Fire Sprinkler System Test 333 Ahern St 2012 613 N.W.MERCANTILE PLACE 3226 CHERRY PALM DRIVE
PORT ST.LUCIE,FIL 34986 TAMPA,FIL 33619
772-878-3350-FAX:772-878-5967 81 3-630-0303-FAX:81 3-630-0312
11326 DISTRIBUTION AVENUE WEST \VAVMAMNk
W 1W 4683 LAREDO AVENUE
JACKSONVILLE,FLORIDA 32256-2745 Automatic Fire Sprinklers, Inc. FORT MYERS,FLORIDA 33905
904-268-3030-FAX:904-268-0724 222 CAPITOL CT. 239-433-3030-FAX:239-433-3263
4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW 16TH TERRACE
CONCORD,NORTH CAROLINA 28027 407-656-3030-407-656-8026 POMPANO BEACH,FLORIDA 33064
704-782-3032-FAX:704-795-6838 954-917-3030-FAX:964-917-9424
NFPA-25 Inspection, Testing and Maintenance of Wet Pipe Fire Sprinkler Systems
Information on this form covers the minimum requirements of INFPA 25-2002 for fire sprinkler systems connected to distribution systems without supplemental tanks or fire pumps.
Separate forms are available to inspect,test and maintain fire pumps,water tanks and other fire protection systems. More frequent inspection,testing and maintenance may be
necessary depending on the conditions of the occupancy and the water supply.
Owner: VIA MARE CONDO ASSOCIATION Ise#: J00736 Report* 1 OF4
Owner's Address: 1635 EAGLE HARBOR PRKWY E STE 4 FLEMING IS.,FL 32003 Owner's Phone Number: 904-651-2707
Property Being Evaluated: VIA MARE BUILDING 1
Property Address: 333 AHERN STREET ATLANTIC BEACH,FL.32233
Date of Work: 29 NOVEMBER 2012 All responses refer to the current work(inspection,testing and maintenance)performed on this date.
This work is(check one): 0 Monthly 0 Quarterly Annual 0 Third Year 0 Fifth Year
Part I-Owner's Section
A.Is the building occupied? OYes ONO 4.Annual Inspection Items(in addition to above Items)
B.Has the occupancy classification and hazard of contents remained the same A.Proper number and type of spare sprinklers? OYes j&No ON/A
since the last inspection? OYes ONO B.Visible sprinklers:
C,Are all fire protection systems in service? OYes ONO 1.Free of corrosion and physical damage? @Yes ONO ON/A
D.Has the system remained in service without modification since the last inspection? OYes ONO 2.Free of obstructions to spray patterns? @Yes ONO ON/A
E. Was the system free of actuation of devices or alarms since the last OYes ONO 3.Free of foreign materials including paint? OYes @No ON/A
inspection? 4.Liquid in all glass bulb sprinklers? @Yes ONO ON/A
F.Weekly logs of inspections required by NFPA#25 on file? OYes ONO C�Visible pipe:
G.All deficiencies reported at last inspection corrected? OYes ONO 1.In good condition/no external corrosion? @Yes ONO ON/A
H.I know the location and understand the operation of all control valves. OYes ONO 2.No mechanical damage and no leaks? @Yes ONO ON/A
J.I would like to have a copy of NFPA#25 @ an extra charge of$50.00. OYes ONO 3.Property aligned and no external loads? Yes ONO ON/A
K.Owner or rep.requests WAFS to release information from D.Visible pipe hangers and seismic braces not damaged or loose? $Yes ONO ON/A
Inspections to the underwriters of my Insurance company. OYes ONO E.Hose,hose couplings and nozzles on sprinkler system passed
inspection in accordance with NFPA 1962? ONIC OyeS ONO @N/A
29NOVEMBE F.Adequate heat in areas with wet piping? @Yes ONO ONIA
Owner or representative(print name) Signature Date G.Has an internal inspection of the pipe been performed by removing
Part 11-Inspectoes Section 5_�Owner or Owner rep.not on site. the flushing connection and one sprinkler near the end of a branch
A.Inspections line within the last 5 years? @NIC OYes ONO ON/A
1.Daily and Weekly Items (if the answer was"No",conduct an internal inspection.)
A.Control valves supervised with seals in correct(open or closed) 5.Fifth Year InspectioK Items(in addition to above Items)
position? @Yes ONO ON/A A.Alarm valves and tH air associate strainers,filters and restriction
B.Backflow Preventers: orifices passed internal inspection? ONIC OYes ONO SN/A
1.Valves in correct(open or closed)position? @Yes ONO (:)N/A B.Check valves internally inspected and all parts operate properly,move
2.Seated,locked or supervised&accessible? @Yes ONO ONIA freely and are in good condition? ONIC OYes ONO @N/A
3.Relief port on RPZ device not discharging? Yes No @)NIA B.Testing
C.For freezer systems,is the gauge near the compressor reading the 0 0 The following tests are to be performed at the noted intervals.Report any failures on Part III of this form.
same as the gauge near the dry-pipe valve? OYes ONO @N/A 1.Quarterly Tests
A.Mechanical water flow alarm devices passed tests by opening the
2.Monthly Inspection Items(in addition to above Items) inspectors test connection or bypass connection with alarms actuating
A.Control valves with locks or electrical supervision in correct(open or and flow observed? OYes ONO SN/A
closed)position? OYes @No ON/A E.Post indicating valves opened until spring or torsion is felt in the rod,
B.Sprinkler wrench with spare sprinklers? OYes @No ON/A then closed bark one-quarter turn? OYes ONO @N/A
C.Gauges on wet-pipe system in good condition and showing normal C.Main drain test for system downstream of backflow or pressure reducing valve:
water supply pressure? OYes @No ON/A 1.Record Static Pressure psi and Residual psi
D.Alarm Valves: Pressure
Gauges show normal supply water pressure,free from physical See comments-on page 2
damage,valves in correct(open or closed)position and no leakage 2.Was flow observed? OYes ONO @N/A
from retarding chamber or drains? Oyes ONO @N/A 3.Are results comparable to previous test? OYes ONO SN/A
3.Quarterty Inspection Items(in addition to above Items) 2.Semiannual Test(in addition to previous items)
A.Pressure Reducing Valve:In open position,not leaking,maintaining OYes ONO A.Valve supervisory switches indicate movement? @Yes ONO ON/A
B.Electrical waterflow alarm devices passed tests by opening the
downstream pressure per design criteria,and in good condition with Not installed inspectors test connection or bypass connection with alarms actuating
handwheels not broken? 0 Design criteria is not available and flow observed? OYes @No ON/A
B.Hydraulic nameplate(calculated systems)securely attached to near 3.Annual Test(in addition to previous Items)
and legible? OYes @No A.Main drain test
C.Fire Department Connection: 1.Record Static Pressure 50 psi and Residual 40 psi
- Pressure
Visible,accessible,couplings and swivels not damaged and rotate (7, See comments-on page 2
smoothly,plugs or caps in place and undamaged,gaskets in place and 2.Was flow Observed) @Yes ONO ON/A
in good condition,identification sign(s)in place,check valve is not
leaking,clapper is in place and operating properly and automatic drain 3.Are results comparable to previous test? @Yes ONO OyA
valve in place and operating property? OYes @No ON/A B.Are all spiinklers date 1920 or later? Unable to determine.Oyes (:)NO
(if plugs or caps are not in place,inspect interior for obstructions.) C.Fast response sprinklers 20 or more years old replaced or successfully
D.Alarm devices free from physical damage? @Yes ONO ON/A sample tested within last 10 years? 9NIC OYes ONO
Report#: 1 OF 4
Part III-Comments(any"No"answers, test failures or other problems found with the sprinkler
Wet Pipe Report page 2 system must be explained here. All items that need repaired or replaced are the owners
D.Standard response sprinklers 50 or more years old replaced or responsibility and are not included in the price ofirspection.
successfully sample tested within last 10 years? @)NIC 0Yes ONo
E.Standard response sprinklers 75 or more years old replaced or
successfully sample tested within last 5 years? @NIC OYes ONo MAIN CTRL VALVETAMPER SEAL#1300470
F.Dry-type sprinkler replaced or successfully sample tested
within last 10 years? ONIC oYes ONo @N/A BACKFLOW TAMPER SEAL#'s 0703437 0703465
G.Specific gravity of antifreeze rorrect? OYes ONo @N/A
H.All control valves operated through full range and returned to normal
position? @)Yes ONo C)N/A DEFICIENCIES:
1.Backflow devices passed backflow test? ONIC @Yes ONo (:)N/A
J.Backflow devices passed full flow test?@Provisions not provided. ONIC OYes ONo ()N/A 1)HEAD PAINTED IN UNIT 339 NORTH LIVING AREA
K.Pressure reducing valves passed partial
flow test? Oprovisions not provided. ONIC oYes ONo @N/A
4.Test to be done every third year: 2)FDC OBSTRUCTED
Hose(more than 5 years old)connected to the system has been service tested in accordance with
NFPA 1962.Water discharged and water flow alarms operated? ONIC 0YeS oNo SN/A 3)GAUGES DUE FOR REPLACEMENT
6.Test to be done every 6th year
A.Sprinklers rated aboveHigh temperature tested? ONIC oYes oNo @N/A 4)FIRE BACKFLOW REQUIRES A CHAIN&LOCK
6.Gauges checked by calibrated gauge or replaced? OYes oNo 5)FLOW BELL DID NOT OPERATE
C.Pressure reducing valves passed full flow test? ONIC OYes oNo @N/A
C.Maintenance 6)SPARE HEADS AND WRENCH MISSING FROM HEAD BOX
1.Regular Maintenance Items
A.If sprinklers have been replaced,were they proper replacements? OYss ONo
B.Used hose was cleaned,drained and dried before being placed back in Wannot be determined
service?Hose exposed to hazardous materials was disposed of or
decontaminated in an approved manner7 0Yes oNo (D�/A NOTE:
C.Systems normally filled with freshwater were drained and (:)Cannot be determined.
refilled twice if raw water got into the system? OYes ONo 1)DID NOT GAIN ACCESS TO UNITS 333&335
D.If any of the following were discovered,was an obstruction investigation @Cannot be determinea.
conducted? ONIC OYes oNo @N/A
Explain reason(s)and obstruction investigation finding in Part M
1.Defective intake screen on pump with suction from open sources,
2.Obstructive material discharged during water flow tests.
3.Foreign materials found in dry-pipe valves,check valves or pumps.
4.Foreign material in water during drain test or plugging of inspector's test connection.
5.Plugging of pipe or sprinklers found during activation or alteration.
6.Failure to flush yard piping or surrounding public mains following new installation or repairs.
7.Record of broken mains in the vicinity.
8,Abnormally frequent false-tripping of dry-pipe valves. Part IV-Observations: Not a part of the NFPA-25 inspection, the following items may need to
9.System is returned to service after an extended period out of service(greater than one year), be reviewed by a fire protection engineer.
10.There is reason to believe the system contains sodium silicate or its derivatives or highly
corrosive vluxes in copper pipe systems.
E.If conditions were found that required flushing,was flushing of system
conducted? ONIC 0yes oNo @N/A
2.Annual Maintenance Items(in addition to previous Items)
A.Operating stem of all OS&Y valves lubricated completely closed,and
reopened? @Yes oNo ()N/A
B.Sprinklers and spray nozzles protecting commercial cooking equipment
and ventilating systems replaced except for bulb-type which show no
signs of grease buildup? OYes oNo @N/A
3.Regular Maintenance items
A.Alarm panel dear? @Yes oNo C)N/A
B.System left in servire? @Yes oNo ON/A
C.Is system impaired?(Impairment program put into place per NFPA-25 and
Wayne Automatic Fire Sprinklers protocols) OYes @No Part IV-Inspector's 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 operational condition upon completion of this inspection except
as noted in Part III above.
The scope ofwork preformed does not include a review offire sprinkler orfire alarm system design.
Date:
29 NOVEMAR 2
Signature of Inspector:
Print Name: MICHAEL TAUVELL
License or Certification Number(if applicable): 11081600012008
Color of tag placed on system:
Ir'7Red
r—Green
613 N.W.MERCANTILE PLACE 3226 CHERRY PALM DRIVE
PORT ST.LUCIE,FL 34986 TAMPA,FIL 33619
772-878-3350-FAX:772-878-5967 81 3-630-0303-FAX:81 3-630-03112
11326 DISTRIBUTION AVENUE WEST \"A/�mW�AYME
4683 LAREDO AVENUE
JACKSONVILLE,FLORIDA 32256-2745 Automatic Fire Sprinklers, Inc. FORT MYERS,FLORIDA 33905
904-268-3030-FAX:904-268-0724 222 CAPITOL CT. 239-433-3030-FAX:239-433-3263
4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW I STH TERRACE
CONCORD,NORTH CAROLINA 28027 407-656-3030-407-656-8026 POMPANO BEACH,FLORIDA 33064
704-782-3032-FAX:704-795-6838 S54-917-3030-FAX:954-917-9424
NFPA-25 Inspection, Testing and Maintenance of Wet Pipe Fire Sprinkler Systems
Information on this form covers the minimum requirements of NFPA 25-2002 for fire sprinkler systems connected to distribution systems without supplemental tanks or fire pumps.
Separate forms are available to inspect,test and maintain fire pumps,water tanks and other fire protection systems, More frequent inspection,testing and maintenance may be
necessary depending on the conditions of the occupancy and the water supply.
Owner: VIA MARE CONDO ASSOCIATION ISC#: J00736 Report#: 2 OF 4
Owners Address: 1635 EAGLE HARBOR PRKWY E STE 4 FLEMING IS.,FL 32003 Owner's Phone Number: 9.4-651-2707
Property Being Evaluated: VIA MARE BUILDING 2
Property Address: 333 AHERN STREET ATLANTIC BEACH,FL.32233
Date of Work: 29 NOVEMBER 2012 All responses refer to the current work(inspection,testing and maintenance)performed on this date.
This work is(check one): 0 Monthly 0 Quarterly Annual 0 Third Year 0 Fifth Year
Part I-Owner's Section
A.Is the building occupied? OYes ONO 4.Annual Inspection Items(in addttlon to above Items)
B.Has the occupancy classification and hazard of contents remained the same A.Proper number and type of spare sprinklers? OYes @No ON/A
since the last inspection? OYes ONO B.Visible sprinklers:
C.Are all fire protection systems in service? OYes ONO 1.Free of corrosion and physical damage? @Yes ONO ON/A
D.Has the system remained in service without modification since the last inspection? OYes ONO 2.Free of obstructions to spray patterns? @)Yes ONO ONIA
E. Was the system free of actuation of devices or alarms since the last OYes ONO 3.Free of foreign materials including paint? @Yes; ONO ON/A
inspection? 4.Liquid in all glass bulb sprinklers? @Yes ONO ONIA
F.Weekly logs of inspections required by NFPA#25 on file? OYes ONO
G.All deficiencies reported at last inspection corrected? OYes ONO C.Visible pipe:
H.I know the location and understand the operation of all control valves. OYes ONO 1.In good condition/no external corrosion? @Yes ONO (:)N/A
2.No mechanical damage and no leaks? @Yes ONO ON/A
J.I would like to have a copy of NFPA#25 @ an extra charge of$50.00. OYes ONO 3.Propedy aligned and no external loads? (g)Yes ONO ON/A
K.Owner or rep.requests WAFS to release Information from
inspections to the underwriters of my insurance company. OYes ONO D'Visible pipe hangers end seismic braces not damaged or loose? (2)Yes ONO (:)N/A
E.Hose,hose couplings and nozzles on sprinkler system passed
inspection in accordance with NFPA 1962? ONIC OYes ONO @)N/A
29NOVEMBE F.Adequate heat in areas with wet piping? @Yes ONO ON/A
Owner or representative(print name) signature Date G.Has an internal inspection of the pipe been performed by removing
Part 11-Inspector's Section Owner or Owner rep.not on site. the flushing connection and one sprinkler near the end of a branch
A.Inspections line within the last 5 years? @NIC OYeS ONO ON/A
1.Daily and Weekly Items (if the answer was"No",conduct an internal inspection.)
A.Control valves supervised with seals in correct(open or closed) 6.Fifth Year Inspection Items(in addition to above Items)
position? @Yes ONO ON/A A.Alarm valves and their associate strainers,filters and restriction
B.Backfiow Preventers: orifices passed internal inspection? ONIC OYes ONO @N/A
1.Valves in correct(open or closed)position? @Yes ONO ON/A B.Check valves internally inspected and all parts operate property,move
2.Sealed,locked or supervised&accessible? @Yes ONO ON/A freely and are in good condition? ONIC OYes ONO @N/A
3.Relief port on RPZ device not discharging? Yes ONo @N/A B.'resting
C.For freezer systems,is the gauge near the compressor reading the 0 The follovAng tests are to be performed at the noted int—als.Report any failures on Part III of tinis form.
same as the gauge near the dry-pipe valve? OYes ONO @N/A 1.Quarterly Tests
A.Mechanical water flow alarm devices passed tests by opening the
2.Monthly Inspection Items(in addition to above Items) inspectors test connection or bypass connection with alarms actuating
A.Control valves with locks or electrical supervision in correct(open or and flow observed? OYes ONO @N/A
closed)position? OYes @No ONIA B.Post indicating valves opened until spring or torsion is felt in the rod,
B.Sprinkler wrench with spare sprinklers? OYes @No ON/A then closed back ona-quarter turn? OYes ONO @N/A
C.Gauges on wet-pipe system in good condition and showing normal C.Main drain test for system downstream of backflow or pressure reducing valve:
water supply pressure? OYes @No ON/A 1.Record Static Pressure psi and Residual psi
D.Alarm Valvesi Pressure
Gauges show normal supply water pressure,free from physical see comments-on page 2
damage,valves in correct(open or closed)position and no leakage 2.Was flow observed? OYes ONO @N/A
from retarding chamber or drains? OYes ONO @)N/A 3.Are results comparable to previous test? OYes ONO SN/A
3.Quarterly Inspection Items(in addition to above Items) 2.Semiannual Test(in addition to previous Items)
A.Pressure Reducing Valve:In open position,not leaking,maintaining OYes ONO A.Valve supervisory switches indicate movement? @Yes ONO ON/A
B.Electrical waterflow alarm devices passed tests by opening the
downstream pressure per design criteria,and in good condition with @ Not installed inspector's test connection or bypass connection with alarms actuating
handwheels not broken? 0 Design criteria is not available and flow observed? OYes @No ON/A
B.Hydraulic nameplate(calculated systems)securely attached to riser 3.Annual Test(in addition to previous Items)
and legible? OYes @No A.Main drain test:
C.Fire Department Connection 1.Record Static Pressure 50 psi and Residual 40 psi
— Pressure
Visible,accessible,couplings and swivels not damaged and rotate See comments-on page 2
smoothly,plugs or caps in place and undamaged,gaskets in place and 2.Was flow observed? @Yes ONO ON/A
in good condition,identification sign(s)in place,check valve is not
leaking,clapper is in place and operating property and automatic drain 3.Are results comparable to previous test) @Yes ONO ON/A
valve in place and operating propedy? OYes @No ON/A B.Are all sprinklers date 1920 or later? Unable to determine.CiYes ONO
(if plugs or caps are not in place,inspect interior for obstructions.) C.Fast response sprinklers 20 or more years old replaced or successfully
0.Alarm devices free from physical damage? @Yes ONO ON/A sample tested within last 10 years? @NIC OYes ONO
Report#: 2 OF 4
Part III-Comments(any"No"answers, test failures or other problems found with the sprinkler
Wet Pipe Report page 2 system must be explained here. All items that need repaired or replaced are the owners
D.Standard response sprinklers 50 or more years old replaced or responsibility and are not included in the price of inspection.
successfully sample tested within last 10 years? @NIC 0yes ONO
E.Standard response sprinklers 75 or more years old replaced or
successfully sample tested within last 5 years? @NIC OYes ONO MAIN CTRIL VALVE TAMPER SEAL#0703468
F.Dry-type sprinkler replaced or successfully sample tested
within last 10 years? ONIC oYes ONO @N/A BACKFLOW TAMPER SEAL#'s 0703437 0703465
G,Specific gravity of antifreeze correct? OYes ONO @N/A
H.All control valves operated through full range and returned to normal
position? @Yes ONO ()N/A
1.Bacidlow devices passed backflow test? ONIC @YeS ONO ()N/A DEFICIENCIES:
J.Backflow devices passed full flow test?Wrovisions not provided. ONIC 0yes ONO (>/A 1)FIRE BACKFLOW REQUIRES A CHAIN&LOCK
K.Pressure reducing valves passed partial
flow test. OProvisions not provided. ONIC OYeS ONO @N/A
4.Test to be done every third year: 2)FDC OBSTRUCTED
Hose(more than 5 years old)connected to the system has been service tested in accordance with
NFPA 1962.Water discharged and water flow alarms operated? ONIC oYes ONO @N/A 3)GAUGES DUE FOR REPLACEMENT
5.Test to be done every 5th year
A.Sprinklers rated aboveHigh temperature tested? ONIC 0Yes ONO @N/A 5)FLOW BELL OPERATED BUT,ALARM NOT SENT TO FACP;
S.Gauges checked by calibrated gauge or replaced? OYes ONO SPRINKLER IS PRESENTLY IMPAIRED
C.Pressure reducing valves passed full flow test? ONIC OYes ONO @N/A
C.Maintenance
1.Regular Maintenance Items
A.If sprinklers have been replaced,were they proper replacements? OYes ONO
B.Used hose was cleaned,drained and dried before being placed back in Wannot be determined.
service?Hose exposed to hazardous materials was disposed of or
decontaminated in an approved manner? OYes ONO @N/A NOTE:
C.Systems normally filled with fresh water were drained and (Dcannot be determined.
refilled twice if raw water got into the system? OYes ONO 1)DID NOT GAIN ACCESS TO UNITS 341 345 347 343
D,If any of the following were discovered,was an obstruction investigation @cannot be determineo.
conducted') ONIC 0Yes ONO @N/A
Explain reason(s)and obstruction investigation finding in Part 1/1
1.Defective intake screen on pump with suction from open sources.
2.Obstructive material discharged during water flow tests.
3.Foreign materials found in dry-pipe valves,check valves or pumps.
4.Foreign material in water during drain test or plugging of inspector's test connection.
5.Plugging of pipe or sprinklers found during activation or alteration.
6.Failure to flush yard piping or surrounding public mains following new installation or repairs,
7.Record of broken mains in the vicinity.
8.Abnormally frequent false-tripping of dry-pipe valves. Part IV-Observations:Not a part of the NFPA-25 inspection, the following items may need to
9.System is returned to service after an extended period out of service(greater than one year). be reviewed by a fire protection engineer.
10.There is reason to believe the system contains sodium silicate or its derivatives or highly
corrosive Auxes in copper pipe systems.
E.If conditions were found that required flushing,was flushing of system
conducted? ONIC 0yes ONO (ElN/A
2.Annual Maintenance Items(in addition to previous Items)
A.Operating stem of all OS&Y valves lubricated completely closed,and
reopened? @Yes ONO ON/A
B,Sprinklers and spray nozzles protecting commercial cooking equipment
and ventilating systems replaced except for bulb-type which show no
signs of grease buildup? OYes ONO @N/A
3.Regular Maintenance Items
A.Alarm panel clear? @Yes ONO C)N/A
B.System left in service? @Yes ONO C)N/A
C.Is system impaired?(Impairment program put into place per NFPA-25 and
Wayne Automatic Fire Sprinklers protocols) @Yes ONO Part IV-Inspectoes 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 operational condition upon completion of this inspection except
as noted in Part Ili above.
The scope of work preformed does not include a review of fire sprinkler or fire alarm system design.
Date: 29NOVEM R2 I
Signature of Inspector:
Print Name: MICHAEL TAUVELL
License or Certification Number(if applicable): 11081600012008
Color of tag placed on system:
R—Red
F.Green
613 N.W.MERCANTILE PLACE 3226 CHERRY PALM DRIVE
PORT ST.LUCIE,FIL 34986 TAMPA,FIL 33619
772-878-3350-FAX:772-878-5967 81 3-630-0303-FAX:813-630-03112
11326 DISTRIBUTION AVENUE WEST AYNE
4683 LAREDO AVENUE
JACKSONVILLE,FLORIDA 32256-2745 Automatic Fire Sprinklers, Inc. FORT MYERS,FLORIDA 33905
904-268-3030-FAX:904-268-0724 222 CAPITOL CT. 239-433-3030-FAX:239-433-3263
4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 31121 NW 16TH TERRACE
CONCORD,NORTH CAROLINA 28027 407-656-3030-407-656-8026 POMPANO BEACH,FLORIDA 33064
704-782-3032-FAX:704-795-6838 954-917-3030-FAX:954-917-9424
NFPA-25 Inspection, Testing and Maintenance of Wet Pipe Fire Sprinkler Systems
Information on this form covers the minimum requirements of NFPA 25-2002 for fire sprinkler systems connected to distribution systems without supplemental tanks or fire pumps.
Separate forms are available to inspect,test and maintain fire pumps,water tanks and other fire protection systems. More frequent inspection,testing and maintenance may be
necessary depending on the conditions of the occupancy and the water supply.
Owner: VIA MARE CONDO ASSOCIATION ISC#: J00736 Report#: 30F4
Owner's Address: 1635 EAGLE HARBOR PRKWY E STE 4 FLEMING IS.,FL 32003 Owner's Phone Number: 904-651-2707
Property Being Evaluated: VIA MARE BUILDING 3
Property Address: 333 AHERN STREET ATLANTIC BEACH,FL.32233
Date of Work: 29 NOVEMBER 2012 All responses refer to the current work(inspection,testing and maintenance)performed on this date.
This work is(check one): 0 Monthly 0 Quarterly Annual 0 Third Year 0 Fifth Year
Part I-Ownees Section
A.Is the building occupied? OYes ONO 4.Annual Inspection Items(in addition to above Items)
B.Has the occupancy classification and hazard of contents remained the same A.Proper number and type of spare sprinklers? OYes @No a/A
since the last inspection? OYes ONO B.Visible sprinklers:
C.Are all fire protection systems in service? OYes ONO I.Free of corrosion and physical damage? @Yes ONO ON/A
D.Has the system remained in service without modification since the last inspection? OYes ONO 2.Free of obstructions to spray patterns? @Yes ONO ON/A
E, Was the system free of actuation of devices or alarms since the last OYes ONO 3.Free of foreign materials including paint? OYes @No ON/A
inspection? 4.Liquid in all glass bulb sprinklers? @Yes ONO ON/A
F.Weekly logs of inspections required by NFPA#25 on file? OYes ONO C.Visible pipe*
G.All deficiencies reported at last inspection corrected? OYes ONO 1.In good condition/no external corrosion? @Yes ONO ON/A
H.I know the location and understand the operation of all control valves. OYes ONO 2.No mechanical damage and no leaks? @Yes ONO 0 N/A
J.I would like to have a copy of NFPA#25 @ an extra charge of$50.00. OYes ONO 3.Property aligned and no external loads? @Yes ONO ON/A
K.Owner or rep.requests WAFS to release information from D Visible pipe hangers and seismic brares not damaged or loose? @Yes ONO (:)NIA
inspections to the underwriters of my insurance company. OYes ONO
E.Hose,hose couplings and nozzles on sprinkler system passed
inspection in accordance with NFPA 1962? ONIC OYeS ONO @N/A
29NOVEMBE F.Adequate heat in areas with wet piping? @Yes ONO ON/A
Owner or representative(print name) signature Date G.Has an internal inspection of the pipe been performed by removing
Part 11-Inspector's Section rx-,Owner or Owner rep.not on site. the flushing connection and one sprinkler near the end of a branch
A.Inspections line within the last 5 years? @NIC OYes ONO ON/A
1.Daily and Weekly Items (If the answer was"No",conduct an internal inspection.)
A.Control valves supervised with seals in correct(open or closed) 5.Fifth Year Inspection Items(in addition to above Items)
position? @Yes ONO ON/A A.Alarm valves and their associate strainers,filters and restriction
B.Backfiow Preventers: orifices passed internal inspection? ONIC OYes ONO SN/A
1.Valves in correct(open or closed)position? @Yes ONO ON/A B.Check valves internally inspected and all parts operate properly,move
2.Sealed,locked or supervised&accessible? @Yes ONO ON/A freely and are in good condition? ONIC OYeS ONO @N/A
3.Relief port on RPZ device not discharging? Yes No @N/A B.'resting
C.For freezer systems,is the gauge near the compressor reading the 0 0 The following tests are to be performed at the noted intervals.Report any failures an Part III of this form.
same as the gauge near the dry-pipe valve? OYes ONO WA 1.Quarterly Tests
A.Mechanical water flow alarm devices passed tests by opening the
2.Monthly Inspection Rome(in addition to above Items) inspectors test connection or bypass connection with alarms actuating
A.Control valves with locks or electrical supervision in correct(open or and flow observedl OYes ONO @NjA
closed)position? OYes @No ON/A B.Post indicating valves opened until spring or torsion is felt in the rod,
B.Sprinkler wrench with spare sprinklers? OYes @No ON/A then closed back one-quarter turn? OYes ONO @N/A
C.Gauges on wet-pipe system in good condition and showing normal C.Main drain test for system downstream of backillow,or pressure reducing valve:
water supply pressure? OYes @No ON/A 1.Record Static Pressure psi and Residual psi
D.Alarm Valves: Pressure
Gauges show normal supply water pressure,free from physical See comments-on page 2
damage,valves in correct(open or closed)position and no leakage 2.Was flow observed? OYes ONO &IA
from retarding chamber or drains? OYes ONO @N/A 3.Are results comparable to previous test? OYes ONO SN/A
3.Quarterly Inspection Items(in addition to above Items) 2.Semiannual Test(in addition to previous Items)
A.Pressure Reducing Valve:In open position,not leaking,maintaining OYes ONO A.Valve supervisory switches indicate movement? 0yes ONO ONIA
B.Electrical waterflow alarm devices passed tests by opening the
downstream pressure per design criteria,and in good condition with @ Not installed inspectors test connection or bypass connection with alarms actuating
handwheels not broken? 0 Design criteria is not available and flow observed? OYes @No ON/A
B.Hydraulic nameplate(calculated systems)securely attached to riser 3.Annual Test(in addition to previous Items)
and legible? OYes ONO A.Main drain test: :
C.Fire Department Connection: 1.Record Static Pressure 50 psi and Residual 40 psi
Visible,accessible,couplings and swivels not damaged and rotate Pressure
I—, See comments-on page 2
smoothly,plugs or caps in place and undamaged,gaskets in place and 2.Was flow observed? @Yes ONO ONIA
in good condition,identification sign(s)in place,check valve is not
leaking,clapper is in place and operating properly and automatic drain 3.Are results comparable to previous test? @Yes ONO ONjA
valve in place and operating property? OYes (DNo ON/A B.Are oil sprinklers date 1920 or later? @ Unable to determine.oYes ONO
(if plugs or caps are not in place,inspect interior for obstructions.) C.Fast response sprinklers 20 or more years old replaced or successfully
D,Alarm devices free from physical damage? @Yes ONO ON/A sample tested within last 10 years? @NIC 0Yes ONO
Report#: 3 OF 4
Part III-Comments(any"No"answers, test failures or other problems found with the sprinkler
Wet Pipe Report page 2 system must be explained here All items that need repaired or replaced are the owners
D.Standard response sprinklers 50 or more years old replaced or responsibility and are not included in the price ofinspection.
successfully sample tested within last 10 years? @NIC oYes ONo
E.Standard response sprinklers 75 or more years old replaced or
successfully sample tested within last 5 years? @NIC OYes ONo MAIN CTRL VALVE TAMPER SEAL#0703433
F.Dry-type sprinkler replaced or successfully sample tested
within last 10 years? ONIC oYes ONo @N/A BACKIFLOW TAMPER SEAL WS 0703437 0703465
G.Specific gravity of antifreeze correct? OYes ONo @N/A
H.All control valves operated through full range and returned to normal
position? @Yes ONo ()N/A DEFICIENCIES:
1.Backflow devices passed backflow test? ONIC @Yes ONo C)N/A
J.Backflow devices passed full flow test?@Provisions not provided. ONIC oYes ONo (DN/A 1)HEAD PAINTED IN UNIT 353 KITCHEN,AC, 1st BED HALL&BED BAT
K.Pressure reducing valves passed partial
flow test? Oprovisions not provided. ONIC oYes ONo @N/A
4.Test to be done every third year: 2)FDC OBSTRUCTED
Hose(more than 5 years old)connected to the system has been service tested in accordance with
NFPA 1962.Water discharged and water flow alarms operated? ONIC oYes oNo @N/A 3)GAUGES DUE FOR REPLACEMENT
S.Test to be done every 5th year
A.Sprinklers rated aboveHigh temperature tested? ONIC Oyes ONo @N/A 4)FIRE BACKIFLOW REQUIRES A CHAIN&LOCK
B.Gauges checked by calibrated gauge or replaced? OYes ONo 5)FLOW BELL DID NOT OPERATE
C.Pressure reducing valves passed full flow test? ONIC OYeS oNo SN/A
C.Maintenance
1.Regular Maintenance Items
A.If sprinklers have been replaced,were they proper replacements? 0 Yes 0 No
B.Used hose was cleaned,drained and dned before being placed back in (Ricannot be determined,
service?Hose exposed to hazardous materials was disposed of or
decontaminated in an approved manner1i OYes oNo &/A NOTE:
C.Systems normally filled with fresh water were drained and Ocannot be detemnined.
refilled twice if raw water got into the system? OYes ONo 1)DID NOT GAIN ACCESS TO UNITS 355
D.If any of the following were discovered,was an obstruction investigation Wannot be determinea.
conducted? ONIC OYes ONo @N/A
Explain reason(s)and obstruction investigation finding in Part/if
1.Defective intake screen on pump with suction from open sources.
2.Obstructive materal discharged during water flow tests.
3.Foreign materials found in dfy-pipe valves,check valves or pumps.
4.Foreign material in water during drain test or plugging of inspectors test connection.
5.Plugging of pipe or sprinklers found during activation or alteration.
6.Failure to flush yard piping or surrounding public mains following new installation or repairs.
7.Record of broken mains in the vicinity.
8.Abnormally frequent false-tripping of dry-pipe valves. Part IV-Observations: Not a pail of the NFPA-25 inspection, the following items may need to
9.System is returned to service after an extended period out of service(greater than one year). be reviewed by a fire protection engineer.
10.There is reason to believe the system contains sodium silicate or its derivatives or highly
corrosive vluxes in copper pipe systems.
E.If conditions were found that required flushing,was flushing of system
conducted? ONIC oYes oNo @N/A
2.Annual Maintenance items(in addition to previous Items)
A.Operating stem of all OS&Y valves lubricated completely closed,and
reopened? @Yes oNo C)N/A
B,Sprinklers and spray nozzles protecting commercial cooking equipment
and ventilating systems replaced except for bulb-type which show no
signs of grease buildup? OYes oNo @N/A
3.Regular Maintenance Items
A,Alarm panel clearl @Yes oNo C)N/A
B.System left in service? @Yes oNo C)N/A
C.Is system impaired?(Impairment program put into place per NFPA-25 and
Wayne Automatic Fire Sprinklers protocols) OYes @No Part IV Inspector's Inforrhatlon
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 operational condition upon completion of this inspection except
as noted in Part III above,
The scope of work preformed does not include a review of fire sprinkler orfire alarm system design.
Date: 29 NOVEM R 2 1
Signature of Inspector:
Print Name: MICHAEL TAUVELL
License or Certification Number(if applicable): 11081600012008
Color of tag placed on system:
RRed
r—Green
613 N.W.MERCANTILE PLACE 3226 CHERRY PALM DRIVE
PORT ST.LUCIE,FIL 34986 TAMPA,FIL 33619
772-878-3350-FAX:772-878-5967 81 3-630-0303-FAX:81 3-630-0312
11326 DISTRIBUTION AVENUE WEST \V/V%/7ARKE
W - 4683 LAREDO AVENUE
JACKSONVILLE,FLORIDA 32256-2745 Automatic Fire Sprinklers, Inc. FORT MYERS,FLORIDA 33905
904-268-3030-FAX:904-268-0724 222 CAPITOL CT. 239-433-3030-FAX:239-433-3263
4370 MOTORSPORT DRIVE OCOEE, FL 34761-3033 3121 NW 16TH TERRACE
CONCORD,NORTH CAROLINA 28027 407-656-3030-407-656-8026 POMPANO BEACH,FLORIDA 33064
704-782-3032-FAX:704-795-6838 964-917-3030-FAX:954-917-9424
NFPA-25 Inspection, Testing and Maintenance of Wet Pipe Fire Sprinkler Systems
Information on this form covers the minimum requirements of NFPA 25-2002 for fire sprinkler systems connected to distribution systems without supplemental tanks orfire pumps.
Separate forms are available to inspect,test and maintain fire pumps,water tanks and other fire protection systems. More frequent inspection,testing and maintenance may be
necessary depending on the conditions of the occupancy and the water supply.
Owner: VIA MARE CONDO ASSOCIATION ISC#: J00736 Report#: 40F4
Owner's Address: 1635 EAGLE HARBOR PRKWY E STE 4 FLEMING IS.,FL 32003 Owner's Phone Number: 904-651-2707
Property Being Evaluated: VIA MARE BUILDING 4
Property Address: 333 AHERN STREET ATLANTIC BEACH,FL.32233
Date of Work: 29 NOVEMBER 2012 All responses refer to the current work(inspection,testing and maintenance)performed on this date.
This work is(check one): 0 Monthly 0 Quarterly @Annual 0 Third Year 0 Fifth Year
Part I-Owner's Section
A.Is the building occupied? OYes ONO 4.Annual Inspection Items(in addition to above Items)
B,Has the occupancy classification and hazard of contents remained the same A.Proper number and type of spare sprinklers? OYes @No (:)NIA
since the last inspection? OYes ONO B.Visible sprinklers:
C.Are all fire protection systems in servicel OYes ONO 1.Free of corrosion and physical damage? @Yes ONO ON/A
D.Has the system remained in service without modification since the last inspection? OYss ONO 2.Free of obstructions to spray patterns? @Yes ONO ON/A
E. Was the system free of actuation of devices or alarms since the last OYes ONO 3.Free of foreign materials including paint? OYes @No ON/A
inspection?
F.Weekly logs of inspections required by NFPA#26 on file? OYes ONO 4�Liquid in all glass bulb sprinklers? @Yes ONO ON/A
G.All deficiencies reported at last inspection corrected? OYes ONO C.Visible pipe:
H.I know the location and understand the operation of all control valves, Oyes ONO 1.In good condition/no external corrosion? @Yes ONO (:)N/A
2.No mechanical damage and no leaks? @Yes ONO ON/A
J.I would like to have a copy of NFPA#25 @ an extra charge of$50.00. OYes ONO 3.Properly aligned and no external loads? @Yes ONO ON/A
K.Owner or rep.requests WAFS to release information from
inspections to the underwriters of my Insurance company. OYes ONO D.Visible pipe hangers and seismic braces not damaged or loose? @Yes ONO ON/A
E.Hose,hose couplingsand nozzles on sprinkler system passed
inspection in accordance with NFPA 1962? ONIC OYes ONO @N/A
29NOVEMB-E F.Adequate heat in areas with wet piping? @Yes ONO (:)N/A
Owner or representative(print name) Signature Date G.Has an internal inspection of the pipe been performed by removing
Part 11-Inspectoes Section 5KOwner or Owner rep.not on site. the flushing connection and one sprinkler near the end of a branch
A.Inspections line within the last 5 years? @)NIC Oyes ONO ON/A
1.Daily and Weekly Items (If the answer was"No",conduct an internal inspection.)
A.Control valves supervised with seals in correct(open or closed) 5.Fifth Year Inspection Items(in addition to above Items)
position? @Yes ONO ONIA A.Alarm valves and their associate strainers,filters and restnction
B.Backnow Preventers: odfices passed internal inspection? ONIC OYes ONO &/A
1.Valves in correct(open or closed)position? @Yes ONO ON/A B.Check valves internally inspected and all parts operate propedy,move
2.Sealed,locked or supervised&accessible? @Yes ONO ON/A freely and are in good condition? ONIC OYes ONO @N/A
3.Relief port on RPZ device not discharging? OYas ONo @N/A B.Testing
C.For freezer systems,is the gauge near the compressor reading the The following tests are to be performed at the noted intervals.Report any failures an Part III of this form.
same as the gauge near the dry-pipe valve? OYes ONO @N/A 1.Quarterly Tests
A.Mechanical water flow alarm devices passed tests by opening the
2.Monthly Inspection Items(in addition to above Items) inspectors test connection or bypass connection with alarms actuating
A.Control valves with locks or electlical supervision in correct(open or and flow Observed) OYes ONO SN/A
closed)position? OYes @No ON/A B.Post indicating valves opened until spring or torsion is felt in the rod,
B.Sprinkler wrench with spare sprinklers? OYes &No ON/A then closed back on"uarter turn> OYes ONO @N/A
C.Gauges on wet-pipe system in good condition and showing normal C.Main drain test for system downstream of backflow or pressure reducing valve:
water supply pressure? OYes @No ON/A 1.Record Static Pressure psi and Residual psi
D.Alarm Valves: Pressure
Gauges show normal supply water pressure,free from physical r See comments-on page 2
damage,valves in correct(open or closed)position and no leakage 2.Was flow observed? OYes ONO @N/A
from retarding chamber or drains? OYes ONO @N/A 3.Are results comparable to previous test? OYes ONO &/A
3.Quarterty Inspection Items(in addition to above Items) 2.Semiannual Test(in addition to previous Items)
A.Pressure Reducing Valve:In open position,not leaking,maintaining OYes ONO A.Valve supervisory switches indicate movement? @Yes ONO ON/A
B.Electrical watefflow alarm devices passed tests by opening the
downstream pressure per design criteda,and in good condition with Not installed inspectors test connection or bypass connection with alarms actuating
handwheels,not broken? 0 Design critena is not available and flow observed? @Yes ONO ON/A
B.Hydraulic nameplate(calculated systems)securely attached to riser 3.Annual Test(in addition to previous items)
and legible? OYes ONO A.Main drain test:
C.Fire Department Connection 1.Record Static Pressure 50 psi and Residual 40 psi
Visible,accessible,couplings and swivels not damaged and rotate - Pressure
smoothly,plugs or caps in place and undamaged,gaskets in place and See comments-on page 2 @Yes ONO (:)NIA
in good condition,identification sign(s)in place,check valve is not 2.Was flow observed?
leaking,clapper is in place and operating properly and automatic drain 3.Are results comparable to previous test) @Yes ONO ON/A
valve in place and operating properly? OYes @)No ON/A B.Are all sprinklers date 1920 or later? G)Unable to determine.oYes (:)No
(if plugs or caps are not in place,inspect interior for obstructions.) C.Fast response spirinklers 20 or more years old replaced or successfully
D.Alarm devices free from physical damage? @Yes ONO ON/A sample tested within last 10 years? @NIC OYes ONO
Report#: 4 OF 4
Part III-Comments(any"No"answers, test failures or other problems found with the sprinkler
Wet Pipe Report page 2 system must be explained here. All items that need repaired or replaced are the owners
D.Standard response spdnklers 50 or more years old replaced or responsibility and are not included in the ptice of inspection.
successfully sample tested within last 10 years? @NIC 0Yes ONO
E.Standard response sprinklers 75 or more years old replaced or
successfully sample tested within last 5 years? @NIC 0Yes ONO MAIN CTRL VALVE TAMPER SEAL#0703436
F.Dry-type sprinkler replaced or successfully sample tested
within last 10 years? ONIC 0Yes, ONO (&q/A BACKIFLOW TAMPER SEAL#'s 0703437 0703465
G.Specific gravity of antifreeze correct? OYes ONO SN/A
H.All control valves operated through full range and returned to normal
position? @Yes ONO ()NIA DEFICIENCIES:
1.Backfiow devices passed backfiow test? ONIC @Yes ONO ()N/A
J.Backflow devices passed full flow test?@Provisions not provided. ONIC 0 Yes ONO ()N/A 1)FIRE BACKFLOW REQUIRES A CHAIN&LOCK
K.Pressure reducing valves passed partial
flow test? 0provisions,not provided. ONIC OYes ONO @N/A
4.Test to be done every third year: 2)FDC OBSTRUCTED
Hose(more than 5 years old)connected to the system has been service tested in accordance with
NFPA 1962,Water discharged and water flow alarms operated? ONIC oYes ONO @N/A 3)GAUGES DUE FOR REPLACEMENT
S.Test to be done every Sth year
A.Sprinklers rated aboveHigh temperature tested? ONIC oYes ONO @N/A 4)HEADS PAINTED IN UNIT 361:CLOSET UNDER STAIRS
B.Gauges checked by calibrated gauge or replaced? OYes ONO HALL BEFORE UNDER STAIR CLOSET,MASTER BED&BATH
C.Pressure reducing valves passed full flow test? ONIC 0YeS ONO @N/A
C.Maintenance
1.Regular Maintenance items
A.If sprinklers have been replaced,were they proper replacements? oYes ONO
B,Used hose was cleaned,drained and dried before being placed back in Wannot be determined,
service?Hose exposed to hazardous materials was disposed of or
decontaminated in an approved manner? OYes ONO W/A NOTE:
C.Systems normally filled with freshwater were drained and OCannot be determined.
refilled twice K raw water got into the system? OYes ONO 1)DID NOT GAIN ACCESS TO UNITS 359 363
D.If any of the following were discovered,was an obstruction investigation @Cannot be determinea.
conducted? ONIC OYes ONO @NlA
Explain reason(s)and obstruction investigation finding in Part I//
1.Defective intake screen on pump with suction from open sources.
2,Obstructive material discharged durmg water flow tests.
3.Foreign materials found in dry-pipe valves,check valves or pumps.
4.Foreign material in water during drain test or plugging of inspector's test connection.
5.Plugging of pipe or sprinklers found during activation or alteration,
6.Failure to flush yard piping or surrounding public mains following new installation or repairs.
7.Record of broken mains in the vicinity.
8.Abnormally frequent false-tripping of dry-pipe valves. Part IV-Observations: Not a part OF the NFPA-25 inspection, the following items may need to
9.System is returned to service after an extended period out of service(greater than one year). be reviewed by a fire protection engineer.
10.There is reason to believe the system contains sodium silicate or its derivatives or highly
rorrosive vluxes in copper pipe systems.
E.If conditions were found that required flushing,was flushing of system
conducted? ONIC oYes ONO (Dq/A
2.Annual Maintenance litermt(in addition to previous Items)
A.Operating stem of all OS&Y valves lubricated completely closed,and
reopened? @Yes ONO ()N/A
B.Sprinklers and spray nozzles protecting commercial cooking equipment
and ventilating systems replaced except for bulb-type which show no
signs of grease buildup? OYes ONO SN/A
3.Regular Maintenance Items
A.Alarm panel dear? @Yes; ONO ON/A
B.System left in service? @Yes ONO ()N/A
C.Is system impaired?(impairment program put into place per NFPA-25 and
Wayne Automatic Fire Sprinklers protocols) OYes Wo Part IV Inspectoes Information
I state that the inforrnation on this form is correct at the time and place of my inspection and that all
equipment tested at this time was left in operational condition upon completion of this inspection except
as noted in Part III above.
The scope ofwork preformed does not include a review of fire sprinkler or fire alarm system design.
Date: 29 NOVEMM/R 2�1,?
Signature of Inspector:
Print Name: MICHAEL TAUVELL
License or Certification Number(if applicable): 11081600012008
Color of tag placed on system:
15—�Red
FGreen