2321 Mayport Rd Dollar Tree fire sprinkler system test report riormommorimir
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 watersuppty.
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: 3/1/2021 All responses refer to the current work(inspection,testing and maintenance)
performed on this date.
This work is(check one): Monthly ✓Quarterly Annual Third Year Fifth Year
Part I-Owner's Section 4.Annual Inspection items(in addition to above kerns)
A Is the building occupied? ()Yes Ohio A Proper numter and type of spare sprinklers? Oyes @hit (,n�,A
B Has the occupancy ciassilcation and hazard of contents remained the sane sines B.Visible spinklere: V ���/;fJ�-
the last irsprcbon? OYos Onto 1 Free of corrosion and physical damage? Oven O^lo OwA
C.Are al fire protection system in service? ()Yes O� 2.Free of obslmctiors to spay patterns? Yes f�1rJo tA
VV
D.Has the system rerreired in service without rtodficatlon since the lest irepecbon? `///-���p' 3.Free of bragn metenals inducing print? Yes /``'JJ�'s",
v es ON" 4.liquid in alplass bulb spankers? vas w,
O,'nto" `-'OW
E Was the system free of actuation of devices or alarm;since the last inspection? V V
()Yes OtJu C.Nside pipe:
F Weekly logs of inspections required by r�PAp2s on file? l///-���ry 1.In good cordboNno external corrosion? Ores CJFIIo dA
G Al deficiencies reported at last nnspoction corrected? v e5 O� 2.No mechanical damage and no leaks? Oyes l 1rvo vr"y,,,q
R.By signing I know the location and understan he o cruel valves.
Oyes OW' 3.Properly likened and no external bads? v v_
Cristen Hall 3/1/2021 D Visible ppe hangers and spent braces not damaged or lose? Oyes ONe
v A
E.Hose,hose copings and nozzles on sprinkler system passed
Owner or representabve(Pont name) Si ature Date A �
❑Owner or Owner rep inspection in accordance with FFPA 19e2? Oyes ^Otte CNA
not onsite F.Adequate heal in areas with wet piping? Oras ( N° eve
Part II-Inspector's Section VV v
G.Has an internal inspection of the pipe teen performed by removing
A Inspections
the flushing connection and one spneder near the end of a branch ^ A
vi
1.Daily and Weekly Items
Ina within the last 5 yeas? Oyes ( N° Da
A Control valves supervised with seeks in correct(open or closed)
(if the answer was'No-.conduct an internal inspection specfion)
V V-8.Becldlow Preventers: o Ne O9/2025
()Yes go OvA S.Filth Year Inspection hems(i n addition to above items) 5 Year Inspection Due:
A Alarm valves and their associate strainerstiters and restncbon
1.Valves in correct(open or dosed)position? Oyes O•.;, at,,q orifices passed internal inspection? CLJC Oyes Os"
Our/A
2.Sealed,locked or supervised 8 accessible? Oyes Qi �q B.Check valves internally inspected and al parts operate popery,neve V �.k� `/-
3.Refit porton RPZ device not dschergerg?
Ones
as �q treaty and are in good condition? ONC Oyes V DA
C.For freezer system.is the gauge near the compressor reading Ile �./ B.Testing
tf_
same as the gauge near the dry-pipe valve? Oyes 01; OWA The follow ng tests are to to performed et the noted intervals.Report any failures on Part III of Msbre
�f 1.Quarterly Tests
2.Monthly Inspection hems On addition to above items)
A Mechanical water lbw alarm devices passed tests by opening the
A.Control valves with locks or electncal supervision in correct(open or
�1..1�q an ms inspectors toll connection or bypass connection with alaractuating
closed)Position? ()Yes @h; Di and flow observed? Oyes ON 04'A
B.Sprinkler wrench with spare spnnklers? ()Yes O.':. @Wp B.Post irdcatlnp valves opened until spring or torsion is tel in the rod, v
C.Gauges on wet-pipe system in good condition and showng normal then then dosed beck one-quarter tum? Oyes ONv V V A
water supply pressure? @Yes V to OVV
OVA C.Mein dein test for system of oeckliow or pressure reducing valve
D.Alarm Valves: 1.Record Static Pressure
40 psi and Residual 35 ''''
Gauges show normal supply water pressure,lee horn physical Pressure
da valves in correct(open or closed) ❑ See comments-on page 2
mage. (pa position and no leakage
from retarding chamber or drains? Oyes a.r O,yA 2.Was lbw observed? ()Yes OW �A
3.Quarterly Inspection Items(in addition to above items) �J� 3.Pee rases comparable to previous test? ()Yes ONO OWA
2.Semiannual Test(n addition to previous items) �J tJ
A Pressure Reducing Veva In open position.ret leaking. maintaining A.Valve supervisory
downstream pressure per design criteria,and in good condition with switches indicatemovement?
ss a loss Oyes Onto /1.r�q
hard wheels not broken? B.Electrical water lbw alarm devices passed tests by opeNng the �J �v�-
@nes O O•nA inspector's test connection or bypass comecton with alarm actuating ON
B Hydraulic nameplate(calculated system)securely Oyes attached to roer and flow observed? o a'A
and legible? ®Yes O i, cvq S.Annual Test(n addition to embus items) v UVJ_
C.Fire Department Connection.
��lf A Main drain test
nn
lrlsible,accessible.w s and swivels not damn 1.Record Static Pressure psi and Residual �,
nR7gad and rotate
El
Pressure
smoothly.plugs or caps in place and uncia negetl.gaskets in piece and See corn:nerds-on page 2
in good condition.idenecation sign(s)in dace.check valve is not
leaking,clapper is in place and operating property and automatic drain 2 Was flow observed Oyes ()N/A
valve in place aoperating properly? /�Y" O` 0" 3_Are recuts comparable to previous test?
orb (iii Ores Ovo A
and
Ipplugs acape ere not in place,inspect interior for oosbucsanzl B.Ne al sprinklers date 1920 or later? Oyes 04, QWA
D.Alarm devices free from physical damage? ()Yes ()tr" OVA C.Fast response spinlders 20 a more years old replaced or successfully
�fJ
�/ sample tested within last 10 years? OYes ON° OOsvA
Wet Pipe Report page2
�' Part III-Comments(any"No"answers,test failures orotherproblems found with the spnnklersystem
D.Standard response spnriders 50 or more years old replaced or Oyes ONo 1�r 1A must be explained here.Also,note here any products noticed on the system that have been the
successfuty sorrels tested within last 10 years? vV subject of a recall or a replacement program.
E.Standard response spmtclers 75 or more years Ski replaced or ��'
ssuccessfullysartple tested within last 5 years? Oven Otvo 1�vyv'A
F.Dry-type sprinkler replaced or successtulj sample tested within last v
10 years? Oren ONe 0°A
G.Specific gravity of antifreeze correct? OVas ONo coA
H.At control valves operated through 1u1 range and retuned to norm!
position? Oyes ()^1° 0"
I.Bacldbw devices passed becklbw test? Oyes ONn CNA
J.Backflow devices passed tut flow test? Oyes ONu A
K.Pressure reducing valves passed partial flow test? 07es ONo IO I'A
4.Test to be done every third year:
Hose(more than S years old)conceded to the system Inas been service tested in accordance with
WPA 1962 Water discharged and water flow slams operated? Qac °Yes °No OVA
5.Test to be done every 5th year �`JJ, Vn.� ��J
A.Sprinklers rated above lxgh temperature tasted? OYes ONo €N+ 1A
B.Gauges checked by calibrated gauge or replaced? Ores ()N° OVA
C.Pressure reducing valves passed hal flow testi ONC°Yes Olb 04A
C.Maintenance V V
1.Regular Maintenance Items �b ��
A If sprinklers have been replaced,were they proper replacenerxs? OYes V
8.Used hose was cleaned.drained and deed before being placed back in service? Oyes ONo
Opp,
C.Hose exposed to hazardous materials was disposed of or
decontanimled in an approved manner? OVes ONo @WA
D.Systems normally filled with fresh water were drained and refilled twice If raw ��;
water got into the system? Ores ONo ®WA
E.Harry of the blowing were discovered was an obstruction investigation
conducted? ()Yes ONo ®WA
Explain reasw(s)and obnbrwbcn irwatgekon finding In Part Ill
1.Detective intake screen on pump with suction from open sources
2.Obstructive maternal discharged doing water lbw tests.
3 Foreign materials found in dry-pipe valves,check valves or pumps.
4.Foreign rreterial in water during dein test or pugging of inspectors test connection
5.Pbugging of pipe or sprinklers found dunrg activation or alteration.
6.Failure to flush yard pipirg or surroundng pubic rreirs following new irstaaatron or repairs.
7.Record of broken maim in the vicinity.
8.Abnormally frequent lase-topping of dry-pipe valves. Part IV - Recommendations: Not a part of are NFPA-25 inspection. the following items may rhued to
be ruvioved by a fire proteceon engineer.9 System is returned to service after an extended period out of service(greater than one year).
10 There is reason to Delete the system cousins sodomsibeate or its denoatoes or hghfy Valve seal #00072527203
corrosive Imes in copper ppe systems.
F.If comdfions were found that required fluslang,was flushing of system
conducted? Oven 04nOWA
2.Annual Maintenance Items(in addition to previous items) v
A Operating stem of a1 OSBY valves lubricated conphetey closed,and �"
re-opened? Oven ON' €)'A
8.Spnrtclers and spray nozzles protecting commercial cooing equipment
and ventilating systems replaced except for bulb-type which show no
signs of grease buildup? Oyes O h N'A
C Does there appear to be recalled Ire sprinklers irsuied at this site? ()Yes o No A
3.Regular Maintenance Items
A.Alarm panel clear? ()Yes ONo OWA
B.System left in service? ®Yes ONo ONIA
C.Is system Impaired?(Inpelrmert program put into place per NFPA-25 and
Fortitude Fire Protection protocols) °Yes ONo Part V-Inspectors Information
I state mat the information on tits term is correct at the tine and pace of my inspection and that all
equipment tested at this time was len in operational condition upon completion of this iapechon except
as noted in Part III above.
Date: 3/1/2021
Printed Name of Inspector Jason Kestner
Signature of Inspector:
License or Certification Number(if applicable): FP 121-000025
Color of tag placed on system: see Green Ye�lcv,
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