HomeMy WebLinkAboutFAI15-0097 Sprinkler, Hydrant, Standpipe, FM200 Inspection 2022 JOB SUMMARY OOTHILL FIREPROTECTION,INC.fi
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DEI N.a$TAL4T10a•WM •IMIALl
From Foothill Fire Protection,Inc.
170 Erma Court
Chico,CA 95928
(530)826-3013
ffprotection.com
Job No. 23841562 Job For Feather Falls Casino&Lodge
Date 2/21/2022 Feather Falls Casino&Lodge
Type Inspection 3 Alverda Drive
PO No. Oroville,CA 95966
Job Description
Annual Sprinkler-FAIL
Annual Fire Hydrant-PASS
Annual Standpipe-PASS
Semi Annual FM200-PASS
Deficiencies
NEW Description:
(13)painted/corroded Sprinklers.(10)outdated gauges.Multiple loaded Sprinklers throughout facility.
Deficient
DISCOVERED
12/29/2020
8:23 PM
NEW Description:
gam' 3 Alverda Dr.Annual Sprinklers Failed
Deficient
DISCOVERED
02/21/2022
10:24 AM
Comments
Mandy Hill
03/07/2022 10:48am PST
Please find attached the most up to date report for your site.During the process of our inspection we found deficiencies.We have
included a brief description of these deficiencies.A quote will be sent out to you shortly to fix these deficiencies.
Disclaimers and Warranties
All inspections and testing are to comply with California Title 19.the current adoption of CA NFPA 25.and or NFPA 72 reaulrements as appropriate and described.
will become part of the original contract and are subject to the terms.Time is of the essence as to payment under this contract.Therefore,timely payments are an expressed
condition precedent to further performance.Non-payment shall therefore be considered prevention of performance.Payment shall be immediately made after the general receives
payment from the owner or financing from a banking institution,however under no circumstances,even if payment is forthcoming,may the general delay payment for more than ten
(10)days after receipt of billing from the subcontractor.If the subcontractor is not paid herein described,he has the right to stop further work.In the event it becomes necessary to
employ the services of an attorney to enforce this obligation,the signer agrees to pay reasonable attorney fees.In the event of a failure to pay within ten(10)days of the date of the
billing FOOTHILL FIRE PROTECTION,Inc.may stop work on the project,and the signer waives any claims for damages against FOOTHILL FIRE PROTECTION,Inc.in the event of
cessation of work for the reasons stated above.Interest will be charged at the maximum rate allowed by law,on past due payment.NOTE:If you accept this bid and submit your
contract using these figures alone,the entire terms of this bid proposal form are included and incorporated into your contract regardless of whether all these terms are stated in the
contract you submit for the signature of FOOTHILL FIRE PROTECTION,Inc.
FOOTHILL FIRE PROTECTION,Inc.Liability:User agrees to compensate FFP for any additional installation/service visits required because of cancellation,readiness,or
unavailability at the company's current prevailing rate.FFP does not represent nor warrant that the system as inspected may not be compromised nor circumvented,that the
system as inspected,repaired,or installed will prevent any loss by fire or otherwise,or that the system will in all cases provide the protection for which it is installed or intended.FFP
shall not be liable for any loss or damage caused to person or property of purchaser of the person or property of others which shall be caused by any damage which the system is
designed to avert or protect against.From the nature of the system inspected,repaired it is impractical and extremely difficult to fix the actual damage,if any,which may
approximately result from the failure of the system to operate or upon the failure of FFP to perform any of its obligations with a resulting loss to the owner or anyone else.In the
event FFP shall be found liable for loss or damage due to failure on the part of FFP or of the system in respect,the liability of FFP shall be limited to the sum of$250.00,pursuant to
the existing agreement,as liquidated damages and not as penalty,and this liability shall be exclusive.
**LIMITATION OF""LIABILITY"The contractor makes no warranties,expressed or implied,including,without limitation,warranties of merchantability and/or fitness for a
particular purpose.No promise not contained herein,or affirmation of fact made by an employee,agent or representative of the Company shall constitute a warranty by the
Company or give rise to any liability or obligation.Contractors liability to Subscriber for personal injury,death,or property damage arising from performance under this contract
shall be limited to the contract price.Subscriber shall hold Company harmless from all third-party claims for personal injury,death,or property damage arising from Subscribers
failure to maintain these systems or keep them in operative condition,whether based upon contract,warranty,tort,strict liability or otherwise.In no event shall the Company be
liable for any special,indirect,incidental,consequential,or liquidated,penal or any economic damages of any character,including but not limited to loss of use of the Subscribers
property,loss of profits or loss of production,whether claimed by the Subscriber or any third party,irrespective of whether claims or actions for such damages are based upon
contract,warranty,negligence,tort,strict liability or otherwise
**NOTICE"Under the Mechanics Lien Law(California Code of Civil Procedure,Section 1181 et seq.)any contractor,laborer supplier or other person who helps to improve your
property but is not paid,for his work or supplies,has a right to enforce a claim against your property.This means that,after a court hearing,the sale is used to satisfy the
indebtedness.This can happen even if you have paid your own contractor in full,if the subcontractor,laborer,or supplier remains unpaid.
II III Iml,.iiiliI ....stitig., wm : „l" ii.•i 1!III Ii ,0111Ip_II •,1 iP ,
NFPA25 as amended by CCR, Title 19
Property Information:
Name: Feather Falls Casino& Lodge Occupancy/Use:
3 Alverda Dr Of l./,�
Address: Construction Type: �fiV' �gpII/
City: Oroville No.Stories: 3 1 D 1
ZIP: 95966 Year Constructed: Il+t; `_� Qi��
Contact: Damon Pound ��\�R` WIN----'
Telephone: (530)533-3885
1 Contractor Information: Number of System Risers [
Name: Foothill Fire Protection, Inc. Copy sent to:
Address: 170 Erma Ct E Owner Date: 02/21/22
City: Chico ElFire AHJ Date:
CA ❑Contractor Date:
State:
(530)826-3013 NOTES:
Telephone: 1) For specific inspection, testing,and maintenance
783132 requirements and information,see NFPA 25,2011
CA License#: edition as amended by California Code of Regulations,
Title 19, §901 to§906.
Job#: 23841562
2) Inspection items may be performed by the owner in
Performed by: Stephen Rampenthal 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.
Forms Included wlth T s Report . umbe o ' orm ,,r/_,
Chapter
✓❑ Automatic Sprinkler System 5 4 ❑ I ❑ ✓❑
❑ Standpipe and Hose System 6 0 Q I ❑ ❑
❑ Private Water Supply System 7 0 ❑ I ❑ ❑
❑ Fire Pump 8 0 ❑ I ❑ E
❑ Water Storage Tank 9 0 ✓❑ I ❑ ❑
❑ Water Spray System 10 0 ❑ I ❑ ❑
❑ Foam Water Sprinkler System 11 0 ✓❑ I ❑ I E
❑ Water Mist System 12 0 ❑ I ❑ I E
❑Concerns that are Not Deficiencies (i.e. Non-Sprinklered Areas) I ❑ Yes El No
*See"Deficiencies and Comments"section at end of each respective form.
AES 1 September 3,2013
Dry Pipe California Code of Regulations -Title 19 Quarterly and 1 of 3
Fire Sprinkler System Inspe ion,Testing,and Maintenance Annual Report
Property Information �*c�F Contractor or Licensed Owner Information
'Building Name Feather Falls Casino&Lodge co C� v Name Foothill Fire Protection, Inc.
Address 3 Alverda Dr v�• ?,h Q Address 170 Erma Ct
}MP�� City Chico St. CA Zip 95928
(City Oroville (License# 783132 'Phone 530-826-3013
(Contact Person Damon Pound I ❑ SFM (Job# 23841562
Phone (530)533-3885 I ❑M CSLB C-16 'Misc.
.ii.: Riser Information ii Main Drain Test(Annual)
Riser Location Riser Main Drain Initial Static Residual Final Static P,F,N/A
No. Diameter Diameter Pressure Pressure Pressure
1 Interior 2nd Floor server room 4 2 110 I 95 112 P
I
El This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached:
.�_ _. . L_ quarterly Insectiattis ,..
1 =Inspection T=Test M=Maintenance P=Pass F=Fail N/A=Not Applicable
NFPA 25 CA ed. Date I Date Date Date
Item I I Description I Reference I-- III -,I J 02/21/22
1.1 I (Control Valves—Identification Sign 13.3.1 I I P
1.2 I I (Control Valves—Inspection 13.3.2 I I I I P
1.3 I IWaterflow Alarm Devices I 5.2.5 I I I P
1.4 I (Supervisory Devices I 5.2.5 I I I P
Gauges(Dry Pipe Systems) 5.2.5.2, 5.2.4.3
1.5 I Pass=Normal Pressures 5.2.4.4 P
13.4.4.1.2
5.2.4.2, 5.2.4.3
1.6 I Air Pressure 13.5.2.4.4 4.4.2.5.1 psi I psi I psi 31 psi
I I
5.2.4.2 1.7 I (Water Supply Pressure I 13.4.4.2.5.1 I psi' psi I P si I 116 Psi
Hydraulic Design Information Sign I I I I P
1.8 I (For Hydraulically Designed Systems) 5.2.6
1.9 I General Information Sign 5.2.8 I I I I N/A
(Not Required for System Prior to 2007 Edition of NFPA 13)
1.10 I Heat Tape 5.2.7 I I I I N/A
1.11 I Spare Sprinklers 5.2.1.4 P
1.12 I Fire Department Connections 13.7 1 I P
1.13 I Dry Pipe Valves—Exterior Inspection 13.4.4.1.4 P
1.14 I Pressure Reducing Valves 13.5.1 P
1.15 Backflow Preventers 13.6.1 I I I I N/A
1.16 PRV—Fire Sprinkler Systems 13.5.1 I I I N/A
Form AES 2.3 Sept.3,2013
.1' " I I l l - 1 1 � I� 114 i %, ,, I I 1
• ' • . • ' • • • II • • I II
Fire Sprinkler System Inspection,Testing, and Maintenance Annual Report °
Property Information ,I��� Contractor or Licensed Owner Information
(43L),
(Building Name Feather Falls Casino&Lodge C )� (Name Foothill Fire Protection, Inc.
(Address 3 Alverda Dr 94�_✓ .,/Q I J o b# 23841562
(City Oroville ARE tJ�PQ' I
ANNUAL INSPECTION,TESTING,AND MA NTENANCE
,#-. ,, Include ALL Quarter! Ins•ections
=Inspection T =Test M=Maintenance P=Pass F=Fail N/A =Not Applicable
Item Description NFPA 25 CA ed. Date Comments Only I P,F,N/A l
Reference
1.17 I Buildings (Freeze Protection) 4.1.1.1 02/21/22 Owner's Responsibility I N/A
1.18 I Sprinklers 5.2.1 02/21/22 I P
1.19 I Pipe and Fittings 5.2.2 02/21/22 P
1.20 I Hangers 5.2.3 02/21/22 P
1.21 I Seismic Braces 5.2.3 02/21/22 P
1.22 I Small Hose Connections* 13.5.6.2.2 02/21/22 N/A
I
2.1 T Field Service Test Required 5.3,1 02/21/22 If REQUIRED, Enter'F'until N/A
(Send Report to Fire Code Official) results are returned from Lab
2 2 T Recalled Sprinklers Title 19 02/21/22 P
If not present=Pass; If present=Fail 904.1(c)
2.3 T Water Flow Alarm Devices 5.3.3 02/21/22 45 sec. P
90 sec. maximum - (Enter Time) 13.2.6
2.4 T Main Drain Test 13.2.5 02/21/22 P
(Enter Data on Page 1 of this Form) 13.3.3.4
2.5 T Priming Water Level Test 13.4.4.2.1 02/21/22 P
D Pipe Valve Trip Test 13.4.4.2.2
ry
2.6 T (Partial Trip Test is Acceptable) I 13.4.4.2.2.3 102/21/22 P
13.4.4.1.5
2.7 T Valve Trip Time 13.4.4.2.5.2 02/21/22 45 sec. P
2.8 T Trip Air Pressure 13.4.4.2.5.1 02/21/22 29 psi P
2.9 T Quick-Opening Device Test 13.4.4.2.4 02/21/22 P
2.10 T Low Air Pressure Alarm Test 13.4.4.2.6 02/21/22 P
2.11 T Low Temperature Alarm Test 13.4.4.2.7 02/21/22 N/A
2.12 T Automatic Air Pressure Maintenance Device Test 13.4.4.2.8 02/21/22 P
2.13 T Control Valve—Operation 13.3.3 02/21/22 P
2.14 T Valve Supervisory Devices 13.3.3.5 02/21/22 P
2.15 T Backflow Preventer Assemblies 13.6.2 02/21/22 N/A
2.16 T PRV—Partial Flow 13.5.1.3 02/21/22 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 2.3 Sept.3,2013
Dry Pipe California Code of Regulations -Title 19 Quarterly and 3 of 3
Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report
Property Information :,,�j Contractor or Licensed Owner Information
y % 1
(Building Name Feather Falls Casino & Lodge `C n�i Name Foothill Fire Protection, Inc.
(Address 3 Alverda Dr tip,4�v_ . 71' Job# 23841562 I
(City Oroville l�RE MPS`_— I
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 1 Comments Only 1 P,F,N/A
Reference
3.1 M Control Valves 13.3.4 2/21/22 P
3.2 I M (Maintenance 13.4.4.3 2/21/22 I I P
3.3 I M (Dry Pipe Valve Interior Cleaned 13.4.4.3.1 2/21/22 I I P
3.4 I M ILow Points in System Drained 13.4.4.3.2 2/21/22 I I N/A
3.5 I M IBackflow Preventer 13.6.3 2/21/22 I I N/A
Obstruction Investigation Required Yes
3.6 M (!f"Yes",see Deficiencies and Comments Section 14.3 12/21/22 I-
1 No N/A
for Results.)
3.7 I M (System Returned to Service I 15 7 12/21/22 il--i Nos I P
D=Deficienc C=Comment (Indicate type)
•-- *+ .!Iwwi Deficiencies and Comments
Item Date Riser D Indicate all equipment,devices and parts that were repaired or replaced
❑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
Quarter 1st i❑ Annual end ❑ Annual 3rd ❑Annual 4th [Jj Annual
Date I I 02/21/22
Print Name I I I Stephen Rampenthal
Signature A6C197-----
Form AES 2.3 Sept.3,2013
.I i,N l l0 1 .'. I'll.1,l' ',Ili i.U .��, '�.I l,,,it' hi 11, . I 'I. I I ." . li'let'l i,I_I,I'0 Ill mini 1,
Service Main Inspection,,Testing, and Maintenance Annual Report 1 of 2
o eqL��
Property Information Contractor or Licensed Owner Information
,>�,- o
2
co Building Name Feather Falls Casino&Lodge (� In
IName Foothill Fire Protection, Inc.
Address I -V., ._,Nr 'Address 170 Erma Court
I FPS
3 Alverda Drive City Chico St. CA Zip 95928
City Oroville CA 95966 'License# 783132 (Phone (530)826-3013
Contact Person Damon Pound I ❑ SFM 'Job#23841562
Phone(530)533-3885 I ❑ CSLB 'Misc.
Quarterly Inspections <`yt' w, ,, ' . " r,T,T
I =Inspection T=Test M=Maintenance I P=Pass F=Fail N/A=Not Applicable
NFPA 25 CA I Date I Date ! Date I Date
Item Description ed.
Reference 02/22/22
1.1 I Control Valves—Identification Sign 13.3.1 N/A
1.2 I Control Valves—Inspection 13.3.2 P I I
1.3 I Hose Houses 7.2.2.7 N/A I I
1.4 I Fire Department Connections 13.7 P I I
1.5 I Pressure Reducing Valves 13.5.1.1 P
1.6 I Backflow Preventers 13.6.1 N/A I I I
1.7 I Supervisory Devices 13.3.3.5.1 N/A
1.8 I Monitor Nozzles 7.2.2.6 N/A I I
ANNUAL INSPECTION, TESTING,AND MAINTENANCE
Include ALL Quarter! Inspections
I =Inspection T =Test M=Maintenance P=Pass F=Fail N/A=Not Applicable
Item I Description NFPA 25 CA ed.I Date
Reference Comments Only I P,F,N/A
1.9 I 'Hydrants 7.2.2.4 12/21/22(Dry Barrel and Wall) Table 7.2.2.4 ' I N/A
1.10 I HydranBarre ts 7.2.2.5!) Table 7.2.2.5 12/21/22I I 3 Hydrants on site P
et
1.11 I 'Mainline Strainers 7.2.2.3 I2/21/22 I I N/A
Table 7.2.2.3
1.12 I 'Piping (Exposed) 7.2.2.1 I2/21/22 I I N/A
Table 7.2.2.1.2
1.13 I 'Piping (Underground) 7.3.1 12/21/22 I I N/A
1.14 I !Hose NFPA 1962 12/21/22 I N/A
2.1 T 'Control Valve-Position 13.3.3.1 12/21/22 I P
2.2 T 'Control Valve-Operation 13.3.3 12/21/22 I P
2.3 T 'Monitor Nozzles 7.3.3 12/21/22 I N/A
2.4 T 'Hydrants-Flush 7.3.2 12/21/22 13 Hydrants flushed I P
2.5 T 'Supervisory Devices 13.3.3.5 12/21/22 I I N/A
2.6 T IBackflow Preventer Assemblies 13.6.2 12/21/22 I I N/A
2.7 T IP(re(Pasrt sureFlow ReducingTest) Valve 13.5.1.3 I2/21/22 I I P
ial
3.1 M (Control Valves 13.3.4 12/21/22 I P
3.2 M 'Mainline Strainers 7.2.2.3 12/21/22 I N/A
Form AES 4 Sept.3,2013
''101! 'I it J .',I. ,'in 1,0 I , I..'I I I. I I. :I I. I 'Il i Y II I h 114 II ill r i' I .
04,1 1 Ii .1 I .... .....-
I
1
Service Main Inspection,Testing, and Maintenance Annual Report
Property Information --F'CA�r�
4',-------))o Contractor or Licensed Owner Information
,L: A
of x
'Building Name Feather Falls Casino&Lodge C A !Name Foothill Fire Protection, Inc.
'Address 3 Alverda Drive v\`, �Q 'Job# 23841562
ARE MPQ'y�
'City Oroville I
ANNUAL INSPECTION,TESTING, AND MAINTENANCE
Include ALL Quarterly Inspections
I =Inspection T =Test M=Maintenance P=Pass F=Fail N/A =Not Applicable
I I NFPA 25 CA ed. ( I I
P,F,
Item Description Reference Date Comments Only IVIA
3.3 I M 'Hose Houses I 7.2.2.7 I2/21/22 I I N/A
Table 7.2.2.7
3'4 I M 'Hydrants I 7.4.2 12/21/22 I I P 1
3'5 I M 'Monitor Nozzles I 7.4.3 12/21/22 I I N/A 1
Obstruction Investigation Required Yes
3.6 M (If"Yes", see Deficiencies and Comments Section 14.3 No N/A
I 12/21/22
for Results.)
3.7 I M 'System Returned to Service I 15.7 12/21/22 I I f
D= Deficiency C=Comment (Indicate type)
Item Date Riser D C *`' Deficiencies and Comments
Indicate all e•ui.metjt,,devices and carts that were re.aired or re.laced
EE
ELI
ELI
ELI
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❑I
ICI
❑❑,.., _
HH
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❑Check here if additional Deficiencies and Comments are listed on Form AES 9. 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
Quarter 1st 0 Annual 2nd ❑ Annual 3rd ❑ Annual 4th ❑ Annual
Date 2/21/22 I
Print Name Enrique Ramos
Signature I I
Form AES 4 Sept.3,2013
Standpipe and Hose System California Code of Regulations-Title 19 Quarterly and 1 of 3
Inspection,Testing,and Maintenance Annual Report
Property Information k�-f�Q�p Contractor or Licensed Owner Information
'Building NameFeather Falls Casino & Lodge !a Name Foothill Fire Protection, Inc.
Address 3 Alverda Dr. 9� ,;," lAddress170 Erma Court
�
��RE MP�'� 'City Chico St. CA Zip 95928
'City Oroville 'License# 'Phone (5301 826-3013
'Contact Person Randahl Nelson I ❑ SFM 'Job# 23841562 11I
'Phone 530-533-3885 I ❑ CSLB 'Misc.
Riser Information Main Drain Test(Annual)
Riser 'IF
Riser Main Drain initial Static Residual Final Static
Location P,F,N/A
No. I I Diameter Diameter Pressure Pressure Pressure
I I I I I I I
I I I I I I I
I I I I I I
I I I I I I I
❑ This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached:
Quarter) Ins•ections
=Inspection T=Test M=Maintenance P=Pass F=Fail N/A =Not Applicable
item I I Description 1NFPA 25 CA ed.I Date Reference Date I Date I Date
( 12/22/22
1.1 I 'Control Valves—Identification Sign 13.3.1 I I I P
1.2 I I 'Control Valves—Inspection ' 13.3.2 I I I IP
1.3 I IWaterflow Alarm Devices I 5.2.5 I I I IN/A
1.4 I 'Supervisory Devices 5.2.5 I I I I N/A
Gauges 6.2.1
1.5 I 'Gauges
=Normal Pressures I 6.2.2 I I IN/A
Water Supply Pressure Below 6.2.1
1.6 i (Dry Pipe or Preaction Valve I 6.2.2 I psi) psi) psi) N/A psi)
1.7 I I 1WaterSuppIyPressureAbove I 6.2.1 I psi I psi I psi I N/A psi
Dry Pipe or Preaction Valve 6.2.2
6.2.1
1.8 I Pressure at Top of Standpipe Riser 6.2.2 psi psi psi N/A psi
13.2.7
6.21
1.9 I Air/Nitrogen Pressure 6.22 l psi l psi 1 psi N/A psi
13.2.7
6.2.1
1.10 I Pressure at Discharge of Fire Pump or Pressure Tank 6.2.2 l psi) psi psi N/A psi
l l 13.2.7
6.22
1.11 I (Pressure Readings Acceptable 13.2.7 I I I IN/A
1.12 I 'Standpipe Hose Valves I 13.5.6.1 I I I IN/A
I Hydraulic Design Information Sign
1.13 6.2.3 I I IN/A
I (For Hydraulically Designed Systems) I
1.14 I I (Heat Tape I 5.2.7 I I I I N/A
1.15 I 'Fire Department Connections 13.7 I I I P
1.16 I (Pressure Reducing Valves I 13.5.1.1 I I I I P
Form AES 3 Sept.3,2013
Standpipe and Hose System California Code of Regulations-Title 19 Quarterly and 2 of 3
Inspection,Testing, and Ma' enance Annual Report
Property Information 1���jp9h Contractor or Licensed Owner Information
\Z 1
!Building NameFeather Falls Casino & Lodge !NC n Name Foothill Fire Protection, Inc.
!Address 3 Alverda Dr. �'�%,,.„ ,�`' Job# 23841562
!City OrovilleE N10'
ANNUAL INSPECTION,TESTING,AND MAINTENANCE
Include ALL Quarterly Inspections
=Inspection T =Test M=Maintenance P=Pass F=Fail N/A =Not Applicable
NFPA 25 CA ed
Item Description . Date Comments Only P,F,N/A
Reference
1.17 Backflow Preventers 13.6.1 2/22/22 N/A 1
1.18 I Buildings (Freeze Protection) 4.1.1.1 2/22/22 Owner's Responsibility P 1
1.19 I Pipe and Fittings 5.2.2 2/22/22 P 1
1.20 I Hangers 5.2.3 2/22/22 P I
1.21 I Seismic Braces 5.2.3 2/22/22 P
1.22 I Hose Connections 6.2.1 2/22/22 P
Table 6.1.2
1.23 I Cabinet 6.2.1 2/22/22 N/A
Table 6.1.2
1.24 I Hose 6.2.1 2/22/22 N/A
Table 6.1.2
6.2.1
1.25 I Hose Storage Device Table 6.1.2 2/22/22 N/A
I I I NFPA 1962
1.26 I Hose Nozzle 6'2'1 2/22/22 I N/A l
Table 6.1.2
2.1 T Control Valve—Position 6.2.1 2/22/22 I P
13.3.3.1
2.2 T Control Valve—Operation 6'2'1 2/22/22 I P
13.3.3.2
2.3 T Supervisory Devices 13.3.3.5 2/22/22 I N/A 1
2.4 T Waterflow Alarm Devices 6.3.3 2/22/22 sec. I N/A l
90 sec. maximum - (Enter Time) 13.2.6
2.5 T Main Drain Test 13.2.5 2/22/22 I N/A
(Enter Data on Page 1 of this Form) 13.3.3.4
2.6 T Hose Rack Hose Valve 13.5.3.3 2/22/22 I N/A
(Partial Flow Test)
2 7 T Pressure Reducing Hose Valve 13.5.2.3 2/22/22 I N/A
(Partial Flow Test)
2.8 T Backflow Preventer Assemblies 13.6.2 2/22/22 I N/A
2.9 T Class I &Ill Hose Valve Test 13.5.6.2.1 2/22/22 I N/A
2.10 T Class II Hose Valve Test 13.5.6.2.2 2/22/22 I N/A
3.1 M Control Valves 13.3.4 2/22/22 I P 1
3.2 M Hose Valves 13.5.6.3 2/22/22 I N/A 1
Obstruction Investigation RequiredYes
3.3 M (If"Yes", See Deficiencies and Comments Section
for Results.) I ID
14.3 2/22/22 No N/A
I I
3.4 I M !System Returned to Service I 1'5� I2/22/22 I®Nos IP
Form AES 3 Sept.3,2013
Standpipe and Hose System California Code of Regulations-Title 19 Quarterly and 3 of 3
Inspection, Testing, and Maintenance Annual Report
Property Information :.�0�f CqC.N c)..,1 Contractor or Licensed Owner Information
'Building NameFeather Falls Casino & Lodge fcliy� i~ IName Foothill Fire Protection, Inc.
(Address 3 Alverda Dr. �'�- ,(._ _, i J(Job# 23841562
'City Oroville ARE "'P_ I
I D=Deficiency C=Comment (Indicate type)
>_ ^ Deficiencies and Comments
Item Date !` Riser D C " indicate all equipment,devices and.arts that were re aired or re•laced
Notes 2/22/22 N/A •;1:1I(30) Stand pipe valves in parking structures exercised and lubed,
Ff-
(Stand pipes are part of a dry manual system.
II
MIi ' II 1
.11., 0 1
Inl
FIII-II 1
Fill 1 I
I. I
INI I
na 11 1
rin1. ... if-- II
it 1
■ -.. .
Ell „ II
II 1
null
FILM 1
❑Check here if additional Deficiencies and Comments are listed on Form AES 9. 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
Quarter 1st ❑ Annual 2nd ❑ Annual 3rd ❑ Annual 4th ❑ Annual
_Date I -------- ---- — i 2/22/2022
Print Name Stephen Rampenthal
Signature rJ __--
Form AES 3 Sept.3,2013
ile M 1 11111'
PROTECTION, � .
DESIGN • INSTALLATION • INSPECTION • REPAIR
Redding Office:3092 Crossroads Dr.Ste. 1,Redding,CA 96003•Phone:(530)223-2492
Greater Bay Area Office:2150 Portola Ave.Ste.D-108,Livermore,CA 94551 •(925)209-6164
Chico Office: 170 Erma Ct,Chico,CA 95928•Phone:(530)826-3013/Fax:(530)893-3013
Rocklin Office:4000 Alvis Ct.,Rocklin,CA 95677• Phone:(916)663-3582/Fax:(916)663-3583
C.L.C16#783132&C10#998129
GAS SUPPRESSION SYSTEM REPORT
SYSTEM ID: Siemans Date: 2/22/22 ['ANNUAL
SEMI-ANNUAL
Customer: Feather Falls Casino& Lodge Property Address: 3 Alverda Drive
Oroville CA 95966
Contact: Monitoring Information: Central Station
Name: Damon Pound Central Station:
Phone: (530)533-3885 Acct#: 47-3726
Email: damon.pound@featherfallscasino.com Phone: 1-800-722-0364
?T.iii T,....,.i..al�P 7e.�n.p3
. tl.\,0 :.�i!.
LI HALON
❑CO2
❑✓ FM-200 4
❑INERGEN
El OTHER
Panel Type: Siemens Model: FS-250
~�^� r. ,i�Y��r'� ! -- r. - c_��'i... `'' �{�" `t`�•.w i�'�iNi
Panel in Normal Condition 0 ❑ ❑
Panel In Trouble ❑ 0 ❑
Is Power Light on ❑✓ ❑ ❑
LED Lights Verified ❑✓ ❑ ❑
Disconnect Switch ❑✓ ❑ ❑
Silence/Reset Switch Operates ❑✓ ❑ ❑
Batteries Indicate Proper Charge ❑✓ ❑ ❑
T }
• k ,
-R^:xr:x-�c, ::r�t»�;_'-K. ,zx..iy,,,wi,^y rg r,•�,.;.�.w. y:'n •�.•v• ''%'r. ;r Bl , .,, j, ,,,_a 7'r _t�4-f ' ,, y .�ilA O i v:T; '•i!d " ,�,:c�ii .�':'.i:iPASs"",�
:r•
-Y y FALv _ r :�..i " ` a: : ;,. � T,,,I, • ; :_ ,t� y_ -,sx . ,- i.�
Battery#1 12V/8AH 12/20 El E
Battery#2 12V/8AH 12/20 C-11 El
CYLINDERS
':� !, 'w;r ^„ 3nnr -Tt;',.:.} y ^ ,,�..rc,�:rc•►:r.a�e;Y:•u".:A•�ag _•?r,:tJ' Pah``s;q:k�';: ^:,s rJr:.'? ., }`aX" �7:.�st ^ "7;"3wu,%::'
rkf _uc: t G.a ::. 31 : : ( : t 9 + y 7' , ` I4
1 AA173757 11/08 22 59 N/A 365
2 AA173777 11/08 23 60 N/A 365
3 AA173784 11/08 23 60 N/A 363
4 AA173800 11/08 22 59 N/A 360
DEVICES
a:5g,on;;,i'. vx4 T`^;7,7,z t7:,Fkvi .;?P::i 9: Ii. FT 5:f,-yk o ..:.r;y�.�. ..:w-,,,, r.,a-f- _.f^p s.`; ..fb—a-;1•i"..-�,;i:'`'-',r•fi t- '-y,.ih�.,•4•i•Y
�:. F.�... ;.�, �.}..- .� L�-M��-: „� ��, e�. - �h�r�{�c - •� ._ter
' _1-.Fi e 7.5.,,, ,m �•' :,,J- 31tl.�e,,,. 4s.s]<tNe ad ,i ,,,..G N is r�•':"s'U^'';_ O\ILL i.v;,Y§i,•'y-,.:29p.'„-Y "j .•� -i. .. ',!z,A,...NI
d".'+� t�� Es-���.S�.e�r.�a&:.rr' �...�.'..:I-.._..�'Sf:�L��Ga. i���l:.i...,w...._.. ���.a`+......,.�ww.,.e.._...__....,..........-�ea:.��".'.n........,.s .',�..'..:x:'^l. _
SMOKE 8 El I:] El D El
PULL STATION 4 El El I=1 ❑ D
ABORT SWITCH 4 ❑ D E 0 El
MAINT/DISC SWITCH 0 ❑ ❑ 1E1 [:1 El
SOLINOID 4 0 0 El El El
AC SHUT DOWN 4 El 0 El El El
POWER SHUNT a El CI 0 El El
BELLS 4 El El El El LI
HORN/STROBE 8 [ElEl El El El
OTHER LI El El El El
OTHER El El El El El
7-7' rimehE
PROTECMN, INC. y
DESIGN • INSTALLATION • INSPECTION • REPAIR
Redding Office:3092 Crossroads Dr.Ste. 1,Redding,CA 96003•Phone:(530)223-2492
Greater Bay Area Office:2150 Portola Ave.Ste.D-108,Livermore,CA 94551•(925)209-6164
Chico Office: 170 Erma Ct,Chico,CA 95928•Phone:(530)826-3013/Fax:(530)893-3013
Rocklin Office:4000 Alvis Ct.,Rocklin,CA 95677• Phone:(916)663-3582/Fax:(916)663-3583
C.L.C16#783132&C10#998129
Were Tested Dectors Cleaned
Proper safety signage installed ✓
Did the monitoring station receive signals ✓
System returned to normal condition ✓
Proper authorities/personnel been notified ✓
Equipment% tested this inspection E25% I=1 50% ❑ 75% 0100%
Were Any Deficiencies Found? ❑ YES ❑✓ NO
Follow Up or Repairs Needed? ❑ YES ❑✓ NO
T�-mrnen�s
Panel is located in the waterfall room.
This panel covers the FM-200 in the following area's 2nd floor surveillance hall, Room 159 bottom of stairs,Buffet Closet,
and Basement Closet.
Inspected by:
Stephen Rampenthal 2/22/22
Inspector Date
'11 ' II'allay ktild3
.* s �
i
DESIGN • INSTALLATION • INSPECTION • REPAIR
Redding Office:3092 Crossroads Dr.Ste. 1,Redding,CA 96003•Phone:(530)223-2492
Greater Bay Area Office:2150 Portola Ave.Ste.D-108,Livermore,CA 94551 •(925)209-6164
Chico Office: 170 Erma Ct,Chico,CA 95928•Phone:(530)826-3013/Fax:(530)893-3013
Rocklin Office:4000 Alvis Ct.,Rocklin,CA 95677• Phone:(916)663-3582/Fax:(916)663-3583
C.L.C16#783132&C10#998129
GAS SUPPRESSION SYSTEM REPORT
SYSTEM ID: Siemens Date: 2/22/22 LIANNUAL
ElSEMI-ANNUAL
Customer: Feather Falls Casino& Lodge Property Address: 3 Alverda Drive
Oroville CA 95966
Contact: Monitoring Information: Central Station
Name: Damon Pound Central Station:
Phone: (530)533-3885 Acct#: 47-3726
Email: damon.pound@featherfallscasino.com Phone: 1-800-722-0364
Syste-••`%'Id. -ram-. .:r- ?� .• +3i• `_�£ "��:�'''-.•<_� •:- - 'Y �,_, �;s .d'";r_.1
m Y��^� e --� ��-g..���.,��.,r..:��:.��;�,yyyyyy'yya�•'.!�!�o _Sr�s�eins �:•:��:.�;.y� Notes
�, t ,d � ,��..�:i°n_.Sr.'�...s!_ ::s;7»a:�:i>...'•7:',';'::.�' 4..w::c.... ,i...e.ei.'.::...-.1.:r.'.1!:::;..-y;..s�e:,�,t..a
❑HALON
LI CO2
ElFM-200 1
❑INERGEN
Ej OTHER
Panel Type: Notiofier Model: RP-2002
.�n. .t'e'..�,•y., ,--.dl;.. - .r. .)- ..�. :'.i:�i{:^ ,:.�-.:�-:.: ,..�: _ _ �t.t��:.-:•,r.:�xr.•'.+�•n.:.,. ,..{�vyw - ..s�.,
..� .F 'j'`"�.�'� :#''+• '.r1_ ..j. -:f;_`.'.{•..r-.[;.., ..2 _ •��1.. a. 4�;•'1 :ri,�,:•a _�•;;
P�7E�~�: ;:1-� �'-,.u��:; �,'r'.�..{:,,�.r. -r:. 3'•q._fi ';^�' 0:.e-s�,t•�.�s`�:l'�I:A=t:��,�".:'�;lr`1:0»�'71i5
_�:w::ii�,�`r.,:.°'-::i,:z�:.,w�:z.C:�t,:�-!-....x�a...t'r_:;:.i.[s.:i::;3'�h�:t.'•'',�.r���.G=G�:»:�&v� .cuy�f.et.3sL��.a.,�^ .;.cz•.,, �a:R..�:,, �..�...,
Panel in Normal Condition [] ❑ ❑
Panel In Trouble ❑ ❑
Is Power Light on ❑✓ ❑ ❑
LED Lights Verified 0 ❑ ❑
Disconnect Switch ❑ ❑ ❑✓
Silence/Reset Switch Operates ❑✓ ❑ ❑
Batteries Indicate Proper Charge [] ❑ ❑
MOTHILL rittE 1
ornicnoN, INC. --.
)341Mia ., ! :1 :'. ,1 VOLTSLL7j1:-§ .• AtE c:1 ' :: . PMS :, MIL
Battery#1 1 2V/8AH 12/20 El El
Battery#2 1 2V/8AH 12/20 CI El
CYLINDERS
1 AA7707565 11/08 136 251 N/A 360
DEVICES
0,0:Att.:;
SMOKE 3 El El E El El
PULL STATION 1 El El [=1 L=1 El
ABORT SWITCH 1 D El El 0 El
MAINT/DISC SWITCH 0 El 0 El L=I El
SOLINOID 1 CI 0 DI El L=I
AC SHUT DOWN 2 0 0 E 0 El
POWER SHUNT 0 El El LI 0 El
BELLS 1 El El El 0 El
HORN/STROBE 2 1:1 E El D 0
OTHER 0 El 0 El El
OTHER E Li El 0 E
"- ; I 1Ricl
a1
PROTECTION I _.-
DESIGN • INSTALLATION • INSPECTION • REPAIR
Redding Office:3092 Crossroads Dr.Ste. 1,Redding,CA 96003•Phone:(530)223-2492
Greater Bay Area Office:2150 Portola Ave.Ste.D-108,Livermore,CA 94551 •(925)209-6164
Chico Office: 170 Erma Ct,Chico,CA 95928•Phone:(530)826-3013/Fax:(530)893-3013
Rocklin Office:4000 Alvis Ct.,Rocklin,CA 95677• Phone:(916)663-3582/Fax:(916)663-3583
C.L.C16#783132&CIO#998129
Were Tested Dectors Cleaned
Proper safety signage installed ✓
Did the monitoring station receive signals ✓
System returned to normal condition ✓
Proper authorities/personnel been notified ✓
Equipment% tested this inspection 025% 050% ❑ 75% El00%
Were Any Deficiencies Found? ❑ YES 0 NO
Follow Up or Repairs Needed? ❑ YES 0 NO
Corn i ts,
This FM-200 is located in the surveillance server room.
Inspected by:
Stephen Rampenthal 2/22/22
Inspector Date
Iliad Midi
rria
DESIGN • INSTALLATION • INSPECTION • REPAIR
Redding Office:3092 Crossroads Dr.Ste. 1,Redding,CA 96003•Phone:(530)223-2492
Greater Bay Area Office:2150 Portola Ave.Ste.D-108,Livermore,CA 94551•(925)209-6164
Chico Office: 170 Erma Ct,Chico,CA 95928•Phone:(530)826-3013/Fax:(530)893-3013
Rocklin Office:4000 Alvis Ct.,Rocklin,CA 95677• Phone:(916)663-3582/Fax:(916)663-3583
C.L.C16#783132&C10#998129
GAS SUPPRESSION SYSTEM REPORT
SYSTEM ID: Sinorix-227 Date: 2/22/22 ElANNUAL
El SEMI-ANNUAL
Customer: Feather Falls Casino&Lodge Property Address: 3 Alverda Drive
Oroville CA 95966
Contact: Monitoring Information: Central Station
Name: Damon Pound Central Station:
Phone: (530)533-3885 Acct#: 47-3726
Email: damon.pound@featherfallscasino.com Phone: 1-800-722-0364
.i:+ ,.Y.. _:x..' ..r-...a.N>y.�... -r .•tt`• ,. _-: .)....�,.��.. __ __,�..,^_^._N.. ....s..1T,�.i`,_'� - "f' r`;
:te_` t'µ_�-.�. 4`itlfy.s:`�i•�"a,� �:?.'.? '.{'..><`.i,•-,:: S-v ' .,�::ty,.'.,':{: _ .. .,F'3:;,i
ss..izz +LwKwLLrrvvCCww'' t � x «..:,,_�, ,t:� � ��.�s��•:.F :_......���Notes;
❑HALON
El CO2
ElFM-200 1
❑INERGEN
El OTHER
Panel Type: Notifier Model: RP-2002
;i-n�;:,.� :a�,.x. hu j,��:x-:s,..,.�/p�'w,i'���<qx.. _ .ea:c �•�:' _ �•.iy. ..�^,:a•.. :.�,..�,+�,y'S.> .M1..s� y,4;:;���-;,: �<:-.n•,✓�:..
!:: - t: ..L�" �R�S 1:• yt h' _ •�f~ - ::1'.:ye Via.. _ _ .I_> /-..
� .... �..-_ _:'-�_�s. .•_� ..:'�.:... ...�.'s„..-_�_�i:J'j."::,'4yy`P,Jam.\O����. �`,?�: 1
P �?,:�:s...w .:a'�;i:��•�.-«iw.- ::t� 4;:� ',4:a:-:. a .w :_.,r:.'{ . as7.:...<,>.:t:,::.,. .. ....i::�.....,-.t..,r_.....
Panel in Normal Condition El ❑
Panel In Trouble ❑ ❑
Is Power Light on ❑✓ ❑ ❑
LED Lights Verified ❑✓ ❑ ❑
Disconnect Switch ❑ 0 ❑
Silence/Reset Switch Operates ❑✓ ❑ ❑
Batteries Indicate Proper Charge ❑✓ ❑ ❑
, : '"‘ si • ciirlui ' . 7
PROTECtiON. INC.
Battery#1 12v/8amp 12/20
El 0
Battery#2 12v/8amp 12/20
111
CYLINDERS
„ ..4„.4.,-.',,1'7,61:??:`,"!.p.4:'t,?,,,'',,•,,,,-,,, '# fts',.:Aii :iirr...:-,:.1:.-:;.J.,,,,a,.,,,,i0S t ,,,._ :',.%.1.,..c.,..,,,g, ;,r t..:1,:.a:.: .-,. , ,.ID TY .-•1, '.4,,,,•f•-• N ' . .0,•.. 7. ”4.1 1 13,•,, .,:,4 si
....,_:,,,.,,,,,,,„_..,„,i,i!,,,o,..,,ot.,,,,,A.,,,,,:.20:,:th,111,„dit:,...,x,,zz....—. ....-.ssi.:ALe;_____ , a •_.....•11,i1,1, V . ii
1 AA368358 11/08 92 208 N/A 360
DEVICES
,-,„.-,-----„,„:,--.,,:r;":,Ti 1 7, 7::7,,,,,:,1'1,-,',,.e.,,-,* .;, t.7",,,,, ,i;;;7,,,A...,",71.A.,,,...gs,1'.'",,,,-,,,,i;• ;.7.4Zo.„..'......,..‘-",,,,,,'" --,.."'•,,,'"',.,,W,7),,,"lc,V.-417,7,,nili;!::Z*W;: 44i1 ,,,*:::::11141.),,;
SMOKE 5
E E El El D
PULL STATION 1
E El E:1 El 0
ABORT SWITCH 1
0 El El C 0
MAINT/DISC SWITCH 0 El E C E El
SOLINOID 1 El El E.
0 El
AC SHUT DOWN 2 0 El El El 0
POWER SHUNT 0 Ill 0 El El El
BELLS 1 El 0 El 0 El
HORN/STROBE 2
El E El El El
OTHER 0
El 0 El L=I El
OTHER 0
1:::1 0 0 0 El
IMOIECTION, INC. •
DESIGN • INSTALLATION • INSPECTION • REPAIR
Redding Office:3092 Crossroads Dr.Ste. 1,Redding,CA 96003•Phone:(530)223-2492
Greater Bay Area Office:2150 Portola Ave.Ste.D-108,Livermore,CA 94551 •(925)209-6164
Chico Office: 170 Erma Ct,Chico,CA 95928•Phone:(530)826-3013/Fax:(530)893-3013
Rocklin Office:4000 Alvis Ct.,Rocklin,CA 95677• Phone:(916)663-3582/Fax:(916)663-3583
C.L.C16#783132&C10#998129
Were Tested Dectors Cleaned
Proper safety signage installed ✓
Did the monitoring station receive signals ✓
System returned to normal condition ✓
Proper authorities/personnel been notified '!
Equipment% tested this inspection ❑25% ❑50% ❑75% E 100%
Were Any Deficiencies Found? ❑ YES ❑✓ NO
Follow Up or Repairs Needed? ❑ YES E NO
Comtnueits
This FM-200 is located in the 2nd floor server room.
Tested the two smokes in side the panel room.
Inspected by:
Stephen Rampenthal 2/22/22
Inspector Date
..• I, Iliad
14:WE !
Lf :i ' I�
DESIGN • INSTALLATION • INSPECTION • REPAIR
Redding Office:3092 Crossroads Dr.Ste. 1,Redding,CA 96003•Phone:(530)223-2492
Greater Bay Area Office:2150 Portola Ave.Ste.D-108,Livermore,CA 94551 •(925)209-6164
Chico Office: 170 Erma Ct,Chico,CA 95928•Phone:(530)826-3013/Fax:(530)893-3013
Rocklin Office:4000 Alvis Ct.,Rocklin,CA 95677• Phone:(916)663-3582/Fax:(916)663-3583
C.L.C16#783132&C10#998129
GAS SUPPRESSION SYSTEM REPORT
SYSTEM ID: Siemens Date: 2/22/22 EIANNUAL
SEMI-ANNUAL
Customer: Feather Falls Casino& Lodge Property Address: 3 Alverda Drive
Oroville CA 95966
Contact: Monitoring Information: Central Station
Name: Damon Pound Central Station:
Phone: (530)533-3885 Acct#: 47-3726
Email: damon.pound@featherfallscasino.com Phone: 1-800-722-0364
El HALON
❑CO2
EJFM-200 1
❑INERGEN
❑OTHER
Panel Type: Model:
w - _ . .1. : :YES._. - NO_::: N/A ::NOTES
Panel in Normal Condition 0 ❑ ❑
Panel In Trouble ❑ El ❑
Is Power Light on 0 ❑ ❑
LED Lights Verified ❑✓ ❑ ❑
Disconnect Switch ❑ ❑✓ ❑
Silence/Reset Switch Operates ❑✓ ❑ ❑
Batteries Indicate Proper Charge ❑✓ ❑ ❑
ft
PROTEC f t ! .
:.i:'. "_''''''•r.i .. . :iY'. .'...1,'-
,' - E_ lk.r:,.ck x''�..‘i
ilATTERIES. VOLTSIAMPSy 1) TE• .:~��. ..�,_. ,_,��_�,�.....
.11
_...5..............a.- ......a.....,...�r f:.gip.r�.._ ...._.. ..........r....-..w. ..-.r..... .�..... ..._...yi�.l.rr............+ ..H..Batte 1 12V/8AH 12/20 E] El
Battery#2 12V/8AH 12/20 El
CYLINDERS
j....,ys" i. ..Sr y1• 0.8' :T.. -7,t:"l:5:r.q._Ysaf•. ..'",. . ,yyr.-, ;,,., ;•,, _. .,i,;-^-. .ri ssri _
�:.'.1';' '��`5:ti:..r,�:-•-� ""��. s -t '.;"�k'"_:,',i'v...,;�.:c7'"' ,.�-':,.'•y �i. _sti:,4, ,.err'... _ -
.� �'. -- -�I .; y r p'F �'i ---•1 r,. a, �,t ..1:, s .,Wi ANSI
,,Fe: .,2ri§t rxx,-,'•t ,...:,. .-s. •,,,,.. ,, 4, , „,„_,. AFd rt �! .. �,- , .. •-f;i...}`i'."F�.�X IJi
's.A::�t: "`+Tf�.T.,_:;,.:ii:.; a:„a`-3::::,,,,;:..:2,,,',,....,..n... ,,:.u.....-w...w...s�..r..-:.,,...a..w..._:`.k.�i„. i._i...� eA»:;t`."..�. .. .i t,. s...
1 AA402714 11/08 22 59 N/A 360
DEVICES
g•....- '_^,:_ v:r.; - :.+r., _ii.« �:r• ..rT. ..;h_-Sr�,IT':�5ti'�•y- ,.r .•,r-r—�..-.'.:: .s--,- .-.,...y.._ -Y.. ,.y;,n [:.' a;-.s,.-.TT,::....,j. ^
a ;--. ... �y'{, ,,,,-7, ...Si ���T n 7if,,.' ! 5 i T,y��K 1�,�y' , ry`ry`Y :<..p. ��e'' : ......, .
y rm� Y.,_ ' ?- +:,�:, tRw, r•r:,.3i '!iA. ��:,V..,.yr h,,H.;Ys'F.. � v . ;t #.I�!�.I 4 `O` V:F!LLr. . �,P(xA7}.IV `�� •x!o i.i ;`u..Y. "`fl���i!�
i Er'''..�:.5-,;- :.iil.{.ir L-21,,l.;..:,..e.�d ri...f.,,,,,-ero •, i,..,,.+.i,i:......L.,,_...........L....,_....,.7...:............_.a..... ..�.. ...+�._ . P.-..,. i...,t.S''.. f
SMOKE 2 El El E ❑ EJ
PULL STATION 1 E E E El LI
ABORT SWITCH 1 [=] El I:1 LI El
MAINT/DISC SWITCH o ❑ El LI LI El
SOLINOID 1 El El ElEl LI
AC SHUT DOWN 1 El LI El El El
POWER SHUNT 0 El El El El El
BELLS 1 El El El El El
HORN/STROBE 2 ElEl [21El LI
OTHER El El El El El
OTHER El El El El [2]
rPOOitJAIL
z-1
� I
PROJECTION* Throt•
DESIGN • INSTALLATION • INSPECTION • REPAIR
Redding Office:3092 Crossroads Dr.Ste. 1,Redding,CA 96003•Phone:(530)223-2492
Greater Bay Area Office:2150 Portola Ave.Ste.D-108,Livermore,CA 94551•(925)209-6164
Chico Office: 170 Erma Ct,Chico,CA 95928•Phone:(530)826-3013/Fax:(530)893-3013
Rocklin Office:4000 Alvis Ct.,Rocklin,CA 95677• Phone:(916)663-3582/Fax:(916)663-3583
C.L.C16#783132&C10#998129
MENKai'' -T1-i+��_r..��•-"a i-f�nx'2•se:.:
Were Tested Dectors Cleaned ✓
Proper safety signage installed ✓
Did the monitoring station receive signals ✓
System returned to normal condition ✓
Proper authorities/personnel been notified ✓ —
Equipment % tested this inspection Ei 25% ❑50% n 75% E 100%
Were Any Deficiencies Found? ❑ YES ❑✓ NO
Follow Up or Repairs Needed? ❑ YES ❑✓ NO
:ommieits s
This FM-200 is located in the bus Server room.
Inspected by:
Stephen Rampenthal 2/22/22
Inspector Date
Inspection,Testing, and Maintenance Cover Sheet
Property Information:
Name: Feather Falls Casino&Lodge Occupancy/Use:
3 Alverda Drive O� AC�,c.
Address: Construction Type: ���;� �0�
•
Oroville 3 coCity: No.Stories: f (I "R )D
ZIP: 95966 Year Constructed: ti; � __✓, if
Contact: Damon Pound
'‘ PREvir
Telephone: (530)533-3885
Contractor Information: Number of System Risers
Name: Foothill Fire Protection, Inc. Copy sent to:
Address: 170 Erma Court El Owner Date: 02/21/22
City: Chico ElFire AHJ Date:
State: CA ElContractor Date:
(530)826-3013 NOTES:
Telephone: 1) For specific inspection,testing,and maintenance
783132 requirements and information,see NFPA 25,2011
CA License#: edition as amended by California Code of Regulations,
Title 19,§901 to§906.
Job#: 23841562
2) Inspection items may be performed by the owner in
Performed by: Stephen Rampenthal 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.
Forms Inclu'e u i h s =epo ChaAt 5 ! Number of Forms I NIA Fail* Pass
❑✓ Automatic Sprinkler System 5 10 10 10
❑ Standpipe and Hose System 6 I 0 ❑ ❑ ❑
❑ Private Water Supply System 7 I 0 ❑ ❑ ❑
❑ Fire Pump 8 I 0 ❑ ❑ ❑
❑ Water Storage Tank 9 I 0 ❑ ❑ ❑
❑ Water Spray System 10 I 0 ❑ ❑ E
❑ Foam Water Sprinkler System 11 I 0 ❑ ❑ ❑
El Water Mist System 12 I 0 ❑ ❑ ❑
❑Concerns that are Not Deficiencies (i.e. Non-Sprinklered Areas) ❑ Yes ❑ No
'See "Deficiencies and Comments"section at end of each respective form.
AES 1 September 3,2013
,'I ' : I I I I ' .iII I 1i I -Y• •li I .l I II' i ' ' i II w III ..III I II.„,I II
i•I• . 1 • iii • . • i1
Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report °
Property Information �t.9F Cq/.r�p Contractor or Licensed Owner Information
44•
Building Name Feather Falls Casino& Lodge y "z �v Name Foothill Fire Protection, Inc.
'Address 3 Alverda Drive v\ ;�Q��S Address 170 Erma Court
I
ARE �P�' (City Chico St.CA Zip 95928
'CityOroville License# 783132 (Phone(530)826-3013
'Contact Person 0 SFM IJob# 23841562
I Feather Falls Casino& Lodge ❑ CSLB 'Misc.
ae •
P--, •v. .' Riser Information Main Drain Test(Annual)
Riser I Location Riser I Main Drain Initial Static Residual Final Static P F,N/A
No. Diameter Diameter Pressure Pressure Pressure
1 I Old Casino Exterior Riser I 4 I 2 I 121 I 95 I 120 I P 11
2 I Basement Exterior Riser Room I 6 I 2 I 121 I 105 I 125 I P 1
I I I I I I I 1
I I I I I I 1
I I I I I I I I
L I 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
Item Description IMF NFPA 25 CA ed. Date __ Date Date I Date _ __�
Reference I —1 T —1 1 ik 02/21/22
1.1 Control Valves—Identification Sign 13.3.1 I P 1
1.2 Control Valves—Inspection 13.3.2 I P 11
1.3 Waterflow Alarm Devices 5.2.5 I P I
1.4 Supervisory Devices 5.2.5 I P I
1.5 Gauges(Wet Pipe Systems) 5.2.4.1 I P
1.6 Enter Water Supply Pressure Below Riser Check 5.2.4.1 I psi psi psi psil
1.7 Enter Water Supply Pressure Above Riser Check 5.2.4.1 I psi psi psi psi,
1.8 Pressure Readings Acceptable 5.2.4.1 I I P I
Hydraulic Design Information Sign 1
1 9 5 2 6 I P 1
(For Hydraulically Designed Systems) 1
1.10 General Information Sign 5 2 8 I N/A
(Not Required for System prior to 2007 Edition of NFPA 13) 1
1.11 Heat Tape 5.2.7 I N/A
1.12 Spare Sprinklers 5.2.1.4 I P 1
1.13 Fire Department Connections 13.7 I P 1
1.14 Alarm Valves—Exterior Inspection 13.4.1 I P I
1.15 Pressure Reducing Valves 13.5.1.1 I P I
1.16 Backflow Preventers 13.6.1 I N/A 1
1.17 I (Small Hose Connections Hose Valve* I 5.1.613:5.5 .13.15.2 I I I N/A 1
1.18 I IPRV—Fire Sprinkler Systems I 13.5.1.1 I I I N/A 1
*Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III 1
standpipe systems.
Form AES 2.1 Sept.3,2013
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Sprinkler System Ins ection, Testing, and Maintenance Annual Report
of 3
Fire
. P. 9 p
Of coll./A,
Property Information ��i Contractor or Licensed Owner Information
'Building Name Feather Falls Casino&Lodge C,, — (Name Foothill Fire Protection, Inc.
'Address 3 Alverda Drive � �C�•���'¢ 'Job# 23841562
'City Oroville ti,RE MP_ I
ANNUAL INSPECTION,TESTING,AND MAINTENANCE
include ALL Quarter, Inspections
I = Inspection T =Test M=Maintenance P=Pass F=Fail N/A=Not Applicable
Item I I Description NFPA 25 CA ed. I Date Comments Only I P,F,N/A I
Reference
1.19 'Sprinklers 5.2.1 I 2/21/22 I F
1.20 'Buildings(Freeze Protection) 4.1.1.1 I 2/21/22 Owner's Responsibility I P
1.21 IPipe and Fittings 5.2.2 I 2/21/22 I P
1.22 'Hangers 5.2.3 I 2/21/22 I P 1
1.23 'Seismic Braces 5.2.3 I 2/21/22 I P
2.1 'Field Service Test Required 5.3.1 I 2/21/22 If REQUIRED, Enter'F' until I N/A 1
(Send Report to Fire Code Official) results are returned from Lab
2.2 IRecalled Sprinklers Title 19 I 2/21/22 I P
If not present=Pass; If present=Fail 904.1(c)
2 3 'Water Flow Alarm Devices 5.3.3 12/21/22 sec. I P
90 sec.maximum - (Enter Time) 13.2.6
2.4 Main Drain Test 13.2.5 12/21/22 I P
I (Enter Data on Page 1 of this Form) 13.3.3.4
2.5 'Control Valve-Position 13.3.3.2 12/21/22 I P 1
2.6 'Control Valve—Operation 13.3.3.1 12/21/22 I P 1
2.7 (Supervisory Devices 13.3.3.5 12/21/22 I I P 1
2.8 IBackflow Preventer Assemblies 13.6.2 12/21/22 I I N/A 1
2.9 ISmall Hose Connections* 13.5.2.3 12/21/22 I I N/A
w/PRV Hose Valves—Partial Flow Test 13.5.3.3 1
2.10 IPRV—Fire Sprinkler Systems 13.5.1.3 12/21/22 I I N/A
3.1 'Control Valves 13.3.4 I2/21/22 I I P 1
3.2 'Small Hose Connections* 13.5.6.3 12/21/22 I I N/A 1
Obstruction Investigation required Yes
3.3 (If"Yes" see Deficiencies and Comments Section I 14.3 12/21/22 I�No
forN/A
Results.)
3.4 [ 'System Returned to Service I 4.5.3 I
2/21/22 (�Nos I 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 1
standpipe systems.
D=Deficiency C=Comment (Indicate type)
Item Date Riser D C Deficiencies and Comments
Indicate all equipment.devices and pads that were repaired or replaced
I I F-IE
I I -1 El 1
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 M-aa-nt-, ance Annual Report
Property Information �Q�j F CQ�p� Contractor or Licensed Owner Information
yl 1a Protection, Inc.
Building Name Feather Falls Casino&Lodge C�,, J Name Foothill Fire
'Address 3 Alverda Drive p ///Cr IJob# 23841562
(City Oroville MP I I
I D=Deficiency C=Comment (Indicate type)
Item Date Riser D C ' Deficiencies and Comments(cont.)
Indicate all equipment,devices and parts that were re'aired or re.laced
. • FAILED ITEMS THAT SHALL BE CORRECTED FOR PASSING REPORT:
1
Notes 02/21/22 ALL 11-11R1(16) Chrome,Quick Response,155 pendants, (2)Are Chrome 401, (4) Chrome 165 pendants, I
' I I(1) Brass 200 uprights, (2) Chrome Standard Response 155-Chrome 401 Dry Pendants I
[-pi(10) Chrome Standard Response 200-Chrome 401 Dry Pendants 1
nIn
1.20 02/21/22 All rin SPRINKLERS ARE PAINTED, DAMAGED AND OUTDATED IN THE FOLLOWING AREAS: l
I --1l. I Sprinklers outdated: (2)Cold Tank Room, (2) Dream catcher Walk in Freezers, I
(8) Shipping and receiving CoolersRR
I
1.20 02/21/22 All ml1 Sprinklers painted/damaged in the following areas: (1) Outside zone#1 resroom 1
Tin(1)At Zone#10 hole in the wall, (2) Zone#13 entry of casino's arch right and middle sprinkler I
Inln(1)Zone#14 arch left sprinkler, (1)Zone#8 Next to emergency exit doors, (2) Box office. 1
rJi(1) Zone#8 Chris office, (1)2nd Floor of pit elevator, (1) Bow and arrow bar left side of stage,1----
1
II1(1) Bow and arrow soda box room, (1) Mechanical Room 202 West pipe middle sprinkler, I
Fin (1) Charter sales second office, (3)Above Mongolian Bar. (4) Brewery Dishwashing Station 1
I 1E1 NOTES: I
1.20 02/21/22 All v Did Not Enter The Following Areas: 1
L1 Closet next to room 202, Basement closet across from down under,Admins last closet on the right, 1
nWardrobe, Charter sales closet. 1
17E1
2.3 02/21/22 All ( I I ✓ Water Flow Alarm Devices Are In The Following: Old Casino: 60sec, Basement: 69sec. 1
❑Check here if additional Deficiencies and Comments are listed on Form AES 9. 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
Quarter 1st - ❑ Annual 2nd - ❑ Annual 3rd - ❑ Annual 4th - ✓❑ Annual
Date 02/21/22
Print Name Stephen Rampenthal
Signature 2-- 62____-i
Form AES 2.1 Sept.3,2013