1089 ATLANTIC BLVD - GAS PIPING PROCEDURE ( , , , i ii . ta c,.H F -- z 7 S' u ____.____.........
-) EcEgvE,
. iir
Procedure: Upon completion of work, inspection and tests shall be made by the contractor's rep- r wgAwitness*
s 4�'�J l
an owner's representative. All defects shall be corrected and system left in service before contrpgt•1- personnel fin Ily • e I I L�
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_ 3
faulty material,poor work ip,or failure to c ply wi h approving/authority's requirements or local ordinances. P O.r `ny� 1l
Property Name: - S et S�1r SSS t ---- .------ -- ------ n0.L- (Q
Property Address: _jam __- J A _ _l___a.-._. _-—•--- Date: 9-/7___--- suit-�y
-- _ ,g-- . spec-1,D1
Accepted by Approving Authorities(Names): _ _S '--
I Q // �i\l. (\Leith
Address: (�Q7 - �o� ,�np.�__._ _.1____-_.--... _____ -- -—_-,
•
Plans Installation conforms to accepted plans: es 0 No •
Equipment use is approved: es ❑ No
If no,explain deviations: _ ___ ___ ___ --._ - ____ ____-.---________
- ; Has person in charge of fire equipment been instructed as to Lames ❑ No •
location of control valves and care and maintenance?:
If no,explain: — --- - - --- -- —
•
instructions Have copies of the following been left on the premise ?:
1.System components instructions D" s D No
- [ 2..Care and maintenance instructions ClArgr ❑ No
3.NFPA25 Q' '8" 0N . -
Location of Supplies Buildings: ff r f / i
System •
--- �nT'•i•`_ ..•• r{ ... -- —
�._-.__._..__. .---- -- Year of Tempe re i
Make - ` Model Manufacture Office Size Quantity L Ratin
-- :
-. irs- 1
Sprinklers _ ^V 302_- QLi--• - --- ;
- v. elortirri,_'
_ O i 1
Pipe and Type - ��� /(`
I Fittings Type of Fittings: ----._.. .224 .^h► - - - ---
__----"-`- -IiAa�dmum Time to O erste
Alarm Valve Alarm Device _; Through Test Connection_
or Flow Type _ _ ]-Ma-kee -- - . Model --- `. .--Min-- -S
ec i
Indicator _ I--1t ---%�.L --- —_---
Dray Valve __ _ Q.O.D._.._ -.
' __-__.i.__ _. _ Serial_
- Make - Model Serial# .._ __ Make _ I Model
---
pry Pipe Time to Trip Through Water Air' 'Trip Point; Time Water Retch Alarm Operated
`) 1/ Operating Testn Connection _Pressure Pressure Air Press. Test Outlet i Properly?
'" 111 PSI_ PSI PSI Min • Sec ' Yes No
Test ------- - -
Q.O.D. •
th ---.- - ;
1/1 .__________IO ration:-- 0 Pneumatic •
~ 0 Electric+^J❑Hydraulic _ —
Operation: t
Piping Supervised? ❑Yes - ❑No _- Detecting Media Supervised? 0 Yes 0 No
• Deluge and :_Does valve operate from the manual trip,remote,or both control stations? _ 0 Yes ❑No
,1(k Preactiorr Is there an accessible facility in each circuit for testing? 1 Yes No
•
•
/� ` valvesIf --
no_explain:
--_ —— ach CirculrOperate Each Circuit Operate-Maximum Time fo
S_pv.Loss Alarm? Valve Release? I Operate a Release ,
•Make Model Yes No Yes i No i Min Sec
, ..„.__ ,...... _-
iti i fr. Pressure i Location& I Make& -- -1.-----sta..-ti - ----------T-WeildiiiiPiiisiiraT----Frciii..--1
Setting ; C PreSSUre '
Reducing ; Floor ; Model Rate !'
ValveTest _______________H________________ -
_ (ak.2,2_utl_et.ip_s_1: Inlet00_2 Outlet(psk:Flowlge-i:
-- ------- -------
_____________......______=77-.___-1-_-_=___ ___-.7:-_-_—:------L--------'--- .-:-.-t •:_=._-z.__ ------ 1 - -- 1
a c ._.,__ : Hydrostatic tests shall be made at not less than 200 psi(13.6 bars)fo--r 2. hours- or 5-0 i -.-7
, (3A bar's-rirbove static pressure in excess of 150 psi(10.2 bars)for 2 hours Differential dry-pipe valve :
, clappers shall be left open during the test to prevent damage. All abovegrou.nd leakage shall be stopped :
Test
Chs 1 I •
'-• 01 P i°r? I. P u ale: Establish 40 psi(2.7 bars)air pressure and measure drop which shall not ex d 1 'A p • ::
, ( . bars in 24 hours. Test pressure tanks at normal water level and air essu "A cee - 81 '
...._ pressure dro
P,whiCh shall not exceed 1 1/2 psi(0.1 bars)in 24 hours. Pr re a....measure air r
• . ___.•:::::::: ::::-.z.::._-=.-z-------------_______,,k____-------------------------.-..nr--..-•--•--.-..-. -
All piping hydrostalcally tested atiejli;si ___sbar for--ficat-Tr-s --Trrio=itiwr. —=-• - .•-------;
Dry piping pneumatically tested 0 Yes P-ko .•
•
•
• Equipment operates properly [?T 0 No .•
;•
; • : Do you certify as the sprinkler COiiiract6F-that additives and corroilTe chemkils,sOilium a-lc-ale or -----";
• • denvatives of sodium silicate,brine,Orler corrosive chemicals were not used for testing systems or ;
; stopping leaks? • Lff Yes CI No
-------.—.—__________
Drain Test i Reading of gauge located near water : Residual pressure with valve test in
Tests ; supply test connection- psi (___bars) ! connection open wide:_psi (_bars)
. • Underground mains and lead in connections to system riiiriliustiiiiiiefore. conn-iation ma-de to-I—pi:inkier
, .
i: . piping:
. Verified by copy of the U-Form No.85B 0 yes 0 No Other(explain):
,
,
Flushed by installer of underground sprinkler piping 0 Yes 0 No i
.----- —-
. : If powder-driven fasteners are used in concrete,has representative i
sample testing been satisfactorily completed? U Yes 0 No
----- _. --. _,---.
__.
• pla___nk... ._____________
Nuniber Used — i LciciFirie— I Number Removea- i
. Testing :
' Gaskets
77176Taela-Fsip
If yes:
--t/O-17(51EeiliFiiitilifirTairei-c-iiiilia-cioTiiiifweTdiiifiii-oied-i-rel-c-o-rii-piTwith fife-FeTiiiileir-ifirillii-filTeliti
AWS D10.9,Level AR-3? 0 Yes 0 No ,
. ,
•
Welding -0-0-9oueitiliittiafttiliWaltrg was performed by_inieliliiiiTcWalrfriCliriairniplirTc-TWitiiitii-Feifuirements ofl
at least AWS 010.9, Level AR-3? 0 Yes 11 No
!
,
_
•
r-D-OjiiiirdeWthit iiiiilaiiCgTvii-ciFrie-Chiiii in-c-OriiRETn-ce-vViiiie-clin-eritivi quality control procedure to :
•
ensure that all discs are retrieved,that openings in piping are smooth,that slag_and other welding residue
is removed and that the internal diameters of piping are not penetrated? LI Yes 0 No
•
Cutouts ; Do you certify that you havei1trol feature to ensure that all cutouts(discs)are retrieved?
0 No
..-._..i-::-..,..7: _-.:--_, . :•____1.2e_!__ . ____.____ .
es 1:3 Ro . IfflO,no,risin: --------,
• Hdrautic Nameplate provididr-
Data
. 1
Itameplate 1 .
• .
I -riritirleft in service with all control valves open:
: Remarks
-..:.7.'i:_::::.. .-.-Z.7.--......--.
i lia—rne—cif6Tfiniontractor...‘? , 1
i .
Rec- Rctitek ..‘
..
.
Test •
-rol:-Pio-p-e-Fty---0-1 (iijned) --- TITLE DATE
Witnessed ;
-
DATE
Ey ..-F-oFS-rilTriklei-Co-riteactor(signe
, ! .,:-:
•
•
. Additional Explanation and-Notes: . .
•
•
• _____--.7.
6 cc I2.0
-- .i • ____ ____tP_ ._/
Ehnlefing inapoctons FORM and Handouts
Pago 2 of 2
Revised:2O13-May-02