HomeMy WebLinkAboutSemi-Annual Wet Sprinkler Inspection - Inspection - 757 TURNPIKE STREET 4/27/2020 IMPACT FIFE SERVICES, L.LC
6 HA PSHI E DRIVE
f HUDSON NH 03051
PA C
IM T O .603.293.7531
F : 603.689.2051
IR1 W .GETEIFEEPF OTE TION. OM
om monwealth of Mass Sprinkler Contractor S = 19959
Inspected to the State Adopted VeWon of N FPA 25
SEMI-ANNUAL WET SPRINKLER INSPECTION
j i3 : 18704871 ATE; 4 2 l2 29 01:00pm EDT CUSTONIER ID:_
SIRP TO: BILL TO:
NAME STOP &SHOP#92 NAw C &W SERVICES
ADDRESS 767 TURNPIKE STREET ADDRESS 99 SUMMER ST, SUITE 220, ATT :All,
CITY NORTH TH ANDOVER STATE MA ZIP 01845 CITY BOSTON STATE VIA ZIP 02110
CONTACT STORE MANAGER PHONE 978) 683-9666 EMAIL
OUST p # AHD 01800332
TYPE OF SERVICE REGULAR Ef EMERGENCY ❑
START THWE END TIME VALVE LOCATION: System#1
VALVE MAKE Star VALVE MODEL F vALME SI E 6 #OF SYSTEMS
FM ALARM PANEL MAKE MONITORING YES NO ❑ NIA❑
A0.0 Is FRCP In normal at start of Inspection? YES 11 NO C1 NIA U
.1 Is the panel&riser accessible' YES tf NO ❑ NIA❑
AO.AO.2 Flow switches operational?Total#of flow-switches tested: I YES id NO ❑ NIA❑
0.3 Tamper switches operational?Total#of tamper switches tested: 3 YES Id NO❑ NIA❑
0.4 Does Inspectors test valve terminate In correct orifice? YES 0 NO U N/A
A 0.5 Alarm line valves In proper position? YES id NO❑ NIA❑
A .6 Is hydraulic or pipe schedule placard attached and legible? YES id NO U NIA.❑
A.03 System gauges in good condition? Date on Gauge 2018 YES Id NO❑ NIA❑
A.0.8 Are all valves supervised and in the appropriate open/closed position? YES id NOU NIA.U
A 1.1 Static Before o 1 psi residual 40 psi Static After so psi Time to Reach Static 1 Drain ize:_
A 1.2 Is residual main strain test reading at base of riser at or above hydraulic demand or previous reading? 'DES Id NO Il N/A Ll
A,1.3 All control valves accessible? YES W NO❑ NIA❑
A 1.4 Alarm valve and trim free from damage? YES id NO U MIA
A 1.5 Fire Department Connection In compliance?Hydrostatically tested in last 5 gears? YES id NO❑ NIA❑
A,2.o Time to alarm: Be11!'V'Irf.M. . Flow-switch 35 Press-switch
A2.0 Time to alarm when flowed via 1'TV: 3
.1 All system signs,valve chart,anti-freeze placard(if applicable)In place? YES id NO LJ N1A.L)
3.0 Alarm line valve sealed In open position? All valves in normal condition? YES ja NO❑ NIA.❑
4.0 Has the tank been assessed for obstructions in the last 5 years YES ❑ NO LJ NIA Id
4.1 Has an obstruction assessment been performed on piping in the last 5 gears? YES id NO❑ MIA Cl
.0 Has the alarm valve andforr back flow and FDC check been assessed for obstructions In the last 5 years? YES JA NO❑ N1A❑
A 6.0 Does fire pump appear to be In good working order? YES ❑ NO❑ NIA W
.1 Has fire pump undergone regular churns as required per N PA 257 YES C1 NO❑ N/Ap
A 6.2 Has antifreeze been tested in last 12 months?(Check chart B1 for results,if inspected today) YES ❑ NO❑ NIAW
A 6.3 Did monitoring company receive signal? YES Id NO Ll N/A❑
.4 FA P left in normal condition? YES Id NO ❑ NIA❑
.7.1 Does customer own a copy of NFPA 25 and understand is/her responsibilities? YES 0 NO❑ NIA U
SW5012 17
B I Antifreeze Test Results:
%at Freeze Point
AFL V'ent at Vent %at Base of Freeze Point at Antifreeze Antifreeze PSI Reading PSI Reading for 7—Is AFL in
Location Loop
(> Baseof Loo Type QUatI
t a Comliane?40G >
C,I Inspection results: Passed W Passed With Deficiencies U Critical Deficiencies Found U System Inoperable L)
** PLEASE, SEE ELECTRONIC, WORK ACKNOWLEDGMENT, OR "A LEI,RT TAB" OF
SERVICE LINK, (EMAMED TO CUSTOMER AT COMPLETION OF THE INSPECTION), FOR
DETAILS 'ON ANY CURRENS" OR PRE VIOUSLY R'PORTED RECOMMENDATIONS,
DEFICIENCIES,OR IMPAIRMENTS."
D 1, General Comments:
E I List the changes,in the occupancy hazard,or fire protection equipm,ent,as advised by the owner, in last inspection
F I Inspection and suggested improvements were discussed with,the undersigned,Owner or Owner's Representative: YES, ILI NO U
"Customer signature may be found on electronic'Work Acknowledgement�in Heii of'this report."
4/27/2020 THIS IS NOT AN INVOICE
CUSTOMER'S SIGNATURE DATE QTY PART It DESCFJPTION' RI
P CE AMOUNT
Semi annual wet s pdnkl'er
CUSTOMER'S PRINTED NAME
71
4/27/2020
TEPCHNICIAN,SIG, I RE DAT:E
David DiSilvestri, Matthew Ma 1310801
TECH 1101 203 1 SPRINKLER SERVICE CALL
AN PRINTED NAME, LICENSE# A
SW5012,517
IMPACT FIRE SERVICES, LL
6 HAMPSHIRE DRIVE
4,, 1 PAC HUDSON NH 03051
0 : 60 . 9 . 1
F : 603.589.2051
IRV 11fW.GETFIREPR TECTI0 I. OM
Commonwealth of Mass Sprinkler contractor SC- 10059
Inspected to the State Adopted Version of NFP A 2
SEMI-ANNUAL WET SPRINKLER INSPECTION
JOB#: 18704871 DATE.0 2 12020 01-.00pm..EDT............................ CUSTOMER r :
SHIP TO: BILL T .
NAME STOP &SHOP#92 NAME C &W SERVICES
ADD"Ss 767 TURNPIKE STREET ADDRESS 99 SUMMER ST, SUITE 220,ATTN: AH,
CITY NORTH AND OVER STATE MA ZIP 01845 CITY EOST N STATE MA Z P 0 110
CONTACT STORE E MANAGER PHONE 7 0 3-9000 EMAIL
ST Po# AH C OO 1800332
TYPE OF SERVICE REGULAR LA Id EMERGENCY ❑
START TIME END TIME VALVE LOCATION: System #
VALVE MAKE E Star VALVB MOREL F VALVE SIZE O #OF SYSTEMS
FIRE ALARM PANEL MAKEMONITORING YES 9 NO ❑ NIA
0.0 Is FACT'in normal at start of Inspection? YES 11 NO ❑ NIA❑
O.1 Is the panel&riser accessible? YES e" NO U N/A Ll
0.2 Flow switches operational Total#of flow-switches tested; 1 YES NO U NIA❑
0.3 Tamper switches operational' Total#of tamper switches tested: 1 YES 0 NO❑ N/A Q
0.4 Does Inspector's test valve terminate In correct orifice? YES W NO❑ N/A❑
A 0.5 Alarm line valves in proper position? YES id NO❑ NIA❑
AO.6 Is hydraulic or pipe schedule placard attached and legible' YES id NO U NIA❑
0.7 System gauges In good condition [date on Gauge 2018 YES Id NO❑ /A.U
AO.8 Are all valves supervised and In the appropriate openiclosed position? YES id NO LJ NIA❑
A 1.1 Static Before 50 psi Residual 40 psi Static After do psi Time to Reach Static 1 Drain I e: 2
1.2 Is residual main drain teat reading at base of riser at or above hydraulic demand or previous Breading YES W N ❑ N/A❑
1.3 All control valves accessible' YES id NO L3 NIA❑
1A Alarm valve and trim free from damage YES W NOU N/A U
A 1.5 Film Department Connection In compliance?Hydrostatically tested in last 5 years' YES 16 NO❑ N/A U
A2.0 Time to alarm: BellfW.l . . Flow-switch 40 Press-switch
---------------------------------
A 2.0 Time to alarm when flowed via]TV: 40
A2.1 All system signs,,valve chart,anti-freeze placard(if applicable)In place? YES W NOU NIA❑
A 3.0 Alarm lire valve sealed In opera position" All valves In normal condition? YES 0 NO LJ N/A❑
4.0 Has the tank been assessed for obstructions In the last 5 years YES Ll NO LJ NIA id
A 4.1 Has an obstruction assessment been performed on piping in the last 5 years? YES id NO❑ N/A❑
A .0 Has the alarm valve and/or bac tiow and FDC check been assessed for obstructions in the last 5 years? YES W NO❑ N/A
.0 Does fire pump appear to be in good working order's YES ❑ NO LJ N/A
A,6.1 Has fire pump undergone regular churns as required per NFPA YES ❑ NO Q N/A
A,6.2 Has antifreeze been tested in last 12 months?(Check chart B1 for results,,if inspected today) YES ❑ NO U NIA
A 6.3 Did monitoring company receive signal? YES id NO❑ N/A J
6.4 FACIA left in normal condition? YES id NO ❑ N/AL)
A..7.1 Does custorner own a copy of NFPA.25 and understand his/her responsibilities? YES W NO Ll N/A❑
SWS012517
B I Antifreeze Test Results:
AFL %at Freeze Point %at Base:of Freeze Point at Antifreeze� Antifreeze PSI,Reading PSI Reading for Is AFL in
Location Vent at Vent Loo of
p Base Loop Type Quantity on ian
Tank Loop coinplce?
1(>40G)
C I In I Passe V Passed,With Deficiencies U Critical Deficiencies Found LJ Systern,Inope rable U
pecti on results: d
PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, OR "ALERT TAB" OF
SERVICE LINK (EMAILED, TO CUSTOMER, AT COMPLETION OF TH I E INSPECTION), FOR
DETAILS ON ANY CURRENT OR PREVIOUSLY REPORTED RECOMMENDATIONS,
DEFICIENCIES,OR IMPAIRM,ENTS.**
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
F I Inspection and suggested,improvements were discuss end wit h the undersigned Owner or Owner's Re resentative: YES LJ NO Wt
P
"Customer signature may be folund on electronic Work Acknowledgementin lieu of this report.*,*
4/2712020 THIS IS NOT AN INVOICE,
CUSTOMER'S SIGNATURE DATE r QTY PART# DESCRIP111110N, PRIIcu AMOUNT
jason vanne Semi annual wet spdnkler
CUSTOMER'S PRINTED NAME
4/27/202O
TECHNIC 1A SIGNATURE DATE
David DISilvestri, Matthew MaPE 131080, 203 1
TECHNICIAN PRINTED NAME LICENSE# SPRINKLER SERVICE CALL
SWS012517