HomeMy WebLinkAboutB06-2812 CF Overhead Sprinkler Hydro TestCONTRACTOR'S MATERIAL & TEST CERTIFICATE FOR ABOVEGROUND PIPING Factory
Additional copies of this form are Loss Prevention Publications - Training Resource Center Mutual
System
available to insured from: Factory Mutual Engineering and Research, 1151 Boston -Providence Turnpike, P.O. Box 9102, Norwood MA 02062
PROCEDURE:
Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All
defects shall be corrected and system left in service before contractor's personnel finally leave the job.
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 owner's representatives signature in no way prejudices any claim against the contractor for faulty material, poor workmanship,
or failure to comply with Rproving authority's requirements or local ordinances.
PROPERTY NAME: Setzer Forest Products TJOB# 06194 DATE: 12/14/06
PROPERTY ADDRESS: 1980 Kusel Road — Oroville, Ca. 95966
ACCEPTED BY APPROVING AUTHORITY'(S) NAMES: Butte County Fire District
ADDRESS: 176 Nelson Ave. — Oroville, Ca. 95965
PLANS INSTALLATION CONFORMS TO ACCEPTED PLANS YES X NO
EQUIPMENT USED 1S APPROVED (IF NO, STATE DEVIATIONS BELOW) YES X NO
HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATIONOW CONTROL AND
VALVES
THE CARKAND MAINTENANCE OF THIS NEW EQUIPMENT? YES X NO
INSTRUCTIONS IF NO, EXPLAIN:
HAVE COPIES OF APPROPRIATE INSTRUCTIONS AND CARE AND MAINTENANCE CHARTS BEEN LEFT ON YES X TNO
PREMISES?
IF NO, EXPLAIN:
LOCATION OF SUPPLIES BUILDINGS
SYSTEM Entire Building
MAKE MODEL YEAR OF ORIFICE SIZE QUANTITY TEMPERATURE
TYCO MANUFACTURE RATING
Upright TY -B 2006 3/4'? 60 2860
SPRINKLERS
PIPE CONFORMS TO NFPA #13 STANDARD YES X NO
PIPE &FITTINGS FITTINGS CONFORM TO NFPA # 13 STANDARD YES X NO
ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST PIPE
ALARM
VALVE OR TYPE MAKE MODEL MIN. SEC.
FLOW WATERFLOW POTTER VSR-F 0 60 -
INDICATOR SWITCH
DRY VALVE Q.O.D.
MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO.
DRY PIPE
OPERATING TIME TO TRIP WATER AIR TRIP POINT TIME WATER ALARM OPER-
TEST THRU TEST PRESSURE PRESSURE AIR PRESSURE REACHED OUT. ATED PROPERLY
PIPE
MIN. SEC. PSI PSI PSI MIN. SEC. MIN. SEC.
WITHOUT
Q.O.D.
WITH
Q.O.D.
IF NO, EXPLAIN:
OPERATION I PNEUMATIC ELECTRIC I HYDRAULIC
PIPING SUPERVISED
YES
NO
DETECTING MEDIA
YES
NO
SUPERVISED?
'
DELUGE AND
DOES THE VALVE OPERATE FROM THE MANUAL TRIP AND/OR REMOTE CONTROL?
YES
NO
PREACTION
IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR TESTING?
YES
NO
VALVES
IF NO, EXPLAIN:
DOES EACH CIRCUIT OPERATE
DOES EACH CIRCUIT
MAXIMUM TIME TO
MAKE MODEL
SUPERVISION LOSS ALARM?
OPERATE VALVE
RELEASE.
OPERATE RELEASE
YES NO
YES NO
MIN. SEC.
HYDROSTATIC: HYDROSTATIC TESTS SHALL BE MADE AT NOT LESS THAN 200 PSI (13.6 BARS) ABOVE
STATIC PRESSURE IN EXCESS OF 150 PSI (10.3 BARS) FOR TWO HOURS. DIFFERENTIAL DRY -
TEST
DESCRIPTION
PIPE VALVE CLAPPERS SHALL BE LEFT OPEN DURING TEST TO PREVENT DAMAGE. ALL ABOVE -GROUND
PIPING LEAKAGE SHALL BE STOPPED.
PNEUMATIC: ESTABLISH 40 PSI (2.7 BARS) AIR PRESSURE AND MEASURE DROP WHICH SHALL NOT
EXCEED 1-1 /2 PSI (0.1 BARS) IN PRESSURE TANKS AT NORMAL WATER LEVEL AND AIR PRESSURE
AND MEASURE AIR PRESSURE DROP WHICH SHALL NOT EXCEED 1- 1/2 PSI (0.1 BARS) IN 24 HRS.
ALL PIPING HYDROSTATICALLY TE'ST'ED AT 200 PSI FOR 2 HRS.
IF NO, STATE REASON:
DRY PIPING PNEUMATICALLY TESTED? YES NO
EQUIPMENT OPERATES PROPERLY? YES NO
DRAIN READING OF GAGE LOCATED NEAR WATER SUPPLY TEST
RESIDUAL PRESSURE WITH VALVE IN
TESTS
PIPE.
TEST 200 PSI
TEST PIPE OPEN WIDE 200 PSI
UNDERGROUND MAINS AND LEAD-IN CONNECTIONS TO SYSTEM RISERS SHALL BE FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING.
VERIFIED BY COPY OF THE FORM # 85B? YES NO OTHER EXPLAIN
FLUSHED BY INSTALLER OF UNDERGROUND YES NO
SPRINKLER PIPING?
BLANK'TESTING
NUMBER USED
LOCATIONS
NUMBER REMOVED
GASKETS
WELDED PIPING?
X YES -7- NO
IF YES...
DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING YES X NO
PROCEDURES
COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9, LEVEL AR -3?
WELDING
DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED YES X NO
IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS DI 0.9. LEVEL AR -3?
DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A YES X NO
DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS ARE
RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER
WELDING RESIDUE ARE REMOVED, AND THAT INTERNAL DIAMETERS OF PIPING
ARE NOT PENETRATED?
HYDRAULIC
DATA NAMEPLATE
NAMEPLATE PROVIDED? YES
IF NO, EXPLAIN:
X
NO
DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN:
REMARKS
NAME OF INSTALLING CONTRACTOR: CEN -CAL FIRE SYSTEMS, INC.
TESTS WITNESSED BY
FOR AUTIVIIITY HAVING JUR DICTIO Signed) ITL DATE
SIGNATURES `j" -20 •-�
FO I LI RACTOR (Signed) TIT E U DATE
ys• � e- - e c> --- - C; .�
ADDITIONAL EXPLAIXTION AND NOTES: