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Home My WebLink AboutFAI15-0072 040-180-062 CF FS 8-16-2022 Durham HS t Inspection,Testing, and Maintenance Cover Sheet NFPA25 as amended by CCR, Title 19 741. Pr• • • 00 _,.1 •iit.,,• 1* I Name: %L ,an, lln,-I+rj Srl,,,,1 ilu}r.L# Occupancy/Use: 6yr ./ ......54M4 _ ��`, , Address: dl Z9 FJ�rnai Oil. Construction Type: Masan y�of eaC/k i O 0.$:.1.4 City: INW0,""'m No. Stories: 2 IF rn n/ 1 ZIP: q5 933 Year Constructed: tw1:/J 1i1 1 P ` f��i i ‘‘��RE Mp Contact: fi,i Telephone: ,714.4-460'-1 New Gyvr' Contractor Information: 1.01.1RisersilliMIIIIMI Name: Hayden Fire Protection Copy sent to: Address: 2515 Zanella Way#5 ❑Owner Date: City: Chico ❑Fire AHJ Date: State: CA ❑Contractor Date: NOTES: Telephone: 1-800-417-0440 1) For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011 CA License#: C-16 827131 Edition as amended by California Code of Regulations, Title 19,§901 to§906. Job#: 2) Inspection items may be performed by the owner in Performed by: e�� EarKA.4..:L4, accordance with California Code of Regulations, Title 19, §904.1(a) r each sysliffi1 inspeetillandMinarMber of forms used for inspection. Check boxes(Fail or Pass)to indicate status of inspected system at end of inspection. Forms Included with this Report NFPA 25 Number of Forms WA Fair Pass Chapter ❑ Automatic Sprinkler System 5 0 ❑ ❑ Standpipe and Hose System 6 0 ❑ I ❑ Private Water Supply System 7 0 ❑ I ❑ ❑ Fire Pump 8 0 ❑ I ❑ ❑ Water Storage Tank 9 0 n I ❑ Water Spray System 10 0 Li ❑ I ❑ Foam Water Sprinkler System 11 0 ❑ I ❑ ❑ Water Mist System 12 0 ❑ n I ❑ Concerns that are not deficiencies(i.e. Non-Sprinklered Areas) El Yes I El No *See"Deficiencies and Comments"section at end of each respective form. AES 1 September 3.2013 Wet Pipe California Code of Regulations -Title 19 Quarterly and 1 of 3 Fire Sprinkler System Inspection,Testing, and Maintenance Annual Report Property Information •--4" caV 01' Contractor or Licensed Owner Information i/.7 o9Z4 Building Name 1,,o.r.% %tar.) 5ci-aal $ss•Iect 1 Name HAYDEN FIRE PROTECTION Address cIat� �„ � �� _ [ .,, { � Address 2-15ZANELLA WAY#5 - `%,��lehziE p C°� CHICO St CA Zp 95928 City , ,,,� (License# (Phone 1-800-417-0440 Contact Person Er,c I 0 SFM IJob# I ,15V1-4404 I 0 CSLB 'Misc. Riser Information Main Drain Test(Annual) 1�7I� • ' • "n initial Static Residual Final Static. �.1/ • Pressure Pressure Pressure I_ (Zed( V�3.1), cIosd- Li it 1" t I I I I 1 I I . I I I I I i - I I I I I I I I I I 1 I 1 I I I ri - This building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached Quarterly Inspections I =Inspection T=Test M=Maintenance P=Pass F=Fail N/A=Not Applicable _ Description 1.1 I Control Valves-Identification Sign 13.3.1 Q 1.2 I Control Valves-Inspection 13.3.2 t) 1.3 I Waterflow Alarm Devices 5.2.5 P 1- 1.4 I Supervisory Devices 5.2.5 N W 1.5 I Gauges(Wet Pipe Systems) 5.2.4.1 1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 -15- psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 --Ic psi psi psi psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1.9 I Hydraulic Design Information Sign (for hydraulically designed systems) 5.2.6 Ai N General Information Sign 1.10 I (not required for system prior to 2007 edition of NFPA 13) 5.2.8 N 0 1.11 I Heat Tape 5.2.7 ly y4 1.12 1 Spare Sprinklers 5.2.1.4 p 1.13 I Fire Department Connections 13.7 1.14 I 'Alarm Valves-Exterior Inspection 13.4.1 A(„ 1.15 I Pressure Reducing Valves 13.5.1.1 ^,v4 1.16 I ckckflow Preventers 13.6.1 N VA 1.17 1 [Small Hose Connections-Hose Valve* 5.1.6, 13.5.2 13.5.5.1 /V Vi 1.18 I IPRV-Fire Sprinkler Systems 13.5.1.1 .. U *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 Property Information �,,-.." C4C�,cO�rt Contractor or Licensed Owner Information :44"/10( �-pI, ( • Building Name 1►Wr r..1t1 t,r#�'d 4% ,,0 i 4, �� Name HAYDEN FIRE PROTECTION Address 4 i, `'' s l!ti fµyl�r. — 11kW rn► kt% 'N Job# (City �iVatn a. , p= ANNUAL INSPECTION, TESTING,AND MAINTENANCE Include ALL Quarterly Inspections 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, Reference 1.19 I Sprinklers 5.2.1 P 1.20 I I !Buildings(Freeze Protection) I 4.1.1.1 I'2 l- Owner's Responsibility Ai in 1.21 I I 'Pipe and Fittings I 5.2.2 I .l+i 11 1.22 I I 'Hangers I 5.2.3 I i !F t' 1.23 iI I (Seismic Braces I 5.2.3 I • I e 2.1 { T (Field Service Test Required I If REQUIRED, Enter'F'until I I (Send Report to Fire Code Official) 5.3.1 results are returned from Lab A. 2.2 I T IRecalled Sprinklers I Title 19 I I If not present=Pass, If present=Fail 904.1(c) { l� 2.3 I T IWater Flow Alarm Devices 90 sec. maximum - (Enter Time) I 5.3.3 13.2.6 I I sec. IMain Drain Test 13,2.5 I I 2.4 T IMain data on Page 1 of this form) 13.3.3.4 2.5 I T 'Control Valve-Position 13.3.3.2 I it. I 2.6 I T 'Control Valve—Operation 13.3.3.1 I ic I 10 2.7 I T 'Supervisory Devices 13.3.3.5 I i 6-7't I +I /H 2.8 I T IBackflow Preventer Assemblies 13.6.2 I e.,4.tit I Ae P, 2 9 I T (Small Hose Connections* I 13.5.2.3 1 I w/PRV Hose Valves—Partial Flow Test 13.5.3.3 -lc.-t t /i it'{Q 2.10 I T (PRV—Fire Sprinkler Systems 13.5.1.3 I „t-/1 Irli v9 3.1 I M 'Control Valves 13.3.4 I 4-17 I 3.2 I M 'Small Hose Connections* 13.5.6.3 I :::: 'Obstruction Investigation requiredYes �J3.3 M (if'Yes", see Deficiencies and Comments Sectionfor Results.) 14.3 No (� 3.4 M jsstem Returned to Service I 4.5.3 �� Yes I�- rt �No *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) Item Da Isar 1 C Deficiencies and Comments Indicate all equipment,devices and parts that were repaired or replaced II 1 I I $ ,1 I 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 t�Q�Ca��k�+ Property Information Contractor or Licensed Owner Information .,, .,� p , (Building Name r.r.. U'`•`:c.' 1C"-N13 1' t , i� Name HAYDEN FIRE PROTECTION 'Address qvi 42.A ner D.. - TtCW &yrtk I1 13 ,�i� Job# µ�- D=Deficienc C=Comment Indicate type) Item Date Riser D C Deficiencies and Comments(cont_) indicate all equipment devices and parts that were repaired or replaced /vo 5c4• • ; . (,c 34 S yew 'tote 0-e l. +,,y ev.r 101 �av yer.cif or ors�we,t . d {ta `i-s, [•vv+5� 1.ocK.* 3 or'IA Einul Ault, IA Check here if additional Deficiencies and Comments are listed on Form AES9 Number attached: ❑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 • 4th - ❑ Annual Date a-1 i•71 Print Name ?yitr, k:{c.?„tr.;- Signature I �� Form AES 2.1 Sept.3,2013