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2321 Mayport Rd Fire Protection Sprinkler System e s r' r' P FORTITUDE FIRE PROTECTION -® 2430 University Blvd W. * Jacksonville, FL 32217 * 904-733-9008 www.fortitudefire.com NFPA-25 Inspection, Testing and Maintenance of Wet Pipe Fire Sprinkler Systems Information on this form covers the minimum requirements of NFPA 25 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 watersupply. Owner Owner Phone Number Job#: Owner's Address: Property Being Evaluated: Dollar Tree#5993 Property Address: 2321 Mayport Rd Atlantic Beach FL 32233 Date of Work: 8/12/2020 All responses refer to the current work(inspection,testing and maintenance) performed on this date. This work is(check one): [}Monthly Quarterly ✓Annual I 1Third Year Fifth Year Part I-Owner's Section 0.Annual Inspection Items(in addition to above items) A A.Is the building occupied? ®Yes ONo A.Proper number and type of spare sprinklers? ()Yes ONo ■V IIA B Has the occupancy classification and hazard of contents remained the same since B.Visible sprinklers: AVVVSIA Sre last Inspection? ®Yes ONo 1.Free of corrosion and physical damage? ()Yes Onto F }, 2.Free of obstructions to spray pafterns? Ia les go ___q C.Are at fire protection systems in service? ®Yes ONo Oyes ONo 3.Free of foreign materials Including paint? ()Yes A D.Has the system remained in service without nndificabon since the last inspection? 4 Ligrid in at glass bulb sprinklers? ()Yes ONo A E Was the system free of actuation of devices or alarms since the last inspection? ®Yes ONo C.Visible pipe: 11JJ ONO F.Weekly logs of inspections required by NFPA/725 on file? In good condition/no external corrosion? ()Yes ,r�+��l0 fi Tr/A ®Yes ONo 2.No mechanical damage and no leaks? ®Yes Oreo VQuq n t G.All deficiencies reported at last inspection cored, \! ®yes ONo 3 Properly aligned and no external loads? H.By signing I know the location and understand th of I ontml valves, �r-�'' e� R. Rav 8/12/2020 D.Visible pipe hangers and seismic braces not damaged or lose? @Yes t�/yvo OVA VA E.Hose.hose couplings and nozzles on sprinkler system passed Owner or represents ave(print name) Signature Date [��N ❑Owner or Owner rep. inspection in accordance with NFPA 1962? °Yes ONo V-/A not Onsite F.Adequate heat in areas wrth wet pipng? °Yes 4 Mlo VOVA V Part II-Inspector's Section 0 Has an internal inspection of the V p ppe been performed by nonmoving A.Inspections the flushing connection and one sprinkler near the end of a branch /� 1.Daily and Weekly Items oyes ah, F V v'v line within the last 5 years? A.Control valves supervised with seals in correct(open or closed) (If the answer was"No",conduct an internal inspection.) position? /�' O 5.Fifth Year Inspection Mens fm addition to above items) 5 Year Inspection Due: 7/2020 ()Yes r ryo OVA B.Backflow Preventers'. SYes �/ tq/ A.Alarm valves and their associate strainers,filters and restriction ,r.w �+w�'1 Valves in correct(open or closed)position? /Ohio OVA orifices passed internal inspection? Quo °yes # yvo 0urq 2.sealed,locked or supervised&accessible? Yes ONo Vr T1/A B Check valves internally inspected and all parts operate property,move `/ OW ��_ 3.Relief port on RPZ device not discharging? ()Yes ay Qrve freely and are in good condition? IC ©Ves yvo / 1/A C.For freezer systems,Is the gauge near the co ��// `vf B.Testing v �" rrpressor rearing the same as the gauge near the dY-pipe valve? ©Yes 0l/A iry The following tests are to be performed at the noted intervals Report afailures on Pan Ill of the form. ( No ��r �VV 1.Quarterly Tests 2.Monthly Inspection Items(in addition to above items) A Mechanical water flow alarm devices passed tests by opening the A.Control valves with locks or electrical supervision in correct(open or ^ inspector's test connection or bypass connection with alarms actuating close position? ®Yes ONo Od/q ° © �, p �./�V..// /�. and flow observed? Yes No v`,A B.Sprinkler wrench oath spare sprinklers? ®Yes ONo r t9/A B.Post indicating valves opened until spring or torsion is tett in the rod. C.Gauges on wet-pipe system in good condition and showing normal pV+� then closed back one-quarter tum? Oyes Quo OA water supply pressure? ®Yes ONo g 11A C.Main damn test for system dovmsheam of backflow or pressure reducing valve. `/ D.Alarm valves: v 1 Record Static Pressure 40 psi and Residual 35 psi Pressure Gauges slow normal supply water pressure,free horn physical ❑ See comments-on page 2 damage,valves in correct(open or closed)position and no leakage A� from retarding chamber or drains? QVes ONo [� IA 2 Was flow observed? @Yes ONo OVA 3.Quarterly Inspection items(in addition to above items) 3 Are results comparable to previous testy ()Yes �Y `J Jo OVA 2.Semiannual Test(in addition to previous items) v A.Pressure Reducing Valve.In open position.not leaking. maintaining A.Valve supervisory switches indcate movement, Oyes V('�lc ()q downstream pressure per design criteria,and in good°omition with B.Electrical water flow alarm devices passed tests by opening the hand wheels not broken? QVes ONo ®v/A inspector's test connection or bypass connection with alarms actuating .e��' sn. B.Hydraulic nameplate(calculated systems)securely attached to riser and flow observed? ®Yes ONo a 4/A and leyble? QY es ONo V A 3.Annual Test(in addition to previous items) V V C.Fire Department Connection: �f A.Main lain test: 1.Record Static Pressure 40 psi and Residual 35 psi Visible,accessiblecouplings and swivels not damaged and rotate Pressure smoothly,plugs or caps in place and undamaged,gaskets in place and ❑ See comments-on page 2 in good condition,identification sign(s)in place,check valve is not 2.Was Sow observed? Oyes ONo WA leaking.clapper is in place and operating property and automatic drain � valve in place and operafng properly? l�ryes �o OVA3.Are results comparable to previous test? ®Yes �lo ON/A (If plugs or caps we not in place.Inspect intenor for obstruct..) V B.Are all sprinklers date 1920 or later? *Yes .Ivo ONia D.Alarm devices Ree from physical damage? QVes a a/A C Fast response spnnklers 20 or more years old replaced or suocessfuity �f sample tested withn last 10 years? ®Yes ao F Naq Wet Pipe Report page2 D.SOndard response s Kers 50 or more p ° icalo 'Si, Part III-Comments(any"No"answers,test failuresorother problems found with the sprinkler system po prim years old replaced or Yes `�.1 �J A must be explained here.Also, note here any products noticed on the system that have been the successfully sample tested within last 10 years? subject of a recall ora replacement program. E.Standard response sprinklers 75 or more years old replaced or e� successfully sample tested within last 5 years? Ones ONo I o O,A F Dry-type sprinter replaced or successfully sample tested within last �.l v 10 years? ()Yes ONo 1^, IN G.Specific gravity of antifreeze correct? ©Yes ONo H.Al control valves operated through full range and returned to normal position? ()Yes /w�Ow �ss,,UA I.Backflow devices passed backflow test? ()Yes ONo OVA J.Backflow devices passed full flow lest? °Yes Evfi ANo ®7/A K.Pressure reducing valves passed portal flow test? Ones OOlin ��af/A 4.Test to be done every third year: V �f. 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? \.�/a 1NIC °yes ONO NO ON/A 5.Test to be done every 5th year A.Sprinklers rated above high temperature tested? Ones oNo ®N/A B.Gauges checked by calibrated gauge or replaced? Ones o- a/ /A Vv C.Pressire reducing valves passed full Cow test? ©NIC Ones r yvo 01/A C.Maintenance 1.Regular Maintenance Items A.If sprinklers have been replaced,were they proper replacements? °Yes vvClio ®N/A B.Used hose was cleaned.drained and died before being paced back in service? °Yes ONo O we C.Hose exposed to hazardous materials was disposed of or eO V q' �1N decontaminated in an approved manner? a- 0- /A D.Systems normally filled with fresh water were drained and refilled twice if raw \� water got into the system? Ones 00'- *NIA E.If any of the following were discovered,was an obstruction investigation conducted? 0Yes Or'i. ON/A Explain reason(s)and obstruction Invesegabon finding in Part III 1 Defective intake screen on pump with suction horn open sources. 2.Obstructive material dscharged during water Cow test. 3.Foreign materials found in dry-pipe valves,check valves or pumps. 4.Foreign material in water during drain test or pugging of inspectors test connection. 5.Plugging of pipe or sprinklers found during activation or atteraten. 6.Failure to flush yard piping or surroundng public reins blowing new installation or repairs. 7.Record of broken maim in the vicinity. 8.Abnormally frequent false-tripping of dry-pipe valves. Part IV - Recommendations: 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 tire protection engineer. 10.There is reason to beleve the system contains sodium silicate or its derivatives or highly corrosive Ponces in copper pipe systems. 5 year inspection past due F.If condtiom were found that required flushing,was flushing of system �� conducted? Oyes 010 f� l/A 2.Annual Maintenance Hems(in addition to previous items) t A.Operating stem of all OS&Y valves lubricated completely closed,and Seal #0003735 0003736 re-opened? Ones ONo OVA B.Sprinklers and spray nozzles protecting commercial cooking equipment V and ventilating systems replaced except for bulb-type which show no signs of grease buldup? 8YesNotIbbsA C.Does there appear to he recalled fire sprinklers installed at this site? Yes No l A 3.Regular Maintenance ttems A.Alarm panel clear? ®Yes °No°ry/A B.System left in service? *Yes ONO ON/A C.Is system impaired?(Impairment program put into place per NFPA-25 and - Fortitude Fire Protection protocols) Oven ®No Part V-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 lime was left in operational condition upon completion of this inspection except as noted in Part III above. Date: 8/12/2020 Printed Name of Inspector: TJ Racer Signature of Inspector: License or Certification Number(if applicable): FPl1 8-000295 Color of tag placed on system: Red ✓Green 1-Yellow t , s . v Y, . . if- ,,z, . 1111441: . ' `HYDRAULIC-SYSTEM $ �- — lie.M4'L I_ al This dding is protectedDeig by a HydraulicallyticSprinkler r sned .. Automatic Spdnsler System. Location No.of Sprinkler. . -''--1.11• 4* ' Basis of Design -'- - Syystem Demand ® !a. ! 1.... SILENT I f SILE NI 4, r. r. FORTITUDE FIRE PROTECTION —® 2430 University Blvd. West * Jacksonville, FL 32217 * 904-733-9008 www.fortitudefire.com Good Afternoon Please find the enclosed inspection reports for your area. If you have any questions, have received in error or need further information please give me a call at 904-733-9008 or email me at stephanie@fortitudefire.com Thank you and have a great day. Stephanie Peiker Vice President