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HomeMy WebLinkAboutFAI15-0097 Fire Alarm Inspection 2020 1 1 OOTHILL FIRE '0, PROTECTION, INC. 4000 Alvis Court, Rocklin, CA 95677 (916) 663-3582 C10 #783132 INITIATING DEVICE SUPPLEMENTARY RECORD OF INSPECTION AND TESTING This form is a supplement to the System Record of Inspection and Testing. It includes an initiating device test record. This form is to be completed by the system inspection and testing contractor at the time of the inspection and/or test. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Inspection/Test Start Date/Time: 12/28/20 7:00 Inspection/Test Completion Date/Time: 12/29/3:30 Number of Supplemental Pages Attached: 1. PROPERTY INFORMATION Name of property: Feather Falls Casino & Lodge. (Detectors) Address: 3 Alverda Drive 2. INITIATING DEVICE TEST RESULTS Device Type Address Location Test Results Smoke 1 Main power room P Smoke 2 Main power room P Smoke 3 Main power room P 4 5 6 Smoke 7 FACP P Smoke 8 Lobby elevator 2nd floor Smoke 9 Service elevator 2nd floor Smoke 10 Lobby elevator electrical room Smoke 11 Lobby elevator 1st floor Smoke 12 Service elevator 1st floor Smoke 13 Service elevator basement Smoke 14 Service elevator electrical room Smoke 15 Old casino housekeeping closet P Smoke 16 Brewery lobby 1st floor Smoke 17 Brewery lobby 2nd floor 18 Smoke 19 Brewery elev. equip room Smoke 20 Ped link door P Smoke 21 Ped link door P Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 1 1 OOTHILL FIRE (''',) PROTECTION, INC. 4000 Alvis Court, Rocklin, CA 95677 (916) 663-3582 C10 #783132 INITIATING DEVICE SUPPLEMENTARY RECORD OF INSPECTION AND TESTING This form is a supplement to the System Record of Inspection and Testing. It includes an initiating device test record. This form is to be completed by the system inspection and testing contractor at the time of the inspection and/or test. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Inspection/Test Start Date/Time: 12/28/20 7:00 Inspection/Test Completion Date/Time: 12/29/20 3:30 Number of Supplemental Pages Attached: 1. PROPERTY INFORMATION Name of property: Feather Falls Casino & Lodge. (Modules) Address: 3 Alverda Drive 2. INITIATING DEVICE TEST RESULTS Device Type Address Location Test Results Pull station 1 Front entry (right) P Pull station 2 Front entry(left) P Pull station 3 Tribal entry(right) P Pull station 4 Tribal entry(left) P Pull station 5 West exit P Pull station 6 North exit P Supervisory 7 Garage panel(alarm) P Trouble 8 Garage panel(trouble) P Heat 15 Lobby elev. electrical room Heat 16 Service elev. electrical room Waterflow 17 Basement P:35 Tampers 18 Basement P Waterflow 19 Dry pipe P:2 Low air monitor 20 Dry pipe P Ansul 21 Kitchen stoves P Ansul 22 Kitchen fryers P Ansul 23 Kitchen ovens P Tamper 24 Dry pipe P Supervisory 25 Waterfall FM200 main entry closet P Monitor 26 Lobby elev. 2nd flr recall Monitor 27 Lobby elev. Pri. Recall Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 1 1 OOTHILL FIRE '0, PROTECTION, INC. 4000 Alvis Court, Rocklin, CA 95677 (916) 663-3582 C10 #783132 INITIATING DEVICE SUPPLEMENTARY RECORD OF INSPECTION AND TESTING This form is a supplement to the System Record of Inspection and Testing. It includes an initiating device test record. This form is to be completed by the system inspection and testing contractor at the time of the inspection and/or test. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Inspection/Test Start Date/Time: 12/28/20 7:00 Inspection/Test Completion Date/Time: 12/29/20 3:30 Number of Supplemental Pages Attached: 1. PROPERTY INFORMATION Name of property: Feather Falls Casino & Lodge (Modules) Address: 3 Alverda Drive 2. INITIATING DEVICE TEST RESULTS Device Type Address Location Test Results Monitor 28 Service elev. primary recall Monitor 29 Service elev. secondary recall Smoke dampers 30 Throughout bldg. Shunt trip 31 Lobby elevator Shunt trip 32 Service elevator Pull station 33 Security booth P Monitor 34 Upstairs access control P Pull station 35 Basement. Hall. Southwest P Monitor 36 Basement fire doors P Waterflow 37 Old casino riser P:62 Riser Tamper 38 Old casino riser P Supervisory 39 Server rm FM200 alarm above brewery P Trouble 40 Server rm FM200 trouble above brewery P Relay 41 HVAC Door holders 42 Brewery P Ansul 43 Brewery pizza P Ansul 44 Brewery stove/grill P Ansul 45 Brewery smoker P Duct detector 46 Rooftop RTU Relay 47 Sound booth Relay 48 Brewery elevator shunt Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 1 1 OOTHILL FIRE '0, PROTECTION, INC. 4000 Alvis Court, Rocklin, CA 95677 (916) 663-3582 C10 #783132 INITIATING DEVICE SUPPLEMENTARY RECORD OF INSPECTION AND TESTING This form is a supplement to the System Record of Inspection and Testing. It includes an initiating device test record. This form is to be completed by the system inspection and testing contractor at the time of the inspection and/or test. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Inspection/Test Start Date/Time: 12/28/20 7:00 Inspection/Test Completion Date/Time: 12/29/20 3:30 Number of Supplemental Pages Attached: 1. PROPERTY INFORMATION Name of property: Feather Falls Casino & Lodge (Modules) Address: 3 Alverda Drive 2. INITIATING DEVICE TEST RESULTS Device Type Address Location Test Results Relay 49 Brewery elev. secondary recall Relay 50 Brewery elev. primary recall Control 51 Old casino housekeeper closet P Trouble 52 Old casino housekeeper closet P Trouble 53 Old casino housekeeper closet P Heat 54 Brewery elev.Equip.room Supervisory 55 Server/MDF FM200 alarm P Supervisory 56 Server/MDF FM200 supervisory P Trouble 57 Server/MDF FM200 trouble P Supervisory 58 Buss. Data closet FM200 alarm P Trouble 59 Buss. Data closet FM200 trouble P Monitor 60 Hood Mongolian grill P Supervisory 61 Waterfall FM200 trouble P Supervisory 65 Slot tech fire alarm P Trouble 66 Slot tech trouble P Supervisory 67 Maintenance bldg. fire alarm P Trouble 68 Maintenance bldg.fire trouble P Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. 1 1 R E 0- PROTECTION, INC.C 4000 Alvis Court, Rocklin, CA 95677 (916) 663-3582 C10 #783132 INITIATING DEVICE SUPPLEMENTARY RECORD OF INSPECTION AND TESTING This form is a supplement to the System Record of Inspection and Testing. It includes an initiating device test record. This form is to be completed by the system inspection and testing contractor at the time of the inspection and/or test. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Inspection/Test Start Date/Time: 12/28/20 7:00 Inspection/Test Completion Date/Time: 12/29/20 3:30 Number of Supplemental Pages Attached: 1. PROPERTY INFORMATION Name of property: Feather Falls Casino & Lodge Address: 3 Alverda Drive. (Notes) 2. INITIATING DEVICE TEST RESULTS Device Type Address Location Test Results Simplex 4008 7,8 Garage Pnl. LIB ckt31 10 pulls Silent knight SK4 65,66 Slot Tech Pnl gaming ckt21 18 smokes,1 Pull Silent knight SK4 67,68 Maintenance.bldg Pnl bay2 ckt18 9 smokes,2 heats (4)FM200 panels (2) notifier RP2002 (1) Siemens FS250 (1)Ansul IQ301 Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. oOTHILL FIRE flo PROTECTION, INC. "of 4000 Alvis Court, Rocklin, CA 95677 (916) 663-3582 C10 #783132 SYSTEM RECORD OF INSPECTION AND TESTING This form is to be completed by the system inspection and testing contractor at the time of a system test. It shall be permitted to modify this form as needed to provide a more complete and/or clear record. Insert N/A in all unused lines. Attach additional sheets, data, or calculations as necessary to provide a complete record. Inspection/Test Start Date/Time: 12/28/20 7:00 Inspection/Test Completion Date/Time: 12/29/20 3:30 Supplemental Form(s)Attached: 5 (yes/no) 1. PROPERTY INFORMATION Name of property: Feather Falls Casino & Lodge Annual Address: 3 Alverda Drive Description of property: Name of property representative: Gary Address: Phone: (530) 533-3885 Fax: E-mail: damon.pound@featherfallscasino.com 2. TESTING AND MONITORING INFORMATION Testing organization: Foothill Fire Protection, Inc. Address: 4000 Alvis Court, Rocklin,CA 95677 Phone: (916)663-3582 Fax: (916)663-3583 E-mail: Monitoring organization: Voltage Specialists Central Station Address: Phone: (800)722-0364 Fax: E-mail: Voltage Specialists Account number: 47-3726 Phone line 1: Phone line 2: Means of transmission: I.P. Communicator Entity to which alarms are retransmitted: Cal fire Phone: 530 533-6363 3. DOCUMENTATION On-site location of the required record documents and site-specific software: FACP 4. DESCRIPTION OF SYSTEM OR SERVICE 4.1 Control Unit Manufacturer: Firelite Model number: MS92000DLS 4.2 Software and Firmware Firmware revision number: 5.3 4.3 System Power 4.3.1 Primary(Main)Power Nominal voltage: 120 Amps: 20 Location: Server room behind FACP Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. SYSTEM RECORD OF INSPECTION AND TESTING (continued) Overcurrent protection type: Breaker Amps: 20 Disconnecting means location: Pnl SP ckt32 4. DESCRIPTION OF SYSTEM OR SERVICE (continued) 4.3.2 Secondary Power Type: Battery Location: FACP Battery type(if applicable): Sealed lead acid capacity of batteries to drive the system: In standby mode(hours): 24 In alarm mode(minutes): 5 5. NOTIFICATIONS MADE PRIOR TO TESTING Monitoring organization Contact: Voltage specialists Time: 7:00 Building management Contact: Gary Time: 7:00 Building occupants Contact: Time: Authority having jurisdiction Contact: Time: Other,if Contact: Time: required 6. TESTING RESULTS 6.1 Control Unit and Related Equipment Visual Functional Description Inspection Test Comments Control unit 0 0 Lamps/LEDs/LCDs 0 0 Fuses ❑ ❑ Trouble signals 0 0 Disconnect switches ❑ ❑ Ground-fault monitoring 0 0 Supervision 0 0 Local annunciator 0 l= Remote annunciators 0 0 Exit doors Remote power panels 0 0 (4) FCPS24F ❑ ❑ 1 6.2 Secondary Power Visual Functional Description Inspection Test Comments Battery condition 0 0 lAll system batteries dated 12/9/20 Load voltage 0 p (2) 12v 8ah @FACP and all FOPS Discharge test 0 0 Charger test 0 0 Remote panel batteries 0 0 Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. SYSTEM RECORD OF INSPECTION AND TESTING (continued) 6. TESTING RESULTS (continued) 6.3 Alarm and Supervisory Alarm Initiating Device Attach supplementary device test sheets for all initiating devices. 6.4 Notification Appliances Attach supplementary appliance test sheets for all notification appliances. 6.5 Interface Equipment Attach supplementary interface component test sheets for all interface components. Circuit Interface/Signaling Line Circuit Interface/Fire Alarm Control Interface 6.6 Supervising Station Monitoring Description Yes No Time Comments Alarm signal 0 ❑ Alarm restoration 0 ❑ Trouble signal 0 ❑ Trouble restoration 0 ❑ Supervisory signal 0 ❑ Supervisory restoration 0 ❑ 6.7 Public Emergency Alarm Reporting System Description Yes No Time Comments Alarm signal ❑ ❑ N/A Alarm restoration ❑ ❑ Trouble signal ❑ ❑ Trouble restoration ❑ ❑ Supervisory signal ❑ ❑ Supervisory restoration ❑ ❑ Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution. SYSTEM RECORD OF INSPECTION AND TESTING (continued) 7. NOTIFICATIONS THAT TESTING IS COMPLETE Monitoring organization Contact: Voltage specialists Time: 3:30 Building management Contact: Gary Time: 3:30 Building occupants Contact: Time: Authority having jurisdiction Contact: Time: Other,if Contact: Time: required 8. SYSTEM RESTORED TO NORMAL OPERATION Date: 12/29/20 Time: 3:30 9. CERTIFICATION This system as specified herein has been inspected and tested according to NFPA 72,2013 edition,Chapter 14. Signed: Printed name: Stephen Rampenthal,Theo Thornton, Date: 12/29/20 Organization: Foothill Fire Protection, Inc. Title: Inspector Phone: (530) 826-3013 Qualifications(refer to 10.5.3): C10 License(#783132) 10. DEFECTS OR MALFUNCTIONS NOT CORRECTED AT CONCLUSION OF SYSTEM INSPECTION, TESTING, OR MAINTENANCE None 100% Pass 10.1 Acceptance by Owner or Owner's Representative: The undersigned accepted the test report for the system as specified herein: Signed: Printed name: Date: Organization: Title: Phone: Copyright©2012 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale or distribution.