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Home My WebLink AboutFAI21-0009 CF Sprinkler 2021 Inspection, Testing, and Maintenance Cover Sheet NFPA25 as amended by CCR, Title 19 Property information: Name: CAL FIRE#11 Occupancy/Use: R3 2788 Humboldt Road Type I-B O :Calfotll, Address: Construction Type: , . , p Butte Meadow No. Stories: 11 . 'D City: `� ZIP. Year Constructed: 1997 "74,, L. -v Contact: Supervisor fiiii MpC Telephone: (530) 873-3429 Contractor Information: Number of System Risers Name: Wilgus Fire Control Inc. Copy sent to: Address: 1703 Sonoma Street X Owner Date 5/12/2021 City Redding 1 Fire AHJ Date 5/12/2021 CA ®Contractor Date 5/12/2021 State: NOTES: Telephone: (530) 241-2465 1)For specific inspection,testing,and maintenance requirements and information,see NFPA 25, 2011 CA License#: License#462979 Edition as amended by California Code of Regulations, Title 19,§901 to§906. Job#. 3044051221 2)Inspection items may be performed by the owner in Performed by. RUSTIN BARTH accordance with California Code of Regulations,Title 19, §904.1(a) 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. NFPA 25 Number of Forms NIA Fail* Pass Forms Included with this Report Chapter u 1 Automatic Sprinkler System 5 , ` 0 Standpipe and Hose System 6 Li 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 [i Concerns that are not deficiencies(i.e. Non-Sprinklered Areas) ❑ Yes X No *See"Deficiencies and Comments"section at end of each respective form. September 3,2013 AES 1 , .� • )- --- ` --�=�-� ��-�- --- -��--- ' ` `~ -.146440 .4- ~^._°~ �w�m� ' _ '^ - Wet Pipe California Code of Regulations - Title 19 Quarterly and Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report 1 of 3 Property Information ,;.cfc',--!moo Contractor or Licensed Owner Information Al t7' I "AN\-$4 Building Name CAL FIRE #11 ` C ;� " r Name Wilgus Fire Control Inc. Address 2788 Humboldt Road r4 %v .�'c„� -�� Address 1703 Sonoma Street ,.MP City Redding St. CA Zip 96001 City Butte Meadows License # 462979 Phone (530) 241-2465 Contact Person Supervisor ® SFM Job # 3044051221 ►Vi CSLB Misc. Riser Information Main Drain Test (Annual) Riser Riser Main Drain Initial Static Residual Final Static No. Location Diameter Diameter Pressure Pressure Pressure P,F,NIA 1 Barracks - Exterior Closet .75" NA NA NA NA N/A Li This building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached Quarterly Inspections 1 = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable 3s4. Item Description S'b:;;NFPA 9k, ed Date Date Date Date A :h ,.:::w.:. 11,:. 5/12/22 ;;.. 1.1 I Control Valves — Identification Sign 13.3.1 P 1.2 I Control Valves — Inspection 13.3.2 P 1 .3 I Waterflow Alarm Devices 5.2.5 P 1.4 I Supervisory Devices 5.2.5 N/A 1.5 I Gauges (Wet Pipe Systems) 5.2.4.1 N/A 1 .6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi NA psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi NA psi psi psi 1.8 I Pressure Readings Acceptable 5.2.4.1 N/A 1.9 I Hydraulic Design Information Sign 5.2.6 N/A (for hydraulically designed systems) 1 .10 I General Information Sign 5.2.8 N/A (not required for system prior to 2007 edition of NFPA 13) _ 1 .11 I Heat Tape 5.2.7 N/A 1.12 I Spare Sprinklers 5.2.1 .4 P 1.13 I Fire Department Connections 13.7 N/A 1.14 I Alarm Valves — Exterior Inspection 13.4.1 N/A 1.15 I Pressure Reducing Valves 13.5.1.1 N/A 1.16 I Backflow Preventers 13.6.1 N/A 1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2 N/A 13.5.5.1 1.18 I PRV — Fire Sprinkler Systems 13.5.1.1 N/A * 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 California Code of Regulations -Title 19 Quarterly and 2 of 3 Fire Sprinkler System Inspection,Testing, and Maintenance Annual Report ,oF CAc4 Contractor or Licensed Owner Information Property Information ti "''O h X3.7 ci'I ?s \z_ Building Name Cal Fire#11 ;rn(C II" Name Wilgus Fire Control Inc. Address 2788 Humboldt Road /tip,,w \/ 1rlf Job# 3044051221 City Butte Meadows �� E P= ' ANNUAL INSPECTION, TESTING,AND MAINTENANCE Include ALL Quarterly Inspections P =Test M= Inspection TMaintenance P=Pass F=Fail N/A=Not Applicable Item Desart. �. . � � • ... ;'• 4' Comments Only P,F,N/A 1.19 I Sprinklers 5.2.1 5/12/2021 F 5/12/2021 1.20 I Buildings(Freeze Protection) 4.1.1.1 Owner's Responsibility N/A 5/12/2021 1.21 I Pipe and Fittings 5.2.2 N/A 5/12/2021 1.22 I Hangers 5.2.3 N/A 1.23 I Seismic Braces 5.2.3 5/12/2021 N/A Field Service Test Required 5/12/2021 If REQUIRED, Enter'F' until 2.1 T (Send Report to Fire Code Official) 5.3.1 results are returned from Lab N/A Recalled Sprinklers Title 19 5/12/2021 N/A 2.2 T If not present=Pass; If present=Fail 904.1(c) / 2.3 T Water Flow Alarm Devices 5.3.3 5/12/2021 90 sec. maximum - (Enter Time) 13.2.6 20 sec. P Main Drain Test 13.2.5 5/12/2021 2.4 T (Enter data on Page 1 of this form) 13.3.3.4 N/A 2.5 T Control Valve-Position 13.3.3.2 5/12/2021 P 2.6 T Control Valve—Operation 13.3.3.1 5/12/2021 P 2.7 T Supervisory Devices 13.3.3.5 5/12/2021 N/A 2.8 T Backflow Preventer Assemblies 13.6.2 5/12/2021 N/A 2.9 -r Small Hose Connections' 13.5.2.3 5/12/2021 N/A w/PRV Hose Valves—Partial Flow Test 13.5.3.3 2.10 T PRV—Fire Sprinkler Systems 13.5.1.3 5/12/2021 N/A 3.1 M Control Valves 13.3.4 5/12/2021 N/A 3.2 M Small Hose Connections* 13.5.6.3 5/12/2021 N/A Obstruction Investigation required 5/12/2021 Yes N/A 3.3 M (If"Yes' see Deficiencies and Comments Section 14.3____ n for Results.) I_j No 5/12/2021 [Yes 3.4 M System Returned to Service 4.5.3ji] No P * 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) eficienddes and Comments �� r DC Indicate all egwl;me,t (rajices andparts th.3t v..,ere repaired or replaced ,x ,. XFire FX 300 storage tank X NO GAUGE/No main drain or inspectors test/NOT FREEZE PROTECTED/Local alarm only X 30 CHROME QUICK RESPONSE SPRINKLER HEADS DUE FOR 20 YEAR REPLACEMENT XMultiple sprinklers are painted and/or corroded Form AES 2.1 Sept.3,2013 Wet Pipe California Code of Regulations-Title 19 Quarterly and 3 of 3 Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report Property Information �40F"cA�!p41 Contractor or Licensed Owner Information IA Building Name Cal Fire#11 ti �'� , Name Wilgus Fire Control Inc. Address 2788 Humboldt Road Job# 3044051221 City Butte Meadows 14 0 D=Deficient C=Comment Indicate t •e) item Deficiencies and Comments(cant) Riser Indicate ail equipment,devices and pails that were repaired or replaced.. XControl valve not locked or monitored Storage tank has no freeze protection • • Li Check here if additional Deficiencies and Comments are listed on Form AES9 Number attached Li See Correction Form AES 10 for corrected deficiencies. Number attached: 1 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 Quarters " A�? i• _Annuarf; � �' qua' 4th+ Annual Date 5/12/21 Print Name Rustin Barth Signature Form AES 2.1 Sept.3,2013