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Home My WebLink About100 Arnold Way - Life Safety System Test SiMPIWW�`s►r1nneft HE SAFE_ Task# 32567206 Quarterly Q Annual ❑ 3 Year ❑ 5 Year ❑ SR# REPORT OF SPRINKLER INSPECTION Pagel of4 D CUSTOMER South Windsor B.O.E INSPECTOR NAME Jon Kielbania BUILDING/LOCATION Timothy Edward SIMPLEXGRINNELL OFFICE 129 STREET 100 Arnold Way 80 Clark Drive Unit 5d CITY/ST/PROV I ZIP/PC South Windsor,CT. East Berlin,CT 06023 Ate: PHONE# 1-800451-6124 PHONE# LICENSE# 1.GENERAL(To be answered by Customer.) YES NA NO a.Have there been any changes in the occupancy classification,machinery or operations since the last inspection? b.Have there been any changes or repairs to the fire protection systems since the last inspection? c.if a fire has occurred since the last inspection,have all damaged sprinkler system components been replaced? If answered"yes"to a,b or c,list changes in Section 13. d.Has the piping in all dry systems been checked for proper pitch within the past five years? Date last checked: (check recommended at least every 5 years) e.Has the piping in all systems been checked for obstructive materials? Date last checked: 6/30/2008 (check required at least every 5 years) f.Have all fire pumps been tested to full capacity using hose streams or flow meters within the past 12 months? g.Are gravity,surface or pressure tanks protected from freezing? h.Standard sprinklers 50 years old or older? ❑ QR(20yr) ❑Dry(10 yr) ❑>325F/163C(5yr) ❑ Corrosive env't. (5yr.) (Testing or replacement required for these types of sprinklers.) I. Are any extra high temperature solder sprinklers regularly exposed to temperatures near 300F/149C? Lj j. Have gauges been tested,calibrated or replaced in the last 5 years? Date 6/30/2008 JA IF] I[T k. Alarm valves and associated trim been internally inspected past 5 years? Date 6/30/2008 1. Check valves internally inspected in the last 5 years? Date m.Has the private fire main been flow tested in last 5 years? Date ❑ Q ❑ n.Standpipe 5 year requirements. 1.Dry standpipe hydrostatic test Date ❑ 0 ❑ 2.Flow test Date 9/10/2008 0 ❑ ❑ 3.Hose hydrostatic test Date ❑ Q ❑ 4.Pressure control valve test Date ❑ Q ❑ 5.Pressure reducing valve test Date ❑ ❑ ❑ o.Have pressure reducing valves been tested at full flow within the past 5 years? Date ❑ Q q.Have master pressure reducing valves been tested at full flow within the past 1 year? ❑ ❑ ❑ r. Have the sprinkler systems been extended to all areas of the building? ❑ ❑ ❑ s. Are the building areas protected by a wet system heated,including its blind attics and perimeter areas? Q I❑ ❑ t. Are all exterior openings protected against the entrance of cold air? ❑ ❑ ❑ 2.CONTROL VALVES a.Are all sprinkler system main control valves and all other valves in the appropriate open or closed position? b.Are all control valves sealed or supervised in the open position? 0 ❑ Control Valves #of Type Easily Accessible Signs Valve Open Secured? (Sealed?) Supervision Valves If Yes,How? (Locked? Operational YES NO YES I NO YES NO YES I NO (Supvd.?) CITY CONNECTION 4 OS&Y ✓ ✓ YES NO Supervised TANK 1-11 PUMP Ll H I H I LLJJ- -i- I Ll 1 --0- - SECTIONAL 9 Butterfly J Supervised SYSTEM 2 OS&Y Supervised EALARM LINE Location of Control Valves: SG71607(Rev.01/08) Copyright 2008 Simple"nnell LP.All rights reserved. ` r► SimplexGrinnelIBE SAFE. REPORT OF SPRINKLER INSPECTION Page 2of4 3.WATER SUPPLIES Pressure Fire Pump&Tank LJ a.Water supply sources? City: Q Gravity Tank: ❑ Pressure Fire Pump&City ❑ Main Drain Test Results Made During This Inspection Pressure Fire Pump&Pond ❑ Test Size Static Supply Residual Return tim Test Size Static Supply Residual Return time to Pipe Test Pressure Pressure to Static Pipe Test Pressure Pressure Static Located Pipe Before Pressure Located Pipe Before Pressure Riser#1 2" 70 50 70 Riser#2 2" 60 45 60 4.TANKS,PUMPS,FIRE DEPT.CONNECTIONS YES NA NO a.Do fire pumps,gravity,surface or pressure tanks appear to be in good external conditions? ✓ b.Are gravity,surface and pressure tanks at the proper pressure and/or water levels? ✓ c.Has the storage tank been internally inspected in the last 3 yrs.(unlined)or 5 yrs.(lined)? Date: LLLU--��Ijj d.Are fire dept.connections in satisfactory condition,couplings free,caps or plugs in place and check valves tight? ✓ I Li e.Are fire dept.connections visible and accessible? ✓ S.WET SYSTEMS YESI NA I NO a.No.of systems: 2 Make&Model 6"Viking"J-1"1999 b.Are cold weather valves in the appropriate open or closed position? Lj 1\11 If closed,has piping been drained? ✓ c.Has the Customer been advised that cold weather valves are not recommended? ✓ d.Have all the antifreeze systems been tested? Date: ]IF LJ The antifreeze tests indicated protection to:(Note temp&type for each.Example:-15F/126C glycol or-15F/-26C glycerin) System 1) 2) 3) 4) 5) 6) e.Did alarm valves,water flow alarm devices and retards test satisfactorily? ✓ 6.DRY SYSTEMS YES NA NO a.No.of systems: na Make&Model: Date last trip tested: ❑ Partial Lj Full b.Are the air pressure and priming water levels normal? T1 ✓ c.Did the air compressor operate satisfactorily? ✓ TT d.Air compressor oil checked? ❑ Belt? ❑ e.Were Auxiliary/Low Point drains drained during this inspection? No.of Drains: ✓ Locations 1) 2) 3) 4) f.Did all quick opening devices operate satisfactorily? Make: Model: ET Er 0- g.Did all the dry valves operate satisfactorily during this inspection? IT ✓ h.Is the dry valve house heated? ET ✓ i. Do dry valves appear to be protected from freezing? ==H 7.SPECIAL SYSTEMS YES NA NO a.No.of systems: na Make&Model: Type: b.Were valves tested as required? ✓ c.Did all heat responsive systems operate satisfactorily? I LJ I ✓ d.Did the supervisory features operate during testing? I I ✓ e.Has a supplemental test form for this system been completed and provided to the customer? (Please attach) ❑ Q ❑ Auxiliary equipment: No. Type: Location Test results &ALARMS YES NA NO a.Did the water motors and gong operate during testing? ✓ b.Did the electric alarms operate during testing? ✓ c.Did the supervisory alarms operate during testing? ✓ SG71607(Rev.01/08) Copyright2008 SimplexGrinnell LP.All rights reserved. �iiftir le ct ri ell aF sAFE. Page 3 of 4 REPORT OF SPRINKLER INSPECTION 9.SPRINKLERS-PIPING YES NA NO a.Do sprinklers generally appear to be in good external condition? ✓ to.Do sprinklers generally appear to be free of corrosion,paint,or loading and visible obstructions? ✓ c.Are extra sprinklers and sprinkler wrench available on the premises? ✓ (#,size,finish,temp,brand,of spare heads) d.Does the exposed exterior condition of piping,drain valves,check valves,hangers,pressure gauges,open sprinklers and strainers appear to be satisfactory? I ❑ ❑ e.Does the hand hose on the sprinkler system appear to be in satisfactory condition? ❑ 0 ❑ f. Does there appear to be proper clearance between the top of all storage and the sprinkler deflector? ✓ 10.EXPLANATION OF"NO"ANSWERS AND DEFICIENCIES. (Sections 1d thru 9): 11.THE INSPECTOR SUGGESTS THE FOLLOWING NECESSARY IMPROVEMENTS.THESE SUGGESTIONS ARE NOT THE RESULT OF AN ENGINEERING SURVEY AND DO NOT REFLECT CONDITIONS ABOVE CEILINGS OR IN CONCEALED SPACES: 12.ADJUSTMENTS OR CORRECTIONS MADE: 13.LIST CHANGES IN OCCUPANCY,HAZARD OR FIRE PROTECTION SYSTEM,AS ADVISED BY CUSTOMER IN SECTION 1 a-c: 14.INSPECTION DEFICIENCIES AND SUGGESTED IMPROVEMENTS WERE DISCUSSED WITH THE CUSTOMER/CUSTOMER IYES1 NO REPRESENTATIVE. ✓ If No,explain. IMPORTANT NOTICE TO CUSTOMER Customer acknowledges and agrees that,in the absence of a Service Agreement between the parties,services hereunder are performed pursuant to the terms and conditions of this Report,agrees that the services have been completed to Customer's satisfaction and that the system is in good working order and repair, unless services performed were of a temporary nature,in which case Customer acknowledges that part of customer's system may have been bypassed or is otherwise inoperable until service can be completed.CUSTOMER'S ATTENTION IS DIRECTED TO THE LIMITATION OF LIABILITY,WARRANTY,INDEMNITY AND OTHER CONDITIONS AT THE REVERSE SIDEIEND OF THIS REPORT.This Agreement has been drawn up and executed in English at the request of and with the full concurrence of Customer. Ce contract a 6te rAdige en anglais A la demande at avec I'assentiment du client. CUSTOMER Date: PRINT NAME CQ S L INNELL INSPECTOR SIGNATURE DUPLICATE TO: STREET: CITY,STATE AND ZIP: SG71607(Rev.01/08) Copyright2008 simplexorinnell I.P.All rights reserved.