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Butte sprinkler quarterly june 2020.ZIP
Bldg #10 Auto sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #11 Physical science sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #16 Life science sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #17 Media center sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #19 Womens locker sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #24 Campus center sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #25 LRC sprinklr 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #250 Chico Center sprinkler6.10.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #32 Arts sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #4 SAS sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #8 Allied health north sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #8 Allied health south sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #9 Technology sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
Bldg #98 Public Service sprinkler 06.09.20.pdf Microsoft InfoPath - Form1
Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi
psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.10 I General Information Sign (not required for
system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department Connections 13.7 1.14 I Alarm Valves – Exterior Inspection
13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems
13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.1 Sept.
3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor
or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections I = Inspection T = Test
M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze
Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1 T Field Service Test Required (Send Report to Fire Code
Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water Flow
Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T Small Hose Connections* w/PRV Hose Valves – Partial Flow
Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections* 13.5.6.3 3.3 M Obstruction Investigation required (If
“Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small hose connections are hose valves and optional hose supplied
by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments
Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection,
Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City D = Deficiency C =
Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts that were repaired or replaced Check here if additional
Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection
equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the
equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection, Testing & Maintenance Items are Completed in the
Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3, 2013
KAPC Field House Spk 06.09.20.pdf Microsoft InfoPath - NFPA 25 Form AES 1 Cover Sheet 2013
Inspection, Testing, and Maintenance Cover Sheet NFPA25 as amended by CCR, Title 19 Property Information: Name: Occupancy/Use: Address: Construction Type: City: No. Stories:
ZIP: Year Constructed: Contact: Telephone: Contractor Information: Number of System Risers Name: Copy sent to: Address: Owner Date: City: Fire AHJ Date: State:
Contractor Date: Telephone: NOTES: 1)For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011 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) CA License#: Job #: Performed by:
Check box for each system inspected and enter the number of forms used for inspection. Check boxes (Fail or Pass) to indicate status of inspected system at end of inspection. Forms
Included with this Report NFPA 25 Chapter Number of Forms N/A Fail* Pass Automatic Sprinkler System 5 Standpipe and Hose System 6 Private Water Supply System 7 Fire Pump 8 Water Storage
Tank 9 Water Spray System 10 Foam Water Sprinkler System 11 Water Mist System 12 Concerns that are not deficiencies (i.e. Non-Sprinklered Areas) Yes No *See "Deficiencies and Comments"
section at end of each respective form. AES 1 September 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly
and Annual Report 1 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job #
CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This
building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass
F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2
1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5 I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi
1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed
systems) 5.2.6 1.10 I General Information Sign (not required for system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department
Connections 13.7 1.14 I Alarm Valves – Exterior Inspection 13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve*
5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems 13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include
Class I, II, or III standpipe systems. Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly
and Annual Report 2 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL
Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only
P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1
T Field Service Test Required (Send Report to Fire Code Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass;
If present = Fail Title 19 904.1(c) 2.3 T Water Flow Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form)
13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2 2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T
Small Hose Connections* w/PRV Hose Valves – Partial Flow Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections*
13.5.6.3 3.3 M Obstruction Investigation required (If “Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small
hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment
(Indicate type ) Item Date Riser D C Deficiencies and Comments Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler
System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information
Building Name Name Address Job # City D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts
that were repaired or replaced Check here if additional Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number
attached: I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance
with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection,
Testing & Maintenance Items are Completed in the Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3,
2013
NEW Welding Dry Spk 06.09.20.pdf Microsoft InfoPath - NFPA 25 Form AES 2.3 Quarterly Annual Dry
Dry Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 1 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job # CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location
Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This building has more than 5 risers. See additional AES 2.9 form attached
Number of AES 2.9 forms attached: Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference
Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2 1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5
I Gauges (Dry Pipe Systems) Pass = Normal Pressures 5.2.4.2, 5.2.4.3 5.2.4.4 13.4.4.1.2 1.6 I Air Pressure 5.2.4.2, 5.2.4.3 5.2.4.4 13.4.4.2.5.1 psi psi psi psi 1.7 I Water Supply
Pressure 5.2.4.2 13.4.4.2.5.1 psi psi psi psi 1.8 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 1.9 I General Information Sign (not required for system
prior to 2007 edition of NFPA 13) 5.2.8 1.10 I Heat Tape 5.2.7 1.11 I Spare Sprinklers 5.2.1.4 1.12 I Fire Department Connections 13.7 1.13 I Dry Pipe Valves – Exterior Inspection 13.4.4.1.4
1.14 I Pressure Reducing Valves 13.5.1 1.15 Backflow Preventers 13.6.1 1.16 PRV – Fire Sprinkler Systems 13.5.1 Form AES 2.3 Sept. 3, 2013 Phone Dry Pipe Fire Sprinkler System California
Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 2 of 3 Property Information Contractor or Licensed Owner Information Building Name Name
Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections (See Previous Page) I = Inspection T = Test M = Maintenance P = Pass
F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 1.17 I Buildings (Freeze Protection) 4.1.1.1 Owner’s Responsibility 1.18 I Sprinklers
5.2.1 1.19 I Pipe and Fittings 5.2.2 1.20 I Hangers 5.2.3 1.21 I Seismic Braces 5.2.3 1.22 I Small Hose Connections* 13.5.6.2.2 2.1 T Field Service Test Required (Send Report to Fire
Code Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass; If present = Fail Title 19 904.1(c) 2.3 T Water
Flow Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form) 13.2.5 13.3.3.4 2.5 T Priming Water Level Test 13.4.4.2.1
2.6 T Dry Pipe Valve Trip Test (Partial trip test is acceptable) 13.4.4.2.2 13.4.4.2.2.3 13.4.4.1.5 2.7 T Valve Trip Time 13.4.4.2.5.2 sec. 2.8 T Trip Air Pressure 13.4.4.2.5.1 psi
2.9 T Quic k-Opening Device Test 13.4.4.2.4 2.10 T Low Air Pressure Alarm Test 13.4.4.2.6 2.11 T Low Temperature Alarm Test 13.4.4.2.7 2.12 T Automatic Air Pressure Maintenance Device
Test 13.4.4.2.8 2.13 T Control Valve – Operation 13.3.3 2.14 T Valve Supervisory Devices 13.3.3.5 2.15 T Backflow Preventer Assemblies 13.6.2 2.16 T PRV – Partial Flow 13.5.1.3 * Small
hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. Form AES 2.3 Sept. 3, 2013 Dry
Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed
Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL Quarterly Inspections (See Quarterly Inspections Page) I = Inspection
T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only P,F,N/A 3.1 M Control Valves 13.3.4 3.2
M Maintenance 13.4.4.3 3.3 M Dry Pipe Valve Interior Cleaned 13.4.4.3.1 3.4 M Low Points in System Drained 13.4.4.3.2 3.5 M Backflow Preventer 13.6.3 3.6 M Obstruction Investigation
Required (If “Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.7 M System Returned to Service 4.5.3 15.7 Yes No D = Deficiency C = Comment (Indicate type
) Item Date Riser D C Deficiencies and Comments Indicate all equipment, devices and parts that were repaired or replaced Check here if additional Deficiencies and Comments are listed
on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number attached: I hereby certify that the fire protection equipment listed above has been fully
inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except
as noted in the “Deficiencies and Comments” section of this form. Quarter Check box if Annual Inspection, Testing & Maintenance Items are Completed in the Indicated Quarter A nnual
Annual Date Print Name Signature Form AES 2.3 Sept. 3, 2013 Annual Annual 1st 2nd 3rd 4th
NEW Welding Wet Spk 06.09.20.pdf Microsoft InfoPath - NFPA 25 Form AES 1 Cover Sheet 2013
Inspection, Testing, and Maintenance Cover Sheet NFPA25 as amended by CCR, Title 19 Property Information: Name: Occupancy/Use: Address: Construction Type: City: No. Stories:
ZIP: Year Constructed: Contact: Telephone: Contractor Information: Number of System Risers Name: Copy sent to: Address: Owner Date: City: Fire AHJ Date: State:
Contractor Date: Telephone: NOTES: 1)For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011 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) CA License#: Job #: Performed by:
Check box for each system inspected and enter the number of forms used for inspection. Check boxes (Fail or Pass) to indicate status of inspected system at end of inspection. Forms
Included with this Report NFPA 25 Chapter Number of Forms N/A Fail* Pass Automatic Sprinkler System 5 Standpipe and Hose System 6 Private Water Supply System 7 Fire Pump 8 Water Storage
Tank 9 Water Spray System 10 Foam Water Sprinkler System 11 Water Mist System 12 Concerns that are not deficiencies (i.e. Non-Sprinklered Areas) Yes No *See "Deficiencies and Comments"
section at end of each respective form. AES 1 September 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly
and Annual Report 1 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Address City St. Zip City License # Phone Contact Person SFM Job #
CSLB Misc. Riser Information Main Drain Test (Annual) Riser No. Location Riser Diameter Main Drain Diameter Initial Static Pressure Residual Pressure Final Static Pressure P,F,N/A This
building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass
F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Date Date Date 1.1 I Control Valves – Identification Sign 13.3.1 1.2 I Control Valves – Inspection 13.3.2
1.3 I Waterflow Alarm Devices 5.2.5 1.4 I Supervisory Devices 5.2.5 1.5 I Gauges (Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi
1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed
systems) 5.2.6 1.10 I General Information Sign (not required for system prior to 2007 edition of NFPA 13) 5.2.8 1.11 I Heat Tape 5.2.7 1.12 I Spare Sprinklers 5.2.1.4 1.13 I Fire Department
Connections 13.7 1.14 I Alarm Valves – Exterior Inspection 13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 1.16 I Backflow Preventers 13.6.1 1.17 I Small Hose Connections - Hose Valve*
5.1.6, 13.5.2 13.5.5.1 1.18 I PRV – Fire Sprinkler Systems 13.5.1.1 *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include
Class I, II, or III standpipe systems. Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly
and Annual Report 2 of 3 Property Information Contractor or Licensed Owner Information Building Name Name Address Job # City ANNUAL INSPECTION, TESTING, AND MAINTENANCE Include ALL
Quarterly Inspections I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item Description NFPA 25 CA ed. Reference Date Comments Only
P,F,N/A 1.19 I Sprinklers 5.2.1 1.20 I Buildings (Freeze Protection) 4.1.1.1 Owner’s Responsibility 1.21 I Pipe and Fittings 5.2.2 1.22 I Hangers 5.2.3 1.23 I Seismic Braces 5.2.3 2.1
T Field Service Test Required (Send Report to Fire Code Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab 2.2 T Recalled Sprinklers If not present = Pass;
If present = Fail Title 19 904.1(c) 2.3 T Water Flow Alarm Devices 90 sec. maximum - (Enter Time ) 5.3.3 13.2.6 sec. 2.4 T Main Drain Test (Enter data on Page 1 of this form)
13.2.5 13.3.3.4 2.5 T Control Valve - Position 13.3.3.2 2.6 T Control Valve – Operation 13.3.3.1 2.7 T Supervisory Devices 13.3.3.5 2.8 T Backflow Preventer Assemblies 13.6.2 2.9 T
Small Hose Connections* w/PRV Hose Valves – Partial Flow Test 13.5.2.3 13.5.3.3 2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 3.1 M Control Valves 13.3.4 3.2 M Small Hose Connections*
13.5.6.3 3.3 M Obstruction Investigation required (If “Yes”, see Deficiencies and Comments Section for Results.) 14.3 Yes No 3.4 M System Returned to Service 4.5.3 Yes No * Small
hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems. D = Deficiency C = Comment
(Indicate type ) Item Date Riser D C Deficiencies and Comments Indicate all equipment, devices and parts that were repaired or replaced Form AES 2.1 Sept. 3, 2013 Wet Pipe Fire Sprinkler
System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance Quarterly and Annual Report 3 of 3 Property Information Contractor or Licensed Owner Information
Building Name Name Address Job # City D = Deficiency C = Comment (Indicate type ) Item Date Riser D C Deficiencies and Comments (cont.) Indicate all equipment, devices and parts
that were repaired or replaced Check here if additional Deficiencies and Comments are listed on Form AES9 See Correction Form AES 10 for corrected deficiencies. Number attached: Number
attached: I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance
with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form. Check box if Annual Inspection,
Testing & Maintenance Items are Completed in the Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual Date Print Name Signature Form AES 2.1 Sept. 3,
2013
Discrepancy Report Butte College spk 06.09.20.pdf
530-624-4514 Page _____ of _____ CUSTOMER: Site Name Inspection # Page # & Note # Discrepancy Description Voltage Cost to Repair Notes Date Quote given to customer Owner opt to Repair?
Date Repaired INSPECTION TYPE: INSPECTION DATE: INSPECTION DISCREPANCY REPORT 530-624-4514 Page _____ of _____ CUSTOMER: Site Name Inspection # Page # & Note # Discrepancy Description
Voltage Cost to Repair Notes Date Quote given to customer Owner opt to Repair? Date Repaired INSPECTION TYPE: INSPECTION DATE: INSPECTION DISCREPANCY REPORT