1085 Atlantic Blv Seaside Apts fire Inspect Rpt2430 University Blvd., West * Jacksonville, FL 32217 * 904-733-9008
www.fortitudefire.com
FIRE HYDRANT INSPECTION
Owner: Owner Phone Number:
Owner Address:
Property Being Evaluated:
Property Address:
Date of Work:
All responses refer to the current work (inspection, testing and maintenance) performed on this date.
This work is (check one): Annual 5 Year Flow Test Existing Repaired New Device
Part I – Owner or Owner Owner or Owner Representative Printed Name Date Rep. Not Onsite
Part II – Inspector’s Section
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
1.Location of Hydrant:
2.Make / Model / Year of Hydrant:
3.Size of Hydrant:
4.Color of Hydrant:
5.Is Hydrant housing accessible?
6.Housing free of external damage?
7.Is the operating wrench available?
8.Does associated piping appear to be free of leaks?
9.Do all the control valve(s) appear to be open?
10.Is isolation valve accessible?
11.Free of leaks (external)?
12.Operating nut is in good condition?
13.Threads of nozzles / caps in good condition?
14.Gaskets on caps in good condition?
15.Is Hydrant in normal open / closed position?
16.Does operating nut appear to work thru full range?
17.Water flowed for 60 seconds or until clear?
18.Free from foreign material in barrel?
19.Does Hydrant drain in 60 minutes or less?Yes No N/A
Did Hydrant open left or right? ________
Seaside Apts
1085 Atlantic Blvd Atlantic Beach FL 32233
7/6/2022
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7/6/2022 ■
Bldg 4
American Darling B84B-5 2018
5 1/4”
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Left
20.Hydrants requiring pumping identified?Yes No N/A
21.Threads / caps / stems / plugs lubricated?Yes No N/A
22.Has a 5-year flow test been performed per NFPA 25?Yes No N/A
Part II – Comments (any “NO” answers, test failures or other problems found with the hydrant inspection must be explained here. Also, note here any products
noticed on the system that have been the subject to a recall or replacement program)
** See Diagram **
Part III – Recommendations (Not a part of the NFPA-25 inspection, the following items may need to be reviewed by a fire protection engineer)
Part IV – Inspectors Information
I state that the information on this form is correct at the time and place of my inspection and that all equipment tested at this time was left in operation conditional upon completion of this inspection except as noted in part III above.
Date:
Printed Name of Inspector:
Signature of Inspector:
License or Certificate Number (if applicable):
Color of Tag Placed on System: Red Green Yellow
5 Year Flow Test Results (if applicable):
Static:_______________________________
Residual:____________________________
Pitot:________________________________
GPM @ 20 psi:________________________
7/6/2022
Jason Kestner
FPI21-000025
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2430 University Blvd., West * Jacksonville, FL 32217 * 904-733-9008
www.fortitudefire.com
FIRE HYDRANT INSPECTION
Owner: Owner Phone Number:
Owner Address:
Property Being Evaluated:
Property Address:
Date of Work:
All responses refer to the current work (inspection, testing and maintenance) performed on this date.
This work is (check one): Annual 5 Year Flow Test Existing Repaired New Device
Part I – Owner or Owner Owner or Owner Representative Printed Name Date Rep. Not Onsite
Part II – Inspector’s Section
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
Yes No N/A
1.Location of Hydrant:
2.Make / Model / Year of Hydrant:
3.Size of Hydrant:
4.Color of Hydrant:
5.Is Hydrant housing accessible?
6.Housing free of external damage?
7.Is the operating wrench available?
8.Does associated piping appear to be free of leaks?
9.Do all the control valve(s) appear to be open?
10.Is isolation valve accessible?
11.Free of leaks (external)?
12.Operating nut is in good condition?
13.Threads of nozzles / caps in good condition?
14.Gaskets on caps in good condition?
15.Is Hydrant in normal open / closed position?
16.Does operating nut appear to work thru full range?
17.Water flowed for 60 seconds or until clear?
18.Free from foreign material in barrel?
19.Does Hydrant drain in 60 minutes or less?Yes No N/A
Did Hydrant open left or right? ________
Seaside Apts
1085 Atlantic Blvd Atlantic Beach FL 32233
7/6/2022
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7/6/2022 ■
Bldg 2
Kennedy 1971
4 1/2”
Yellow
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Left
20.Hydrants requiring pumping identified?Yes No N/A
21.Threads / caps / stems / plugs lubricated?Yes No N/A
22.Has a 5-year flow test been performed per NFPA 25?Yes No N/A
Part II – Comments (any “NO” answers, test failures or other problems found with the hydrant inspection must be explained here. Also, note here any products
noticed on the system that have been the subject to a recall or replacement program)
** See Diagram **
Part III – Recommendations (Not a part of the NFPA-25 inspection, the following items may need to be reviewed by a fire protection engineer)
Part IV – Inspectors Information
I state that the information on this form is correct at the time and place of my inspection and that all equipment tested at this time was left in operation conditional upon completion of this inspection except as noted in part III above.
Date:
Printed Name of Inspector:
Signature of Inspector:
License or Certificate Number (if applicable):
Color of Tag Placed on System: Red Green Yellow
5 Year Flow Test Results (if applicable):
Static:_______________________________
Residual:____________________________
Pitot:________________________________
GPM @ 20 psi:________________________
7/6/2022
Jason Kestner
FPI21-000025
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