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HomeMy WebLinkAboutFAI15-0097 CF FA Gym 2021 MOORETOWN RANCHERIA GYM_ Fire Alarm Supplement-INITIATING DEVICES_ 8-12-2021 (Semi-Annual).pdf Fire Alarm Supplementary Form Location Code:045-203-1493 Contact:RONALD BUTZ Contact Address:1 ALVERDA DR OROVILLE, CA 95966 Phone: Email:Ronald.Butz@mooretown.org Property Evaluated:MOORETOWN RANCHERIA GYM (Business) 1 ALVERDA DR OROVILLE, CA 95966 Description:Fire Alarm Supplement (INITIATING DEVICES) Company:Eagle Security Systems Address:3268 Esplanade Ste A Chico, CA 95973 Company Phone:530-345-6395 Inspector:Connor Dalton 152852 NICET I, Expires: 7/1/2023 Date of Work:8/12/2021 Frequency:Semi-Annual Attached Files There are no attachments for this submission Deficiency Summary There are no reported deficiencies for this submission General Comments There are no general comments for this submission VYANET Operating Group, Inc., 410 SW Columbia, Suite 120, Bend, OR, 97702 Phone: 541-812-6409Page 1 of 3 Eagle Security Systems 3268 Esplanade Ste A Chico, CA 95973 Phone: 530-345-6395 Fire Alarm Supplementary Form The work covered on this form is (select one):Semi-Annual Date of Work8/12/2021 Account Information Facility Name: MOORETOWN RANCHERIA GYM Property Type: Business Location Code: 045-203-1493 Service Address: 1 ALVERDA DR, OROVILLE, CA, 95966 Owner: RONALD BUTZ Owner's Phone: Owner's Address: 1 ALVERDA DR, OROVILLE, CA, 95966 Legend PS - Pull StationSD - Smoke DetectorDD - Duct DetectorMM - Monitor Module (Ansul, temp, CO, etc) CM - Control ModuleWF - WaterflowTS - Tamper SwitchHD - Heat DetectorSC - Signal/Sounder Control OtherSPKR - SpeakersSTROBE - StrobesHORN - Horns/Horn-StrobesBATT - Batteries TypeTotalTestedNot Tested PassedFailedTypeTotalTestedNot Tested PassedFailed PS50500SD10100 WF11010 TypeAddressLocationNotesFrequencyLast TestedTest ResultsComments SD11 - FACUN/A WF31 - RiserSemi-Annual8/12/2021Pass PS4.11 - LobbyN/A PS4.21 - Gym EastN/A PS4.31 - Gym Stage NorthN/A PS4.41 - Gym Stage SouthN/A PS4.51 - Gym FrontN/A Comments Any deficiencies or other problems found with the devices must be explained using the comment specific for each device. Additional comments can be added here. Please see the summary section at the top of the form for the comments. ©2014 FormLink Systems, Inc., Fire Alarm Supplement v1.1Page 2 of 3 Eagle Security Systems 3268 Esplanade Ste A Chico, CA 95973 Phone: 530-345-6395 Inspector's Information Inspected ByConnor Dalton I state that the information on this form is correct at the time and place of my inspection, and that all equipment tested at this time was left in operating condition upon completion of this inspection except as noted in the Comments. Signature of Inspector Date8/12/2021 ©2014 FormLink Systems, Inc., Fire Alarm Supplement v1.1Page 3 of 3 MOORETOWN RANCHERIA GYM_ Fire Alarm Supplement-NOTIFICATION APPLIANCES_ 8-12-2021 (Semi-Annual).pdf Fire Alarm Supplementary Form Location Code:045-203-1493 Contact:RONALD BUTZ Contact Address:1 ALVERDA DR OROVILLE, CA 95966 Phone: Email:Ronald.Butz@mooretown.org Property Evaluated:MOORETOWN RANCHERIA GYM (Business) 1 ALVERDA DR OROVILLE, CA 95966 Description:Fire Alarm Supplement (NOTIFICATION APPLIANCES) Company:Eagle Security Systems Address:3268 Esplanade Ste A Chico, CA 95973 Company Phone:530-345-6395 Inspector:Connor Dalton 152852 NICET I, Expires: 7/1/2023 Date of Work:8/12/2021 Frequency:Semi-Annual Attached Files There are no attachments for this submission Deficiency Summary There are no reported deficiencies for this submission General Comments There are no general comments for this submission VYANET Operating Group, Inc., 410 SW Columbia, Suite 120, Bend, OR, 97702 Phone: 541-812-6409Page 1 of 3 Eagle Security Systems 3268 Esplanade Ste A Chico, CA 95973 Phone: 530-345-6395 Fire Alarm Supplementary Form The work covered on this form is (select one):Semi-Annual Date of Work8/12/2021 Account Information Facility Name: MOORETOWN RANCHERIA GYM Property Type: Business Location Code: 045-203-1493 Service Address: 1 ALVERDA DR, OROVILLE, CA, 95966 Owner: RONALD BUTZ Owner's Phone: Owner's Address: 1 ALVERDA DR, OROVILLE, CA, 95966 Legend PS - Pull StationSD - Smoke DetectorDD - Duct DetectorMM - Monitor Module (Ansul, temp, CO, etc) CM - Control ModuleWF - WaterflowTS - Tamper SwitchHD - Heat DetectorSC - Signal/Sounder Control OtherSPKR - SpeakersSTROBE - StrobesHORN - Horns/Horn-StrobesBATT - Batteries TypeTotalTestedNot Tested PassedFailedTypeTotalTestedNot Tested PassedFailed Bell10100HORN50500 STROBE20200 TypeAddressLocationNotesFrequencyLast TestedTest ResultsComments Bell11 - Riser ExteriorN/A HORN21 - LobbyN/A HORN31 - Gym EastN/A HORN41 - Gym NEN/A HORN51 - Gym NWN/A HORN61 - Gym SouthN/A STROBE71 - Men’s RRN/A STROBE81 - Women’s RRN/A Comments Any deficiencies or other problems found with the devices must be explained using the comment specific for each device. Additional comments can be added here. Please see the summary section at the top of the form for the comments. ©2014 FormLink Systems, Inc., Fire Alarm Supplement v1.1Page 2 of 3 Eagle Security Systems 3268 Esplanade Ste A Chico, CA 95973 Phone: 530-345-6395 Inspector's Information Inspected ByConnor Dalton I state that the information on this form is correct at the time and place of my inspection, and that all equipment tested at this time was left in operating condition upon completion of this inspection except as noted in the Comments. Signature of Inspector Date8/12/2021 ©2014 FormLink Systems, Inc., Fire Alarm Supplement v1.1Page 3 of 3 MOORETOWN RANCHERIA GYM_ Fire Alarm-FIRE-LITE MP1224_ 8-12-2021 (Semi-Annual).pdf Form for Inspection, Testing and Maintenance of Fire Alarms and Signaling Systems Location Code: 045-203-1493 Contact: RONALD BUTZ Contact Address: 1 ALVERDA DR OROVILLE, CA 95966 Phone: Email: Ronald.Butz@mooretown.org Property Evaluated: MOORETOWN RANCHERIA GYM (Business) 1 ALVERDA DR OROVILLE, CA 95966 Description: Fire Alarm (FIRE-LITE MP12/24) Company: Eagle Security Systems Address: 3268 Esplanade Ste A Chico, CA 95973 Company Phone: 530-345-6395 Inspector: Connor Dalton 152852 NICET I, Expires: 7/1/2023 Date of Work: 8/12/2021 Frequency: Semi-Annual Attached Files There are no attachments for this submission Deficiency Summary Please refer to the Deficiency Summary located on applicable Fire Alarm Supplementary Forms for additional deficiency details. General Comments There are no general comments for this submission VYANET Operating Group, Inc., 410 SW Columbia, Suite 120, Bend, OR, 97702 Phone: 541-812-6409 Page 1 of 4 Eagle Security Systems 3268 Esplanade Ste A Chico, CA 95973 Phone: 530-345-6395 Form for Inspection, Testing and Maintenance of Fire Alarms and Signaling Systems Separate forms are available for inspection, testing, and maintenance of the rest of the fire protection system of which the fire alarms and signaling systems are a part. More frequent inspection, testing, and maintenance may be necessary depending on the conditions of the occupancy and the water supply. Notes: All questions are to be answered Yes, No, or Not Applicable. All "No" answers are to be explained in the Comments for this form. 1. Refer to NFPA-72 for specific inspection frequency requirements for the different components. 2. The work covered on this form is (select one): Semi-Annual Date of Work 8/12/2021 All responses refer to the current work (inspection, testing and maintenance) performed on this date. 1. Property Information Owner: RONALD BUTZ Owner's Phone Number: Owner's Address: 1 ALVERDA DR, OROVILLE, CA, 95966 Property Being Evaluated: MOORETOWN RANCHERIA GYM (Business) Property Address: 1 ALVERDA DR, OROVILLE, CA, 95966 Assembly Description: Fire Alarm (FIRE-LITE MP12/24) 2. Owner's Section A. Are the fire alarms and signaling systems in service? Yes No B. Have fire alarms and signaling systems remained in service since the last inspection? Yes No C. Was the system (of which the fire alarm and signaling systems are a part) free of actuation of devices or alarms since the last inspection? Yes No D. The required record documents are available and include the current revisions of all fire alarm software and the revisions of software of any systems with which the fire alarm software interfaces? Yes No Owner or Representative Ronald Butz Signature Date 8/12/2021 3. Monitoring Information Monitoring organization: Vyanet Address: Phone: 541-241-1800 Fax: Email: Account number: 203-1493 Phone line 1: 530-533-4292 Phone line 2: 530-533-4293 Means of transmission: Pots Entity to which alarms are retransmitted: Phone: 4. System Information 4.1 Control Unit: Manufacturer: Radionics Model number: D7024 4.2 Software and Firmware Revision number: 2.03 4.3 System Power: 4.3.1 Primary (Main) Power: Nominal voltage: 120 Amps: 20 Location: Panel A Overcurrent protection type: Breaker Amps: 20 Disconnecting means location: #26 4.3.2 Secondary Power: Type: Battery Location: Panel Battery type (if applicable): Lead-acid Nickelcadmium Primary (dry cell) Sealed lead-acid Calculated capacity of batteries to drive the system: In standby mode (hours): In alarm mode (minutes): 5. Notifications Made Prior To Testing Contact Time Monitoring organization: Vyanet 1100 Building management: Onsite 1100 Building occupants: Onsite 1100 Authority Having Jurisdiction: Ahj 1100 Other, if required: NFPA 72 v1.0 Page 2 of 4 Eagle Security Systems 3268 Esplanade Ste A Chico, CA 95973 Phone: 530-345-6395 6. Testing Results 6.1 Control Unit and Related Equipment Description Visual Inspection Functional Test Results Control unit Yes No Yes No Pass Fail N/A Lamps/LEDs/L CDs Yes No Yes No Pass Fail N/A Fuses Yes No Yes No Pass Fail N/A Trouble signals Yes No Yes No Pass Fail N/A Disconnect switches Yes No Yes No Pass Fail N/A Ground-fault monitoring Yes No Yes No Pass Fail N/A Supervision Yes No Yes No Pass Fail N/A Local annunciator Yes No Yes No Pass Fail N/A Remote annunciators Yes No Yes No Pass Fail N/A Remote power panels Yes No Yes No Pass Fail N/A Other: Yes No Yes No Pass Fail N/A 6.2 Secondary Power Description Visual Inspection Functional Test Results Battery condition Yes No Yes No Pass Fail N/A Load voltage Yes No Yes No Pass Fail N/A Discharge test Yes No Yes No Pass Fail N/A Charger test Yes No Yes No Pass Fail N/A Remote panel batteries Yes No Yes No Pass Fail N/A 6.3 Alarm and Supervisory Alarm Initiating Device Complete supplementary device test form for all initiating devices. 6.4 Notification Appliances Complete supplementary appliance test form for all notification appliances. 6.5 Interface Equipment Complete supplementary interface component test form for all interface components. Circuit Interface / Signaling Line Circuit Interface / Fire Alarm Control Interface 6.6 Supervising Station Monitoring Description Yes/No Time (sec) Results Alarm signal Yes No 43 Pass Fail N/A Alarm restoration Yes No 40 Pass Fail N/A Trouble signal Yes No 38 Pass Fail N/A Trouble restoration Yes No 37 Pass Fail N/A Supervisory signal Yes No Pass Fail N/A Supervisory restoration Yes No Pass Fail N/A 6.7 Public Emergency Alarm Reporting System Description Yes/No Time (seconds) Results Alarm signal Yes No Pass Fail N/A Alarm restoration Yes No Pass Fail N/A Trouble signal Yes No Pass Fail N/A Trouble restoration Yes No Pass Fail N/A Supervisory signal Yes No Pass Fail N/A Supervisory restoration Yes No Pass Fail N/A 7. Notifications That Testing Is Complete Contact Time Monitoring organization: Vyanet 1145 Building management: Onsite 1145 Building occupants: Onsite 1145 Authority Having Jurisdiction: Ahj 1145 Other, if required: 8. System Restored To Normal Operation Date: 8/12/2021 Time: 1145 9. Comments Any "No" answers, test failures or other problems found with the fire alarm system must be explained using the comment specific for each question. Additional comments can be added here. Please see the summary section at the top of the form for the comments. NFPA 72 v1.0 Page 3 of 4 Eagle Security Systems 3268 Esplanade Ste A Chico, CA 95973 Phone: 530-345-6395 10. Inspector's Information Inspected By Connor Dalton I state that the information on this form is correct at the time and place of my inspection, and that all equipment tested at this time was left in operating condition upon completion of this inspection except as noted in the Comments. This system as specified herein has been inspected and tested according to NFPA 72, 2013 edition, Chapter 14. Signature of Inspector Date 8/12/2021 NFPA 72 v1.0 Page 4 of 4