HomeMy WebLinkAboutFAI15-0097 Hydrant 2020 Private Fire California Code of Regulations -Title 19 Quarterly and 1 of 2
Service Main Inspection, Testing, and Maintenance Annual Report
Property Information g — �fiQ‘
�,<<cS. Contractor or Licensed Owner Information
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'Building Name Feather Falls Casino&Lodge I i [ 1 , Name Foothill Fire Protection, Inc.
'Address I +Fi/kr �141 Address 4000 Alvis Court
3 Alverda Drive ti‘ R=` City Rocklin St. CA Zip 95677
'City Oroville CA 95966 (License# 783132 (Phone (916)663-3582
'Contact Person Damon Pound I ❑ SFM IJob#20292831
'Phone(530)533-3885 I ❑ CSLB 'Misc.
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Quarterly Inspections
I = Inspection T=Test M=Maintenance P=Pass F=Fail N/A =Not Applicable
NFPA 25 CA Date Date Date Date
Item Description ed.
Reference 12/28/20
1.1 I Control Valves—Identification Sign 13.3.1 N/A
1.2 I Control Valves—Inspection 13.3.2 P
1.3 I Hose Houses 7.2.2.7 N/A
1.4 I Fire Department Connections 13.7 P
1.5 I Pressure Reducing Valves 13.5.1.1 N/A
1.6 I Backflow Preventers 13.6.1 N/A
1.7 I Supervisory Devices 13.3.3.5.1 N/A
1.8 I Monitor Nozzles 7.2.2.6 N/A
ANNUAL INSPECTION, TESTING, AND MAINTENANCE
Include ALL Quarterly Inspections
I = Inspection T =Test M =Maintenance P=Pass F=Fail N/A =Not Applicable
NFPA 25 CA ed
Item Description . Date Comments Only P,F,N/A
Reference
1.9 I Hydrants 7.2.2.4 12/28/21 N/A
(Dry Barrel and Wall) Table 7.2.2.4
1.10 I Hydrants 7.2.2.5
(Wet Barrel) Table 7.2.2.5 12/28/21 (3) Hydrants on site I P
1.11 I Mainline Strainers 7.2.2.3 12/28/21 I P
Table 7.2.2.3
1.12 I Piping (Exposed) 7.2.2.1 12/28/21 I P
Table 7.2.2.1.2
1.13 I Piping (Underground) 7.3.1 12/28/21 P
1.14 I Hose NFPA 1962 12/28/21 1 N/A
2.1 T Control Valve-Position 13.3.3.1 12/28/21 P
2.2 T Control Valve-Operation 13.3.3 12/28/21 P
2.3 T Monitor Nozzles 7.3.3 12/28/21 N/A
2.4 T Hydrants-Flush 7.3.2 12/28/21 P
2.5 T Supervisory Devices 13.3.3.5 12/28/21 I N/A
2.6 T Backflow Preventer Assemblies 13.6.2 12/28/21 N/A
2 7 T Pressure Reducing Valve 13.5.1.3 12/2$/21 P
(Partial Flow Test)
3.1 M Control Valves 13.3.4 12/28/21 P
3.2 M Mainline Strainers 7.2.2.3 12/28/21 P
Form AES 4 Sept.3,2013
Private Fire California Code of Regulations -Title 19 Quarterly and 2 of 2
Service Main Inspection, Testing, and Maintenance Annual Report
OF cA(!4,
Property Information 74. ',p iF Contractor or Licensed Owner Information
'Building Name Feather Falls Casino&Lodge i { J�i Name Foothill Fire Protection, Inc.
'Address 3 Alverda Drive 'j7\ �, Job# 20292831
'City Oroville ‘N,tE M —.
ANNUAL INSPECTION, TESTING, AND MAINTENANCE
Include ALL Quarterly Inspection
I = Inspection T =Test M=Maintenance P=Pass F=Fail N/A =Not Applicable
Item Description NFPA 25 CA ed. Date Comments Only P,F,N/A
Reference
3.3 M Hose Houses 7.2.2.7 12/28/2C N/A
Table 7.2.2.7
3.4 M Hydrants I 7.4.2 I12/28/2CI 3 hydrants on site I P
3.5 M Monitor Nozzles I 7.4.3 I12/28/2CI I N/A
Obstruction Investigation Required
3.6 M (If"Yes", see Deficiencies and Comments Section 14.3 12/28/2C ID
Nos N/A
for Results.)
4.5.3
3.7 M System Returned to Service 15.7 112/28/21[Yes❑ No I P
D=Deficiency C=Comment (Indicate type)
Deficiencies and Comments
Item Date Rise PC
Indicate all equipment,devices and parts that were repaired or replaced
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❑Check here if additional Deficiencies and Comments are listed on Form AES 9. Number attached:
❑ 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 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
— 1st 0 Ann.. 111111..91.111 ❑ Annu Annual
Date I12/28/2020
Print Name I Stephen Rampenthal I I I
Signature I Stephen Rampenthal I I
Form AES 4 Sept.3,2013