HomeMy WebLinkAboutTyco Report of Inspection 2013ttlco l:{:,:,r, f sinetcxGrinneu
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woRK oRoER ' 27521270
BU ING / LOCATION Unitd INSPECTOR AlAnton
STREET
crw/STATE/ztP
ATTN:
131 Ansel Hallet R@d oArE 12mm13
Yarmouth, MA 02062
I. GENERAL
A. (To be arcrrered by the OwrEr or O'vnels repr€sentattve)
a. Ha\rE ttpre beeo any ctrang€s in the oc.rrpercy cksificdixl, machkEry or operatixls sincs $s hst inspedixf
b. Ha\re thqe been any ct|arE€8 or rrpsirs b the firc prcaectix| syddlls sinco tha H lmFciion?
c. lf a fiIe has occuned since the last inspection, have all damaged sprinlder sylstem co.nponents been rephced?
d. Has the piping in all dry slstefiE been ctEcked fo. proper ditch within the pasl ftve yesrs?
Date last checked N/A (checking is recornmended at least every 5 F€rs)
(ch€ckrE is recomrnended at ld every 5 years)
f Have all flre pumps been l6ted to their full capacity through the use of hose streams or flollv meters within the past 12 months?
9. Are gravity, surface or pressure tanks proteded from frcezirE?
h. Are any ol the spdnkler 50 ye6rs old o( oEeA _ (tedins
i. Are any extra high temperature soHer spdnklers regularly aeGed
B. (To be ansr re.ed by the ircpeclor)
a. Have the sprinkler systems been extended to all visible areas of the building?
b. Does there appear to be proper clsarance betv.een the top of all storage and the sprinlder delhctor?
c. Are the building areas pfotecled by a u.et slrstem. h€ted, including its blind attics ard perimeler areas, where accEsible?
d. Are all visible exteriq openings prctected against the entrance of cold aif.?
2. COTIITROL VALVES
a. Are all sprinHer system main control yalves and all .th€r rdlrcs in the appropriate open or clo€ed position?
b. Are all control valves s€aled or suporyis€d in the opeo pciti)o?
3. WATER SUPPLIES
a. Water supply sources? City: Yarnouth
Pressure Fire Pump & Tank NA
Gravity Tank N/A Pr6sure Fire Pump & City NA
Waterflo$/ Test Results Made During This lnspection Pressure Fire Pump & Pond NA
il. TANXS, PUMPS, FIRE Ir€PT- COt{lrl€CTIONS
a Oo fire pump6, gravity, su ace or press{rre tanks appear to be in good qtemal corditioos?
b Are gravity, surface and pressure tanks at the proper pressure and/or w"t€r levels?
and/or replacement is recommended for such sprinlders)
to temperatures near 300F?
YES NA NO
x
x
x
x
x
x
x
x
x
x
x
x
IrIIIII
IIIIIII IIIII
IIrI
II
III
III
x
x
IIII
Easily
Acc€ssible
Signs Valve Open Supervision
Operatioml
Control Valves lol
Valv6
Type
YES NO YES NO YES NO YES NO
(SeabdA
Ger€d?)
(Supvd.?)
Secured?
rF YES. Hol/W
YES NO
CITY CONNECTION 3 PIV/OSY X X x x LCI(SPV x
TAN K
PUMP
SECTIONAL
SYSTEM 2 X X x X SPV X X
ALARM LINE 2 X x X SPV x
IIIIIIIIIIIITTIIII
IIIIIIIIrIIT
I
I IIII
Test
Pipe
Locat€d
Size
Test
Pipe
Static
Pre6sure
Befoae
Pr6sure
Static
Pressure
After
T6t
Pipe
Located
Size
Test
Pipe
Static
Pressure
Befo.e
Static
Pressure
Main Drain Riser 1 68 62 68
Main Drain Riser 2 7',68 61 68
ITV ()a)1t7'.r--r-I II
-I
I-II III-r-r---IE I
I-I-
YES NA NO
x
x
x
x
II
I
IIIIc. Are fire dept. connections in satisfactory cooditions, coqplirEs free, cap6 or plugs in plac€ and check valv6 tighn
d. Are fire dept. coffEctbos visible and acc€ssible?
REPORT OF INSPECTION
e. Has the pipirE in all systerns beei ctEcked fo( obdnrclive materials?
Date hstchecked 1l6an12
x
EALL x
TERMS AND CONDITIONS
1, ulrlrtlon ot Llrblllvi L'mlhflofl! ol R"Edv lt ls lr)d€Elood
ard seo.d bv tt qJ<clll.r f|!. Cclr9ary L nol tn hc|Br &n
lBt bensro cov.r,rE, ! Eny, !h!I D' obhlntd bv tl. oshmtr
ard !d Mdtit Pelabh b CqnFrU h"rlrds '(. b€ed uF t
tu v&. c,nF t.l$c$ zitE !'+6 ol bbEv !'t tuli h ttb
srvlc. Elqltd .'rd aB hr'hlt" b tlt vdE olti6 Odom"t
pEpit std tE FDF9 of cfi63 L'ctd 6 !|. F!'ls' clt
!qn...!Ees b lool ddclv'tv to d' cutb'nad! tuurer b
'evt' brnllh. o. drttr' h t1t 'Et or &v I@! o' ldEv ''d
tEt qldloEr d..t6 'rt eEhts all dgti ot rsttv Esainst
CqrFny bv $l€y ol &brbgttldl Cddr6v mak* no !@_
J'gfyorwar-ry, rrdrltrg -, hP{'dwtenvoft dE d'te
!Vorfrn ..tbrtP.rtql{F'Pos$stlqipd€nior3svl@
a+,.d !, Cqif.iv wr ddd or slrt @rtar'r " tl. cdts
s.$nrqr tFr*ofr tEl ttF qiPrnnt d "fvl6 i/ 5 d€lorad
I b rnplldjdl ..d EeEmely dtr@l! to D( tho adIJEl damtc"'
I any. wildttrtly Pt iFEbl, Gsdltqn i!!@ d tB partd
company lo Peffom ey o' lE 'bIgadclt onderthlt S'Nic'
R.qsst A@dlnlly, cudomer agE€! 6t! Comlanv +EIl b'
ssrFa tan [*!ry tor rry IG.. ddaet ( ldJry tlCng dt!'t'
v or lndlEc0v nom o.c!r!ne!, d tl' drseqiDn"! ltl6drcm'
rh.ll tlE gq'Jpmclt or !.rrle Ysr d'dg€d to d'tect 'r a6rt
ShqJd co.np{Iv D€ iolld labl' for lnv to5'' damts6 or liluv
lnill! flm a HrnE olth' '+lPm!nt
or ssv" ln 4v 13 P'cl'
CsrPanys [.U[t 6]E! D€ lliniled to 'n 'T loun 'qd to r't s"-
Ve R.qr.d Pdc. (* hcrlllad bv th' Pd6 for arlv addldoEl
ivllro or whm tho !ru &d ndsic Fvmst !'m ls *r"te4
cuitom!/s dm. and mtt!.ial Paym'rt! b @mPrty \ /h'E ltis
S6ft{c. Re$Elt cer! moud€ 5l'r.3' lshtlily sh'I be flmli'd to
th. mdht oI ih. P.vmdtt! slloet€d lo th€ sht rftE{s th' lnd_
d6n @cn€4 SEh sffi shal !€ cornPld€ and odus'le I Cue
bllEr !t6cts! c6lP6nv to 3snrll. glBabr lat'fiiv' tE Pd8 snd
am6nd hE s.wLa Raqu$t by at*hlns a dd" 3€6ng h'lh tl1'
arBrfit c'f addddEl IaEnV ed tho adddond s1o'rnt Pav'Ut bv
th6 CustcD6.lorh6 asdrrPdo' by Cglparv olsldl llr ts 0F
bltny. FEvld.d ho{w€r td such tld695nal In no wtv b' Inier
*r"a o Ua c.rnpt"y o - tn$cr' IN No EvEr'IT SHALI-
.O'"A' ", ,,** ,OA * DAMAGE LOSS, INJURY OR Atff
OTHERCI,ATI ARISIN9 FROM AIY SER!1CINq ALTEFATIONS'
MODIEA\NONq CHANGES, OR MOVET ENIS OF THE COV€REO
SYSTEII(S) OR ANY OF ITS @MPONENT PARTS BY THE CU+
,ouat oo ^*
*"o "o"-'
CoMPANY SHALr NOT 8E U^AE
rOR INDIRECT, INCIDEI'ITAL OR CONSEAUENTIAL DAMAGES OF
ANY KND, INCTUDNG BL.IT NOT UI'IIED TO DAMAGES AAISING
FROM THE USE. LOSS OF THE USE PERFORMANCE' OR FA]LURE
oF rHE crvEAED 5"fSIEUF) To PERFoRM' Th6 [ndi'{ds of ll&
Bilt9 361idth ln tft s'rvl@ Requst shal lnuit to tb€ bsdt ol
AI F.r6nl5, !!b3ld€ds snd EffIat'! ol comPEnv' Yth6tn'r dlF l
or ;ndF.l cmPav' 'md',6€!' ae4ts' ofi65 ard d6ctffi'
z UmlLdwrn rrv' COMPAI{Y WAAFA'IIE THAT fs lvoRK AN_
SIttP AI'ID MATERIAL FURMSHED UNDER THIS SERMCE
REAUEST WII! EE FREE FROM DEFECTS FOR A PERIOD OF
NINETY (so) DAYS FROM THE DATE oF FURNlsHlNG l/thR csn_
P.rry PFVd€! PDd'-Ei or tqllP'nBtn 'I 'drst' CornF€'ly sm eat_
R.nt ifi! Prod&t or 'qiiPmenr
dJv to lho ettdt Er'atttd tY 6o'h
Thlrd P.tv. Sj(CEPT AS EXPRESSLY SEf FORT}I HEREN COUPA_
NY DISCLAMS ALL WARMNIIES' D(PRESS OR IMPUED'
,,O'O* "- *, UUmED TO ANY IMPUED WARMNIIES OF
MERCIANTABIUTY OR FIINESS FORA PARNCUIAR PURPOSE
IMTH RESPECT TO THE SERVICES P€RFORUED OR THE PROD'
,*. .**" O" *,'"UENT, IF
''NY.
SUPPORTED HEREUIS
,"* -ur* *ta *o ** oR REPRESENTATIoN'
ANO UNDMTAKES NO OBUGATION TO ENSURE BY THE SER'
VCES ;BFOF!,EO UHOER THIS SERVCE REqUEST. TTIAT COM.
a tnd.mrv. OJsldn"igl! ! h hdBmr['' hou lEin €$ tnd€lld
cont try !!.id rry sEd loe5' darlEgE.x od+ Inddm t)9qi
6-r ..d 6!b. .nd Eet.1ss hdu4E nrsd! (ldale co's' aie
h! tom .ny d1d .{ i_nd PrV daLnt for Pdldd l,uv' d€tfl FDP
dt dtr!6 or..ond*lo'!. td'.rt! tpcdrelv "!v d 'rt'
IEsuhh! item h. .!9o$rt otwt€l! to H@dorj! cdtdbn'
$fidl6 o.tra o.emd P'}n'6fs CoaFdv ol tl. tf&rld ol -E
haaddr! @n(ffont, a!*ta h {rv vtv fom 6v td o' ooh'ld "
Odro6r or CotrtP.nv Bls&! h tnv vt'v io tllt &n.rIl{ll' hdi4
in btr not In&!n b tE Sdl6! hdlrrf! tgr*n"t tl|Ets rdl
d.ht .r. b$.d upql dt'.d, s6T tn!' t'd (hdJtins hn d eft
n6d b ..trE d Ps.iv. Ndhat..) *td labo9o' ctlg$!' C@
parl, l.s,6! $. nCn b ttLct dmld b EPnltrn ! h tnv 5dr
4, H.zdou3 d.dals Custom'r EPFS4& $rt' ei6Pt to the
!xb.!tih.tc.rnp y hs ben giv'n fiitbn noud of th' told_
lng hdrdE Pdor b th. o.&uliod of thlt SBftlo Rcqu6t to th'
b€3t ol Cuslome/s la/o$'l'dse thd ls n6:
.'p.mitcdfm<lsPea'Asd€"Edb'osttA
. dd( or tft.{os! dselq
' i.!d fd alr mrrbrt{i l!!P@r, P,Dle"oi' or 'fter fiE&d nd(
r r.bct6, sb.dos{orit'inho mah'lt4 fr;dd'trydB or odl.r
pot n{alD lodc or dtEtwls6 hat'dou' md'dtl clrlttlmd h or dr
h. s!rf.c. d lh€ f@l!, $aIE, c€lInoF' lllldadon d otFr 3t^E-
tl.d comP.n.nts ol lll. sr'a d 6nv hlld'l! whel. wotk E r€qutld
1o b. Porio,ned urdd Ns servlc' R69uen
AII olthe sbov. q! h*!hdt'r tttuFd to tt 'tle'd't! Cdldltod'
ComP-y *En t'wE Ul. fuN to rd' 6'r h' IlPr!6sttdctr lbbd
abov€. It haddrs @fiItons ltE "'d'tn!d bt conP'nv duttg tt'
c.us. d comp.tt/s tiblt, $€ dr'oEv ol srdr q'fldtnt !h6ll corF
.dtis tn svlrn bevdd CodPtlyt contd t t c(fnP€ny dldl h''/'
no obusdn to tu$€r p'rtm h th€ a€a vrh6€ tt6 hEz'nous c"1_
.!tir!! qid lnd *E {!' t55 b''l tEds sdt !v Clslomd d ctr+
n€d ln wduns !v .n lntLp6ndsrl ltstnq EeEn'v' 4d clttdn$ 6hd
pty dEtP{d a4€rE.3 6{id l.JnoulEdoo eP€lle! E' dBtmln'd
by cmPenY.
THt Ssde Requ6t &$ tpt Pro!{ds fo' l'L 6s1ol ctPtr'' cd'ttlF
m.ot or dlsPo!.t or arry h@rdou! w;!r6 mtl'dal5' 6 h@6tdE!t flEl*
rld., €n@lrt!{ld h w c{ fl' Covllld Sv!E'(s) {d/d duins
D*tormaD@ of the Sdles Stirt mabnal! shdl Ei {'16t 6mdn
lho lBponslbl.iv ed P@PgV of cGtomer' comFanv sh" rct bg
r$porlru. fortlEG6dE. EnDvd ordsP6d orsud haad@!,
5. EqoiPm.ni ol'soonn'cnon& Tits eFElst3 c'mP6try3 mdc' lo
Yd tM t!. svst$&yd'\'@(!) !tt'd 6ll ttt fac' .. $l! sei@
R.q!€ts t mPanlly n P'drndily dsdtFded s! m lor'9!' l'
.*vl6 an4 lhc,6not dste't P'rottn sdror l?PododrdsE ! or
t'.Grlt d.nC!.
8. G.n6L Ut&ss otlswGs +'dn€4 wod( 'fE! b€ d'm b'tw"n
lh. h.@ of 8:oo Al' 'trl 5!o PM' Ed6tv' c' s5tudt'* S$&y!
.nd C.dPariv holider! Alwqk l! subl€ctlo r!ti# td 'Eb
ln!ln
a.adetE stln t|' !'(ti! ard co'dtolE ofclston'ir
.lr6monltont_act ri$ CmP€r'' f dr l! h e{E t CofiP5v stEl
iu. r..pon or" ur"rru' to n{tdds'Mc'! tlu€ locacd b'vmd '
L! @rt!d. trdldn! hrnotlr td lo EEi'dd 6tE tt€'3 Ffi6@
Pages, fI!!. dvll '[s!'d]$c' or llnrEt slv'r8 \r'dnd' rrs or nv
otrcr causr tevora urc cotor oi comP'nv cudoln" l! all?'a ltEl
th!udtafonofti'Ulltv ard ot|€ Pccvldo Edtu'tl ln rlv edst!
a€rEeIDont/cofltr..t, ( m6 It ln d'"q o( s" lolh abovt' !@!.! to 3€rv_
t66 Pqtum6d -d m'Ldd! EltpCled' Th! l{rlu '{ t{s Sgric'
Roqu€st lhau sov6rn noMt|sbrdns tly ln'onsist€nt d addHond
t.rnr.' .ot$td}3 h s',!v F'ltts od'ror c6t. doa'nerrsub_PANYS PROOLICTS OR THE SYSTEIIS OR EOUIPUENT OF THE
tqeo l{::,?,,, f sinetexGnnnea
REPORT OF INSPECTION
Make & Model MANIFOLD 6'CSC VALVES
b. Are cdd $re€trler valv6 in the approprkte open q clc€d pGitirr?
lf clced, has piping been drained?
c. H6 the owner or owne/s repr€ssntative been ad/hed lhelt cdd tllather valves aIe nd recornrsded by NFPA?
d. Ha\€ all the artifeeze syslems b€en te€ied?
e. Date antilreeze systerns $rere tested
f. The antifreeze tests indicated protection tol
system I _ 2_ 3_ 4_ 5 _ temperature
9. Did ala.m vatves, waterno,v ahrm iddicators ard retards te.l satisfac{orily?
Make & Model
Date last trip t6ted
b. ls the air pressure and priming wat€. l€l/el6 normal?
c. Did the air compr€ssor operate satistuctorily?
d. Were all low points drained durirE thb irEpectbn?
e. Dad all quick op€ning devices operate satisfactority?
f. Did allthe dry valves operate satisfetodly during this inspeclion?
g. Do dry valves appear to be prolec{ed from treezing?
6. DRY SYSTEMS
a. No. o, slstems N/A
7. SPECIAL SYSTEMS
a. No. ofsystems N/A Make & Model
Type
b Were valves tested as required?
c. Did ali heat responsive s)€tems operate satist cto.ily?
d. Did the supervisory teatures operate during tesiing?
H@t Responsive Devices: Type
Valve No.
Vatve No
Vatve No.
Valve No.
Auxiliary equiplnert
2...3...4...5
2...3...4...5
2.-.3...4...5
2...3...4...5
No.
Type of ted
Vat'/e No.
VatvE No.
Vati€ No.
V.teE No.
6
6
6
6
5
5
4
4
4
4
3
3
3
3
2
2
2
2
6
6
6
6
Type
Test resufts
8. ALARMS
a. Did the water motors and gong oper-ate duriryg t6ling?
b. Did the ebctric akrms operate during ?
c. Did the supeMsory alarms operate during testing?
9. SPRINKLERS . PIPING
a. Do sprinklers generally appear to be in good extemal condition?
b. Do sprinhers generally appe6r to be free of cofiosixt, p6irt, or loading and vbibb obstructixrs?
c. Are extra spinlders avaihble on the p{ernis€6?
d. Does the exlerior condition of piping, drah vah,es, check !'alv6, haogers, pressure gauges, open sgdlnKers
and strainers appear lo be satisfactory?
e. Does the haM h6e on the sprinkler syslem appear to be in satisfactory condition?
'10. EXPLANATION OF -NO" ANSUTERS (For Sections lB thru 9):
YES NA NO
x
x
x
x
x
IIIIIIII
IIIIIIrII
IIII
YES NA NO
x
x
x
x
x
IIIIIIIII
IIIIIIIIII
NA NO
x
x
x
IIIII
IIIII
rI
NO
x
x
x x
YES NO
x
x
x
x
x
IIIII
IIII
NO COVERAGE UNDER CONVEYER EELT ALONG REAR OF BUILOING
TAMPER SWITCH FOR WPIV ON SYSTEMS #1 & #2 DID NOT REPORT TO FACP OURING TESTING
5. WET SYSTEMS
a. No. ot sydqms 2
h. ls the dry \ratue house healed?
Location
1
1
1
1
NA
NA
TERMS AND CONDITIONS
It L lhgsdcC ard e&E nelv dfion b fix th' acual dtmq€'
n Biy, rfidl il:v plortns, leslt tom f"u! m lho F6rt o'
c.mpay L, P.,fom ay ol iE obflc'ldls und.rll]l! s!ft{t'
R.+6st Ac@Elnslv. culiDire"g*t t|at, CdP'n' dE[ be
q.lrd fan l.bulv for imv tos', d6mss6 or lilurv ddn! &ecr'
t ot lrdt€.lv tom o@,l!E'' o' tl. qii'gslds llsttrui"
rritd tr]. oqdPmsn or t'Mct v"5 deilgn€d to deLd d aErL
SlFdd Co.,rP!.tv ts bond trtbl' lor anv lo$' dm'{€ or ldinv
.ndns iiom a f.Dre o! lh' €qdPmet or q$e in anv '!sp€'{
Cor?any't kunrv sn I bo lmiltd to En 6m'ut e$ral lo lh€ S'r_
{o. Req*d Ptlc. (a! lnc.asd bv d,l6 Flc. ror att addloEl
irodo orwfi.r! $s [m. .nd mal€[l.l Pevma't l'm lt 3d&t4(
C!d6.nei. {ri6 and m't!'id P!vm6'n6 !o CdnParv WiPB tH3
sd!'ie RaqlEst @Er! muliPl' tlt's' list)lfilv shsl b' nrllld to
lh. 6nsrd of the Psvridtri dloclred b ul' 5lt' wtlr€ lh€ ln'l
d.rt c@nE t su.i 36 snal bs @nPId' 6d endunla [cu!_
tamlr d4{'Is CmPsnv to ssu',. sresl€r llablliv l}16 pard6 lhai
arlgd Ur! SRica R'q!6t ry d!'cHns ' dder sd&19 tu'rt li'
.rnounl ol addtlcEl llsbiltv 6nd lh€ adddonal tmdnt P'vabl' by
&6 cusldns fo. th. a3snP{on bv CqtP&v of sidr gedq [*
blfig, PE{d.d h 4'r $d suci ddEshtll ln m s€v bs loleF
FBled io hdd CohP.nv a' an lnsrt lN NO EVENT SHAIL
COUPANY BE UAELE FOR ANY DAIIAGE LOSS' INJTIRY OR Al{l
OTHER CLr'J ARISING FROU ANY SERVICING' ALTERATIONS'
MOUECINONS, CHANGES. OR MOVEMENIS OF THE COVERED
SYSTEU(S) ORA}IY OF ITS @MPONENI PARTS BY THE CIJS'
TOMER OR ANY THIRD PAFTY. COMPA}'I/ STIATL NdI BE LIABLE
FOR INDIFECT, INCIDEI'ITAL OR CONSEQUENTIAL DAI'IAGES OF
AI,IY I{ND. TNCTUDING BUI NOT UMITEO TO DAMAGES ARISING
FROM THE USE LOSS OF IHE USE PERFORUANCE OR FAIUAE
OF THE COVEREo AYSTEMG) To PERFORM ftt tinltafon! or0+
Blt seI h.tt tn ti! S"!t@ RtquEl s!E[ huE t' th€ bdrdt ot
AI F.rBtl!, subEld.rl.s 'nd afiIa!6s o(compaty' whottE dl.ct
Or ldlEct, cmPnly! "'dor'et' 'seitt' oflcq! trd detor!'
1. untdon O, tLbflryi Umltldon3 ff 8'rn'dv' n B l,d'lshod
rd .E!.d b, tlF qidoli€r $a Co'tp€nv ! not m hsltr,d
t t binln€ @vdEg', I t v, !h'll b' otehtd lvxB dsto'nd
lndftdan n FvebL b CqnPen! ll6r&tn.. c b€ltd ur..r
fi. r.tuc oa t). llrvlcs mdtE s"Ps or hbw tettutt ln 'i!
Srrt B.qtd sd a! ulred ti fi' \6L ol lis oltott'r's
P'l9|ff sd 01. F.FV 'f dl6n lo'd'd m tE P"'tl*' c{t
iomf &d! b ldi 6d'!lEb' b tE ClElom'/t h$r{ !o
Dcolr hrtiri.! of d.l,to' h ltl. t/!d ol tt' t@5 o' liqv 4!d
ffi Cllliofi.r d@d rnd $eiw! 'll dglt ol t*ovdv aFhlt
Cor,fat, !y $try oa 6.q!9a!q! Cdp-rv trEkE m gu-'
i'riy o.rr,,iar*n , hcrido! r,y irPn.d raranty c'l trE clEr'lt6il
ry.. rhs &.a P.,tldl., F Pc' htt'qrlPmttn 6svl4
.+r0.d by ConFr{ vit d'tsd or '€t @nMd or tl. .*
..qnd ltt dldn tt.t 0n €+lFnct or !*vE! v€! dlslonBd
z umn.d w.finv. coMPAN/ W'aARA{TS THAT ITS \'/1DRXl',AN_
SHIP A}IO MATERIAL FURNISHED UNDER THIS SERVICE
REOUEST WLL BE FEEE FROM DEFECTS FOR A PEFIOO OF
NINETY (91)) DAYS FRO$ THE DATE OF FURNISHIIIG' \'uh€r! Cqn_
PEny PloVdBProdrci oroquiFntnt ofalh.rq C'rnP6[v [{a'
Rent lh6 P,odEt or .qdPttant or'y to he 'ned
wErsnl6d bv 'uc'i
Thld P{ty. E<CEPT AS EXPRESSLY SEf FORTH HEREIN' COUPA_
NY DISCLAIMS ALL WAR8ANIIES' E)€RESS OR IMPU ED'
INCTUDII.G BUT NOI UMMED TO AJt'/ IMPUED WARRANTIES OF
T,ERCHAMASILITY OR MNESS FOR A PARTICULAF PURIDSE
IVIH RESPECI IO THE SERMCES PEjIFORMEO OR TBE PROEL
UCTS, SYSIEI/IS OR EOUIPMENT' IFANY' SUPPORTEO IIEREUI$
DEF. @!,IPANY MKES NO WARRANTY OR REPRESENTATION'
ANO UNDERTAKES NO OBU&qION TO EIiSURE BY THE SER'
V]CES iERFORMED UNDER THIS SERVICE REAUESI' THAT COM'
PANYS PRODUCTS OR TIIE SYSTEiIS OR EAUPUENT OF lHE
3. lnd.mnlty' OEt n.r Eslllt lo hdsnnlt' hold hant '$ erd d!ftod
Coflp€w .g!bc .lv tld ar b!!tq da,tEgt!' co!B' Ltclld'c r9!i
les ard @se' .nd aq'n@ ldudtE r€lsabl' dslos cGE 'tle
tR ton *ry sld .r frtd P5,1v d'tff br FrsEt hiuv' d€dfi pt!}
dV d.ri.g. ot @nonlc Io* lrEludlE
"'df€!v
,nv dtt'46
l.!d&Et m tB .wo.u' car{.*N to H!z{dou! Cc'ddonr
*ne$.r or.Ea edo.ncPciodlitt codp'ny of!t'' 'odsbn" 'l nld
hazllllcl!@ndlto, adslrEh rdrEvtor'|l $vidormisddot
Cusbm* or cdPfiI I!bEE h trvYy,' to lt& Ag.lrqt hdrl
h bd not lhited to tl. sEvlei uns [ilt icrem6r(' $/llg'l" rJdr
dEi,lt!r ber.d uP.n df!'i rilttt' bd {rrlidltis h.t Et [tE
ned b .d!. or P$dv. ffgtiFE), !l,tr [sbiav o' oolatnla CdF
pa.Vrs!6 s $€ drhl L EE5d cor_m!61L t'FEsEnt i ln tiv E!''t!
,r Hdldous M.t.!t.rs. cu.tomer EP'EEB $'t' dEPt b 6'
.xtdit hd CoEPuy ns bt'n qlvq HitLn nodc' ol tht tofow_
ln! hdrd3 pdor to ltl. q.cLtlon ofthE Sen'lct R'quesl to lh'
bsi ot Custom''r loF${6d9t t64 13 no:
''pendrdfi.d3p3.&'Ad*redUvOSIL\
'tlskolt&.do{itlB",. med h. sr rtrrk lng, Igttdt{, Fot!.ro(t, o. ootrn1.dlal d*
. *b!d@. asb*losent lnllE n'stslC' tunitldlhvd' o' ott6r
por.rfidlyt@dcorotlE llt h@dout ma!6rl6l @td6d h or m
th6 surfad d tt.lhorE wad!, 'dtln!!' bsdaton do0s&e
tlr.l cooPonEd! otth€ t !t of anv bridlno vhsn! woft tt r'qutlrl
to b. Pgdodn€d ud€r tl! Sei'c' Reqoest
Nl .( $6 &ovs .r.€ herdnditr lEtutld !o as 'Hlztrdd]! Conduom"
comp$y 6hdl h.v. 116 dC{ lo relv on t16 tEPGltnHqr [!bd
.hoE. I h@!ltdr. @idtdont @ gtEdrt{ld b, Cqrft'ly d'hs tl'
.o@. or ComPdr/t $6rk, h€ ds'D!*v ol sEh dd{ort tlEil @n-
sdtut .n .v.nt b.vmd ComPadt "otd and colrF€flv ch'll har€
m obnlidn io ftrtn{ Pertm h th' tr@ wtE ' $6 hddols c"F
dliiru.r{ u ! dr. a,ea ha3 b6s 'nad'
sd€ bv cudom{gs elG
fed ln rvnd.E b, .fl hdeP€idont l6tr€ tgsEy' djd olto'ntr sltd
pay dllrLtPfoa o.psns.s s(td nmodlEadon et9a'4 a! d'l6mln€d
by conP.rly.
TH3 s.t{c6 Requ€.t do6! not Fwld' &( t'l' @61 of 6Pl'Jr'' cs'ialll.
nst .. dlspold ol ah, h.i strhus w;!rt maledtl!' d herd'u! lltsle
dals, &couli.Bd ln $J oI lht Cov''!d svsttn(!) ard/ordudnE
pqbmar6 ofth. SeNicet sdd neLdtls $t[ tt ltn't rqdn
lh6 nsPoBrblllv ud PDP6dv c{ CGiom6r' conPanv shgl mt b'
l*poacblofdElet6!n!.lttlBrd ordtP6dc{ludth@!'dou!,
5. Equlpmcnt Otsconn.cilonr't& t6PrE€ttl! Cqnpfi/3 no66 to
Yo! lhlt the svst h(syd6vJc6{, list€d on lh€ ftc' or ti6 S'rvbs
Re$rn 5s tgnPdEw or Ps[Eisidv d!6 'ct'd .,E m lcloqln
ssv@ .nd, thu!, €rltot d'!tc! P'rfom 44d tlpod ocdr,lllta c(
t_arE rli 5l!nd5.
6. G.ndI Uri4.s oh-wE sPEff'4 woi(!i!I b' donr
th. h@rs of s:@ AM ad 5SO PU. @(cl6ivE ot S'tudsy'' Ss'd'vt
and comp.rly holldry!. All w'd( I! 'lsl'ctt' Ilvld rld l!!'lirrg h
acoltbrlca rilth th€ Em! t'd cdtdtolE of CBtcnei!
is.EonsLbonlractyih C..nFry. r o 15 in slbct CotP-v shtl
not b. Grpordd. brlaflul!lo r$d!t!'ftie! duato "rE ! b€lvond '
lb @ntrcl hdlrdrg hn not [nibd io fild.{ld 'tsbgat' rqtsbe
P3g.q fres. d!'ll dsobodlrE orsr'!t5.v6r'weEtl€ 'nr'oranv
oth6r causa bG/o.dtl codt{ ql dnPav qltomerF tdsrEitEt
th6 Umlaton ol Uauflt, and oher Fltisioru 5d torh ln ,ly ad6nn!
agr.dn6fli/Eirtra.t ron b I. efbct s!'ffir abol6' sPdy io Gsv'
ice! p6rbrn€d .nd md.dC! aPdltd Thd bflE "
tls Sdnca
Re$rBt shal lstm F!,lhslar*Ins sr:v Inondsl€d oFddhond
bd,c .id cdldtot b an, Frlhas. oder or odt" dod'Ei sutt
tqeo l{::,?,,, f etunetexGrinnca
REPORT OF INSPECTION
II. THE INSPECTOR SUGGESTS THE FOLLOWNG NECESSARY IMPROVEMENTS, HOry!EVE& THESE SI,|GGEST|oNS ARE NOT THE
RESULT OF AN ENGINEERING SURVEYT
EXTENO COVERAGE UNDER CONVEYOR EELT AT REAR OF BUILDING (APPROX, 5'WIDE 8Y 'M' LONG)
TROUBLESHOOT TAMPER SWITCH FOR WPIV ON SYSTEM f2 WHICH DID NOT REPORT TO FACP OURING TESTING
,I2. AOJUSTMENTS OR CORRECTIONS MADE:
PERFORMED MAIN DRAIN & ITv FLOW TESTS
I3. LIST CHANGES IN THE OCCUPANCY HAZARD OR FIRE PROTECTION EOUIPMENT, AS ADVISED BY THE OWT,IER IN SECTION IA:
14. INSPECTION AND SUGGESTEO IMPROVEMENTS WERE DISC VIflTH THE UNDERSIGNED OWNER
OR OWNER'S REPRESENTATIVE?
Signature ot orvner of o,rne/s prepresentative X
YES NO
x
Oale 1ZnlN13
TERMS AND CONDITIONS
l. Urit tlo. o' Lhbllltvi uDlt dm! Of R.m.dv. lt E m.'erslood
e.d rr.!.d b, tE currcrt..0l.t CdrPt, It iol d h5@r td
H Ilr3rrte dF.!q I trv. .i![ b. otaakd bt nE d'lolE
.d tEt dnsts pav&b io ComF.nv h€rardf, .o baed uFn
tttt.rsoati.sic.!sdttt.r.otl.blhv.'t@ri'lhis
s.ivt R6P!c ad e ullLbd t' tl. ulu. ol b. cutlm?s
prcr.d., td fl. FoP6rv ol !itt.6lEt.d m h! pods cus'
toq a!r63 lo loo( oxduslElv to ti. Cu!ton./. he6r ro
r..ow
'or
tiujes d &m9. ln tl. €rnt ot 'nv lo5' or L'i6v ed
$Er o,.tffi tsle* ltxt Fj6. Etl dgt{ oi l.@.ry .9al6t
CqiF ty by ky or &bor.dd. Comp-v rokB rc 9@F
:'arv orwazB, rtrl.fng av Lrplhd t!futv ot dsdudd
Ity o. fitE 6.. Flndra F|F!. thEt €q,lFmd o' 6'MB
3l+dLd by Cdp€.!, vlf, d.td or .El od,rtE. or th' et
..ssr t'!.!nqi lhd h. .qdFrut c, s.fvkt B! d'sl!i'd
It B impra.lel and axtreely dm.dl to fx th. 6ctual dsnEges.
fuy. whlchI1aypE{maLlv r. lt ftom h[ul. on th' P'rt'r
Cotp$y 10 perom snv ol I! oblrgadons und€r lhi' S€fri'e
Requed A@rdingly, Custom.r a!r*3 tna! C,mPan, 6hall be
6xeiPl nm [abirny fd an, hs3, dmes6 d lniurv td3in! die'r
ty or h.ltedy nm odmi6., t 6. ffi€+'nes tErc'ioirl.
rridr tE .qriFrc.n or $tlict *.s d..bn.d lo &ted d aErt
SlB.ld ccnpay b. lbud i.bb tbr 8v lost, dtntse or lni!'v
alising nom a lail@ of th€ .qjPm4l o. 6!$l@ ln e, BsPec1.
cnp*/! iaullty shall b6 limt d to an amout 6qual b rhe ss-
vico ReqJ.d Pij€ (as lnd@ssd bv lh' Ptl6 for 6tv addlfio"l
wo.l0 or{herc tte ttrl6 md maldiel P5vfi€il led l' slected.
customo/s iin€ and msLi.l p.vm.nB lo comPanv !\'lEd this
S.di@ Rsquest 6ve6 muldPlo !lte5, lltbllilv 6hall b6 limhed to
ih. sl@nt ol ltE Paymdts dl@t.d lo lho $1. *heF li6 inci_
d6t o@rrcd, Such sum shall b! cmtl6t' md €xdlslvo lt c!$
lom€r dedrss cmPanv !c .ssum gr.elor liabililv lh' Pani$ shall
en6d fi. SeEi@ RBqsst by eltaclin! a nds sdtnO fodh rhe
€nrount ol a.tdjona, liatilrv &d uE actltlond a,tlMl PavaH6 bv
tt* Custorner to. rhe asuf,pid bv Cohp3ny of 5'i<*' gFiq lie
H[ty, p@vided ho*mr }lal .kn .ir!.t!nal h m wav b€ int'r
pl.ted to hdd comPsdy * an lrulrsr. lN NO EVENT SHALL
COMPAI'Y BE LIABLE FOR ANY DAMAGE, LOSS, INJURY OR ANY
OTHER CLAIiI ARISING FROM ANY SERMCING' ALTERATIONS'
MODIFICATIONS, CHANGES. OR MOVEMENTS OF THE COVERED
SYSTEM(S) OR ANY OF ITS COMPONENT PARTS AYTHE CUS'
TOMER OR AI,[Y TTIIRO PARTY. @MPANY SHALL NOT AE UABTE
FOR INDIRECT, INICIOENTAL OR COI1SEOUENIIAL DAMAGES OF
ANY KIND, ]NCLUDINGBUT NOT LIMITEO TO DAMAGES ARISJNG
FROMTHEUSE. LOSSOFTHE USE, PEFFORMANCE' OR FAILURE
OF IHE COVEREo SYSTEM (S) TO PERFORM Th' [EtaliG oi lla'
E|jlily s.{ for$ in th. S6vi6 R€qu.sl slEn hsm to th6 bs'fit of
All FBnl3, s(lbsi<fi*i4 .rd sfillEls ol ComP'nv, wh€tlEr diE t
Or lr*1161 Ctrraiv's .mdov€6, €g'ts. o'lieB md dlEloB'
2, Llmlt.d w.mnty coMPAlry WARRANTS THAT lTs \ oRKl'lAN_
SHIP ANO MATERIAL FU RNISHED U NDER THIS SER\NCE
REqUEST WLL BE FREE TROM DEFECTS FOR A PERIOD OF
NINETY (90) DAYS FROM THE DATE OF FURNISHING VJhCE CM.
Pdy pEudes PodEt s .qulprn.nl ol olhe6, Companv -ill sd-
Rad th€ podLd 6 .qLiPh6.n d y to tl.. *ndn eamrted by sudr
TTJd P4tY, EXCEPT AS EXPRESSLY SET FORTH HEREIN' COMPA-
I.IY OISCIAMS ALL WARRANIIES, E{PRESs OR IMPUED'
INCLUDING BUT NOT UMITIED TO ANY IMPI]EO WARRANTTES OF
MERCHANTABILIry OR FITNESS FOR A PARTICULAR PURPOSE
WTH RESPECT TO TTIE SERVICES PERFORMED OR THE PROO'
UCTS, SYSTEMS OR EQULPMENT, IF AI'8. SUPPORTEO HEREUN'
DER, CPMPANY MAIGS NO WARMNTY OR REPRESENTATION'
AND UNDERIAKES NO OBLIGATION TO ENSIJRE BY IHE SER'
\ncEs PERFORMED UNDERTHIioaRMCE REOUEST' THAT COM_
PANY'S PROOUCTS OR THE SYSTEMS OR EOUTPMENI OF ThE
CUSTO'IER W LI, CORRECILY HANDTE THE PROCESSING OF
3. lnd.miv Cuno*r sod3 to hdcMjtv hoH h'mL6t ai d'lbid
Comp.ry .!.inc -ry td al !os.' lbm!'!, 6l!, i'rd'&{ ee€{
b.r snd @36. -d e@ens6 hdudlr{ Esor$16 @€rl!' @8, die
h9 aEm .ny sil sll tlrd Pary .bhs ld psdd hi'v, d€'tl FoP
.ny daEo€ or ..ftmlc lo$, Lclsdhg sp.d66llv lny &naoe
Bultn! tffi $. sqosuc otMt B to H!z!rd.o3 Codi!@
wh.6.r q not @slomd pe.o{fiet C.mp.nv ot i',t $ddtnc' oi cld
h.,rd ! @ndNmi aiFino In av €v lrDm .nv .cl or omlttld ol
CBtofr.r or Con!.iy elEting i. anv Mv to tl! A9,6nErt hdrd'
h bd .or [nh.d to lh. ssi6a uds uit .9l. m'r( *iotEr tudr
d.lms al. based up.o dt_.<d $dtut, 61 0ndudn! b(n n6l [*
h.d lo ..1,8 d P:sivc nesliterE), 3tic! k bintv o. odf,rY/is' CoG
psy l..lE lrE 4ri lo sd.cl 6[3d to ,wltet a h tnv 5u'h
4, H.zdous M.ted.ls. Custome.cPc!.ntsrh'l 'rc6rr 1o th6
.nenl that Comranv has ben glven wra.n .ono ot tlE tollow_
ing h.Erds Prior to th6 ex€cutloa ol thl. SeM" R'qu"t to th'
b$l olCustoE6a. *nowleds6lh@ L no:
'pe..n[ mfimd sP6.'As defrEd bY OSHA
dlk ol lnfecrids d€e
.!.didsl nunodlo, EsPtdorv Fot dbn. d.ihlr nEdL'lti'l(
.rb€.16, aslostosantairiing trl.n4 bnneld€nrd' d 'dEr
pot..{idly toxic or ouBdl$ ha.Eou. aldll c'nttl'€din or6
lh. rurfac. of ih€ f@8, eaIs. 6llln!3. lrud.tlfi or oth'r d,c
!r.d dn 66rn! ofuE e. oa sny hidn! {h'r! N b r.qui'ld
to h P.dmad under rhjs S6rvico R6qdn,
All or lire abow {e herdnaner Gl6@d to s. 'Haz'rd@5 Condiuons'
Comp€ny 6hd naE tho dqht to clv oo lh6 tlPosontellos lidod
Ebos, It i@dor @BfitloE rE encofldld b, cotlPttv du'tno tt€
@urs. of comp6ty! {qt, th€ diowry ol sEt corxldod 'harl
6n_
3tjM. an senl b€ydd compery'5 corird and CmPlnv sh.ll he
m oblicdjoi io tunh6 F lom in th. a,€a eh't! th' ha'dous .*
dllio. Bld utl tho are ha5 b.a m.dt $t6 bv C!3l6s t3 @d|
f €d ln wrnin! b, a lndePerd6nt l6d.g .!s'ty, s<' Cusrmr shd
p.y (llsruPlid qPens* alxl @rnoulizdon €+€ns63 tt d't'mined
Thl. S.rvl@ R.quest does not Provd. tot th€ colt ol ePt@. co'alF
monl or dl3P6.l ol anv hdard@s w.5t6 hat'rlatli d h"t'dd3 nEre
d.13, .n ourne,ed ln arry ol EF CowEd Svst'm(!) 6nd/or &dnq
p€rloltlan a d dE ServiB. Sdd mait'iglt 'hdl
!t tm" mdo
the esposibilily and P.opstv ot Cuslom'r' ConP&v shall mt be
r6poBitte td lhe res$r€. emval or dilpcd of such haze'ous
5. EqltpD.nt ol*onn&dona lhis 6pF*ntt codpa v's node ro
You uEi tLo sysl6mGyd€rc6(s) llstEd on lh' i&' ol lhl5 s'ryice
R.qu.sl a3 teFp@iy o. Pgrui.ntlv dl3@onet6d ar€ no lons" l'
!6.U@ and, t.hus, @not del€<1, pslom 5nd/or r'po'l oc@McBs d
r!nsmit!lgnals,
6. G.n6.L Unl6s oth6wls. +e6€d, wo* lhall b€ don' b'tw*n
lh6 haB or s:oo Ari ad 5:oo PM €tc16l!' ol Satrdav!' Slod8vB
.rn Cqnpay holidays All wdt It ELbl!'r lo EV* &d nbnf'E in
.@rdaE $ltl rhe tsras and @.dtioN ol cun6ei!
.!.6rer.l/@nfEcr *fti CdnP.rry. it om '' h 'ne4 ComPa'v sh'!
norb. BsP6sibl6lorf.nuEto rqrde!ervi6! dEtoec6 bevdd 7
It! @drol, lnclu.hg bd rct [mil6d lo m't'dd 'hdL€p! Po stoP
D.O.!, fr!s. clvil dieb.dlsc€ or unGl 3ov.r' wetths, fG d ar'y
olh6r c.us. beyond ih€ dntrcl of c.mp.ny. Cuslom'r it tuac tlat
lho Llnilaton ol uabilit .rd oihsr provillons 3.1 lorih In ev 'isting
agBement/conFacl iI on6 is In .ffsct, or 561 lodh ab'!6, aaPly lo *rv-
lca3 p.rtu.nsd and malodels suPPllod. Th' i"ru ol his $ryics
R€q*ir shall O@ern mtwitEtariino &y honsisl'nt ot rddtond
l.ihs and con ftjons In arly prrda36 od'r * otld &'@ant eE