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HomeMy WebLinkAboutFAI21-0019 078-170-063 CFFS Church Of The Nazarene-Oroville-2023-9 FS Inspection,Testing, and Maintenance Cover Sheet • NF PA25 as amended by CCR,Title 19 Name: `4)9-0 kN&Z-0 61.l42C.t'L Occupancy/Use. Li ak-t (}G�2QR-i I Address: Z23 lk tQ-V 1,St& - Construction Type: Clru2c '• i 49 CgC/�pI 'zi1 Z/ City: _ (1.t 1 Vk Z No. Stories: 1 i co r D i ZIP: 5Q(� Year Constructed: 1 q'55 5 1�v .\ • ;y/'� a ARE woc-- Contact: `.� Telephone: S. �7 '33 — 14(Jt 1 I Lim, �l IQ ,,, x g: x� i a t' ✓ q3- t. :: c J �{',i"' 1 ,, Cie • . t t ix M1 t� " [� ' Iz• ,,. 'S tl nI ;Ss sK `� �z Name: Wilgus Fire Control Inc. Copy sent to: Address: 4544 Mountain Lakes Blvd. ❑Owner Date: City: Redding ❑Fire AHJ Date: State: California ❑Contractor Date: NOTES: Telephone: (530)241-2465 1) For specific inspection,testing,and maintenance requirements and information,see NFPA 25,2011 CA License#: 462979 Edition as amended by California Code of Regulations, Title 19, §901 to§906. Job#: '3(11(,Q .5-4 rrt 2)Inspection items may be performed by the owner in Performed by: (r t t.Q ( Lit-- accordance with California Code of Regulations,Title 19, §904.1(a) p 11-ET.4,1i•: f fir $_ itR dr %Yalta; #henumberoff)tiiiiusedforIns ect7�y�' 44,.�a,'i(T(1_:�_ • ,M- SZ"r.'..1 . tt: r.` -i • ans[�e.cled system.at a �µ1 of 1 5 echo ...-... ___.............._._ _,. - • • �___•_� _. _-.__v..,_._..... - ^_is': J..__4=�-C.. '.z�# 1YT2141_:�•L i. NFPA 25 Forms Included with this Report Number of Forms NIA , . Fail Pass Chapter: Automatic Sprinkler System 5 I I ❑ Standpipe and Hose System I 6 I I ❑ Private Water Supply System I 7 Li n I I ❑ Fire Pump I 8 L n ❑ Water Storage Tank I 9 I-1 ❑ Water Spray System I 10 n n ❑ Foam Water Sprinkler System I 11 Li I 1 ❑ ❑ Water Mist System I 12 l l n ❑ Concerns that are not deficiencies (i.e. Non-Sprinklered Areas) E Yes ❑ No d atsr�.Ae i a 1AfM.gPtr r s e r e four-1 _ . . • .._ - .4--.:._47'_ AES 1 September 3,2013 Wet Pipe California Code of Regulations-Title 19 ■ Quarterly and 1 of 3 Fire Sprinkler System Inspection,Testing,and Maintenance El Annual Report Property Information ��� Contractor or Licensed Owner Information za- IBuilding Name fl R-D Oct�.Z Gkua-ON oi( /J 'Name Wilgus Fire Control Inc. 'Address ZZ3' ¶ .+ U ts-fq v4`�Q 'Address 4544 Mountain Lakes Blvd. NE Ma ICity Redding St. Ca Zip 96003 (City 0 Q&-k1 i l l 2. ''License# 462979 (Phone (530)241-2465 (Contact Person--11 em_ ID SFM IJob# -3 5-4 I n CSLB IMisc. Riser Information Main Drain Test(Annual) - k:. Riser Riser Main Drain Initial Static Residual Final Static Location P,F,N1A ��;` ; �:��:.�;;�,�„_ ,; Diameter_ Diameter Pressure Pressure Pressure \ II-illowS;Ylto t-tall I t-t it 12't I ►oc I ( c I - I P I I I I I I I I I I I I I I I I I I I I 0 This building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached I I Quarterly Inspections I =Inspection T=Test M=Maintenance P=Pass F=Fall N/A=Not Applicable t � �, r,:3 1 i ;' : ) �'. �� D B` Sit ,c c2;1p,: i � •3"�� 4r � a$iLi! : =r :. 1.1 I Control Valves—Identification Sign 13.3.1 P 1.2 I Control Valves—Inspection 1 13.3.2 e 1.3 I IWaterflow Alarm Devices 5.2.5 P 1.4 I Supervisory Devices 5.2.5 P • 1.5 I Gauges(Wet Pipe Systems) V 5.2.4.1 9 1,6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 -75-- psi psi psi psi 1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 I 00 psi psi psi psi 1.8 I Pressure Readings Acceptable 5.2.4.1 1 9 I Hydraulic Design Information Sign 5.2.6 (for hydraulically designed systems) t 1T 1.10 I General Information Sign 5 2 8 (not required for system odor to 2007 edition of NFPA 13) Q 1.11 I Heat Tape 5.2.7 it 14 lfti 1.12 I Spare Sprinklers 5.2.1.4 P 1.13 I Fire Department Connections 13.7 111111kP 1.14 I 'Alarm Valves—Exterior Inspection 13.4.1 1.15 I Pressure Reducing Valves 13.5.1.1 au ifi 1.16 I Backflow Preventers 13.6.1 e 1.17 I Small Hose Connections-Hose Valve* I 5.1.6 13:5.135.15.2 I N(A II I 1.18 I I IPRV—Fire Sprinkler Systems I 13.5.1.1 I - (it I I I 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 N Quarterly and 2 of 3 Fire Sprinkler System Inspection,Testing,and Maintenance El Annual Report Property Information ��CF caCi�o Contractor or Licensed Owner Information S. col Building Name p,Z C.im4 K ) (Name Wilgus Fire Control Inc. 1 (Address 2z 3 Ivlei' tQ_U tS1zi �`�Q (Job# 3 CQ 5 4 ICIry 020V 1 (l ARE MP I I ANNUAL INSPECTION,TESTING,AND MAINTENANCE Include ALL Quarterly Inspections I =Inspection T =Test M=Maintenance P=Pass F=Fail N/A=Not Applicable M .ti NFPA 25 CA ed. 'A- .1� Descript�ori' I Date ( Comments Only P,F,NIA �'��� Reference 1.19 I Sprinklers 5.2.1 ki_•.- 23 I P 1.20 I Buildings(Freeze Protection) 4.1.1.1 I I I Owner's Responsibility P 1.21 I Pipe and Fittings 5.2.2 I I P 1.22 I Hangers 5.2.3 I I I P I 1.23 I Seismic Braces 5.2.3 I I P I 2.1 T Field Service Test Required 5.3.1 I I If REQUIRED, Enter'F'until (Send Report to Fire Code Official) results are returned from Lab P 2.2 T Recalled Sprinklers Title 19 I I I If not present=Pass: If present=Fail 904.1(c)2.3 T rater Flow Alarm Devices 5.3.3 I I I "3 0 sec. P I 90 sec.maximum - (Enter Time) 13.2.6 2.4 T Main Drain Test 13.2.5 (Enter data on Page 1 of this form) 13.3.3.4 I I l I P 2.5 T Control Valve-Position 13.3.3.2 I I I P 2.6 T Control Valve—Operation 13.3.3.1 I I I P lI 2.7 T Supervisory Devices 13.3.3.5 I I p I 2.8 T Backflow Preventer Assemblies 13.6.2 I I I ((rt Small Hose Connections* 13.5.2.3 A 2.9 T w/PRV Hose Valves—Partial Flow Test 13.5.3.3 I I I jI fA 2.10 T PRV—Fire Sprinkler Systems 13.5.1.3 I I I IQ 1C I 3.1 M Control Valves 13.3.4 I I I P 3.2 M Small Hose Connections* 13.5.6.3 I I I I a l A Obstruction Investigation required Yes 3.3 M (lf"Yes",see Deficiencies and Comments Section 14.3 �No I I for Results.) 3.4 I M (System Returned to Service I 4.5.3 I ‘4( ([Yes I c 1 FIN° 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=Deficienc C=Comment (Indicate type) f Item Date Riser D C Indicate all equipment,devices d partsthat were repaired pr replaced 1. I I I I I 1 I I I I I 1 I I mini Form AES 2.1 Sept.3,2013 A Wet Pipe California Code of Regulations-Title 19 a Quarterly and 3 of 3 Fire Sprinkler System Inspection, Testing, and Maintenance n Annual Report Property Information ov Contractor or Licensed Owner Information r``t/ 9Z Building Name¢� � Z C�4�u12e y(! Name Wilgus Fire Control Inc. (Address ZZ3g W10i +L )i5 tO 9 _civ !Job# ';(11 2'S4{ (City ©PZ D=Deficient C=Comment (Indicate type) Item Date Riser D C Deficiencies and Comments(cent) Indicate all equipment,devices and parts that were repaired or replaced ❑I nIn L. 11I -1 LIILJ n nF nin nin Olin fin E1if�"1 LJiiu HE ❑I❑ nin Lill Check here if additional Deficiencies and Comments are listed on Form AES9 Number attached: See Correction Form AES 10 for corrected deficiencies. Number attached: I 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 • ; r . Date 1.3 a- Print Name _ _.._ Signatu Ifs• Form AES 2.1 Sept.3,2013