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Home My WebLink About1 WATSON FARM 13-78 INVIAI.IA'l10( rl SPRINKLER SYSTEMS _ FC:on:tr:actor's, Ma terial and Test Certi icat:fo r underground Piping tr contractor s repressmadve and_*wssed by an coffers CEDURE and tests SW be made t y: finally have the lob rt rompbtan of work irtspettiott em da t .�rice before contrsctora Personnel n,presentative. At tlefects shall be corrected and sys► sltM§be PraPa�for approving auevrtbas.owners.and & both representstn a 1 no d�any Claim against contractor for fa ultY material.Poor A certificate shag De filled out and fined bye.&�� t,t ro way prel contractor. It I.understood the owner rePr suthoril>rs rt n ments or Local ordinances, workman .or floss to comply with apnrot�rtg _ ,f DATE 111,11 PROPERTY NAME PROPERTY ADDRESS Y APPROV► T z:( ES) N ? A JI,S N 14 t_ � tits S G 1 t- YES ❑ NO PLANS INSTALLATION CONFO ACCEPT 13 3LANS YES ❑ NO EQUIPMENT USED IS APPROVED IF NO.STATE DEVOTIONS YES ❑ NO HAS TO LPERSON IN CHARGE OF FIRE Ea j.ENT BEEN OCATION O INSTRUCTED� F CONTROL VALVES A 41 CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? IF NO,EXPLAIN INSTRUCTIONS HAVE COPIES OF APPROPRIATE 1NST'91; IONS AND CARE AND YES El NO MAINTENANCE CHARTS BEEN LEFT C 4 IAI EMISESI IF NO.EXPLAIN LOCATION SUPPLIES BUILDINGS _ TYPEs TYPe,�o r /-�� s . _ W NO ES ❑ PIPE CONFORMS TO _ S TANDARDE YES ❑ NO FITTINGS CONFORM TO STANDARD UNDERGROUND IF NO.EXPLAIN PIPES AND JOINTS C STRAPPED.OR BLOCKED IN YES ❑ NO JOINTS NEEDINGANCJiORA 31.ANDARD ACCORDANCE WITH IF NO,EXPLAIN 4: Fk>trr the required rate until M'.tt•is dear as Indicated by no Collection of foreign material in budV begs at outlets such as hydrants and biovwofts. .1:s1 at flours not less tlt n 390 GPM(1476 Umin)for 4 inch pipe.SW GPM (3331 slum)for ydratt Pine bWo i5W GPM S:0 i Lhhin)for 6.9rtch Pipe.2440 GPM(9235 Umin)tot 1 D-rich Pipe.and 3520 GPM(13323 Lenin)for 12-Inch PiPe. W 4. 1 Q* tot Pr°d1Ce �d flO�"rates.obtain s 0(5,n+a�sde HYDROSTATIC: Hyaosutic tests snap r rr ads at not less than 200 Psi(13.6 bars)for two tours a s0 t (3.s bars) TEST above slant pressure in excess of 150 G 4 11,L3 bars)for two fours is satisfactory•have we or no"Mge at LEAKAGE: New pipe lad with rubber*s+r'sit Joints snap.N the cp.go(a jw!(1 gg�)per 100 fortts kresPOI of pipe DESCRIPTION the p Ttte amount d leakage at the} m;shag not If such leakage occurs at a few joints the Installation&hap be diameter. The is~shalt be dislnbtA a �or all pods- ed above may be corlslderad txtsatlstactory and neCessar' i>F airs made. The amount d allowable leakage specified Increased by i A cz per h valve diamet r Ik' (30 mtn5 mmlh) �are al under Isolating ddi �tessect+on. N dry barrel hydrants are tested with the m am v81Ve open.so the rctd Per minute(150 mUn*,)WA&p Is Pe^maE d lot each hydrant- YES ❑ NO N ROUND PIpma FLUSF E:i..CCORDING TO t MWTANDARD BY PAI y p l v IF NO.EXPLAIN ' `T ` VV _ THROUGH WHAT TYPE OPENING HO FLUSHING FLOW WAS OBTAIN:1) HYDRANT BUTT ❑OPEN PIPE FLUSHING �UBLIC WATER ❑TANK OR RE S:F;IR;FIRE PUMP YES Q NO TESTS {{ $TANDARD BY(COMPANY} LEAD-INS FLUSHED ACCORDING TC IL IF NO.EXPLAIN T THROUGH WHAT TYPE OPENING H FLUSHING FLOW WAS TAIN- PUBLIC WATER QTANK OR RF:1;1 VOIR [_','FIRE PUMP n 3 GOT O FLANGE QOPEN PIPE lib rc 8•1(b)Pan I. i 13-79 MAR IV E SYS I f.\1\ JOINTS COVERED 70- EW UNDERGROUND P11 II IG HYDROSTATICALLY TESTED AT YES t NO HYDROS _ 2 __ HOURS TES200 PSI F) L AMOUNT OF LEAKAGE I t_%SURER GALS _ HOURSLEAKAGE -- TEST ALLOWABLE LEAKAGE GALS. HOURS ALL OPERATE SATISFACTORILY NUMBER INSTALLED Y'E AND MAKE YES �] NO 3 HYDRANTS 'o YES ❑ NO WATER CONTROL VALVES LE F" d1DE OPEN IF NO.STATE REASON CONTROL VALVES YES ❑ NO HOSE THREADS OF FIRE OE' R MEM CONNECTIONS AND HYDRANTS INTERCHANGEABLE WITH Ti M:S:OF FIRE DEPARTMENT ANSWERINGALARM DATE LEFT IN SERVICE v REMARKS NAME OF INSTALLING CONI F It Tpp SIGNATURES e TESTS WCINESSED BY - DATE FOR pj mew q ;.2 D) TITLE FOR IN `' E.:R(SIGNED) TITLE OAT O 2 ADDITIONAL EXPLANATION AND NOTES RECORD OF COMPLETION NATIONAL FIRE ALARM CODE Sec. 1-7,2.1 Complete parts 1,2 and 4-10 after system is installed and installation wiring has been checked. Part 3 after operational acceptance test. Name of Protected Property: 5.00 �u✓'m Address: / -- 7 3 W U+-50 h 'zt✓►1'� Rep. Of Protected Prop. (name/phone): /y1J r'rr14#1 �Ovu a e Authority Having Jurisdiction::�/rj re Address/Phone Number: 1. Ty e(s) of System or Service: ff NFPA 72, Chapter 3 -Local If alarm is transmitted to location(s)off premise, list where received: NFPA 72, Chapter 3 -Emergency Voice/Alarm Service Quantity of voice/alarm channels: Single: Multiple: Quantity of speakers installed: Quantity of speaker zones: Quantity of telephone or telephone jacks included in system: ❑ NFPA 72, Chapter 4-Auxiliary Indicate type of connection: Local energy, ❑ Shunt, ❑Parallel Telephone ❑ Location and telephone number for receipt of signals: ❑ NFPA 72, Chapter 4-Remote Station Alarm: Supervisory: ❑ NFPA 72, Chapter 4-Proprietary If alarms are retransmitted to public fire service communications center or others,indicate location and telephone number of the organization receiving alarm: Indicate how alarm is retransmitted: NFPA 72 Chapter 4- Central Station �O� The Prime Contractor: The, l gvNn .0 l.//��34�L) Central Station Location: otk ill &-60) OL-57 9$D) Means of transmission of signal from de protected premise to the central station: ❑ cCulloh ❑Multiplex ❑One-Way Radio Digital Alarm Communicator ❑ Two-Way Radio ❑Others Means of transmission o signals from the protected premise to the central station: a. -i; y1, 1 — leeff hones b. System Location: Organization Name/Phone Representative Name/Phone Installer Supplier SimplexGrinnell LP (860) 438-3207 Service Organization SimplexGrinnell LP Doug Huntley (860) 438-3200 Location of Record( s-BuilO_Drawings: Location of Owner's Manuals: Loc�jion of Test R�o A contract, dated.�-/ - for t st and inspection in a ordance with NFPA stand `d(s) No.(s) dated-/I-6'ts in effect. 2. Record of System installation (Fill out after installation is complete and wiring checked for opens, shorts, ground faults, and improper branching,but prior to conducting operational acceptance tests.) This syste =icesinnn 1 n accordance withthe NFPA standards as listed below,was inspected by on —'X U' 3 , includes the devices listed below and has been in sery ❑�/ NFPA 72, Chapters ❑1 ❑ 3 ❑4❑5 ❑6 ❑7 (check all that apply) L� NFPA 70,National Electrical Code,Article 760 [.� Manufacturer's instructions ❑ Other(specify): Signed: Date: 1 ' a Organization: � 3.Record of System Operation All operational features and functions of this system were tested by �vM AbCa- on�• 1.03 , and found to be operating properly in accordance with the requirements of: ❑ NFPA 72,Chapters ❑1 ❑3 ❑4 ❑ 5 ❑6 ❑7 (check all that apply) ❑ NFPA 70,National Electrical Code, Article 760 0-" Manufacturer's instructions ❑ Other specify): Date: �•/ 1.03 Signe Organization: im lexGrinnell 4.Alarm Initiating Devices and Circuits (Use blanks to indicate quantity of devices.) MANUAL (a) Manual Stations❑Noncoded, Activating❑Transmitters ❑Coded (b) Combination Manual Fire Alarm and Guard's Tour Coded Stations AUTOMATIC Coverage: Complete: Partial: (a)_{� Smoke Detectors ❑ Ion [g-P-Moto (b) Duct Detectors ❑Ion ❑Photo (c) Heat Detectors ❑RR ❑FT/RR ❑RC (d) Sprinkler Water Flow Switches: ❑Transmitters ❑Noncoded, activating ❑Coded (e) Other(list): 5.Supervisory Signal Initiating Devices and Circuits(Use blanks to indicate quantify of devices.) (a) Coded stations (b) Noncoded Stations Activating Transmitters (c) Compulsory Guard Tour System Comprised of Transmitter Stations and Intermediate Stations Note: Combination devices recorded under 4(b) and 5(a). SPRINKLER SYSTEM (a)$ Coded Valve Supervisory Signaling Attachments Valve Supervisory Switch,Activating Transmitters (b) Building Temperature Points (c) Site Water Temperature Points (d) Site Water Supply Level Points Electric Fire Pump: (e) Fire Pump Power (f) Fire Pump Running (g) Phase Reversal Engine-Driven Fire Pump: (h) Selector in Auto Position (i) Engine of Control Panel Trouble 0) Fire Pump Running Engine-Driven Generator (k) Selector in Auto Position (1) Control Panel Trouble (m) Transfer Switches (n) Engine Running Other Supervisory Functions(s) (specify): 6.Alarm Notification Appliances and Circuits Quantity of indicating appliance circuits connected to the system: S Types and quantities of alarm indicating appliances installed: (a) Bells Inch (b) Speakers (c) Horns (d) Chimes (e) Other: (f) S Visual Signals Type: 3`1 with audible w/o audible (g) Local Annunciator 7.Signaling Line Circuits: Quantity and Style(See NFPA 72,Table 3-6.1) of signaling line circuits connected to system: Quantity:_ r Style: 8. System Power Supplies a) Primary(Main): Nominal Voltage: 120 Current Rating: 20 Amp Overcurrent Protection: Type: Circ it Breake �T r Current Rating: 20 Amp Location: ja c 2 CLosti i Ci 2cu cT 0 ZZ b) Second (Standby): ge Battery: Amp-Hour Rating �, 1 Calculated capacity to drive system,in hours: EDA ❑ 24 ❑ 60❑90 ❑Engine-driven generator dedicated to fire alarm system: r . r 0. 1 • c) Emergency or Standby System used as backup to Primary Power Supply, instead of using a Secondary Power Supply: Emergency System described in NFPA 70, Article 700 Legally Required Standby System described in NFPA 70, Article 701 ❑ Optional Standby System described in NFPA 70, Article 702, which also meets the performance requirements of Article 700 or 701. 9. System Software a) Operating System Software Revision Level(s): OP, b) Application Software Revision Level(s): c) Revision Completed by: )oNNattrr (Name) (Firm) 10. Comments: > > (signed) fKr Central Station or Alarm Service Company (title) (date) Frequency of routine tests and inspections, if other than in accordance with the referenced NFPA standard(s): System deviations from the referenced NFPA standard(s) are: (signed) for Central Station or Alarm Service Company (title) (date) Upon c In letion of the system( )satisfactory test(s)witnessed(if required by the authority having jurisdi tion). (signed) representative of the authority i jurisdiction (title) (date)