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Home My WebLink AboutAnnual Dry Spinkler Inspection - Inspection - 500 GREAT POND ROAD 7/19/2019 5 IMPACT T FIRE SERVICES, LL 26 HAMPSHIICE DRIVE IM H J�DySON NH 1 ACV s , ,7 31 F .603.589.2051 IRVA".GETFIREPROTECTION.COM Commonwealth of Mass Sprinkler Contractor S - 100 9 Inspected to the State Adopted version of NFPA 25 ANNUAL DRY SPRINKLER INSPECTION JOB : 1 1 7 DATE: 07/1 /20 1: o ITS EDT CUSTOMER ID: SHIP To: BILL To: NAME NORTH ANDOVER COUNTRY CLUB NAME NORTH ANDOVER COUNTRY Y CLUB ADDRESS Soo GREAT POND ROAD ADDRESS Soo GREAT POND LOAD CITY NORTH AND OVER STATE [VGA zip 01 ciTY NORTH Al D VER STATE MA zip 01845 CONTACT Jeff Isbell PHONE E 78)687-7414 EMAIL jisbell@northandoverce.com osT POD# TYPE OF SERVICE REGULAR id EMERGENCY ❑ START TIME END TIME VALVE LOCATION Basement VALVE MAKE Reliable VALVE MODEL D VALVE SIZE 4" #of SYSTEMS 1 FIRE ALARM PANEL MAKE Silent KnIaht MONITORING YES 0 No U NIAU Al Fire alarm panel in normal upon arrival"? YES Id NO❑ NIA❑ A2 1s the panel&riser accessible? YES Id NO❑ N/A❑ A3 Dry pipe-sprinkler system in normal condition upon arrival? YES 16 NO❑ N/A❑ A4 Alarm lire valve in open position upon arrival? Sealed YES Id NO❑ N/A❑ AS Quick opening device valves open upon arrival? Sealed U? Make/Model: YES ❑ NO❑ N/A I A6 Air line valve in open position upon arrival?Sealed YES Id NO❑ NIA❑ A7 Sprinkler system air gauge reading before testing 48 psi Q.O.D. Reading before testing psi A8 Has a full trip test been conducted in the last 3 years? YES id NO❑ NIA❑ A9 Date of last trip test 61612017 Partial ❑ Full A10 System gauges in good concttlon Date on Guage 2016 YES &d No❑ NIA❑ All is hydraulic or pipe schedule placard attached and legible? YES ❑ NO W NIA U Al2 All system signs,valve chart in place? YES U No Qd N/A❑ A 3 Spare sprinkler box properly supplied with heads&wrenches? YES id NO❑ N/A❑ A14 Low air pressure switch supervisory/trouble activated properly? In: N/A psi YES ❑ NO❑ N/A Id A15 Static 110 psi residual 95 psi Size A16 is residual main drain reading at base of riser at or above hydra lie demand-or re ious reading? YES Ad NO❑ NIA❑ A17 Tamper su erviso /trouble activated properly? YES ❑ NO❑ N/A I A18 Time to ring alarm from water motor gong less than 5 minutes? YES LJ NO❑ N/A I A19 Time to ring alarm from pressure switch to panel less than 60 seconds? YES id NO❑ N/A❑ A20 Exterior building alarms activated properly? YES ❑ NO❑ NIA Id A21 D valve,associated trim,FDD,and air compressor free of damage'? YES 0 NO U NIA❑ :. A22 Has air compressr oil been changed in the last 12 months? YES ❑ NO❑ ILIA Wr .: A 3 All control valves accessible and exercised through full range of motion? YES Id NO❑ ILIA❑ A24 QOD Trip at psi seconds Time to restore pressure NIA A25 All low points drained? How many 8 YES 46 NO EI N/A. -------------------------------- A26 Alarm line valve left sealed In open position? YES id No❑ NIA Ll All All valves left in normal condition? YES NO❑ MIA❑ A28 QOD reset and normal' YES ❑ NO❑ NfA I A29 Fire Department Connection in compliance?Hydrostatically tested In last 5 years? YES ❑ N046 N/A❑ A30 Has an obstruction assessment been performed In the last 5 years?Date: 911f16 Pass's Fail Q Flushed YES 0 NO Q NIA❑ 31 Has a pneumatic leak test been performed in the last 3 years?Date: 616M7 Pass 6d Fail❑ YES 0 NO U NIA❑ A32 Has the tank been accessed for obstructions in the past 5 years' YES ❑ NO❑ NIA E A32 Does fire pump appear to be in good working order? YES ❑ NO❑ NIA I A33 Has fire pump undergone regular churns as required per NFPA YES ❑ NO❑ NIA lEf A 4 Does customer own a copy of NFPA 25 and understand hisiher responsibllites,such as low point maintenance YES ja NO❑ NIA❑ p 012517 A3a Heads appear free of leaks and damage? YES Ild NO Q /A p A36 Heads free of foreign material? YES Q NO46 N/A Ll A37 Minimum 1 T#clearance from deflector to obstruction's YES Od NO Q N/A Q A38 All proper escutcheon plates in place's YES Id NO El 1A L1 A39 Standard response sprinkler heads less than 50}years old? ate: YES 0 NO p NIA A40 Quick response sprinkler heads less than 20 years old? Dante: 2007 YES 0 NO p NIA Ll A41 rinkier heads less then 10 years old? Date: 2006 YES Ll NOO N/A Ll A42 Sprinkler heads in harsh environments less than 5 years old? Date: YES U NO Ll NIA I A43 Have any heeds been tested? Date: YES U NO G1 NIA Id A43 Exposed piping and hangers in good condition's YES 0 NO 0 N/A Ll A44 Has standpipe and hose valves been inspected and determined to be in complance in last 12 months? YES U NO Ll N/A Id A45 Has standpipe been flow tested in last 5 years? YES L7 NO L) N/A 0 A46 Did monitoring compare reoei o signal? YES..L1 NO p NIA 19 47 FA P left in normal condition? YES Ll NO Ll N/A 0 For P react!on/Deluge systems that were operated during this inspection: .13 1 Has valve been.operated via detections stem? YES Ll NO Ll NJA0 B 2 Has vavle been operated via manual release's YES Ll NOU 1A Id B 3 Ha a open nozzles been flowed or internally Inspection In lest a ears? YES Q NO U N/A E B 4 Please list make/model/quantity of devices used to trip solenoid Results of trip test if performed during this inspection: 1 1 or Air PSI Water PSI Is Supply Air PSI at Time hater PSI Time for Time for Condition of Performance of Valve before before Trip Valve Fully of Trip at I Valve to Water to Valve Interior Trip Test in Location Trip Open? Time of Trip Trip reach 1TV and all Parts Compliance? Dry Valve 48 110 4 Turns 14 110 47 PT Good Yes D I Inspection Results: Passed U Passed With Deficiencies 6d Critical Deficiencies Bound U System Inoperable Q PLEASE SEE ELECTRONIC WORK ACKNOWLEDGMENT, OR "ALERT TABS' OF SERVICE E LINK(EMAILED TO CUSTOMERAT COMPLETION OF THE INSPECTION), FOR DETAILS ON ANY CURRENT OFF PREVIOUSLY REPORTED RECOMMENDATIONS, NS, DEFICIENCIES, OR IMPAIRMENTS.** E 1 GeneralComments: Repair of feed side of air compressor replaced / " brass threaded check valve 1 3/4"X 02 nipple. 1 4" bail valve. Total cost$350.00 per J.S. F 1 list the changes In the occupancy hazard or fire protection equipment,as advised by the owner above: 1 Inspection and suggested improvements were discussed with the undersigned Owner or Owner's Representative: YESO NO U **Customer signature nnay be found on electronic Work Acknowledgment in lieu of this report." 7/19/19 THIS IS NOT AN INVOICE CUSTOMER'S I 1ATU E DATE CITY PART# DESCRIPTIONPENCE AMOUNT- Annual Dry Spdnkler Inspeebon CUSTOMER'S PRINTED NAME - 1 1 TECHNICIAN SIGNATURE DATE Joshua Whitney, Paul Rice 151038 TECHNICIAN PRINTED NAME LICENSE# 031 SPRINKLER SERVICE CALL o o1 517