HomeMy WebLinkAbout466 Evergreen Way - Life Safety System T CONTRACTOR'S MATERIAL TEST CERTIFICATE FOR ABOVEGROUND PIPING
PROCEDURE
Upon completion of work,inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative.All defects shall
be corrected and system left in service before contractor's personnel finally leave the job.
A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities,owners and contractor.
It is understood the property owner's authorized representative is a legal signatory and fully representitive of the Property owner's or propedy
that it is in compliance with the applicable approving authoritiy's requirements and local oordinances.
cepts full responsibility for the system as installed and agrees
PROPERTY NAME
Red Hawk# DATE
Bone Fish Grill @ Evergreen Walk 3004889
PROPERTY ADDRESS 3/1/2013
400 Evergreen Walk Suite#466 South Windsor, CT
ACCEPTED BY APPROVING AUTHORITY('S)NAMES
AHJ
ADDRESS
PLANS
INSTALLATION CONFORMS TO ACCEPTED PLANS
EQUIPMENT USED IS APPROVED x YES NO
IF NO,EXPLAIN DEVIATIONS x YES NO
HAS ST RORP
BEEN INRUCTED AS TOLOCATIOON O CONTROLL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT
x YES NO
IF NO,EXPLAIN
INSTRUCTIONS
HAVE COPIES OF THE FOLLOWING BEEN GIVEN TO THE PROPERTY OWNER OR
PROPERTY OWNER'S AUTHORIZED REPRESENTITIVE:
1.SYSTEM COMPONENTS INTRUCTIONS
2.CARE AND MAINTENANCE INSTRUCTIONS: X YES _NO
3. NFPA 25: X YES _NO
LOCATION OF SUPPLIES BLDGS. X YES NO
SYSTEM Entire Tenant Space
MAKE MODEL YEAR OF QUANTITY TEMPERATURE RATING in
ORIFICE SIZE
MANUFACTURE degrees
SPRINKLERS Reliabe F1FR/Pend 2012 1/2" 55 165
Reliabe F1FR/UPR 2012 1/2" 2 165
Reliabe F3QR/Pend 2012 1/2" 3 165
Reliabe F3QR/SW 2013 1/2" 5 200
E
PIPE CONFORMS TO NFPA#13 STANDARD
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PIPE AND FITTINGS CONFORM TO NFPA#13 X YES NO
STANDARD X YES NO
FITTINGS IF NO,EXPLAIN
ALARM DEVISE MAXIMUM TIME TO OPERATE THROUGH TEST PIPE
ALARM VALVE OR TYPE MAKE MODEL MIN.
FLOW INDICATOR Exist Flow sec.
DRY VALVE Q.O.D.
MAKE NA MODEL SERIAL NO. MAKE MODEL SERIAL NO.
DRY PIPE
TIME TO TRIP WATER TRIP POINTAIR TIME WATER ALARM OPERATED
OPERATING TEST THRUTEST PIPE PRESSURE AIR PRESSURE REACHED TEST
PRESSURE PROPERLY
OUTLET
MIN. SEC. PSI. PSI. PSI. MIN. SEC. YES
Without NO
Q.O.D.
With
Q.O.D
IF NO,EXPLAIN
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OPERATION T—JPNEUMATIC ELECTR
DELUGE& IC I HYDRAULIC
PREACTION PIPING SUPERVISED YES NO DETECTING MEDIA SUPERVISED YES NO
OPERATE FROM THE MANUAL TRIP ANDIOR REMOTE CONTROL STATION YES I NO
IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR TESTING IF NO,EXPLAIN
YES r NO
DOES EACH CIRCUIT DOES EACH CIRCUIT MAXIMUM TIME TO
MAKE MODEL OPERATE SUPERVISION OPERATE VALVE RELEASE OPERATE RELEASE
NA LOSS ALARM
YES NO YES NO YES NO
HYDROSTATIC: Hydrostatic tests shall be made at not less than 200 psi(13.6 bars)for two hours or 50 psi(3A bars)above static
pressure in excess of 150 psi(10.2 bars)for two hours. Differential dry-pipe valve clappers shall be left open during test to prevent
damage.All aboveground piping leakage shall be stopped.
TEST FLUSHING: Flow the required rate until water is clear as indicated by no collection of foreign material in burlap bags at outlets such as
DESCRIPTION hydrants and blow-offs. Flush at flows not less than 400 GPM If 514 Umin)for 4-inch pipe,600 GPM(2271 Umin)for 5-inch pipe,750
GPM(2839 Umin)for 124nch pipe.When supply cannot produce stipulated flow rates,obtain maximum available.
PNEUMATIC: Establish 40 psi(2.7 bars)air pressure and measure drop which shall not exceed 1-1/2 psi(0.1 bars)in 24 hours. Test
pressure tanks at normal water level and air pressure and measure air pressure drop which shall not exceed 1-1/2 psi 0.1 bars in 24 hours.
ALL PIPING HYDROSTATICALLY TESTED AT 200 PSI FOR 2 HRS. 1F NO,STATE REASON
DRY PIPING PNEUMATICALLY TESTED YES X NO NA
EQUIPMENT OPERATES PROPERLY X YES I IND
READING OF GAGE LOCATED NEAR WATER SUPPLY TEST PIPE. RESIDUAL PRESSURE WITH VALVE IN TEST
TESTS DRAIN TEST STATIC PRESSURE: PSI PIPE OPEN WIDE PSI
Underground mains and lead in connections to system risers flushed before connection made to sprinkler piping.
VERIFIED BY COPY OF THE U FORM NO.85B =YES XQNO OTHER EXPLAIN
FLUSHED BY INSTALLER OF UNDER GROUND Exist Underground
SPRINKLER PIPING YES X NO
TANK TESTING NUMBER USED LOCATIONS NUMBER REMOVED
AND GASKETS 0
WELDING PIPING YES I X I NO
IF YES........
DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES
COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9,LEVEL AR-3 =YES=NO
DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED
WELDING IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9,LEVEL AR-3 =YES=NO
DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A
DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS ARE
RETRIEVED,THAT OPENINGS IN PIPING ARE SMOOTH,THAT SLAG AND OTHER
WELDING RESIDUE ARE REMOVED,AND THAT THE INTERNAL DIAMETERS OF
PIPING ARE NOT PENETRATED YES NO
HYDRAULIC DATA NAMEPLATE PROVIDED IF NO,EXPLAIN
NAMEPLATE YEs No
DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN:
REMARKS 3/112013
NAME OF SPRINKLER CONTRACTOR
Red Hawk Fire&Security,LLC 55 Robinson Ave.Orange,CT 06460
TESTS WITNESSED BY
SIGNATURES F PE D R(SIG ) TITLE DATE
F ER CONTRA (SINGED) TITLE DATE
St-r-vai.
ADDITIONAL EXPLANATION AND NOTES
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