HomeMy WebLinkAboutQuarterly Wet Sprinkler Inspection - Inspection - 351 HOLT ROAD 6/22/2020 (3) IMPACT FIFE SERVICES, LLC
6 HAMPSHIRE DRIVE
HUD SON NH 03051
IMPACT .603. 93.75 1
F . 603.589. 051
FIRWWW.GETFIREPROTECTION.COM
cmmonwealth of Klass Sprinkiar Contractor S C-2 10050
Inspected to the State Adopted Versfon of HFPA 25
QU"TERLY WET SPRINKLE.INSPECTION
JOB :18834646 DATE: 8 2212 20 08:00am EDT CUSTOWR ID:
Ste' BILL TO:
NAME LIF AM INDUSTRIES - NORTH AND OVER NAw LIF AM INDUSTRIES LLC
ADDMS 351 H LT F D ADDFx S PO BOX 774, ATT f : ACCOUNTS I A A
CITY NORTH ANDOVERSTATE M A zip 01845 CITY FREEPORT STATE IL zip 61032
CONTACT LON BARTOLIPHONE 775 316- 016 EMAIL L i .13A T L1@ EWELLC .0 1v
CST P
TYPE OF SERVICE REGULAR id EMERGENCY U
START`I"TIME END TIME VALVE LOCATION: Riser#4
VALVE MAKE VietaUjiC VALVE MODEL 717 vALvE SIB 811 #OF SYSTEMS 1
FIRE ALARM PANEL MAKE Notifier MONITORING YES fd NO U NIA❑
A 0.0 Is I=A P In normal at start of Inspection? YES d NO LJ NIA U
A 0.1 Is the anal&riser accessible? YES 9f NO Q NIAQ
A 0.2 Alarm line valves In ro erposition? YES Ef NO 0 NIA 0
1.0 is hydraulic or pipe schedule placard attached and legible? YES NO U NIA 0
A 1.1 System gauges In good condition? Date on GUage,. 2017 YES Ef NO LJ NIA LJ
1.2 Static Before ' 0 psi I' esldual 135 psi Static After 160 psi Time to teach Static Instant Drain Size: 20
1.3 is residual lain drain test readln at base of riser at or above hydraulic demand or previous reading? YES Ef N /A C3
2.0 Are all valves supervised and In the appropriate open/closed osltlon? YES 16 NO L3 NIA❑
.1 Alarm valve and trim free from damage? YES 16 NO L7 N/A L7
A 3.0 Fire Department Connection in compliance Hydrostatically tested in last 5 years? YES NO W N/A.
4.0 Time to alarm: Bell[ .l . . Time to alarm when flowed vla 1T
A .0 All system signs,valve chart,anti-freeze placard(if applicable)in place? YES id NO Ll NIA Ll
,0 Alarm line valve sealed in open position 7 All valves In normal condition? YES V NO U N/A.U
.1 FA P left in normal condition? YES W NO LJ NIA L]
6.2 Did monitoring company receive signal? YES Id NO Ll N/A Ll
.3 Has the tank been assessed for obstructions In the last 5}years? YES U NO LJ NIA J
A 6.4 Has an obstruction assessment been perforated on piping in the last 5 years? YESid NO L) Nl fiI
A.6.5 Has the alarm valve andfor backf low and FDD check been assessed for obstructions in the last 5 years? YES Id NO Ll NIA U
A..7.1 Has antifreeze been tested in last 12 months?(Check chart B1 for results,if Inspected today) YES L1 NO Ll NIA 16
A.8.0 Does fire pump appear to be in good working order? YES Q NO J NIA W
. .1 Has fire pump undergone regular churns as required per N1rPA YES Ll NO Ll NIA id
A,9.0 Does customer own a copy of NFPA 25 and understand fits/her responsibilities? YES id NO LJ NIA Ll
QWS 1 517
f
I Antifreeze Test Results:
AFC, °�at Prep Port at Base of Freeze Point at Antifreeze Antifreeze PSI Reading PSI Reading for is AFL in
Location 'Tent t dent Leo
� r A Ease o Loop Type Quantity on Tank Loop Compliance?
I Inspection results: Passed❑ Passed With Deficiencies Id Critical Deficiencies Pound Ll System Inoperable
PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, OR "ALERT TAB" OF
SERVICE LINT EMAILED TO CUSTOMER AT COMPLETION OF THE INSPECTION), FOR
DETAILS ON ANY CURRENT OR PREVIOUSLY REPORTED RECOMMENDATIONS,
EMENDATIONS,
DEFICIENCIES,OR IMPAIRMENTS,"
D 1 General on ents
E l List the changes in the occupancy hazard or fire protect 1 on equipment,as advised by the owner,sconce last inspection
F I Inspection and suggested improvements were discussed with the undersigned Owner or Owner's Representative: YES NO ❑
"Customer signature may be found on electronic Work Acknowledgementin lieu of this report."
6122/20 HIS IS NOT ANN YOKE
CUSTOMER'S SI NAT RE DATE QTYIPART# DESCRIPTION PRICE AMOUNT
1ER1=PED NAME ..............-
22/2
TECtINI IAN SIGNATURE DATE
Chris Fora,Joshua Whitney, Sj"i 1
..........
TECHNICIAN PRINTED NAME LICENSE# 2031
SPRINKLER SERVICE CALL
QWS012517