834646 DATF,: 2212 2 08-. EDTCUSTOMER ID: - BILL : S :T S AW LIF AM INDUSTRIES - NORTH AND ER NAmE LIF AM INDUSTRIES LLC ADDRESS 351 H I T IUD ADDRESS PCB BOAC 774, ATTN: ACCOUNTS PA A CITY NORTH ANDOVER STATE MA ZrP 01845 CITY FREEPORT STATE IL zip 61032 CONTACT L N BARTOLI PHONE 77 316-0016 EMAM L N.BAI T LI@NEWELLC .0 I CUST POD TYPE OF SERVICE REGULAR id EMERGENCY Ll START TIME END TIME E AL' E LOCATION: Riser#7 ALvEmA E SI of An VALVE MODEL VAL SIZE 11 itOF SYSTEMS FIRE ALARM PANEL NLk Notifi r MONITORING YES Id NO Ll N/A 0.0 Is FA P In normal at start of Inspection? YES 9 NO U NIA❑ 0.1 Is the panel&riser accessible? YES ZY NO LJ NIA LJ A 0.2 Alarm line valves in ro erposition? YES NO Q NIA U A 1.0 is h draulic or pipe schedule placard attached and legible? YES NO 0 NIA A 1.1 System auges In good condition? Date n tie e: 07 YES NCB NIA C 1.2 Static Before 150 psi 1 esIdual 130 ps1 Static After 150 psi Time to beach Static Instant Brain Size: A 1.3 is residual main drain test reading at base of riser at or above hydraulic demand or previous reading? YES Id NO Ll NIA C] A.2.0 Are all valves su ervlsed and in the a ro riate open/closedposition? YES d NO Q NIA Q A.2,1 Alarm valve and trim free from damage? YES id NO Ll NIA Ll A 3.0 Fire Department Connection in compliance?Hydrostatically tested in last 5 years? YES Ll NO W NIA U A 4.0 Time to alarm: BelM.M. . Time to alarm when floored via lT V A .0 All system signs,valve chart,anti-freeze placard if applicable)In place? YES W NO Ll NIA. A 6.0 Alarm line valve sealed In open position All valves In normal condition? YES W NO U NIA Ll A.6.1 FACIA left In normal condition? YES V NO Ll NIA E) A.6.2 Did monitoring company receive signal's YES V NO Ll NIA A.6.3 Has the tank been assessed for obstructions in the last 5 years? YES 0 NO LJ NIA.W A 6.4 Has an obstruction assessment been performed on piping in the last 6 gears? YES Id NO L) NIA U 6.5 Has the alarm valve and/or back flow and FDC check been assessed for obstructions in the last 5 years? YES Id NO U NIA. .7.1 Has antifreeze been tested in last'1 months'?(Check dart 131 for results,if Inspected today) YES LlO� CIA IdA. .0 Daes fire pump appear to be in good work!ng order's F, C� NCB NIA id A, .1 Has fire pump undergone regular churns as required per NFPA ? YES U NO L) NIA. . .0 noes customer own a copy of NFPA 25 and understand his/her responsibilities? YES 0 NO J N/A D i } Q1 S012 17 I Antifreeze Test Results: AFL Flo at Freeze Point %at Base of Freeze Point at Antifreeze Antifreeze PSI Reading PSI Reading for Is AFL in Location 'dent attVent Loop Ease of Loop Type Quantity on Tank Loop Compliance? 40G 40 'r C l Inspection results: Passed Ll Passed With Deficiencies id Critical Deficiencies Pound U System Inoperable U ** PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, GI "ALERT TAB" OF SERVICE LINK (EMAILED TO CUSTOMER AT COMPLETION F THE INSPECTION), FOR DETAILS ON ANY CURRENT OR PREVIOUSLY REPORTED RECOMMENDATIONS, DEFICIENCIES,OR IMPAIRMENTS. D I General Comments: List the changes in the occupancy hazard or Fire protection equipment,as advised by the owner,since last inspection: F 1 inspoction and suggested improvements ivere discussed with the undersigned Owner or Owner's Representative: YES id NO 0 .: "Customer signature may be found on electronte'Work Acknowledgement to lieu of this report." "IL4/22/20 THIS IS NOT AN INVOICE CUSTOMER'S SIGNATURE DATE QTY PART ff DESCRIPTION PACE AMOUNT turter€y wet CX1 E 'S PRINTED NAME 6122120 'THNICIAN SIGN URE DATE Chris Toro, Joshua Whitney S0000 1 TECHNICIAN PRINTED NAME LICENSE# 2031 SPRINKLER SERVICE CALL WS01251 IMPACT FIDE SERVICES, LL 26 HAIPIIRE DRIVE HUDSON NH 03051 D . 603.293.7531 IMPACT F .603.589.2051 FIR ~. ETF I f F PRTETI N. D Commonwealth of Mass Sprinkler contractor S - 10059 Inspected to the State Adopted Version of NFPA 25 QU"TERLY WET SPRINKLER INSPECTION JOB#:18834646 ]ATE: / 2/2 r 3:88 EDT CUSTOMER ID: .......... IEF TO: BILL TO: NAME LIF A Ii INDUSTRIES -NORTH AND OVER NAME LIF AM INDUSTRIES LLC ADDRESS 351 H LT RD ADDREss PO BOX 774, ATTN: ACCOUNTS PAPA CITY NORTH TH AND OVER STATE MA zip 01845 CrfY F EEP f T STATE IL ZT 61032 CONTACT L N BAIT LI PHONE 8 316-0016 EMAIL L N.BAF T LI@NEWELLC .CO CUST P TYPE of SERVICE REGULAR id EMERGENCY L START TIME END TIME VALVE LOCATION, Riser r#8 vA.L,vE�E Firmti VALVE MODEL N VALVE SIZE 41F of SYSTEMS 1 F E ALARM PANED mAKE Notifier MONITORING YES id NO D N/A❑ 0.0 Is PA P In normal at start of inspection'? � LJ N/A Ll 0.1 Is the panel riser accessible? � N/A� A 0.2 Alarm line valves in ro errposition? YES Ef NO LJ N/A Q A 1.0 Is hydraulic or pipe schedule placard attached and legible? YES &f NO ❑ N/A.Q 1.1 System gauges In good condition? [date an usage: 2019 YES d NO 0 N/A Ll A 1.2 Static Before 160 psl Re 12S... psI static After 150 psi Time to Reach Static instant Grain I e; A 1.3 is residual main drain test reach at base of riser at or above draulic demand or previous reading? YES Ef NO Ll N/A C] A 2.0 Are all valves supervised and In the a propriate o eniclosed ositlon YES d NO L3 N/A Q A.2.1 Alarm valve and trim free from damage? YFS Ef NO Ll N/A L7 A 3.0 Fire Department Connection In complianco?hydrostatically tested in fast 5 years? YES Ll NO 1' NIA Ll A 4.0 Time to alarm: elllW.M.G. Time to alarm when flowed via ITV .0 All system signs,valve chant,anti-freeze placard(if applicable)in place? YES W NO Q N/A U .0 Alarm line valve sealed in open position's All valves in normal condition? YES V NO L3 N/AQ A 6.1 FA P left in normal condition? YES 1W NO Q N/A U A 6.2 Did monitoring company receive signal? YES Id NO U ILIA U A.6.3 Has the tank been assessed for obstructions in the last 5 gears? YES W NO El NIA I .4 Has an obstruction assessment been performed on piping in the last 5 years? YES Id NO LA N/ A 6.5 Has the alarm valve and/or backflow and FDD check been assessed for obstructions In the last 5 gears? YES Id NO 0 N/A U .7.1 has antifreeze been tested in last 12 months (Check chart 131 for results,if inspected today) YES LJ NO L] N/A Id A.8.0 Does fire pump appear to be in good working order's YES U NO Ll N/A W AXI Has fire pump undergone regular churns as required per NFPA ? YES Ll NO Q N/A id A. .0 Does customer own a copy of NFPA 25 and understand histher responsibilities? YES id NO L] N/A U QWS012517 B 1 Antifreeze Test Results: AFL Vent �at Freese Point %at Base of Freeze Point at Antifreeze Antifreeze PSI Reading PSI leading four Is AFL in Location went at went Loop Base of Loop Type Quatifity on Tarok Loop Compliance? 40 4 1 1 nspec tion results: Passed U Passed With Deficiencies Id Critical Deficiencies Pound 0 System Inoperable I PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, OR 91AL R.T TAR" O SERVICE LINT EMAILED TO CUSTOMER AT COMPLETION OF THE INSPECTION), FOR DETAILS ON ANY CURRENT OR PREVIOUSLY REPORTED RECOMMENDATIONS, DEFICIENCIES,OR III PAIRMENT S, D I General Comments: 1 List the changes in the occupancy hazard or fire protection equipment,as advised by the owner,since last inspection 1 Inspection and suggested improvements were discussed Nvith the undersigned Owner orOwner's Representative: YES Qd NO Ll "Customer signature may be found on electronic Work Acknowledgement in lien of this report," rg\t 6/22/20 THIS IS NOT AN INVOICE TO EI 'S SIGNATURE DATE QTY PAPT# DESCRIPTION IPTIO PRICE AMOUNT C S 4 Quarterly Bret C"YOMEWS PRINTED NAME /22/2 CHINICII N SICK 'PURE DATE Chris Toro,Joshua WhitneyS050081 i SP�L SERVICE A,L,�., TECHMCIAl PRINTED 1AME LICENSE�# IMPACT FIRE SERVICES, L.L 26 HAMPSHI E DRIVE HUDSON NH 03051 : 603.293.7631 IMPACT F : . 89 i 1 FIREV"".GETFIREPROTECTION.COM Commonwealth of mass sprinkler Contractor S - 10059 Inspected to the state Adopted Version of off PA 2 QUARTERLY WET SPRINKLER INSPECTION jB#:18834646 DATE: / / 2 -. a ... DT CUSTOMER t : SHIP TO: BILL TO: NA E LIF AM INDUSTRIES -NORTH ANDOVER NAr E LIF AM INDUSTRIES L.LC ADDRESS 1 H LT FAD ADDRESS PCB BOX 774, ATTN: ACCOUNTS PA A CITYNORTH STATE MA zip 1 iTY EEPiT STATE IL EP 61032 CONTACT LOB! BARTOLI PRONE 316-0016 EWdL L I .EART L I @I EWE LLC .CO GUST P TYPE of SERVICE REGULAR 0 EMERGENCY U START TIME END TME-1 VALVE LOCATION. Wall Hydrant VALVE MAKE VALVE MODEL VALVE SIZE " #OF SYSTEMS FI EALAIMPA EL MAKE Notifier MONITORING YES id NO LJ N/AU A0.0 Is FA P 1n normal at start of Inspection'? ES NO C7 NIA Ll ...................... 0.1 I the panel riser accessible'? YES NI 7 0. Alarm line valves in r er osition YES � NO LJ � U A 1.0 Is hydraulic or pipe schedule placard attached and legible? YES if NO Ll NIA C A.1.1 stem gauges lr cod condition'? Date n u e: 017 YES ! NIA U A 1.2 Static Before 145 pSI Residual 130 psi Static After 145 psi Time f beach Static instant ]rain Size: - 1.3 1s residual main drain test readi.nq at base of riser of or above hydraulic demand or,previous reading? YES Ef NO L) N/A El .0 Are all valves supervised and In the appropriate o entcl sed sitlon ES El NO U 1A Ll A 2.1 Alarm valve and trim free from damage? YES 0 NO U N/A L7 .0 Fire Department Connection in compliance Hydrostafically tested 1n last 5 years? YES LJ NO W NIA A 4.0 Time to alarm: Bell[W.M.G. I Time to alarm when flowed via ITV A5.0 All system signs,valve chart,anti-freeze placard(if applicable)In place? YES 9 NO U N/A C7 6.0 Alarm line valve sealed 1n open position All valves In normal condition? YES ' NO ❑ NIA U 6.1 FACT'left In normal condition? YES U NO U N/A Cl 6.2 Did monitoring company receive signal? YES 9 NO U NI 6.3 Has the tank been assessed for obstructions 1n the last 5 years? YES W NO U NIA A 6.4 Has an obstruction assessment been performed on piping in the last 5 gears? YES Ef NO U MIA C1 A 6.5 Has the alarm valve and/or backflow and FDC check been assessed for obstructions in the last 5 years? YES id NIA U A..7.1 Has antifreeze been tested in last 12 months?(Check chart 131 for results,if inspected today) YES Ll NO Ll NIA 16 A. .D Does fire pump appear to be in good working order? YES 0 NO U NIAW A. .1 Has fire pump undergone regular churns as required per NFPA YES U NO Ll NIA W . .0 Does customer own a copy of C FPA 25 and understand his/her responsibilities? YES id NO L1N/A U S01251 I Antifreeze Test Results: AFL %at Freeze Point %at Base of Freeze Point at Antifreeze Antifreeze PSI Reading PSI Reading for Is AFL i Location Vent at Vent Loop 4 4 Base of Loop Type Quantity on Tank Loop Compliance? C 1 Inspection results: Passed Ll Paused With Deficiencies id Critical Deficiencies Found Ll System Inoperable PLEASE SEE ELECTRONIC 'FORK ACKNOWLEDGMENT, OR "ALERT T TAB'S OF SERVICE LINK (EMAILED TO CUSTOMER AT COMPLETION OF THE INSPECTION), FOR DETAILS ON ANY CURRENT OR. PREVIOUSLY REPORTED RECOMMENDATIONS, DEFICIENCIES,OR IMPAIRMENTS." D i General Comments: 1 List the changes in the occupancy ha zard or fire proteetion equipment,as advised by the owner,since last inspection F 1 Inspection and suggested improvements were discussed with the undersigned Owner or Owner'sRepresentative: YES 46 NO **Customer signature may be found on electronic Work Acknowledgement 1n Heu of this report.** / 2/2 THIS I NOT AN INVOICE CUSTOMER'S SIGNATURE DATE T PART# DESCRIPTION PRICE AMOUNT 1 Quarterly Bret C R'S Plu '' NAM OOP 22/2 NICIAN SIGNATS& BATE Chris Toro,Joshua WhitneyO 50081 1 SPRINKLER SERVICE CALL TECHNICIAN PRINTED NAME LICENSE SE 501 517 IMPACT FIRE SERVICES, LL 26 HAMPSHIRE DRIVE HUDSON NH 03051 . 603.293.7531 IM ACT F. 3. 3 . 1 FIREVA".GETFIREPROTECTION.COM Commonwealth of Mass Sprinkler Contractor S -219059 Inspected to the State Adopted Version of NFPA 2 QUARTERLY WET SPRINKLER INSPECTION ,SOB#:1 3 DATE:0 /22/2 20 EDT CUSTOMER I : SHIP TO: BILL TO: NAB LIF AM INDUSTRIES - NORTH AND OVER NAmE LIFOAM INDUSTRIES LLC ADDRESS E 351 H LT RD ADDRESS PO BOX 774, ATT N:ACCOUNTS PAYA CITY NORTH ANDOVER STATE MA zip 01845 oiTY FREEPORT STATE IL zip 61032 CONTACT L N B RT LI PHONE 316-0016 EMAIL L N.BAI T LI @NEWELLCO.COIV ST TYPE OF SERVICE REGULAR EMERGENCY Ll START TIME END TIME VALVE LMATION. Riser VALVE MAKE Automatic VALVE MODEL VALVE SIZE " of SYSTEMS FIRE ALARM PANEL MAKE Notlfl r MONITORING YES 0 No L1 N/A Ll A 0.0 is FA P In normal at start of Inspection? YES NO ❑ NIA Ll 0.1 Is th anel&riser accessible? YES NO U NIA LJ 0.2 Alarm fine valves In ro erposition? YES tf NO JJ NIA C7 A 1.0 Is hydrauI1c or pipe schedule placard attached and legible? YES tf NO 0 N/A Ll A 1.1 System gauges In good condition? Date on cage: 2019 YES Ef NO L) N/A L A 1.2 Static l3ofore 160 psi Residual idual U5 psi Static After 150 psi Time to Reach Static Instant Drain Size:_......__. , 1.3 Is residual main drain test reading at Base of riser at or above hydraulic demand or previous reading? YES d NO Cl NIA Cl 2.0 Are all valves supervised and In the appropriate o entclosedposition? YES Ef NO ❑ NIA C A.2.1 Alarm valve and trim free from damage? YES 0 NO Ll NIA L .0 Fire Department Connection in compliance?Hydrostatically tested in last 5 years? YES LJ NO W NIA❑ A4.0 Time to alarm: ellfW.IVI. . Time to alarm when flowed via 1TV .0 All system signs,valve chart,anti-freeze placard if applicable)in place? YES id NO C1 N/A L 6.0 Alarm line valve sealed in open position? All valves in normal condition? YES iZ NO U Nl L7 A 6.1 FA P left in normal condition? YES W NO U NIA U A 6.2 Did monitoring company receive signal? YES id NO 0 N/ L1 6.3 Has tho tank been assessed for obstructions in the last 5 years? YES %Y NO Ll NIA Ll .4 Has an obstruction assessment been performed on piping In the last 5 years? YES Id NO LJ NIA 6.5 Has the alarm valve and/or backtlovwr and FDC check been assessed for obstructions in the last 5 years? YES Ef NO L) NIA Cl A.7.1 Has antifreeze been tested in last 12 months?(Check chart BI for results,if inspected today) YES NO U NIA ld A.8.0 Does fire pump appear to be in good working order? YES Il NO Q NIA id A.8.1 leas the pump undergone regular churns as required per NFPA YES Q NO Ll NIA id . .O Goes customer own a copy of NFPA 25 and understand his/her responsibilities? YES id NO LJ NIA. v off. 17 B I Antifreeze Test I esxzlts: AFL %at Freeze Point %at Base of Freeze Point at Antifreeze Antifreeze PSI Reading PSI Reading for Is AFL in Location dent t Loop Base of Loop Type Quantity on Tank LoopCompliance? r 40G) 1 Inspection results: Passed Ll Passed With Deficiencies W Critical Deficiencies Found U System Inoperable U PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, O "ALERT TA B' O SERVICE LINK (EMAIL D TO CUSTOMER AT COMPLETION OF THE INSPECTION), FOR DETAILS ON ANY CURRENT OR PREVIOUSLY IOUSLY REPORTED RECOMMENDATIONS, DEFICIENCIES,OR IMPAIRMENT . D I General Com ents I List the charges in the occupancy hazard or fire protection a uipment,as advis d by the owner,since last inspection F i Inspection and suggested improvements were discussed with the undersigned Owner or Owner's Representative: YES Id NO "Customer signature may a found on electronic Work Acknowledgement in Heu of this report.** 1h rl) F13%� 6/22/20 THIS IS NOTA INVOICE CUSTOMER'S SIGNATURE DATE QTY PART PART# DESCRIPTIONPRICE AMOUNT Qua rte y wet C J '" M R'S PRINTED NAML�� 6/22/20 TrCHNIMN91 DATE Chris Toro,Joshua WhitneyS1150081 � I SPRINKLER SERVICE �.,�,, T C NICIAi PRINTED NAME LICENSE# WS012517 IMPACT FIDE SERVICES, LL 26 HA IP HIRE DRIVE : 603.293.7531 IMPAC F;603.589.2051 FIRW".GETFIREPROTECTION.COM Commonwealth of Mass Sprinkler contractor c* i005 Inspected to the State Adopted Version of NFPA 25 QUARTERLY WE'D`SPRINKLER INSPECTION N j : 1883 DATE:9 /22 2 20 08-.00am EDT CUSTONER YD: SHIP TO: I LL T : NAB LIFOAM INDUSTRIES R NORTH AND OVER NAmE L]FOAM INDUSTRIES LLC ADDRESS 351 H LT RD ADDRESS PO BOAC 774,ATT : ACCOUNTS PA A CITY NORTH ANDOVER sTATE MA zip 01845 CITY FREEP RT STATE IL zip 61032 CONTACT L N KART LI PHONE 75 316-0016 EMAIL L N.BART LI@NEWELLC :C r UST P TYPE SERVICE REGULAR M E 1 Y L START TIME END TIME VALVE LOCATION: Riser#9 VALVE lit 11 VALVE MODEL VALVE SIB " #�D SYSTEMS FIRE ALARM PANEL MAKE MONITORING YES 0 NO U NIA U 0.0 is FACT'In normal at start of Inspection? YES 9 NO LA NIA L� 0.1 Is the anel&riser accessible? YES tf NO L3 NIA0 A 0.2 Alarm line valves In proper position? YES ed NO Ll WAD *1.0 Is hydraulic or pipe.,schedule placard a#tached and legible? YES Qd N NIA 0 1.1 System gauoges in food condition? Date on ua e: 2017 YES d NO El MIA L1 1.2 Static Before 150 psi Residual 135 psi Static After 60 psi Time to leach Static instant Drain Size. A 1.3 Is residual main drain test readinn at base of riser at or above hydraulic demand or previous reading? YES d NO U N/A CJ A 2.0 Are all valves supervised and In the appropriate en/closed sits n? YES Ef NO Q N/A Ll A 2.1 Alarm valve and trine free from damage? YES Id NO U N/A Li A 10 Fire Department Connection In compliance?Hydrostatically tested In last 5 years? YES L7 NO W /A Li A 4.0 Time to alarm: Bell/W.M.G. Time to alarm when flowed aria 11 .0 All system signs,valve chart,anti-freeze placard(if applicable)In place? YES ate` NO Li N/A CJ 6.0 Alarm line valve sealed in open position? All valves In normal condition? YIDS ia NO Ll NIA L) *6.1 FACT'left in normal condition? YES W NO LI NIA Li A 6.2 Did monitoring company receive signal? YES W NO Lt N/ALA A 6.3 Has the tank been assessed for obstructions In the last 5 years? YES L] NO L1 NIAU .4 Has are obstruction assessment been performed on piping in the last 5 rears? YES Id NO L) NIA Il 6.5 Has the alarm valve and/or backflow and FDC check been assessed for obstructions in the last 5 years? YES id NO Li NIA Ll A.7.1 Has antifreeze been tested in last 12 months? heck chart 131 for results,if inspected today) YES U NO U N/A Iff A.8.0 Does fire pump appear to be in good workingorder? YES U NO L) NIA id . .1 Has fire pump undergone regular churns as realu!red per NFPA 5? YES L1 NO L1 NIA W A. .0 Does customer own a copy of 1 FPA 25 and understand hi Cher responsibilities? YES id NO J N/A Ll QWS012517 B I Ant ifree ze Test Result s: API % t Freeze Point °oat � Freese Pont�� t��freeze Apt€free e P �Reading Pit Reading 'oar I AFC.in Location went at ent0G) Loop Base of Loop Tye Quantity on Tank LoopornP�ia��ce (>40G) 1 Inspection results: Passed Q Passed With Deficiencies id Critical Deficiencies Found 0 System Inoperable PLEASE SEE EL CT ONIC 'CORK ACKNOWLEDGMENT, OR "ALERT TAB OF SERVICE LINT EMAILED TO CUSTOMER AT COMPLETION TION OF THE INSPECTION), FOR DETAILS ON ANY CURRENT OR PREVIOUSLY REPORTED RECOMMENDTINS5 DEFICIENCIES,OR IMPAIRMENTS. ' D I General Comments: E 1 List the changes in the occupancy hazard or fire protection equipment,a s advised by the owner,since last Inspection F I Inspection and suggested improvements were discussed vAth the undersigned Owner or Ownees Representative: YES id NO Q "Customer signature may be found on electronic Work Acknowledgement in Heu of this report." 6/22/20 THIS IS NOT AN INVOICE CUSTOMER'S SIGNATURE DATE QT PART## DESCRIPTION PRICE A O T i Quarterly wet CqqIMEWS PRINTED NAME 6/22/20 NICIAN SIGNATURE DATE Chris Toro,Joshua Whitney S1150081 ............... NICIAN PRINTED NAME LICENSE 20 t TEC SPRINKLER SERVIC CALL QWS012517 1 NEWWA Backflow Prevention Device Assembly Test Report Form Owner of Pro pert - --.............................. Date 6 22 20 - Time :00a 1 Mailing Address Tested by Chris Toro Ceilifi ate#WS 1 o-oo32 5 ity,Town zip Contact Person RPZ ❑ DCVAN PVB ❑ SRVB ❑ Make Feo Model No. o Device Address and Location Size 10 Serial No. Test After Installation ❑ Device Identification Number Test After Repairs ❑ Annual Test E Test Kit Serial# Calibration Date Other ❑ 1 c hacWq re nt o�Device m �� . Pressure aer�r��r Breaker r Spill e istant aer rm Baker Check valve Check valve Flow Relief Valve Check valve Check valve Flow Condition No, I No.2 Tightness Condition DP Opening No.2 DP DP Evaluated Evaluated Point ................ 1-1------- ............. ................. -------- Closed Tight ❑ Closed Tight ❑ Flow ❑ Opened at PSID Flow ❑ Leaked ❑ Leaked ❑ No-Flow ❑ No-Flow ❑ - •� PSID PSID Did Not Open❑ PSID :Double 'heck.Valve Device Assembly.. `V . it Inlet valve DP Opening Paint Backpressure Test Check valve No. 1 Check valve No.2 Flow Condition DP DP Evaluated .----------- _--------- . -------- ......r...., -----_-.--------------- . ........Y............... Opened at TC1 PSI TC#4 PSI PSID •1.2 •� Flow 0 PAID PAID �' Did Not erg❑ No-Plow❑ t the time of the test,the downstream shut-off valve was: Closed Tight 0 Leaked 0 Not Tested ❑ Line Pressure 145 PSI Protection Type: Service Line ❑ Fire Service Line 0 Internal Domestic Plumbing System❑ PASSE FAILD OTHER 1:1 ig�ature of Certified ester Test witnessed by; Remarks Serial number is 00 112 1201 w er works Official rq Owner Agent State Official Service Restored 11