The URL can be used to link to this page

Home My WebLink AboutClub House Bld-19-00630 • Imo.1 US ho..S�. C31t� 1 - CA 6-3 e Contractor's Material and Test Certificate for Aboveground Piping PROCEDURE Upon correlation of work,gmpedion and testa shall be made by the contractor's representative and witnessed by and owner's representative.All defects shad be co rected and system left In service before contractor's personnel Malty leave the Job. A meditate shall be 1%led out and signed by both representatives.Copies shell be prepared for approving authorities,owners,and contractor. ft is understood the owner's representative aiglndure in no way prejudices any direr against contractor for faulty metered,poor workmanship,orfailure to comply with approving authority's refits or local ordinances Q l Property n St ail' ) 3 tN Igfr ''ta, /�,rtwA cap1A W) Date Lj ,7 •1 ia i Accepted by approving authorities(nannies) S ck.fi IN lc rnrtc, t", f",rc- Pc Q Adder Plans a& o i Z M•µ,n 54 Sw4r yotilkz,►it" n",. _________ Installation conforms to accepted plans 0 es Equipment used is approved 0 es 0 o If no,explain deviations Has person in charge of fire equipment been instructed as to location of control valves and care and maintenance of this (Yes°No If• no,explain deviatron Instructions Have copies of the following been left on the premises? iles o1.System components instru tions 2.Caine and maintenance instructions es o3.NFPA 25 es — Location ofSupplies build system. Year of Temperadxe Make Model manufacture Orifice size Quantfty , rating 1-1 c-a 315 lie Poi 4 IQ., op Sprinklers ,1-1(6 i3J. NA-- 14,71 f/et.. ).,1-t iss .T.1 Gv t 3 1 $� 0-o1 tC %n- . I ;r?,Dd . fiA co , i y,$Y3s 1t, SO 2+r►Ql { •' I.. 15 s .'tit q Ti 5.33C D r Qtvt 1 41 1 '' 135 Pipe and Type of pipe BU(SCH 40 des Type of fittings }CAST IRON THREADED Alarm device Maximantime ktopenilethlnigh test connection Alarm valve or Tvoe Make Model Minutes Seconds flow indicator VSD Dy Valve Q.0.D. Make Model Serial no. Make Model Serial no. Time to trip through Water Top point err Time water reacher. cl Man operated Dry pipe test connection1.2 Pressure Air pressure operating psiMinutes —Seconds Yes No test Q.O.D. M seo�6s ?0 50 1 ,)"' i IS I/` von . O.O.D. If no,explainOpera �E )Hyd Rohl Ea►aservised ( tjYes iC[ Cf4ia supli orvleed fires Deluge and ` Does valve from the manual trip,remote,orb control stations? C JYes E Is there an accessible fadMy in each oy8s Ow If no,explain preactioncircuit for tasting? Does each operate� Does each circuit valve . M time to operate VaIvesVeS Make Mode loss alarm? release? release . Yes No Yes No Minutes Seconds Location Malta and Residual pressure Pressure and floor model Setting Static ure (towing) Row rate reducing valve , Inlet OW) Outlet(psi) Inlet(psi) Outlet(psi) Row(gpm) test • r 1 Measure from time inspector's test creifteclioft is opened 2 NFPA 13 only requires the 60-second limitation in specific sections 44#10 Hwkostatic Hydrostatic test shall be made at not less than 200 psi(13.6 bar)for 2 hours or 50 psi(3.4 ba)above static presage in excess of 150 psi(10.2 bar)for 2 hours. Differential dry-pipe valve clappers shall be left open during the test to prevent damage Test AN aboveground piping leakage shall be stopped Description Pneumatic:Establish 40 psi(2.7 bar)air pressure and measure drop,which shall not exceed 1%psi(0.1 bar)in 24 hours. Test pressure tanks at normal water level and air pressure and measure air pressure drop,which shall not exceed 131 psi(0.1 bar)In 24 hours. All piping hydrostatically tested at psi( bar)for 2 hours If no,state reason Dry piping pneumatically tested es o Equip operates properly • es o Do you certify as the sprinkler contractor that additives and corrosive chemicals,sodium silicate or derivatives of sodium site, brine or other corrosive chemicals were not used for testing systems or stopping leaks? 6)1 Yes QNo Drain Reading of gauge located near water Residual pressure with valve in test Tests test supply test : CITY psi( bar) connection open wide: ! pe( bar) Underground mains and lead-in connections to system risers flushed before connection made to sprinkler piping Verified by copy of the Contractor's Material and Test Ofes Other Explain Certificate for Underground Piping Flushed by installer of underground sprinkler piping {71(es If powder-driven fasteners are used in concrete,has (Dyes ONO if no,explain representative sample testing been satisfactorily completed? Blank testing Number used Locations Number removed gaskets Welding PiPIrl9 Oyes®No H Y Do you certify as the sprinkler contractor that welling procedures Oyes comply with the requirements of at least AWS B2.1? Welding Do you certify that the welding was performed by welders qualified in QYes ONo compliance with the requirements of at least AWS 82.1? Do you certify that the welding was carried out in compliance with a documented quality control Q(es procedure to ensure that all discs are retrieved,that openings in piping are smooth,that slag and other ding residue are removed and that the internal diameters of piping are not penetrated? Cutouts(discs) Do y0ucertifythat you have a control feature to ensure that all cutouts(discs)are retrieved? e(, Hydraulic data Nameplate provided? if no,explain v� nameplate Remarks Date left in service with all control valves open Nameofsprinkiercontractor Peak Fire Protection Co., Inc. Tests witnessed by For property owner(signed) Tice Date Signatures _ Steen t ,4 S/ l Y/2017 For sprinkler meter(signed) Ne Date 041 g tdccL► 4 ,1 s0006 5/q/i't Co\ ho' ?u 6314 G l (..AS hoot_ 200113 Additional • explanations and notes