inspection, testing, and maintenance fire sprinkler system nfpa 25...
TRANSCRIPT
Property Information:
Name: ___________________________________
Address: _________________________________
City: _____________________________________
Zip: ______________________________________
Contact: __________________________________
Phone: ___________________________________
Contractor Information:
Name: ___________________________________
Address: _________________________________
City: _____________________________________
Zip: ______________________________________
Contact: __________________________________
Phone: ___________________________________
Main Drain Test Results:
System Riser ID: __________ Initial Static Pressure: ____________________ (psi) Residual Static Pressure: ____________________ (psi) Restored Static Pressure: ____________________ (psi)
Type of System:
Wet Pipe Dry Pipe Preaction Deluge
Abbreviation Key:
I = InspectionT = TestM = MaintenanceA-O = After OperationMI = Per Manufacturer’s Instructions
CA Licence #: ________________________________________
Job#: _______________________________________________
Performed By: ________________________________________
Occupancy Use: ______________________
Construction Type: ____________________
No. Stories: __________________________
Year Constructed: ____________________
Date of Inspection, Testing, Maintenance: _________________
Number of System Risers: _____
Copy Sent To:
Owner Date: ___________ Fire AHJ: Date: ___________Contractor Date: ___________
Inspection, Testing, and Maintenance Fire Sprinkler System NFPA 25, Chapter 5 as amended by CCR, Title 19 Page 1
1) For specific inspection, testing and maintenance requirements and information, see NFPA 25, 2002 Edition as amended by California Code of Regulations, Title19, §901 to §906.
2) Inspection Items may be performed by the Owner in accordance with CaliforniaCode of Regulations Title 19 §904.1(a).
NOTES:
Forms included with this reportAutomatic Sprinkler System
Standpipe and Hose SystemsPrivate Water Supply System
Fire PumpWater Storage TankWater Spray System
Foam Water Sprinkler System
* See “Deficiencies and Comments” section at the end of each respective form.
NFPA 25 Chapter Number of Forms N/A FAIL* PASS
Item
1.1
1.2
1.3
1.4
1.5
1.6
1.7
1.8
1.9
1.10
1.11
1.12
1.13
1.14
1.15
1.16
1.17
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
I
Daily / Weekly
Daily / Weekly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Quarterly
Annually
Preaction/Deluge Valves - Enclosure Temp.
Dry Pip Valves - Enclosure Temp.
Gauges (Dry, Preaction, Deluge Systems) 5.2.4.2 / 5.2.4.3
Control Valves
Alarm Devices
Gauges (Wet Pipe Systems)
Hydraulic Nameplate
Pipe and Fittings
Sprinklers
Spare Sprinklers
Fire Department Connections
Alarm Valves - Exterior Inspection
Preaction/Deluge Valves - Exterior Inspection
Pressure Reducing Valves
Dry Pipe Valves - Exterior Inspection
Backflow Preventers
Buildings
12.4.3.1
12.4.4.1.1
12.3.2.1
5.2.6
5.2.4.1
5.2.7
5.2.2
5.2.1
5.2.1.3
12.7.1
12.4.1.1
12.4.3.1.6
12.5.1.1
12.4.4.1.4
12.6.1
5.2.5
Activity Frequency Description PASSFAILN/ANFPA 25Reference
Inspection, Testing, and Maintenance Fire Sprinkler System NFPA 25, Chapter 5 as amended by CCR, Title 19 Page 2
Item
1.18
1.19
1.20
1.21
1.22
1.23
1.24
1.25
1.26
1.27
1.28
1.29
1.30
2.1
2.2
2.3
2.4
I
I
I
I
I
I
I
I
I
I
I
I
I
T
T
T
T
Annually
Annually
5 Years
5 Years
5 Years
5 Years
5 Years
5 Years
5 Years
5 Years
5 Years
5 Years
5 Years
Annually
Annually
Annually
Annually
Hangers
Seismic Braces
Hangers (Accessible concealed spaces) 5.2.3.3
Seismic Braces (Accessible concealed spaces)Pipe and Fittings (Accessible concealed spaces)
Sprinklers (Accessible concealed spaces)
Alarm Valves - Interior Inspection
Alarm Valves - Strainers, filters, orifices
Check Valves - Interior Inspection
Preaction/Deluge Valves - Interior Inspection
Preaction/Deluge Valves - Strainers, filters, orifices
Dry Pipe Valves - Interior Inspection
Dry Pipe Valves - Strainers, filters, orifices
Alarm Devices (90 seconds)
Main Drain Test (Enter data on page 1)
Antifreeze Test
Control Valve - Position
5.2.3
5.2.3
5.2.3.3
5.2.2.3
5.2.1.1.4
12.4.1.2
12.4.1.2
12.4.2.1
12.4.3.1.7
12.4.4.1.8
12.4.4.1.5
12.4.4.1.6
5.3.3/12.2.7
12.2.6/12.2.6.1/12.3.3.4
5.3.4
12.3.3.1
Activity Frequency Description PASSFAILN/ANFPA 25Reference
2.6
2.7
2.8
2.9
2.10
2.11
2.12
2.13
2.14
2.15
2.16
2.17
2.18
2.19
2.20
2.21
2.22
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
T
Annually
Annually
Annually
Annually
Annually
Annually
Annually
Annually
Annually
3 Years
5 Years
5 Years
5 Years
5 Years
5 Years
10 Years
20 Years
Supervisory
Preaction Valve - Priming Water
Preaction Valve - Low Air Pressure Alarm 12.4.3.2.10
Preaction Valve - Full Flow Trip Test
Dry Pipe Valve - Priming Water
Dry Pipe Valve - Low Aire Pressure Alarm
Dry Pipe Valve - Quick Opening Device
Dry Pipe Valve - Trip Test
Backflow Preventer Assemblies
Dry Pipe Valve - Full Flow Trip Test
Gauges
Pressure Reducing Valve
Fire Department Connection Backflush
Sprinklers - Extra High Temperature
Sprinklers - Corrosive environment orcorrosive water
Sprinklers - Dry
Sprinklers - Fast Response
12.3.3.5
12.4.3.2.1
12.4.3.2.2
12.4.4.2.1
12.4.4.2.6
12.4.4.2.4
12.4.4.2.2
12.6.2
12.4.4.2.2.2
5.3.2
12.5.1.2
12.7.4
5.3.1.1.1.3
5.3.1.1.2
5.3.1.1.1.5
5.3.1.1.1.2
2.5 T Annually Control Valve - Operation 12.3.3.1
2.23
2.24
2.25
3.1
3.2
3.3
3.4
3.5
T
T
T
M
M
M
M
M
50 Years
75 Years
Annually
Annually
Annually
Annually
5 Years
Sprinklers
Sprinklers 75 years in service
Sprinklers manufactured prior to 1920 - Replace
Control Valves
Preaction/Deluge Valves
Dry Pipe Valves/Quick-Opening Devices
Dry Pipe Valve - Low Point Drains
Obstruction Investigation
5.3.1.1.1
5.3.1.1.1.4
5.3.1.1.1.1
12.3.4
12.4.3.3.2
12.4.4.3.2
12.4.4.3.3
Chapter 13
Date of Inspection, Testing, Maintenance: _______________
Inspection, Testing, and Maintenance Fire Sprinkler System NFPA 25, Chapter 5 as amended by CCR, Title 19 Page 3
Date of Inspection, Testing, Maintenance: _______________
Deficiency List
Quarterly Annual 5 Year
Abbreviation Key:
INTERIORB = BedroomMB = Master BedroomMBA = Master BathMC = Master ClosetBA = BathK = KitchenLR = Living RoomDR = Dining RoomH = HallwayP = Patio/BalconyE = Entry Way
LO = LoftLC = Loft Closet2F = Second FloorC = ClosetL = LaundryB2 = Second BedroomB3 = Third BedroomUTIL = Furnace/Water Heater
EXTERIORPK = Parking/Car PortG = Gas RoomELEC = Electrical RoomM = Maintenance LR = Laundry RoomFC = Fitness CenterMR = Media RoomCH = Club HouseTH = TheaterGYM = GymLOB = LobbyO = Office
PL = Pool/Pool RoomPR = Pump RoomEL = Elevator RoomH = HallwayS = Stairs1 = First Floor2 = Second Floor3 = Third Floor4 = Fourth FloorMR = Men’s RestroomWR = Women’s RestroomESCT. = Escutcheon
Bldg./Apt. Item Painted Bent Esct. Corroded Loaded Recalled Comments
Inspection, Testing, and Maintenance Fire Sprinkler System NFPA 25, Chapter 5 as amended by CCR, Title 19 Continued
Bldg./Apt. Item Painted Bent Esct. Corroded Loaded Recalled Comments
Property Information:
Name: ___________________________________
Address: _________________________________
City: _____________________________________
Zip: ______________________________________
Contact: __________________________________
Phone: ___________________________________
Main Drain Test Results: (use if additional space is needed)
System Riser ID: _______________________ Initial Static Pressure: ______________________________________________________________________ (psi) Residual Static Pressure: ______________________________________________________________________ (psi) Restored Static Pressure: ______________________________________________________________________ (psi)
Type of System:
Date of Inspection, Testing, Maintenance: _________________
Inspection, Testing, and Maintenance Fire Sprinkler System NFPA 25, Chapter 5 as amended by CCR, Title 19 Page 4
Total Deficiency Breakdown:
Comments:
TOTAL SPRINKLER HEADS TO REPLACE
TOTAL SECTIONS OF PIPE TO STRIAGHTEN PER 15’TOTAL SECTIONS OF PIPE TO REPLACE PER 15’
TOTAL SIGNS NEEDED
TOTAL LOCKS NEEDEDTOTAL VALVES TO REPLACE
TOTAL FDC CAPS NEEDED
TOTAL FLOW SWITCHES TO REPLACETOTAL STANDPIPE CAPS NEEDED
TOTAL JUNCTION BOXES TO RELOCATETOTAL GAUGES TO REPLACETOTAL SPRINKLER ESCUTCHEONS TO REPLACE
Wet Pipe Dry Pipe Preaction Deluge
PASSFAIL Signature: ______________________________________ Date: _________________