HomeMy WebLinkAboutFAI19-0007 CF FS 5 YR 2018 QUYRE Fire Protection
P.O. Box 3176 • Chico,California 95927 • Phone(530)345-1012 • Fax(530)345-1630
Inspection, Testing, and Maintenance Cover Sheet
NFPA25 as amended by( CCR, Title 19
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Name: ZZ;, oD vp Occupancy/Use: I
Address; ea a Construction Type: ti4 CA o
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City: 1 C1 Ci c No. Stories; co _ ,:, 5;
ZIP: q S q i7 Year Constructed: I \
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Contact: E
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Telephone: G,�--" 550o
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Brandon Squyres
Name: Copy sent to:
Address: P.O. Box 3176 Ell Owner Date:
City: Chico ❑Fire AHJ Date:
State: California E]Contractor Date:
(530)345-1012 NOTES:
Telephone: 1) For specific inspection,testing, and maintenance
275206 requirements and information,see NFPA 25, 2011
CA License#: Edition as amended by California Code of Regulations,
Title 19, §901 to§906.
5 r)'
Job#: Quarterly / Annual / Yea
2) Inspection items may be performed by the owner in
Performed by: .3?-4P,G0 N 6 i OS accordance with California Code of Regulations,Title 19,
§904.1(a)
Z 3 0 1 a 1 C110: IF btJ(7C'f631 P ula *aS00:iti tir `0 k » :a• • a s h
a Ch bo eck xes(Fa:l or Pass)to i • t .<: • xY 1 •:
':*orrrisincludei wittl Chas Re. ort Chapter ` Number Fa o€ rins WA Pail*: R6ss
❑ Automatic Sprinkler System 5 L4 E E rii-
❑ Standpipe and Hose System 6 C C
❑ Private Water Supply System 7 — C
❑ Fire Pump 8 E _ C
❑ Water Storage Tank 9 ❑ C E
❑ W• ater Spray System 10 _ C E
❑ F• oam Water Sprinkler System 11 _ E
❑ W• ater Mist System 12 E E E
❑ Concerns*� that
��are
ynot deficiencies (i.e. Non-Sprinkleredi� Areas)�rr ® Yes ❑ No
4 8EDaj1'iehcees a`x,' CQ d.3 M,+ ;x �,y,a°,��'n'.,ifes $ I fi f< I. .. ;I3 II.. .,. ,,. .II.:.ri5` '`vy 1
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SQUYRES Fire Protection -
P.O. Box 3176 • Chico,California 95927 • Phone(530)345-1012 • Fax(530)345-1630
Wet Pipe California Code of Regulations -Title 19 S-Year 1 of 3
Fire Sprinkler System Inspection,Testing, and Maintenance Report
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Property Information ��.;-. L!� •p b Contractor or Licensed Owner Information
2'
Building Name`�tZZi� �00p Vp `��r IA i. Name Brandon Squyres
i9,# a %44 Address P.O. Box 3176
(Address 'Z G3 S— 1� E M��� City Chico St. Ca Zip 95927
License#
275206 1Phone 530-345-1012
I City 131C16,S I SFM IJob#
IContact Person I ✓j CSLB C-16 'Misc.
�, x
Riser Riser I Mtn Drain Initial Static Residual Final Static P,F,NIA
Location
No. Diameter Diameter Pressure Pressure Pressure
f I SOJTIfslOi rn2tOCL 14 i I l l I 6U I 6 I Go I3IF/NA
I I I I I I IP/F/NAI
I I I I I I IP/F/NAI
IP/F/NAI
I I I I I I IP/F/NAI
L; This building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached: I
,< � .,, t '�' .,. .6ti��i°¢�,� .,���rx,.E4§,s9,��rE`ydi. .l —'O.'� �i/i�ii ,. s � Jy 3 � '� k�,. ` F <
..� , ,. :., � »,. _< >"i/Gdo'/r.�/iiNlbi�i/ii/ar i .« n. :., r,,��aw, <;,<;
I=Inspection T=Test M=Maintenance I P=Pass F=Fail N/A=Not Applicable
NFPA 25 CA
item 1 Description ed. Date Comments Only P,F,NIA
Reference
1.1 I IControl Valves—Identification Sign 13.3.1 I l/Icc dJ 7 N/Al
1.2 I 'Control Valves— Inspection 13.3.2 I G/47/jg V F N/Al
1.3 I IWaterflow Alarm Devices 5.2.5 I i f ,)F N/Al
1.4 I Supervisory Devices 5.2.5 I I 1'F N/A
1.5 I !Gauges(Wet Pipe Systems) 5.2.4.1 I ('P)F N/A
Hydraulic Design Information Sign I P F , '.1
1.6 I (For hydraulically designed systems) 5.2.6II
1.7 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 I Olp(psi IP F 9
1.8 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 I 6V psi N/A
1.9 I Pressure Readings Acceptable 5.2.4.1 / P^ F N/A
1.10 I General Information Sign 5 2 8
(not required for system prior to 2007 Edition NFPA 13) P F f(V/H�
1.11 I Heat Tape 5.2.7 I P F 6141
�l
1.12 1 Spare Sprinklers 5.2.1.4 I OF N/A
1.13 I Fire Department Connections 13.7 I t
F N/A
I1.14 I Alarm Valves—Exterior Inspection 13.4.1IF N/A
I1.15 1 Pressure Reducing Valves 13.5.1.1 ' P F
I 1.16 1 Backflow Preventers 13.6.1 Nii/ ^J
IP F ("'
SQUYRES Fire Protection
P.O. Box 3176 • Chico,California 95927 • Phone(530)345-1012 • Fax(530) 345-1630
Wet Pipe California Code of Regulations -Title 19 5'Year 2 of 3
Fire Sprinkler System Inspection,Testing,and Maintenance Report
Property information �tiDFA�'�A Contractor or Licensed Owner Information
'Building - {" -. ) N:::
Brandon Squyres
(Addde g Name �IZZP'� �)?SG' IJ�
'2- B ST T �`.. f a-,
* -nth
`City `� I. C C-,S `
rii:"61,;;
�s���:i.�,. ^,Z: . .- �;. .,�; :... .,%..fr �.tir�ii� � j;,:ijyY�.�.1;.:.. ,� iaHy�ay�� � .`^sJ"�"�` .�� �'�"3tf1+ �s '-h 6 �,�g /i <%ygy�7%tN ,,.i1 ?s•. 3, Ilirr //`//T517,/ - ,,k/0,//% 00 //�/i i u,,,,, k v, s A. `,,0 } );, 5,!l..: . ., ';e7� ;. n� .�'sa�.'�.;1/�4' 4u$�c:r�t. � �!r/may oo.,.1y,&4/�/V6it ii r ia. ii;..,,<,��5•,•..,,.�.,«l.�t�s.tM�:r .a:�§Y..s.'��c.�:a.,�w,.,..... .,...:
= p = n P=Pass F=Fail N/A=Not Applicable
I —Ins ectron TTest M=Maintenance
NFPA 25 CA ed.
Item • Oescriptiopn Date 1 Comments Only I P,F,N/A
Reference
1.17 I Small Hose Connections Hose Valve* 5.1.6, 13,5.2 I / P F N/A
13.5.5.1 b-Z7'IV
1.18 I PRV- Fire Sprinkler Systems 13.5.1.1 I ( `P F N/A
1.19 I Buildings(Freeze Protection) 4.1.1.1 I Owner's Responsibility IP F N/A
1.20 I Sprinklers 5.2.1 I i IsOk P F N/A
1.21 i Sprinklers-Accessible Concealed Space 5.2.1.1.6 I (�27-t , fP F N/A
1.22 I Pipe and Fittings 5.2.2 1 I IP F N/Al
1.23 i Pipe and Fittings-Accessible Concealed Space 5.2.2.3 I 1 NP F N/A
1.24 I Hangers 5.2.3 I \ >P F N/A
1.25 I Hangers-Accessible Concealed Space 5.2.3.3 I ' P F N/A
1.26 I Seismic Braces 5.2.3 I P F N/A
1.27 j I Seismic Braces-Accessible Concealed Space 5,2.3,3 I P F N/A,
1.28 I Unsprinklered Areas CFC 901.4 I ) DYes 2 No i
2.1 I T Field Service Test Required
Send Report to Fire Code Official 5 3"1 results are returned from Lab P F NIA
2.2 I T Recalled Sprinklers Title 19 I w t F N/A
if not present=Pass; if present=Fail 904,1(c) `,tom
Water Flow Alarm Devices 5 3 3 G sec. (lt'JF NIA
2.3 T 90 secs max. Enter time 13.2.E ' I ` Tt
2.4 T Main Drain Test 13.2.5 -2�-is F N/A
(Enter data on Page 1 of this form) 13.3.3.4
2.5 a T Control Valve-Position 13,3.3.2 1 I OF NIA
2.6 I T Control Valve-Operation 13.3,3.1 I ,y N/A
2.7 1 T Supervisory Devices 13.3.3.5 I I --I OF N/A`
2.8 I T Backfiow Preventer Assemblies 13.6.2 I 6 2?.4 IP F N/A
2.9 I T Small Hose Connections 13.5.2,3 r F
w/PRV Hose Valves-Partial Flow Test 13.5.3.3 I IP
6.6
2.10 I T PRV-Fire Sprinkler Systems 13.5.1.3 I I IP F /A
2.11 f T Pressure Gauges-Calibration 5.3.2 OF NIA
13.5.6.2.2 I 10 IPFIi/Ai
2.12 T Small Hose Connections
*Small hose connections are hose valves and optional hose supplied by the fire sprinkled system. They do not include Class I, II, or III
standpipe systems.
IQUYRE Fire Protection
ini
P.O. Box 3176 • Chico,California 95927 • Phone(530)345-1012 • Fax(530)345-1630
"' title, •Irpe 1.,,II II I I III N'n Iliiil I(III Hi°((''JO,. rl( U IC ' II Ii rII 5Year
Fire Sprinkler System Inspec io.n, T•esting,
and Maintenance Report 3 9f 3
Property Information > Licensed Owner Information
p ftY ���� . C �S Contractor or
Building Name ?cZ2P� VP (� , ..„ )y, (Name Brandon Squyres
(Address `-- (3 5-1- t5. . ?`' Job#
City I to C.,S `�i'
r r� 's r/ ...! r !r/a /i irr
�'. � � �..��d � i//j i/jy/fir/ir�ii/�✓i '�� \
� .� � -;..,.,.,,.������!f!/i�/�/i�q'L•;q li������y!/////,�/i�iY.�&'�i�l�,csiia/� /s -.<..„thu;,�/y:,✓ :.E. a 3. �:i 3� ��� —��•.,.,i.. ,>d��������i/,/�������/
I =Inspection T =Test M =Maintenance P Pass F=Fail N/A=Not Applicable
NFPA 25 CA ed.
Item Description Date Comments OnlyI P,F,i+ilA
Reference
3.1 M 'Check Valves- Internal inspection 13.4.2 I6 Z7-{ �F N/A
3.2 M
IControl Valves 13.3.4 I f I fl�l F N/A
3.3 I M IFDC-Backflush I 14 14..33..2.2.43 I ) ) F N/A
[...Internal Pipe Inspection-See Deficiencies and Yes(r, F N/A
3.4 M Comments Section for Results. 14.2
3.5 I M I Obstruction Investigationand RCommentsequired. If"Yes", see I 14.3 F NIA
ciencies Section for Results II 17
'/
3.6 I M 'System Returned to Service I 4.5.3 I W
os f' )F N/A
DtDefici DateY C= s mentD (Indicate type)
C
Deficiencies and Comments
Indicate all equipment.devices and parts that were repaired or replaced
I I j
f I ,> NI-L CDaelk,G'(o>S5 t Yri> v14 'FFcit, D P•F401?-- 6--27-If31
I I� co pi -r I r- �PtJ "1`I
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Li Check here if additional Deficiencies and Comments are listed on Form AES 9 Number attached:
ElSee Correction Form AES 10 for corrected deficiencies. Number attached:
l 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.
IPrint Name j ` t Pv, (vp 05 1
Signature q7. __, /7 `� Date 6 -2'