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Home My WebLink AboutFAI15-0062 Roseleaf 2018 5 year sprinkler SQUYRES Fire Protection P.O.Box 3176 • Chico,California 95927 • Phone(530)345-1012 • Fax(530)345-1630 Inspection, Testing, and Maintenance Cover Sheet NFPA25 taS amended by GCR, Titie 'I9 3 Name: /'Oleic? v/-.PWX Occupancy/Use: Address: /70o o. -Ct Construction Type: .t,, ,p City: de 4�/ No. Stories: = _ - P ° ZIP: ri"`6> Year Constructed: 5' F i , vim.. Contact: C��X �� Telephoner,f^ 22_0-..› - Contractor Into cation; Ns€ber of System Risers Brandon Squyres Name: Copy sent to: P.O, Box 3176 Ei Owner Date: Address: Chico 0 Fire AHJ Date: City: State: California 11 Contractor Date: NOTES: Telephone: (530)345-1012 1) For specific inspection,testing, and maintenance requirements and information,see NFPA 25, 2011 275206 Edition as amended by California Code of Regulations, CA License#: Title 19, §901 to§906. Job#: Quarterly / Annual IC-67.(;;) 2) Inspection items may be performed by the owner in Performed by: t7of--44;Q X3:14 accordance nce with California Code of Regulations,Title 19, §904.1(a) Check bxox for eocti•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 ; _.,,,,,,,,,,,,....,.,,,_,,,..,,,,,,r,‘„,,,,.7,, ,,-m .x, ur,.1 n 'f. :, ea i7. :.. . .R � 9r2,Nz*-:.N, - c :'Z' Forms Included with this Report Chapter /Number ofForrns NIA ' Fail* Pees /: Automatic Sprinkler System 5 7 — E el ❑ Standpipe and Hose System 6 _. E C ❑ Private Water Supply System 7E C O Fire Pump 8 E E E ❑ Water Storage Tank 9 — E C ❑ Water Spray System 10 — C C O Foam Water Sprinkler System 11 — C C ❑ Water Mist System 12 — C C oncerns that are not deficiencies(i.e. Non-Sprinklered Areas) CI Yes ' 'to 'See"Deficiencies and Comments" section at end of each respective form, QUYRE5 Fire Protection P.O. Box 3176 • Chico,California 95927 • Phone(530) 345-1012 • Fax(530)345-1630 Wet Pipe California Code of Regulations-Title 19 5-Year- 1 of 3 Fire Sprinkler System Inspection,Testing,and Maintenance Report O C�,� Contractor or Licensed Owner Information Property Information I.f.-. .�. x BuildingName .„,,,,,/t, '0(4. �',� �'is+ Name Brandon Squyres 1 P >+r rix 1 C;�?/ ;N,„j" f%+, Address P.O. Box 3176 +� ��I E M�-�� CityChico St. Ca Zip95927 Address 7,0 Zo License# 275206 Phone 530-345-1012 SFM Job# Contact Person C�r e E✓ CSLB C-16 Misc. '?�. ,, Ai NUtN. * 4:: Vii/ „ %ti6ar4s/, „ ;�/��/ //air/////lir / //. Riser Riser ' Main Drain Initial Static Residual Final Static P,F,N/A No. ��`°c °n Diameter Diameter Pressure Pressure Pressure 1w, / /�v wY YI zi; 7Sr Sr gU (/F/NA P/F/NA P/F/NA P/F/NA P/F/NA Li This building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached: itaa . � t � � „ �/./ ✓/ W � �.,. . . ,5 ,,. s /r ;i /irtif� i��/ i,//// ir1Y %// �� le . ss : o� grATI I.Inspection T=Test M=Maintenance P=Pass F=Fail N/A=Not Applicable NFPA 25 CA Item Description ed. Date Comments Only P,F,NIA Reference y 1.1 I Control Valves-Identification Sign 13.3.1 e--2C7s— F N/A 1.2 I Control Valves- Inspection 13.3.2 F N/A 1.3 I Waterflow Alarm Devices 5.2.5 F N/A 1.4 I Supervisory Devices 5.2.5 6)F N/A • 1.5 I Gauges(Wet Pipe Systems) 5.2.4.1 F N/A] 1.6 1 Hydraulic Design Information Sign 5.2.6 P F (For hydraulically designed systems) v , i 1.7 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi P F Ilk 1.8 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi F N/A) 1.9 I Pressure Readings Acceptable 5.2.4.1 0 F N/Ai 1,10 I General Information Sign 5.2.8 P F 0/ (not required for system prior to 2007 Edition NFPA 13) 1.11 I Heat Tape 5.2.7 P F t 1.12 I Spare Sprinklers 5.2.1.4 Ig F N/A 1.13 I Fire Department Connections 13.7 cf,0 F N/A 1.14 I Alarm Valves-Exterior Inspection 13.4.1 F N/A 1.15 I Pressure Reducing Valves 13.5.1.1 eP F / 1.16 I Backflow Preventers 13.6.1 P F N( ..,„„s. 4 SQES Fire Protection P.O. Box 3176 • Chico, California 95927 • Phone(530) 345-1012 • Fax(530)345-1630 Wet Pipe :- ' :i:. '' --: California Code of Regulations -Title 19 5 Year , ,„ Fire Sprinkler System 'Inspection,Testing, and Maintenance Report 4 ch ''' Property Information ..,--.6-f- A- Contractor or Licensed Owner Information I I I I I 111 I I I I I I I I I I I I I I I I I I I I I I I I I I I I 111 I I I ,fvt"--k,r'-'4 T.:(,);.% I =Inspection T =Test M=Maintenance P=Pass F=Fail N/A=Not Applicable Keterence 1.17 I Small Hose Connections-Hose Valve* gr-%--/r P F 0 1.18 I PRV-Fire Sprinkler Systems 13.5.1.1 P F PON 1,19 I Buildings (Freeze Protection) 4.1.1.1 Owner's Responsibility 1 F N/A 1.20 I Sprinklers 5.2.1 i: F N/A ' ' 1.21 I GphnWe,a'AouassiNeConcoa�dSpace 5.2.1.1.6 '. F N/A 1.22 ) Pipe and Fittings 5.2.2 _ F N/A 1.23 I Pipe and Fittings-Accessible Concealed Space 5.2.2.3 14 F N/A 1.24 I Hangers 5.2.31' F N/A 1.25 I Hangers-Accessible Concealed Space 5.2.3.3 4 F N/A 1.26 I Seismic Braces 5.2.3 a F N/A 127 I Seismic Braces-Accessible Concealed Space 5.23.3 ; F A - 1.28 I Unsprinklered Areas CFC 901.4 DYes n No 2 1 T Field GamjoeTeo R Required 5�1 If REQUIRED, Enter untilp 0� OendRepo�(o+oe:odoumu�/ results are returned from Lab Recalled Sprinklers Title 13 d� F N/A 22 T ~° � If not present=Pass �p,msont=Fa8 �O41(c) Water Flow Alarm Devices 5.3.3 /�. sec. F N/A 2.3 T 90oecsmau �n�rYno 132.6 �� `N1ain Drain Test 13.2.5 �� F N/A 2.4 T ��u,r6�,aonpago 1 of*`/soonn> 13 3�3�4 �� dh 2.5 T Control Valve'PosiUon 13.3.3.2 (..D F N/A __- - 2.6 T Contm|Va|ve-Opnnodon 13.3.3.1 @ F N/A `�` 2.7 T Supervisory �� Dovioes 13.3.3.5 F N/A 28 T Backflow Preventer Assemblies 13.6.2 P F I0 Small Hose Connections* 13,5.2.3 2.9 T P F qy` w/PRV HoaaVmivom-PartialF|owTeo� �3.5. 3 _ ur� 2.10 T PRV-Fire SprinNerSystems 13.5.1.3 P F /^�n 1 2.11 T Pressure Gauges-Calibration 5,3.2 m F N/A . '�. . 2.12 T SmmUHose Conne�ions° 13.5.6.2.2 �-' P F CIA ^ *Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or Ill standpipe systems. _ 4 SQUYRES Fire Protection EW P.O. Box 3176 • Chico, California 95927 • Phone(530)345-1012 • Fax(530)345-1630 Wet Pipe California Code of Regulations�•Title 19_ Year Fire Sprinkler System inspection, Testing, and Maintenance Report 3 of 3 Property Information0...fCq.-v � Contractor or Licensed Owner Information a. 1 ,iiy. mingiiiiiiiiimumimmimiim Building Name e • //w sr//e h - }y—, Name Brandon Squyres Address fro 2 ok- ' ,,\` - /r.,--- -,., )5; Job# '1:1 , 'C. 'FAQ'.-+' City a.),// L MP -> 4 ,,,,,,,,‘,,&-N,‘ -‘, :•.:< : -., : IIIIIIIIIIIIIIIIIIIIIIIIIIIIII -,.,...•E.. >..:re �,:wr:441,'Irrr✓".',":. :oii/-,1 /n't4o" /ooir i/o•ff•.'1,./ ,:.i ii7/•:..: *.z .- :/„l , , \'' ,,,,,, , ,- kt \ 3 ,::c',kk` l` �t , x / f.r '' /i/l/s r// //,',"(�/r///////r - •- \i \\ a�/i%/%�i//r//!/�//� i/!,' , MV' k,,i / /%r. j o r r� \• \,. p�3 �!/�� ;_: �w \\�` 0 :�� //////%/•r////, > .r •//i %`�ssyr /:..,.,z>i �'"-z,�,;,a.,b;,�-,„ah,:• s,�.�; ,.:• r< ,:M��r�/r.,,,,,,,,,� I =Inspection T =Test M= Maintenance P=Pass F=Fail N/A=Not Applicable MFPA 25 eA et d.on Date Item DescriptComments Only P,F,NIA • Reference 3.1 M Check Valves-Internal inspection 13.4.2 5'4`$ 9 F N/A 3.2 M Control Valves 13.3.4 1 F N/A 3.3 M FDC-Backflush 14.3.2.3 li F N/A 14.3.2.4 , p Internal Pipe Inspection-See Deficiencies and 3.4 Mal es a NIAComments Section for Results. 14.2 "`, No 3.5 M Obstruction Investigation Required. If"Yes", see 14 3F NIA Deficiencies and Comments Section for Results 3.6 M System Returned to Service 4.5.3 b Yes .9 F N/A No l� D=Deficiency C=Comment (Indicate type) item Date Riser D , CDeficiencies and comments Indicate at! equipment devices and parts that were repaired or replaced Li Check here if additional Deficiencies and Comments are listed on Form AES 9 Number attached: ' I See Correction Form AES 10 for corrected deficiencies. 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 fullyy operable except as noted in the "Deficiencies and Comments"section of this form. Print Name J9/17G-/ AIL Signature Dater`r--