HomeMy WebLinkAboutFAI15-0057 028-240-005 CF FS 3-19-2024 Inspection, Testing, and Maintenance Cover Sheet
NFPA25 as amended by CCR, Title 19
Property Information:
Name: Bangor Union Elementary School Distric Occupancy/Use: _
Address: 7549 Oro Bangor Highway Construction Type: 5,4�.OF CA4jfi (11
Bangor 1
r��I 411 .Zt°1
City: No. Stories: lili,./.471,— a
95914 1 '`" Y J�
ZIP: Year Constructed: 1 \ _ , :�S
Contact: Scott Johnson y; # NIP!`
Telephone: (530)679-2434
Contractor Information: Number of System Risers
Name: Foothill Fire Protection, Inc. Copy sent to:
Address: 170 Erma Court EOwner Date: 03/19/24
City: Chico ❑Fire AHJ Date:
State: CA ❑Contractor 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#: 33143126
2)Inspection items may be performed by the owner in
Performed b Enrique Ramos accordance with California Code of Regulations,Title 19,
Y:
§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 with Fail* Pass
IIIII
❑./ Automatic Sprinkler System 5 0
❑ Standpipe and Hose System 6 0 E ❑ 1 ❑
❑ Private Water Supply System 7 0 E ❑ ❑
❑ Fire Pump 8 0 E ❑ ❑
E Water Storage Tank 9 0 E ❑ ❑
❑ Water Spray System 10 0 E ❑
❑ Foam Water Sprinkler System 11 0
❑ Water Mist System 12 0 E
❑./ Concerns that are Not Deficiencies(i.e. Non-Sprinklered Areas) E Yes 1 0 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 ";��CF Contractor or Licensed Owner Information
Building Name Bangor Union Elementary School District i 15/ Name Foothill Fire Protection, Inc.
(Address 7549 Oro Bangor Highway +f�jJQ�� Address 170 Erma Court
%tE MN City Chico St.CA Zip 95928
ICity Bangor (License# 783132 (Phone(530)826-3013
(Contact Person I ❑ SFM (Job# 33143126
I Bangor Union Elementary School District I ❑ CSLB 'Misc.
Riser Information E Main Drain Test(Annual) M
Riser Location Riser Main Drain Initial Static Residual Final Static p F,N/A
No. Diameter Diameter Pressure Pressure Pressure
1 Gym Interior 3 1.25 89 N/A
2 Pump House 1 1 91 I I I N/A
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 I 1
Quarterly Inspections
1 =Inspection T=Test M=Maintenance P=Pass F=Fail N/A =Not Applicable
NFPA 25 CA ed. Date Date Date Date
Item Description Reference 03/19/24
1.1 Control Valves—Identification Sign 13.3.1 P
1.2 Control Valves—Inspection 13.3.2 P
1.3 Waterflow Alarm Devices 5.2.5 P
1.4 Supervisory Devices 5.2.5 P
1.5 Gauges(Wet Pipe Systems) 5.2.4.1 P
1.6 Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi psi psi
1.7 Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi psi psi
1.8 Pressure Readings Acceptable 5.2.4.1 P
1 9 Hydraulic Design Information Sign 5 2 6 P
(For Hydraulically Designed Systems)
1.10 General Information Sign 5.2.8 N/A
(Not Required for System prior to 2007 Edition of NFPA 13)
1.11 Heat Tape 5.2.7 N/A
1.12 Spare Sprinklers 5.2.1.4 P
1.13 Fire Department Connections 13.7 P
1.14 Alarm Valves—Exterior Inspection 13.4.1 P
1.15 Pressure Reducing Valves 13.5.1.1 P
1.16 Backflow Preventers 13.6.1 N/A
1.17 Small Hose Connections- Hose Valve* 5.1.6, 13.5.2 N/A
13.5.5.1
1.18 PRV—Fire Sprinkler Systems 13.5.1.1 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 2.1 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
'Si.:,sueCZC ���,
Property Information 'gyp iF Contractor or Licensed Owner Information
'Building Name Bangor Union Elementary School District i )b 00 !Name Foothill Fire Protection, Inc.
'Address 7549 Oro Bangor Highway 'jNQ;,' [Job# 33143126
'City Bangor ', E NIA_ !
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 Reference a e 1=11111719"5""tiliComments Only P,F,N/A
1.19 Sprinklers 5.2.1
1.20 Buildings(Freeze Protection) 4.1.1.1 Owner's Responsibility
1.21 Pipe and Fittings 5.2.2
1.22 Hangers 5.2.3
1.23 Seismic Braces 5.2.3
Field Service Test Required If REQUIRED, Enter'F' until
2.1 (Send Report to Fire Code Official) 5.3.1 results are returned from Lab
2.2 Recalled Sprinklers Title 19
If not present=Pass; If present=Fail 904.1(c)
Water Flow Alarm Devices 5.3.3
2.3 90 sec. maximum - (Enter Time) 13.2.6 sec.
2.4 Main Drain Test 13.2.5
(Enter Data on Page 1 of this Form) 13.3.3.4
2.5 Control Valve-Position 13.3.3.2
2.6 Control Valve—Operation 13.3.3.1
2.7 Supervisory Devices 13.3.3.5
2.8 Backflow Preventer Assemblies 13.6.2
2.9 Small Hose Connections* 13.5.2.3
w/PRV Hose Valves—Partial Flow Test 13.5.3.3
2.10 PRV—Fire Sprinkler Systems 13.5.1.3
3.1 Control Valves 13.3.4
3.2 Small Hose Connections* 13.5.6.3
I Obstruction Investigation required I ID Yes
3.3 (If"Yes" see Deficiencies and Comments Section 14.3 No
r for Results.)
3.4 I (System Returned to Service I 4.5.3 I IEYes
No I
111
*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' Date RiseDeficiencies and Comments
Indicate all equipment,devices and parts that were repaired or replaced
I I
I L ILJ
I I 1 1
I ILJ
1 I III 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 Maintenance Annual Report
Property Information "<'7k1)441 Contractor or Licensed Owner Information
�f
'Building Name Bangor Union Elementary School District y [ a Name Foothill Fire Protection, Inc.
'Address 7549 Oro Bangor Highway � ,441
tr` Job# 33143126
'City Bangor
D=Deficiency C=Comment (Indicate type)
Item Date Riser D C Deficiencies and Comments(cont.)
Indicate all equipment,devices and parts that were repaired or replaced
1III-
II`1 I-1HH
Lille
!J
111
III
W
`I III
1I1J
HH
`L` IIu'11111
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
Quart d - ❑ Annual Annua riu4th - ❑ Annual
Date 03/19/24
Print Name Enrique Ramos
Signature
Form AES 2.1 Sept.3,2013