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Home My WebLink About062-250-026 CF Archive (2)+lIftk Supporting Families with Childhood Cancer Fire Marshall Butte County Fire and Rescue 176 Nelson Avenue Oroville, CA 95969 To Whom It May Concern: 16 Digital Drive #130 Novato, CA 94949 (415)382-9083 February 1, 2011 We want to let you know about our summer plans for Camp Okizu in 2011. As you know, the camp is located at 445 Zink Road (off Bald Rock Road) in Berry Creek. We will operate four weeks of residential summer camp for the siblings of our cancer patients starting June 20 and concluding on July 17. At Siblings Camp there will be 120-150 campers each week and 50-70 staff members. Our Oncology Camp for the pediatric cancer patients will operate for three weeks beginning July 25 and concluding August 14. At Oncology Camp there will be 90 to 130 campers and 50 to 70 staff each week. We will also be operating weekend programs throughout April, May, September and October with up to 250 participants. We will have enough vehicles on site to evacuate our campers to a local (within 10 miles or so) staging area with two trips in the event of fire or other emergency. We will bring food supplies and drinking water for up to 48 hours. If we are not able to return to camp within a day or two, then transportation will be arranged through Marin Airporter or another commercial company to take the campers home. The Novato office staff will contact all families to arrange for the campers to be picked up. ?u thanks you for your support of our programs. Please let us know if there is any additional information would be helpful to you in planning for our summer operation. incerely, Randall & Camp Director el D. Amylon, M.D. Okizu Medical Director -,W -- A. butte County Fire Department Ky, C% California Department of Forestry and Fire Protection V. co Fire Prevention Bureau �` U 176 Nelson Avenue, Oroville, CA 95965 , >FtR1~ 530-538-7888/530-538-2105(fax) . Fire Safety Inspection Business Address: DcQS Business Name: C -P4— P phi -Z- ZOwner/Manager: Owner/Manager:9 -or_ Bus: c;,N- -SaQ- Other: Other Contact: Bus: Other: Building Owner: Bus: Other: Address: Fire alarms stem defective Occ. Class: \i"'I■I0F.yax"IIIIMP►I[s]wYelI :ay_lel14Iva :»y/=F_\4:4oil1;179140111110 1. Fire extinguishers: required, service due 10. Exit(s): obstructed, inadequate 2. Extension cords: Excessive use, defective 11. Exit sign(s): required, illumination, photo luminescent 3. Excessive rubbish, trash, debris 12. Exit sign lights: obstructed, defective 4. Fire alarms stem defective 13. Exit lighting: required, defective 5. Sprinkler system: service required, defective 14. Heating system: defective appliance, flue combustibles 6. Kitchen hood ext. system: service due 15. Wiring: exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops 16. Address posted and visible from road 8. Smoke detectors: required, defective 17. Other 9. Fire drill log checked Yes u No ❑ 18. Other type of inspection - State below DETAILED EXPLANATION AND CORRECTIONS: CORRECTED: Date: Discu ed ith: Si rte' c I i o (Print) Inspecting icer: Battalion 1 2 3 4C2 6 7 1 Station: (a Q,. FPB I Ft- T DANS By order of the Fire Chief: You are hereby notified to correct all violations immediately or show cause why you should not be required to do so. A re -inspection will be conducted on . Willful failure to comply with this notice is a misdemeanor. Violations that are not corrected immediately and/or remain after the re -inspection may be processed as a criminal offense. Thank you for your assistance and cooperation in minimizing the fire and life loss in our community. (H & S sec. 13112) White Copy — Station File Yellow Copy — Re-inspect/business Pink Copy — Business 0 Check when sent to prevention �m Damon, Blatt From: Michael D. Amylon [amyion@stanford.edu] Sent: Monday, May 19, 2008 12:15 PM To: Damon, Matt Subject: Damp Okizu Evacuation Plan Hi Matt, I got your message about developing an evacuation plan for Camp Okizu. I left a voice mail for you at your office, but thought I'd send our preliminary language to you by email as well for comment. Is this adequate? What other elements would you suggest we include? Here is our Evacuation Plan from our Emergency Procedures document: XIII. EVACUATION PLAN 1) In the event that evacuation of the camp is necessary due to fire or other natural disaster or emergency situation, the Crisis Plan will be activated and the Crisis Managers will coordinate evacuation with the Harts Mill CDF Station staff as per their pre -plan for our facility. We will have enough vehicles on site to shuttle all campers and staff in two trips to a local (within 10 miles or so) staging area as designated by CDF. Buses to transport campers and staff to a longer term safe location or to transport them home will be arranged through Marin Airporter or another commercial bus company. If campers and staff are to be evacuated to home, then the Novato office staff will coordinate phone contact with all families to provide them with the necessary information to pick up their child either at the regular bus stops or at another location (for example, a temporary evacuation staging area). 2) In the event of evacuation of the camp, kitchen staff will follow the Food Service procedure for packing food and water to accompany the campers to the evacuation safety site sufficient for at least 48 hours. Thanks for your help. Mike Amylon Medical Director Camp Okizu 1 Page 1 of 1 Damon, Matt From: Damon, Matt Sent: Thursday, May 08, 2008 10:42 AM To: info@okizu.org Subject: Your letter to Butte County Fire Department dated 3/10/08 Dear Ms. Randall and Dr. Amylon, I have reviewed your letter dated March 10, 2008 and would like you to submit a plan for a complete evacuation of your facility in Berry Creek, in the event that it should become necessary. This is due to not having enough vehicles directly available to accomplish this. Please contact me if you have any questions. Thank you, Fie Caphaal DelxztyFmeMarsl" CAL R)W1 ftift Cats* Fie 176 NeJ9mAwzRw Omv&, CA99%6 530,9386837 ext 166 Office 5330-990-5817 Cell 53Q-538-2105 Fax 5/19/2008 140 K I Z Supporting Families with Childhood Cancer 16 Digital Drive, Novato, CA 94949 TEL 415.382.9083 FAX 415.382.8384 info@okizu.org www.okizu.org March 10, 2008 Chief Butte County Fire and Rescue 176 Nelson Avenue Oroville, CA 95969 Dear Chief, - I want to let you know about our plans for Camp Okizu in 2008. The camp is located at 445 Zink Road (off Bald Rock Road) in Berry Creek. The camp will be used for a variety of camp weekends in the spring and fall and for our summer resident camp. We will operate our Family Camp Weekends April 18-20, May 2-4, May, May 23-25, Aug 29 -Sept 1, Sept 12-14, Sept 26-28, Oct 10-12 with up to 250 participants. We will operate four weeks of residential summer camp for the siblings of our cancer patients starting June 21 and concluding on July 20. At Siblings Camp there will be 120-150 campers each week and 50-70 staff members. Our Oncology Camp for the pediatric cancer patients will operate for three weeks beginning July 26 and concluding August 17. At Oncology Camp there will be 90 to 130 campers and 50 to 70 staff each week. We will not have enough vehicles on site to evacuate our campers in the event of fire. The Okizu Foundation thanks you for your support of our programs. Please let us know if there is any additional information that would be helpful to you in planning for our summer operation. Sincerely, Suzie Randall Michael D. Amylon, M.D. Camp Director Medical Director 11 S 25-78 INSPECTION, TESTING, AND MAINTENANCE OF NATER - BASED FIRE PROTECTION SYSTEMS Inspection, Testing, and Maintenance Cover Sheet NFPA 25 as amended by CCR, Title 19 Property Information: Name: Address:,° Address: S� 101 -7, i i Ik City: ,, ZIP: Telephone: Contact: �. . Telephone: Contractor Information: Occupancy /Use: Of CAt/.a Construction Type: Zle�k h" No. Storie • Year Constructed: Name: ' Address:,° , City:r/ .. State: Telephone: Licenseff 3(__�'CA 6`C Job # %!6 Performed by: (Print) Dote: Contractor information may be pre-printed Number of System Risers Copy sent to: ❑ Owner Date ❑ Fire AHJ Date ❑ Contractor Date NOTES: 1) For specific inspection, testing, and maintenance requirements and information, see NEPA 25, 2002 Edition as amended by California Code of Regulations, Title 19, §901 to §906. 2) Inspection Items may be performed by the Owner in accordance with California Code of Regulations Title 19 §904.1(a) Forms included with this report NEPA 25 Num Cha ter her of Forms NIA FAIL* PASS Automatic Sprinkler System5 ,'100 Standpipe and Hose Systems 6 Private Water Supply System 7 Fire Pump 8 1-1 Water Storage Tank 9 ID Water Spray System 1 Foam Water Sprinkler System 1 1 *See" Deficiencies and Comments" section at end of each respective form. to Fire Marshal AES 1 March 21, 2006 :_ ` rr � t • ♦ - i _.,...,, �� ' ; =. s {". 3 � . f f .3'• �, ' . , . �.�, ; ' is 1;-_r �-" yam. .1 w•� .. 1.. i r. �,:\_�..' i � - - ` - - ` Ra - ANNEX B 25-79 Inspection, Testing, and Maintenance Fire Sprinkler System Page 1 of 4 NFPA 25, Chapter 5 as amended by CCR, Title 19 Date of Inspection, Testing, Maintenance: % System Riser ID: ' Property Information: Type of System: of: CAI./ Name: ��lJ" _/Z� �` Wet Pipe �Q� � 09y ��s� Z�l'J t�- �`�Gt ❑Dry Pipe Address: ❑ Preaction ❑Deluge 9�A!AE MF`� City: Main Drain Test Results: Initial Static Pressure: /00 Residual Pressure: (psi) Restored Static Pressure: (psi) Abbreviation Key: I = Inspection T = Test M = Maintenance A -O = After Operation MI =Per Manufacturer's Instructions Item Activity Frequency Description NFPA 25 Reference Fail NIA Pass 1.1 I Daily Weekly Preaction/Deluge Valves — Enclosure temperature 12.4.3.1 1.2 I Daily Weekly Dry Pipe Valves — Enclosure temperature 12.4.4.1.1 1.3 I Quarterly Gauges (Dry, Preaction, Deluge Systems) 5.2.4.2 5.2.4.3 1.4 I Quarterly Control Valves 12.3.2.1 1.5 I Quarterly Alarm Devices 5.2.6 1.6 I Quarterly Gauges (Wet Pipe Systems) 5.2.4.1 1.7 1 Quarterly Hydraulic nameplate 5.2.7 1.8 I Quarterly Pipe and Fittings 5.2.2 1.9 l Quarterly Sprinklers 5.2.1 1.10 I Quarterly Spare Sprinklers 5.2.1.3 1.11 I Quarterly Fire Department Connections 12.7.1 1.12 I Quarterly Alarm Valves — Exterior Inspection 12.4.1.1 1.13 I Quarterly Preaction/Deluge Valves — Exterior Inspection 12.4.3.1.6 1.14 I Quarterly Pressure Reducing Valves Dry Pipe Valves — Exterior Inspection 12.5.1.1 12.4.4.1.4 1.15 l Quarterly 1.16 I Quarterly Backflow Preventers 12.6.1 1.17 I Annually Buildings 5.2.5 State Fire Marshal AES 2 March 21, 2006 s .a t_ r � � '� � _ - ..r - t ��'. .t � �, t t q .� t � i-'�1 1 / � 1-'1 Yt• S �j 's �i � � r � }� �� i a.� �l-. i .� �S 1 � _ o r 25-80 INSPECTION, TESTING, A. .j MAINTENANCE OF WATER-BASED FIRE PROTECTION SYSTEMS tate Fire Marshal AES 2 March 21 2006 Inspection, Testing, and Maintenance Fire Sprinkler System Page 2 of 4 g NFPA 25, Chapter 5 as amended b CCR e19 Titl Date of Inspection, Testing, Maintenance: System Riser ID: Property Information: Name: 1F Type of System: o.aC�,t, �, 'yj Wet Pipe �� ❑ Dry Pipe' Address: ❑ Preaction ❑ Deluge,,, City. � t�R Item Activity Frequency Description NFPA 25 Fail N/A Pa ss Reference 1.18 I Annually Hangers 5.2.3 1.19 I Annually Seismic Braces 5.2. 3 1.20 I 5 Years Hangers (Accessible concealed spaces) 5.2.3.3 1.21 I 5 Years Seismic Braces (Accessible concealed 5.2.3.3 spaces) 1.22 I 5 Years Pipe and Fittings (Accessible concealed 5.2.2.3 spaces) 1.23 I 5 Years Sprinklers (Accessible concealed spaces) 5.2.1.1.4 1.24 I 5 Years Alarm Valves — Interior Inspection 12.4.1.2 ' 1.25 I 5 Years Alarm Valves - Strainers, filters, orifices 12.4.1.2 1.26 I 5 Years Check Valves — Interior Inspection 12.4.2.1 1.27 I 5 Years Preaction/Deluge Valves — Interior 12.4.3.1.7 Inspection 1.28 1 5 Years Preaction/Deluge Valves - Strainers, 12.4.3.1.8,% filters orifices 1.29 1 5 Years Dry Pipe Valves — Interior Inspection 12.4.4.1.5 1.30 1 5 Years Dry Pipe Valves - Strainers, filters, orifices 12.4.4.1.6 2.1 T Annually Alarm Devices (90 Sec) 5.3.3 ' 12.2.7 2.2 T Annually Main Drain Test (Enter data on Page 7) 12.2.6 12.2.6.1 12.3.3.4 2.3 T Annually Antifreeze Test 5.3.4 12.3.3.1 2.4 T Annually Control Valve - Position Control Valve — Operation 2.5 T Annually 12.3.3.1 12.3.3.5 2.6 T Annually Supervisory Preaction Valve — Priming Water Preaction Valve — Low Air Pressure Alarm Preaction Valve — Full Flow Trip Test 2.7 T Annually 12.4.3.2.1 V// 2.8 T Annually 12.4.3.2.10 2.9 T Annually 12.4.3.2.2 tate Fire Marshal AES 2 March 21 2006 ANNEX B Inspection, Testing, and Maintenance NFPA 25, Chapter 5 as amender Cate of Inspection, Testing, Maintenance: 1Z�-%0-0;7 P operty Information: Name: _�C�W, P 0��/71� r A dress: G! `7,sV Z Ad 25-81 Fire Sprinkler System Page 3 of 4 J by CCR, Title 19 System Riser ID: Type of System: XWet Pipe 0 Dry Pipe 0 Preaction , 0 Deluge ItInkm Activity Frequency Description NFPA 25 Reference Fail N/A Pass 210 T Annually Dry Pipe Valve — Priming Water 12.4.4.2.1 2,11 T Annually Dry Pipe Valve — Low Air Pressure Alarm 12.4.4.2.6 2,12 T Annually Dry Pipe Valve — Quick -Opening Device 12.4.4.2.4 2.13 T Annually Dry Pipe Valve — Trip Test 12.4.4.2.2 2.14 T Annually Backflow Preventer Assemblies 12.6.2 2.15 T 3 Years Dry Pipe Valve — Full Flow Trip Test 12.4.4.2.2.2 tz 2.16 T 5 Years Gauges 5.3.2 2.17 T 5 Years Pressure Reducing Valve 12.5.1.2 2.18 T 5 Years Fire Department Connection Backflush 12.7.4 2.19 T 5 Years Sprinklers — Extra High Temperature 5.3.1.1.1.3 2. 0 T 5 Years Sprinklers — Corrosive environment or corrosive water 5.3.1.1.2 2.2 1 T 10 Years Sprinklers - Dry 5.3.1.1.1.5 2.22 T 20 Years Sprinklers - Fast Response 5.3.1.1.1.2 2.23 T 50 Years Sprinklers 5.3.1.1.1 2.24 T 75 Years Sprinklers 75 years in service 5.3.1.1.1.4 2. 5 T Sprinklers manufactured prior to 1920 -- Replace 5.3.1.1.1.1 3.1 M Annually Control Valves 12.3.4 3.2 M Annually Preaction/Deluge Valves 12.4.3.3.2 3.3 M Annually Dry Pipe Valves/Quick-Opening Devices 12,4.4.3.2 3.4 M Annually Dry Pipe Valve — Low Point Drains 12.4.4.3.3 3. M 5 Years Obstruction Investigation Chapter 13 State Fire Marshal AES 2 March 21, 2006 25-81 INSPECTION, TES' -1 AND MAINTENANCE OF WATER BAShij FIRE PROTECTION SYSTEMS Inspection, Testing, and Maintenance Fire Sprinkler System Chapter 5 as amended P Y em Page 4 of 4 NEPA 25, Cha p nded b CCR, Title 19 Date of Inspection, Testing, Maintenance: Property Information: Name: 9 Address: System Riser ID: Type of System: )� Wet Pipe O Dry Pipe ❑ Preaction ❑ Deluge State Fire Marshal AES 2 March 21, 2006 ~:IRE SAFETY INSPECTION REPOT" Butte County Fre Department California Department of Forestry and Fre Protection k Oroville, California 95965 *A30) 538-788,8 _ Business Name Owner/Property Inspection Date: Ck 2 6 Business Phon : — APlf: NO. CORRECTIONS REQUIRED NQ LOCATION 1 REMARKS CLFJtR® ,, LOCATION 1 Provide address num I.D. visible from street EXITING 2 Remove obstructions at exits, doors, aisles, stairways, etc. 3 Exit door to open without a key or arry special kraMedgel effort - 4 Repair exit door hardcore. 5 Remove obstrictiors from door reqxied to be dosed. 6 Remove locks/latches from doors with panic hardware. 7 Provide sgn over main exit door -'This door to remain unlocked during business hours'. 8 Remove storage from under unprotected staff ! / 9 ProvkWmaintain exits em fighting. E)URI FIRE SHERS 10 Have fire exti . s serviced and tagged. RE -INSPECTION DATES INSPECTOR 11 Praxle/mount fire edinguisher as indicated. 12 Post a sign indicating fire edinguisher location. 1st 13 Provide clear access to fire add usher. FIRE PROTECTION EQUWIiIENT 2nd 14 Maintain, repair, paint, inspect, andror test sprinkler/st ridpipe systemulrydrant/FDC/PIV. Refer to FPB 15 Maintain 3 feet minimum clearance for accessluse of fire appliances/equipment. Dstrid Attorney / / 16 Replace damagedrpaintedhnissing sprinkler heads, F caps. Feral Clearance / / 17 1 Provide 5 -year certification test for sprinklerktanclpipe system- I Occupancy Class ❑ Check Pre -Fire Phan for accu 18 Provide spare sprinklerheads (min. ardorcompatible wrench. BY ORDER O F THE FIRE CHIEF 19 Hoodrduct a dinguishing system to be serviced/ tagged every 6 mo. 20 Remove grease from hood, dud, and filters. KEEP CLEAN) You are hereby notified to correct all violations immediately or show cause FIREALARM SYSTEMS why you should not be required to do so. A reinspection will be conducted on Wlr Iful failure to comply with this notice is a 21 Maintain, repair, inspect, andror test fire alarm system. misdemeanor. Violations that are not corrected immediately and/or remain FIRE SEPARATIONS after the reinspection may be processed as a criminal offense. Thank you 22 Repair holes in required fire resisWe construction. for your assistance and cooperation in minimizing the fire and fife loss in 23 Provided it self or automatic closing fire rated assemblies. your community. 24 Keep attic access and scuttle openings closed. ELECTRICAL Signature of R 25 DsmAnue use of extension cords. ' 26 Install permanent wiring for foxed and stationary snces. ❑ Owner ❑ Wriager ❑ Employee Other 27 Provide cover plates for all unction boxes. Inspecting Officer 28 Remove exposed wiring or protect in approved conduit. e- 29 Provide a 30 -inch dear space to and in front of electrical panel. FPB: Engine Com 30 Maintain wiring in good condition and protect from damage. klb VIOLATIONS NOTED THIS DATE FLAMMABLE LKIUI06 GASES THANK YOU FOR BEING FIRE SAFE! 31 Provide a flammable liquid storage cabinet or reduce storage to 10 gallons or Additional Comments: 32 less. Remove all flammable liquids not used for maintenance purposes. _ 33 34 Store flammable liquids from exits, stairs, or corridors. Secure compressed cylinders. 1 I re— S 35tC' wx TSHOUSEKEEPING STORAGE • HOUSEKEEPING 35 Arrange storage in an manner to provide aooessJ 36 37 Remove combustible storage from water hater and electrical room. Remove storage to 24 inches below ceiling or 18 inches belay sprinkler heads. C ,ea 0"', C`} Vat y V `% 38 Remove Iini)detxis from behind washers and dryers. e V y� (a --r / 39 Remove waste/rubbish mal-Mis from the premises. / (( 40 Keep dumpsters 5 feet away from combustible walls, eaves, or openings. MISCELLANEOUS �' l�_r•� �, �j 41 Other violations ardor comments. Page of BETTER BUILDERS CONSTRUCTION, INC. John J. Starr, License No. 323225 5263 Royal Oaks Dr., Oroville, CA 95966 Phone (530) 589-2574 Fax (530) 589-2942 February 3, 2004 Butte County Fire Fire Captain Ted Crawford 176 Nelson Ave. Oroville, CA. 95965 The attached sheets are for the fire pump test at Camp Okizu, in Berry Creek. If you need any other information, please call John at 589-2574. Thanks for your help with this project.- - -- - -- - - - - - Sincerely, Phil Valade Better Builders Construction Inc. L DAYBREAK TECHNOLOGIES, INC 3069 ALAMO DRIVE, #197 VACAVI LLE, CALIFORNIA 95687 Ph: 707/ 451-9335 Fax: 7071451-9445 December 20, 2003 DIAMOND `M' FIRE 2400 CATTLE DRIVE ROAD CORNING, CALIFORNIA 96201 Attn: Jim Maeder Subject: FIRE PUMP TEST — CAMP UKIZU, Berry Creek -Gentlemen: - - -_ - - On December 15, 2003, acceptance performance tests were run on the Peerless Pump Company electric motor driven fire pump. This pump is rated for 200 GPM @ 60 PSI. A certified factory test curve on the pump is attached. Test results on the pump were as follows: DISCHARGE SUCTION DIFFERENTIAL PRESSURE PRESSURE PRESSURE G_ ELECTRIC 0 95 30 65 MOTOR 218 58 -5 63 DRIVEN 230 53 -5 58 PUMP 252 52 -6 58 All flows measured with a Pitot through a 1%" Nose The electric motor driven pump was run for 1 hour and, in addition, 6 manual and 6 automatic starts and stops were run on the fire pump, and all alarms were checked. The jockey pump operation was checked and found to be satisfactory. Pressure switches were set as follows: ON OFF Jockey Pump 85 PSI 100 PSI Electric Fire Pump 70 PSI 80 PSI Electric motor minimum run timer was set to 10 minutes. 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Class. A -,,5 G( -:2--L Hm: Fax. Hm: Hm: XT YWQDTi 1`rr7nV n1V VnIT12 TiA('nJTV U-FVFAI.Fn TRF F01.1.0WING: 1. Fire Extinguishers: Required, service due 10. Exit(s) obstructed, inadequate 2. Extension cords: Excess use, defective 11. Exit sign(s) required, illumination 3. Excessive rubbish, trash, debris 12. Exit sign lights need replacing 4. Fire alarm system defective 13. Exit lighting: Required, defective 5. Sprinkler system: Service required, defective 14. Smoke detectors: Required, defective 6. Kitchen hood extinguishing system service due 15. Wiring: Exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops 16. Heating system: Defective appliance, flue combustibles 8. Knox Box keys 17. Address posted and visible from road 9. Fire Drill Witnessed Yes ❑ No ❑ 18. Other 1 1 1. aw\►`/VYIWK11\►11IKUNNX"ILow WYU"��MLaIrm Date: oil? qb q Discussed with: (Print)_ Signed: Battalion 1 2 3 4 '5 6 7 Station: FPB Inspecting Officer: FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOPE TIO ITH CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DA Fire Prevention Bureau Butte County Fire Rescue White Copy - Business 176 Nelson Avenue California Department of Forestry Yellow Copy — Occupancy File Oroville, CA 95965 and Fire Protection Pink Copy — Station File Telephone 530-538-7888 Facility Inspection Report Occ. Class. Fax 530-538-2105 Address: �26j rz) z? /.it.`fL j2 Business Name: Owner/Manager: Bus: Hm: Fax. Assistant Manager: Bus: HIn: Building Owner: Bus: Hm: Address: Am YWQDVd-'rTnV nF Vn1TR TiAVJ1I.1TV RFVFAl.FD TNF. FOLLOWING: 1. Fire Extinguishers: Required, service due 10. Exit(s) obstructed, inadequate 2. Extension cords: Excess use, defective 11. Exit sign(s) required, illumination 3. Excessive rubbish, trash, debris 12. Exit sign lights need replacing 4. Fire alarm system defective 13. Exit lighting: Required, defective 5. Sprinkler system: Service required, defective 14. Smoke detectors: Required, defective 6. Kitchen hood extinguishing system service due 15. Wiring: Exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops 16. Heating system: Defective appliance, flue combustibles 8. Knox Box keys 17. Address posted and visible from road 9. Fire Drill Witnessed Yes ❑ No ❑ 18. Other DETAILED EXPLANATION AN 1) UOIC LC 1 IUA J: �-v R R •� l �.L. �- - Date: Discussed with: Signed: Battalion 1 2 3 4' 5 6 7 I Station FPB -/ �=!`�L " �Z FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOPERATION WITH CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: ��`� Fire Prevention Bureau 176 Nelson Avenue Oroville, CA 95965 Telephone 530-538-7888 Fax 530-538-2105 Address: :�) //U Owner/Manager: . Assistant Manager: Building Owner. Address: Butte County Fire Rescue California Department of Forestry and Fire Protection Facility Inspection Report Business Name: Bus: Bus: Bus: Hm: Hm: Hm: White Copy - Business Yellow Copy — Occupancy File Pink Copy — Station File Occ. Class. Fax: AN IN4PRCTION OF YOUR FACILITY REVEALED THE FOLLOWING: 1. Fire Extinguishers: Required, service due 10. Exit(s) obstructed, inadequate 2. Extension cords: Excess use, defective 11. Exit sign(s) required, illumination 3. Excessive rubbish, trash, debris 12. Exit sign lights need replacing 4. Fire alarm system defective 13. Exit lighting: Required, defective 5. Sprinkler system: Service required, defective 14. Smoke detectors: Required, defective 6. Kitchen hood extinguishing system service due 15. Wiring: Exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops 16. Heating system: Defective appliance, flue combustibles 8. Knox Box keys 17. Address posted and visible from road 9. Fire Drill Witnessed Yes 0 No 11 18. Other DETAILED EXPLANATION AND CORRECTIONS: UUMMU rEIJ: ate: Discussed with: Signed: rint /' G ex Inspecting Officer attalion 1 2 3 4 `5 6 7 Station: [G' fPB ✓ - FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUK c;VUYERATIUN wrrtl ORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: i� . Stere Fowler, Lff e Saf ety ca California Department of Forestry ani Fire Protection °R t' ButtC^,—,nty Fire Department To: Glenn Date- April ?, 7001 RE: Camp Okizu Infirmary Patiently waiting for the sprinkler plans—made only one change to fire extinguisher requirements—added one in the laundry room that will also serve the mechanical room GENERAL INFORMATION _ ` t CONTRACTOR'S MATERIAL&TEST CERTIFICATE FORABOVEGROUNDPIPING /� V PROCEDURE Upon completion of worK Inspection and tests shall be made by tt.e contractor's representative and witnessed by an owners representative. All defects shall be corrected and system left In service before contractors personnel finally leave the lob. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is understood the owners rep. resentative's signature in no way prejudices any claim against contractor for faulty mwerial, poor workmanship, or failure to comply with approving authority's requirements or local ordinances. PROPERTY NAME T 7A1, .y�,,,� ^� �� SI„ J�� DATE/ J—l�-0/ PROPERTYAODRESS ,/rrr/l�/�I��(/I �"'` K `7 MEASURED FROM TIME INSPECTOR'S TEST CONNECTION IS OPENED. 85A(1O-88) PRINTED IN U.S.A. (OVER) Figure 1-10.1(2) Contractor's Material and Test Certificate for Aboveground Piping, 1989 Edition ACCEPTED 8 APPROVING AUTHOR R S (NAMES) ADDRESS PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS ,AYES O NO EQUIPMENT USED IS APPROVED ,BYES O NO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION YES 0 NO OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT^ IF N0, EXPLAIN INSTRUCTIONS HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: ES ONO 1. SYSTEM COMPONENTS INSTRUCTIONS AYES Cl NO 2. CARE AND MAINTENANCE INSTRUCTIONS YES D NO 3. NFPA 13A RYES O NO OF SYSTOEM SUPPLIES BUILDINGS G �> /2.>R..��? ' J (C YEAR OF ORIFk:E TEMPERATURE MAKE MODEL MANUFACTURE SQ QUANTITY RATING 31 SPRINKLERS t 1 " � 716 � 260 ll �' iv% 2— 6) c / !%/ eC PIPE AND Typeot Ppe FITTINGS Type of Fittings ear. ml? MAXIMUM TIME TO OPERATE ALARM ALARM DEVICE THROUGH TEST CONNECTION VALVE OR FLOW TYPE MAKE MODEL MIN. SEC. INDICATOR ? Z- - DRY VALVE O.O.C. MAKE MODELSERIAL NO. MAKE MODEL SERIAL NO. TIME TO TRIP TIME WATER ALARM THRU TEST WATER AIR TRIP POINT REACHED OPERATED D Y PIPE CONNECTION' PRESSURE PRESSURE AIR PRESSURE TEST OUTLET' PROPERLY OP ATING ST MIN. SEC. PSI PSI PSI MIN, SEC. YES NO Wnnout I O.O.D. With 0.0.0. IF `!O, EXPLAIN MEASURED FROM TIME INSPECTOR'S TEST CONNECTION IS OPENED. 85A(1O-88) PRINTED IN U.S.A. (OVER) Figure 1-10.1(2) Contractor's Material and Test Certificate for Aboveground Piping, 1989 Edition 13-10 STANDARD FOR THE INSTALLATION OP SPRINKLER SYSTEMS SIGNATURES BSA BACK 1989 Edition TESTS WITNESSED BY — —ICT'I IT %J"Ntn (Z)K.NF-U) TITLE DATE FOR SPRIN L CONT TOR SIGNED) TITLE �L �Gt�G" 'G�OAT AND Figure 1-10.1(a) (continued) Contractor's Material and Test Certificate for Aboveground Piping. OPERATION O PNEUMATIC O ELECTRIC ❑ HYDRAULIC PIPING SUPERVISED O YES ❑ NO I DETECTING MEDIA SUPERVISED O YES O NO DOES VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL STATIONS YES DELUGE i O ONO IS H Fi - AN SSIBL ACILI IN EACH CIRCUIT O ESTING I NO, XPLAIN PRFACT VAL O YES O NO DOES EACH I CUI CH IR UIMAXIMUM IM O MAKE MODEL SUPERVISION LOSS ALARM OPERATE VALVE RELEASE OPERATE RELEASE Y 511 NO YES NO I MIN. SEC. HYDROSTATIC- Hydrostatic tests shall be made at not lase than 200 psi (13.6 bars) lot two hours or 50 psi (3.4 bars) above static pressure in excess of 150 pal (101 bars) la two hours. Differential dry-ppe valve dappen: be TEST shall Leh open during test to prevent damage. All aboveground piping ieakage shall be stopped. DESCRiPT10N PNEUMATIC Establish 40 ps1 (2.? bars) air pressure and measure drop which shall not exceed 1.12 psi (0.1 bars) n 2a hours. Test ho pressure tania at normal water level and ak ressure and measlIu,, re air ess ure d which shall not exceed 1.12 i 0.1 bars n hours. ALL PIPING HYDROSTATICALLY TESTED AT GLc 11 PSI FOR TG— HRS. IF NO, STATE REASON DRY PIPING PNEUMATICALLY TESTED O YES Np�r 0 EQUIPMENT OPERATES PROPERLY ,OYES ❑ NO DO YOU CERTIFY i S THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS. SODIUM SILICATE OR DERIVATIVES OF SODIUI.�SILICATE. BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR TESTS STOPPINGLEAKS? YES O NO DRAIN READING OF GAGE LOCATED NEAR WATER:=AESNIOUAL PRESSURE WITH VALVE IN TEST TEST SUPPLY TEST CONNECTION: PSITIONOPENWIDE PSI UNDERGROUND MAINS AND LOAD IN CONNECT"—NS TU SYSTEM RISERS FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING, VERIFIED BY COPY OF THE U FORM NO. BSD l� YES O NO OTHER EXPLAIN FLUSHED BY INSTALLER OF UNDER- GROUND SPRINKLER PIPING YES O NO TFS NUMBER USED LOCATIONS NUMBER REMOVED GAS WELDED PIPING YES ❑ NO IF YES ... DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR T4AT WELCING PROCEDURES COMPLY J 'WITH THE REQUIREMENTS OF AT LEAST AWS 010.9. LEVEL AR -3 /YES O NO WELDiNG DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR-3YES O NO 00 YOU CERTIFY THAT WELDING WAS CARRIED OUT INCOMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DI SCS ARE RETRIEVED. THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF �/ PIPING ARE NOT PENETRATED YES O NO CUTOUTS ,o t DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL (DISCS) CUTOUTS (DISCS) ARE RETRIEVED? HYDRAUUC O YES O NO NAME PLATE PROVIOFOIF NO, EXPLAIN DATA NAMEPLATE IO(YES O NO DATE LEFr IN SERVICE WITH ALL CONTROL VALVES OPEN: REMARKS ,. � 6"-- l = �.� NAME OF SPRINKI FR C(YdTRACTnQ SIGNATURES BSA BACK 1989 Edition TESTS WITNESSED BY — —ICT'I IT %J"Ntn (Z)K.NF-U) TITLE DATE FOR SPRIN L CONT TOR SIGNED) TITLE �L �Gt�G" 'G�OAT AND Figure 1-10.1(a) (continued) Contractor's Material and Test Certificate for Aboveground Piping. a e Lown ompany Manufacturers Representative 20212 Redwood Rd., Ste. 201-B Castro Valley, CA 94546-4324 Contractor's Lic. D21-715370 Ph 510 886 5260 Fx 510 537 7707 West Coast Fire Protection Systems 334 Sacramento St #3 Auburn, CA 95603 /12/01 Attention: Ted Bria Subject: FIRE PUMP TEST,Camp Gkizu Ca.. - ITT AC Pump Serial #32763 0101 Gentlemen: Field performance tests were run on this fire pump on 01/11/01. The results are tabulated below. Pressure data was obtained with calibrated gauges. RPM was taken with a light pulse tachometer. Electrical data was taken with a digital multi - meter. Electric Fire Pumn -- Rated 300 GPM @ 130 PSI GPM Suction Discharge Net PSI Volts/Ames RPM 0 30 163 133 490/27,26,29 3586 300 30 160 130 471/45,49,52 3566 450 30 150 120 475/50,57,59 3555 Please see attached pages •f_ -�,`7-• i _ __ •^•1`;_ .•1 `�•i ,c `r•:� 1�.7� li'ct r...c-.�t».1• _�;• - tr,-} �••t ~' t` ~.,1 Ir \ i{••.�. �wr � •`. .. •,Lt-:.�•.� �• �•••f 1�•T .��rJ _'•IJ.. `t•-♦ ,�''♦��-�! _�� -i >.1 J..• +fi.e.%:.� .�.:.F� t� - -. - - •S't - r•t •',T 1'�•fY �•t-1i-1� •'j. 7'•. �� .�,�♦ i � 1.� .r r�� 'i'1 l+ 1� t� �,1 _ - t. .L)•;•. ` _ �.� �{ r�.. t�_!S` { •:�1 � I'!, S' .1.�.Y, r1 4 ��.� � •1 S L • :. - _� ♦- .j �. :I- { :.i. :•. ,� •�•- •A. i. .•�, •f� { f .,•-./ :11, ..M R., ... . J.•iil /-. ��•)1 - .i e.� lS_ V�.i.,L �i.S,'��-.Y.�b.r �,y. .r• 't: !'.;ry '�• i•.•1.� r•'• "�. ti 1• C/ t r f.•r` 4` •i' •�- ♦ • '`11 i'• •: '� •.f♦�•-t�•J +�� {� r - .•} .j.A YJr'r r••1 y •`i.y�.t �. .7r •+. f. jiy(••�!-(�..• S .,`'I'.*'•l. r ,--'�r,`.. - ; ice\ •7 - i : J. i f �I•.l �7-" Ji!'. f r. --..' i..►..• {_•,_' - ..•. ,�V •.r i_7 J .3 •.. .. .{.�. �:. iu: - „Y. . '� 7.•R A-•�./. �.� �ii.a « ,•. },{�fi)�.. - - - - ..r-r 7^• Y'^tt �- •• C f r ( !• i- 7.. 1 •iii 1 �• •� (,,�-� 't )'.!'' �.. �,ra i c ^'! ti C'= )' •�'r �! � t -t;{ f c f. k �1 • ! tr ! -! 1 1 �.� t` .: f r 1 t . f t' l: 7. ,= .• 3 + . i f .S ..' •.�' 9,►,�.E .l 1 d 1 :i -G 1 ►•. . _ { 1_,I �) I. �.� r- ti; :i.i t '1'. ' - r. ,. ., r. .. - T -. t ( t(` `• • - , ! t t '� '.t �`�fi f- 1 f':• � r f �{,J f ' 1 - - - ,'�',_ - - - - • �.. v �. i � • ... . - 1 .. , ! . . t } � ,T t • � .. _ ' t 1 _. ; i _ • l' r .... 1 .. I .. l. ', . .. � • i .. 1. S t l ♦ J . .1 - - - - f ga 6 manual and automatic stop 'and starts were run. The pressure settings are main pump on at 155#, off at 175#, and jockey on at 125# and off at 135#. The jockey pump was tested and set. The pump is operating at the start pressure that is set. The main pump is set for auto stop. Alarm contacts for pump were not connected. This pump was out of service. Transfer switch was tested successfully. The fire pump panel has a 100 AMP breaker ahead of it in the service. This breaker is too small, a 400 AMP maybe needed. Building electric service shunt signal should be taken from pump run signal, not from pump control relays. Modifications to pump control relays violate UL label of fire pump panel. Very Truly Yours Craig E. Brown. The Brown Co. , Representatives for ITT AC Fire Pumps C.C. Ted Crawford, Fire Captain, Department of Foresty and Fire Protection, Butte County JL PRE-ENGINEERED Cflre4fa�' SYSTEM INSPECTION REPORT Ul -A PROT-01 C01-1111 M' SHOW APPLIANCES A ND LOCATION OF SURFACE NOZZLES LM RESTAURANT ❑ MARINE ❑ INDUSTRIAL 4 h A 'I A 0., -L�( -J ...... 0 .. 0 ................................... 51'X 2" ;t '� C3 u 5 1. IS SYSTEM MOUNTING BRACKET IN ACCESSIBLE COCAT!ON AND SOUNDLY MOUNTED? .......................................... 2. IS PIPING TIGHT, SECURED AND CHECKED FOR BLOCKAGE?...................................................................... 3. ARE GREASE TIGHTS INSTALLED AT ALL HOOD PENETRATIONS?.................................................................. 4. IF MULTIPLE SYSTEMS, DID ALL SYSTEMS OPERATE SATISFACTORY?.............................................................. 5. IS SYSTEM PROPERLY INSTALLED FOR AREA(S) TO BE PROTECTED?............................................................... 6. ARE ALL NOZZLES PROPER TYPE AND SIZE?....................................................................................... 7. IS MANUAL PULL OPERATIONAL AND IN PROPER LOCATION?...................................................................... 8. ARE FUSIBLE LINKS, H.A.D.S OF PROPER TEMPERATURE RATING?................................................................. 9. WERE FUSIBLE LINKS REPLACED ON SEMI-ANNUAL INSPECTION?................................................................. 10. IS AUTOMATIC DETECTION OPERATIONAL?........................................................................................ 11. DID FUEL SHUT OFF PROPERLY?................................................................................................... 12. DID ELECTRIC SHUTOFFS/ALARMS OPERATE?..................................................................................... 13. ARE BURSTING DISC AND CHEMICAL IN GOOD CONDITION?....................................................................... 14. IS CARTRIDGE WITHIN THE REQUIRED WEIGHT?................................................................................... 15. ARE NOZZLES CLEAN AND CAPS/SEALS PROPERLY INSTALLED?................................................................... 16. IS CYLINDER PRESSURE IN OPERATIONAL RANGE?................................................................................ 17. ARE FILTERS CLEAN?............................................................................................................... 8. ARE ALL SAFETY PINS REMOVED, CARTRIDGES RE -INSTALLED AND SYSTEM REPLACED IN NORMAL OPERATION CONDITION? ... 9. HAVE PERSONS WORKING IN SYSTEM AREA BEEN INSTRUCTED AS HOW TO OPERATE SYSTEMS BY MANUAL METHODS? ......... 0. WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE PRESENTLY ADOPTED EDITIONS OF NFPA 17,17A AND 96?......................................................................... 1. WAS THE SYSTEM TAGGED IN ACCORDANCE WITH RULE 4A-21.240? ("NO" ANSWER MUST BE EXPLAINED IN THE COMMENTS SECTION OF THIS REPORT.)........................................................................................... 2. WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE MANUFACTURER'S MANUAL AND THE MANUFACTURER'S SPECIFICATIONS?....................................................................................... . 3. DOES SYSTEM COMPLY WITH UL300?................................................................................. . f I, THE IJNDERSIGNED, CERTIFY THAT I PERSONALLY INSPECTED THE ABOVE PREMISES AND FOUND CONDITIONS AS NOTED. 1 SERVIC TECHNICIAN/;' } DATETIME CUSTOMER SIGNATURE DATE AM PM FL 1041 � /97 nrrinr ntln%f • ' QUARTERLY ❑ ANNUALLY ❑ SEMI-ANNUALLY [9'NEW INSTALLATION INSPECTION NO. INVOICE NO. BU 3INESS } / AD RESS CITY STATE ZIP CODE MA AGER/OWNER F PHONE SYS TEM LOCATION AREA TYPE SYSTEM AMT. MODEL NO. CYL NDER SIZE MfTHOa}OF ACT ATION AMT. DEGREE OF ACTUATION SYSTEM INSTALLED AS PER PLATE NO. PAGE / s Edi LAST DATE YDROSTATIC T T LAST DATE OF RECHARGE CYLINDER SERIAL NO. FUEL SHUT OFF �OsF- / a pA5 SIZE ECECTRIC�' SIZE M' SHOW APPLIANCES A ND LOCATION OF SURFACE NOZZLES LM RESTAURANT ❑ MARINE ❑ INDUSTRIAL 4 h A 'I A 0., -L�( -J ...... 0 .. 0 ................................... 51'X 2" ;t '� C3 u 5 1. IS SYSTEM MOUNTING BRACKET IN ACCESSIBLE COCAT!ON AND SOUNDLY MOUNTED? .......................................... 2. IS PIPING TIGHT, SECURED AND CHECKED FOR BLOCKAGE?...................................................................... 3. ARE GREASE TIGHTS INSTALLED AT ALL HOOD PENETRATIONS?.................................................................. 4. IF MULTIPLE SYSTEMS, DID ALL SYSTEMS OPERATE SATISFACTORY?.............................................................. 5. IS SYSTEM PROPERLY INSTALLED FOR AREA(S) TO BE PROTECTED?............................................................... 6. ARE ALL NOZZLES PROPER TYPE AND SIZE?....................................................................................... 7. IS MANUAL PULL OPERATIONAL AND IN PROPER LOCATION?...................................................................... 8. ARE FUSIBLE LINKS, H.A.D.S OF PROPER TEMPERATURE RATING?................................................................. 9. WERE FUSIBLE LINKS REPLACED ON SEMI-ANNUAL INSPECTION?................................................................. 10. IS AUTOMATIC DETECTION OPERATIONAL?........................................................................................ 11. DID FUEL SHUT OFF PROPERLY?................................................................................................... 12. DID ELECTRIC SHUTOFFS/ALARMS OPERATE?..................................................................................... 13. ARE BURSTING DISC AND CHEMICAL IN GOOD CONDITION?....................................................................... 14. IS CARTRIDGE WITHIN THE REQUIRED WEIGHT?................................................................................... 15. ARE NOZZLES CLEAN AND CAPS/SEALS PROPERLY INSTALLED?................................................................... 16. IS CYLINDER PRESSURE IN OPERATIONAL RANGE?................................................................................ 17. ARE FILTERS CLEAN?............................................................................................................... 8. ARE ALL SAFETY PINS REMOVED, CARTRIDGES RE -INSTALLED AND SYSTEM REPLACED IN NORMAL OPERATION CONDITION? ... 9. HAVE PERSONS WORKING IN SYSTEM AREA BEEN INSTRUCTED AS HOW TO OPERATE SYSTEMS BY MANUAL METHODS? ......... 0. WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE PRESENTLY ADOPTED EDITIONS OF NFPA 17,17A AND 96?......................................................................... 1. WAS THE SYSTEM TAGGED IN ACCORDANCE WITH RULE 4A-21.240? ("NO" ANSWER MUST BE EXPLAINED IN THE COMMENTS SECTION OF THIS REPORT.)........................................................................................... 2. WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE MANUFACTURER'S MANUAL AND THE MANUFACTURER'S SPECIFICATIONS?....................................................................................... . 3. DOES SYSTEM COMPLY WITH UL300?................................................................................. . f I, THE IJNDERSIGNED, CERTIFY THAT I PERSONALLY INSPECTED THE ABOVE PREMISES AND FOUND CONDITIONS AS NOTED. 1 SERVIC TECHNICIAN/;' } DATETIME CUSTOMER SIGNATURE DATE AM PM FL 1041 � /97 nrrinr ntln%f