482 Stewart St Wayne Fire 2015 613 N.W.MERCANTILE PLACE 3226 CHERRY PALM DRIVE
PORT ST.LUCIE, FL 34986 TAMPA,FL 336109
772-878-3350-FAX:772-878-5967 \VAV/WAYNE 81 3-630-0303-FAX:81 3-630-0312
`11326 DISTRIBUTION AVENUE WEST Automatic Fire Sprinklers, Inc. 4683 LAREDO AVENUE
JACKSONVILLE,FLORIDA 32256-2745 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:954-917-9424
NFPA-25 Inspection, Testing and Maintenance of Dry-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� BBT INVESTORS LLC ISC#: 192720 Reportft� 1 OF 1
Owner's Address: 2251 ST JOHNS BLUFF ROAD SOUTH JAX, FL.32246 Owner's Phone Number: (904)645-0003
Property_Being 1VOK ted: DRESSER RAND
(�Uroperty Ad'ess: ) 482 STEWART STREET ATLANTIC BEACH, FL.32232
6 rWor
kr 12/30/2014 All responses refer to the current work(inspection,testing and maintenance)performed on this date.
This work is(check one): 0 Monthly Quarterly 0 Annual 0 Third Year 0 Fifth Year
Part I-Owner's Section
A.Is the building occupied? Oyes ONO B.Testing
B.Has the occupancy classification and hazard of contents remained the same operating properly and automatic drain valve in place and
since the last inspection? OYes ONO @Yes ONO ON/A
C.Are all fire protection systems in service? OYes ONO operating property)
D.Has the system remained in service without modification since the last inspection'> OYes ONO (If plugs or caps are not in place,inspect interior for obstructions
4.Annual Inspection Items(in addition to above items)
E. Was the system free of actuation of devices or alarms since the last Oyes ONO A.Proper number and type of spare sprinklers? OYes ONO @NIA
inspection? OYes ONO B.Visible spinklers
F.Weekly logs of inspections required by NFPA#26 on file?
G.All deficiencies reported at last inspection corrected? OYes ONO 1.Free of corrosion and physical damage? OYes ONO @N/A
H.I know the location and understand the operation of all control valves. OYes ONO 2.Free of obstructions to spray patterns? 0 Yes ONO @N/A
J.I would like to have a copy of NFPA#25 @ an extra charge of$50.00. OYes ONO 3.Free of foreign materials including paint? OYes ONO @N/A
K.Owner or rep.requests WAFS to release information from 4.Liquid in all glass bulb sprinklers? OYes ONO @N/A
inspections to the underwriters of my insurance company. OYes ONO C.Visible pipe
1.In good condition/no external corrosion> 0 Yes ONO @N/A
2.No mechanical damage and no leaks? OYes ONO @N/A
12/30/2014 3.Property aligned and no external loads? OYes ONO @NIA
Owner or representative(print name) signature Date D.Visible pipe hangers and seismic braces not damaged or loose'? OYes ONO @N/A
Part 11-Inspector's Section FX—Owner or Owner rep.not on site. E.Dry-pipe valves passed internal inspection? OYes ONO @NIA
F.Must be done before cold weather
A.Inspections 1.Adequate heat in areas with wet piping? 0 Yes ONO @N/A
1.Daily and Weekly items 2.Low temperature alarms functioning? OYes ONO @N/A
A.Control valves supervised with seals in correct(open or dosed)
posffio0 @Yes ONO ON/A 3.Interior of pipe that passes through freezers free of ice
B.Dry-Pipe valves Enclosures around valves maintaining a blockage? ONIC Oyes 0 No (DWA
minimum of 40 F and gauges in good condition showing normal G.Has an internal inspection of the pipe been performed by
air and water pressure? (j)Yes ONO ON/A removing the flushing connection and one sprinkler near the
end of a branch line within the last 5 years? ONIC OYes ONO &WA
C.Back Flow Prevente7s
1.Valves in correct(open or closed)position? (j)Yes ONO ON/A (if the answer was"No",conduct an internal inspection I
2.Sealed,locked or supervised&accessible? @Yes ONO ON/A 5.Fifth Year Inspection items(in addition to above items)
3.Relief port on RPZ device not discharging? 0 Yes ONO @NIA A.Check valves internally inspected and all parts operate property.
D.For freezer systems,is the gauge near the compressor reading move freely and are in good condition? ONICOYes ONO @N/A
the same as the gauge near the dry-pipe valve? OYes ONO @N/A B.Strainers,filters,restricted orifices and diaphragm chambers on
2.Monthly Inspection Items(in addition to above items) dry-pipe valves passed internal inspection? ONIC 0Yes ONO @N/A
A.Control valves with locks or electrical supervision in correct B.Testing
(open or dosed)position? @Yes ONO ON/A The following tests are to be performed at the noted intervals.Report any failures on
B.Dry-Pipe Valves: Part III of this form.
Free from physical damage,thin valves in appropriate(open or 1.Quarterly Tests
closed)position,and no leakage from intermediate chambeO @Yes ONO ON/A A.Mechanical water flow alarm devices passed tests by opening
C.Sprinkler wrench with spare sprinklers? (D Yes ONO ONIA the inspectors test connection or bypass connection with alarms
3.Quartlery Inspection items(in addition to above items) actuating and flow observed? 0 Yes (j)No ON/A
A.Pressure Reducing Valve:In open position,not leaking 0 Yes ONO B.Post indicating valves opened until spring or torsion is felt in the
maintaining downstream pressure per design criteria.and in (j)Not installed. rod,then dosed back one-quarter turn? OYes ONO @N/A
good condition with handwheels not broken? 0 Design criteria is not available. C.Is the priming level correct? OYes ONO @N/A
B.Hydraulic nameplate(calculated systems)securely attached to D.Has low air signal passed its test'? OYes ONO @N/A
nser and legible? OYes @No E.Quick opening devices passed test?oProvisions not provided.oYes ONO (DIVA
C.Fire Department Connections. F.Main drain test for system downstream of backflow or pressure reducing valve
Visible,accessible,couplings and swivels not damaged and 1.Record Static Pressure 45 psi and Residual Pressure 35 Psi.
rotate smoothly,plugs or caps in place and undamaged r See comments-on page 2
gaskets in place and in good condition,identification sign(s) @Yes ONO ON/A
in place check valve is not leaking,dapper is in place and 2.Was flow observed?
3.Are results comparable to previous test? @ Yes ONO ON/A
Report#: 1 OF 1
2.Semiannual Test(in addition to previous items) 2.Annual Maintenance Items(in addition to previous items)
A.Valve supervisory switches indicate movement? oYes ONO @N/A A.Operating stem of all OS&Y valves lubricated,completely closed, 0Yes ONO @NiA
B.Electrcal water flow alarm devices passed test by opening the andreopened?
inspectors test connection or bypass connection with alarms B.Interior of dry-pipe valves cleaned? 0Yes ONO @)N/A
actuating and flow observed? OYes ONO @N/A C.Low points drained prior to the onset of freezing weather? oYes ONO @N/A
D.Sprinklers and spray nozzles protecting commercial cooking
3.Annual Test(in addition to previous items) equipment and ventilating systems replaced except for bulb-type
A,Main drain test. OYes ONO @N/A
1.Record Static Pressure psi and Residual Pressure psi. which show no signs of grease buildup?
r— See comments 0Yes ONO @N/A Part III-Comment(any"No"answers, test failures or other problems found
2.Was flow observed?
3.Are results comparable to previous test? oYes ONO (DN/A with the sprinkler system must be explained here.Also, note here any
B.Are all sprinklers dated 1920 or later? 0 Unable to determine.@Yes (DNo products noticed on the system that have been the subject of a recall or a
C.Fast response sprinklers 20 or more years old replaced or Yes ONO replacement program.)All items that need repaired or replaced are the
successfully sample tested within last 10 years? @NIC 0 owners responsibility and are not included in the price of inspection.
D.Standard response sprinklers 50 or more years old replaced or
successfully sample tested within last 10 years? @NIC oYes ONO MAIN CTRL VALVE TAMPER SEAL#'s 0836184 0836185
E.Standard response sprinklers 75 or more years old replaced or
successfully sample tested within last 5 years? @NIC oYes ONO
F,Dry-type sprinklers replaced or successfully sample tested
within last 10 years? 0 Unable to determine.oYes ONO (DIVA
G.All control valves operated through full range and returned to oYes ONO @N/A DEFICIENCIES REMAINING FROM ANNUAL:
normal position'?
H.Low temperature alarms passed test? oYes ONO @N/A (1)WATER MOTOR GONG IS NOT OPERATING
1.Dry-pipe valve parlial flow trip test
1.Record initial air pressure psi and water pressure psi.
2.Record tripping air pressure psi and tripping time (sec.).
3.Above results comparable to previous tests'? OYes ONO @N/A
J.Automatic air maintenance devices passed test? 0Yes ONO @N/A
K.Backflow devices passed backflow test? oYes ONO @NIA
L.Backflow devices passed full flow test?oProvisions are not provided.0 Yes 0 No @N/A
M P ressure reducing valves passed 0 No @)NIA
partial flow test? Oprovisions are not provided.0 Yes
4.Test to be done every third year:
Dry-pipe full flow trip test.
1.Record initial air pressure psi and water pressure psi.
2.Record tripping air pressure psi and tripping time (sec.).
3.Record water delivery time (min.). (sec.).
Water delivery time not required to be 60 sec.per NFPA 25
4.Above results comparable to previous tests) oYes ONO @N/A
S.Test to be done every fifth year:
A.Sprinklers rated above High temperature tested,)ONIC OYes ONO (DIVA
B.Gauges checked by calibrated gauge or replaced? OYes ONO
C.Pressure reducing valves passed full flow test? ONIC OYes ONO @NIA
C.Maintenance
i.Regular Maintenance Items
A.If sprinklers have been replaced,were they proper OYes ONO
replacements? @cannot be determined.
B.Air leaks in dry-pipe system resulting in air pressure
loss more than 10 psitweek repaired? OYes ONO @N/A
C.Dry-pipe systems maintained in dry condition? @Yes ONO
D.Have low point drains been emptied? @Yes ONO ONIA
E.If any of the following were discovered,was an Part IV-Observations. Not a part of the NFPA#25 inspection,the
obstruction investigation conducted? ONIC 0 Yes ONO @N/A following items may need to be reviewed by a fire protection engineer
F.Alarm panel clear? @Yes ONO ON/A
G.System left in service? @Yes ONO ONIA
Explain reason(s)and obstruction investigation findings in Part H/
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 vaAes 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/repairs.
7.Record of broken mains in the vacinity.
8.Abnormally frequent false-tripping of dry-pipe valves.
9.System is returned to service after an extended period out of service(more than one year).
10.There is reason to believe the system contains sodium silicate or its derivatives or highly
corrosive fluxes in copper pipe systems.
'' ""^ ........ . '
J.If conditions were found that required flushing. flushin
a ONO @N/
of system conducted?
rs I min
Part V-Inspectoes Information
rit
Date� 12/30/2014
Signature of Inspector:
Print Name� MICHAEL TAUVELL
License or Certification Number(if applicable): FPI 13000027
1 state that the information on this form is correct at the time and Color of tag placed on system:
place of my inspection and that all equipment tested at this time FX_Re d
was left in operational condition upon completion of my inspection F_�_,een
except as noted in Part III above.
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