1085 Atlantic Blvd Fire Hydrant Inspection rr
� FTiTUD °
FIRE PROTECTION -®
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: Seaside Apts
Property Address: 1085 Atlantic Blvd Atlantic Beach 32233
Date of Work: 6/8/2021
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 M Rep. Not Onsite
Part II — Inspector's Section
1. Location of Hydrant: Bldg 2
2. Make / Model of Hydrant: Kennedy K 11
3. Size of Hydrant: 4 1/2
4. Color of Hydrant: Yellow
5. Is Hydrant housing accessible? ® Yes ❑ No ❑ N/A
6. Housing free of external damage? Yes ❑ No = N/A
7. Is the operating wrench available? Yes ❑ No [ N/A
8. Does associated piping appear to be free of leaks? • Yes ❑No ❑ N/A
9. Do all the control valve(s) appear to be open? It Yes ❑ No ❑ N/A
10. Is isolation valve accessible? pp Yes ❑ No ❑ N/A
11. Free of leaks (external)? ® Yes ❑ No E N/A
12. Operating nut is in good condition? ® Yes _ No _ N/A
13. Threads of nozzles / caps in good condition? • Yes No ❑ N/A
14. Gaskets on caps in good condition? 1. Yes fl No ❑ N/A
15. Is Hydrant in normal open / closed position? ® Yes ❑ No ❑ N/A
16. Does operating nut appear to work thru full range? IlYes n No ❑ N/A
17. Water flowed for 60 seconds or until clear? • Yes ❑ No ❑ N/A
18. Free from foreign material in barrel? pp Yes ❑ No ❑ N/A
19. Does Hydrant drain in 60 minutes or less? Yes ❑ No ❑ N/A
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? II Yes ONo ❑ 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)
MO
5 Year Flow Test Results(if applicable):
Static: All11111.°
Residual_
Pitot:
GPM @ 20 psi:
— r:( ía
4...........
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 Ill above.
Date: 6/8/2021
Printed Name of Inspector: Jason Kestner
/
Signature of Inspector: 7`1'
License or Certificate Number (if applicable): FPI21-000025
Color of Tag Placed on System: n Red ni Green Yellow
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FORTITUDE
FIRE PROTECTION
2430 University Blvd., West * Jacksonville, FL 32217 * 904-733-9008
vvww.fortitudefire.corn
FIRE HYDRANT INSPECTION
Owner: Owner Phone Number:
Owner Address:
Property Being Evaluated: Seaside Apts
Property Address: 1085 Atlantic Blvd Atlantic Beach 32233
Date of Work: 6/8/2021
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 0 Repaired 0 New Device
Part I — Owner or Owner
Owner or Owner Representative Printed Name Date Rep. Not Onsite
Part II — Inspector's Section
1. Location of Hydrant: Bldg 4
2. Make / Model of Hydrant: American Darling B84B-5
3. Size of Hydrant: 5 1/4"
4. Color of Hydrant: Yellow
5. Is Hydrant housing accessible? ® Yes ❑ No ❑ N/A
6. Housing free of external damage? • Yes No ❑ N/A
7. Is the operating wrench available? Yes ❑ No I N/A
8. Does associated piping appear to be free of leaks? N Yes ❑No ❑ N/A
9. Do all the control valve(s) appear to be open? ® Yes ❑ No ❑ N/A
10. Is isolation valve accessible? • Yes ❑ No ❑ N/A
11. Free of leaks (external)? • Yes ❑ No ❑ N/A
12. Operating nut is in good condition? ® Yes ❑ No ❑ N/A
13. Threads of nozzles / caps in good condition? ® Yes ❑ No [ N/A
14. Gaskets on caps in good condition? • Yes ❑ No ❑ N/A
15. Is Hydrant in normal open / closed position? ® Yes ❑ No ❑ N/A
16. Does operating nut appear to work thru full range? II Yes n No ❑ N/A
17. Water flowed for 60 seconds or until clear? Yes ❑ No ❑ N/A
18. Free from foreign material in barrel? "' Yes ❑ No ❑ N/A
19. Does Hydrant drain in 60 minutes or less? 1. Yes ❑ No 0 N/A
20. Hydrants requiring pumping identified? 0 Yes 0 No ® N/A
21. Threads / caps / stems / plugs lubricated? MI Yes fl No 0 N/A
22. Has a 5-year flow test been performed per NFPA 25? ®Yes ENo 0 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)
a:a
5 Year Flow Test Results(if applicable):
Static:
Residual: --_
Pitot:
GPM @ 20 psi:
111. 0 D.
ii
4..........,
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 Ill above.
Date: 6/8/2021
Printed Name of Inspector: Jason Kestner
Signature of Inspector:
( A y
License or Certificate Number (if applicable): FPI21-000025
Color of Tag Placed on System: I I Red *Green ri Yellow