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HomeMy WebLinkAbout30 West Road - Life Safety System Tests MACK FIRE PROTECTION FIRE PROTECTION 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 owner's representative's signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PROPERTY NAME: CIL Group Home DATE: May 31, 2016 PROPERTY ADDRESS: 30 West Road, South Windsor,CT 06074 PLANS ACCEPTED BY APPROVING A.H.J.: FIRE MARSHAL AHJ ADDRESS: INSTALLATION CONFORMS TO ACCEPTED PLANS ® YES ❑ NO EQUIPMENT USED IS APPROVED ® YES ❑ NO IF NO, STATE DEVIATIONS INSTRUCTIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION ® YES ❑ NO OF CONTROL VALVES AND CARE AND MAINTENANCE OF THE NEW EQUIPMENT? IF NO EXPLAIN: HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: SYSTEM COMPONENTS INSTRUCTIONS ® YES ❑ NO CARE AND MAINTENANCE INSTRUCTIONS ® YES ❑ NO NFPA 13A ® YES ❑ NO LOCATION SUPPLIES BUILDINGS: 30 West Street, South Windsor, CT 06074 SPRINKLERS MAKE MODEL YEAR OF ORIFICE SIZE QUANTITY TEMPERATURE MANUFACTURE RATING TYCO LFII 2015 112" 36 160 TYCO TY-FRB 2015 1/2" 9 200 TYCO DS-1 2015 1" 3 155 PIPE AND TYPE OF PIPE: SCH. 10 &SCH. 40 BLACK STEEL PIPE FITTINGS TYPE OF FITTINGS: GROOVED VICTAULIC FITTINGS AND BLACK CAST IRON THREADED FITTINGS ALARM VALVE ALARM DEVICE MAXIMUM TIME TO OPERATE OR FLOW THROUGH TEST CONNECTION INDICATOR TYPE MAKE MODEL MINUTES SECONDS Vane Potter VSF-R 30 DRY PIPE DRY VALVE O.D. OPERATING MAKE MODEL SERIAL# MAKE MODEL SERIAL# TEST TIME TO TRIP THRU WATER AIR TRIP POINT TIME WATER ALARM OPERATED N/A TEST CONNECTION PRESSURE PRESSURE AIR REACHED TEST PROPERLY PRESSURE OUTLET MIN.WITHOUT SEC. PSI PSI PSI MIN. SEC. YES NO Q.O.D. ❑ El WITH Q.O.D. ❑ ❑ IF NO, EXPLAIN: DELUGE AND OPERATION ❑ PNEUMATIC ❑ ELECTRIC ❑ HYDRAULIC PREACTION PIPING SUPERVISED ❑ YES ❑ NO DETECTING MEDIA SUPERVISED ❑ YES ❑ NO VALVES DOES VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL STATIONS ❑ YES ❑ NO IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR TESTING ❑ YES ❑ NO N/A IF NO, EXPLAIN: DOES EACH CIRCUIT OPERATE SUPERVISION LOSS ALARM ❑ YES ❑ NO DOES EACH CIRCUIT OPERATE VALVE RELEASE ❑ YES ❑ NO MAXIMUM TIME TO OPERATE RELEASE MIN. SEC. 13-232 INSTALLATIog OF SPRIALER SYSTEMS Contractor's Material and Test Certificate for Aboveground Piping PROCEDURE Upon completion of work,inspection and tests shall be made by the contractor's representative and witnessed by the property owner or their authorized agent.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 owner's representative's signature In no way Prejudices any claim against contractor for faulty material,poor workmanship,or failure to comply with approving authority's requirements Or local ordinances. Property name Date ip Property address r Accepted by approving authorities(names) Address F L) Plans NO To ]N Installation conforms to accepted plans Equipment used is approved s ID No If no,explain deviations Yes Has person in charge of fire equipment been Instructed as to location of control valves and care and maintenance Yes 1:3 No of this new equipment? If no,explain Instructions Have copies of the following been left on the premises? ---61 1. System components Instructions Yes Y QCJNo rl"� 2. Care and maintenance instructions Yes QNo 3. NFRA 25 Q Yes ONo Location of ❑Yes QNo system Supplies buildings Make Model manufacture of Orifice Temperature size Quantity rating Sprinklers Pipe and Type of pipe fittings Type of fittings Alarm valve or Alarm device Maximum time to operate flow Type Make through test connection indicator "i 'J10 , — III Y I Mo I Minutes Seconds D valve Q.O.D. Make Model Serial no. Make Model Serial no. Time to trip Water Time water Alarm Dry pipe through test Air Trip point reached operated operating c nnectione,b Pressure pressure air pressure test outleta,b properly test Minutes Seconds psi ris I Without No O.O.D. With Q.O.D. If no,explain National Fire Protection Association a Measured from time inspector's test connection Is opens b NFPA 13 only requires the 60-second limitation In specific sections FIGURE24.1 Contractor's Material and Test Certificate for Aboveground Piping, 2010 Edition i�it::i"'i S ia,li:eai Fsre Frol�Ct;cr;ksscriaYCn c'dri'i=j.Licer•aed,b,a r?ement.for indivi;ival u:e arcs dov ntcad m O�IALe, 215;D HARTFORU i-DproUvstiun or(airs Tisslos in any Ic:m r•;ra,ittea t;i;rovl SPRINKLER, wtitlen r:;isaipr.Cf NJ-PA.Fcr in;;ufres or;C repor,uraulhvriaed use. o tac?ICensing,Oifpagr_n.t?d t,'er iCEVlr`I 1:17i;.Noeti;a; 51'STEM9 ACCEPTANCE 13-233 Operation ❑Pneumatic ❑Electric ❑H draulics Piping suEoperate ❑Yes ❑No Detecting media supervised Dyes ❑No Does valvom the manual trip,remote,or both control sta [Dyes No Deluge and preaction Is there an accessible facility In each circuit If no,explain valves for testing? Yes ❑No Does each circuit operate Does each circuit operate Maximum time to Make Model su erviston loss alarmg valve release? operate release Minu es s Location Make and Residual pressure Pressure- and floor model Setting Stallic' reducing pressure (flowing) Flow rate valve test Inlet(psi) Outlet(psi) inlet(psi) Outlet(psi} Flow(gpm) Hydrostatic: Hydrostatic tests shall be.made at not less than 200 psi(IS.e bar)for 2 hours or 50 psi(3.4 bar) above static pressure in excess of 150 psi(10.2 bar)for 2 hours. Differential dry pipe valve clappers shall be left Test open during the test to prevent damage.All aboveground piping leakage shall be stopped. description erim—arla Establish 40 psi(2J bar)air pressure and measure drop,which shall not exceed 1 Yz 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 1Yz psi(0.1 bar)in 24 hours. :Equipment iping hydrostatically tested at psi(—bar)for—hours If no,state reason ptping pneumaticaffy tested ❑Yes [�No operates properly []yes ❑No Do you certify,as the sprinkler contractor that additives and corrosive chemicals,sodium silicate or derivatives of sodluu silicate,brine,or other corrosive chemicals were not used for testing systems or stopping leaks? iGlXes UN. Drain Reading of gauge located near water Residual pressure with valve in test Tests test supply test connection: si —bar connection open wide: si —.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 ❑Yes ❑No Other Certificate for Underground Piping. Explain Flushed by installer of underground sprinkler piping ❑Yes ❑No If powder-driven fasteners are used in concrete, U Yes ❑No If no,explain has representative sample testing been satisfactorily completed? Blank testing Number used Locations gaskets Number removed Welding piping ❑Yes No If yes... Do you certify as the sprinkler contractor that welding pro dures used compiled with the minimum requirements of AWS B2.1,ASME Section IXce Welding and Brazing ❑YeS ❑No Qualifications,or other applicable qualification standard as required by the AHJ? Do you certify that all welding was performed by welders or welding operators qualified in accordance with the minimum requirements of AWS 82.1,ASME Section Yes ❑No IX Welding and Brazing Qualiffoatlons,or other applicable qualification standard as Welding required by the AHJ? Do you certify that the welding was conducted in compliance with a documented quality control procedure to ensure that(1)all discs are retrieved;(2)that openings in [Dyes ❑No piping are smooth,that slag and other welding residue are removed;(3)the internal diameters of piping are not penetrated;(4)completed welds are free from cracks, incomplete fusion,surface.porosity greater than Vic in.diameter,undercut deeper than the lesser of 25%of the wall thickness or'/az in.;and(5)completed circumferential butt weld reinforcement does not exceed 3/az in.? ©2009 National Fire Protection Association NFPA 13(p,2 of 3) FIGURE 24.1 Continued 2010 Edition NSA 1 cn'.JCtcoer 4'. If pril,.luction or iririsrni_alovl in w1v form v.,r;tie,j pe,11,.12S PA.Far iaauirss or to repast LIIBLI! use,Contact 13-234 INSTAUATIONQF SPRINKLER SYSTEMS Cutouts Do You certify that you have a control feature to ensure that (discs) all cutouts(discs)are retrieved? No Hydraulic Nameplate provided If no,explain data nameplate es UNo Sprinkler contractor removed all caps and straps? 6Yes ❑No Date left in service with all control valves open Remarks Name of sprinkler contractor CIL M.2 Tests witnessed by Signatures The property owner or their authorized agent(signed) Title Date For filer contractor (signed) Title Date .2 Additional explanations and notes Q 2009 National Fire Protection Association NFPA 13(p.3 of 3) FIGURE 24.1 Gwinued LO 2010 Edition