Fillable Report of Inspection Testing of Dry Pipe Fire (City of Oakland)

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Report of Inspection Testing of Dry Pipe Fire (City of Oakland)

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I acknowledge that the listed deficiencies have been discussed with me
I am requesting a quote for the repair of said deficiencies.
O wne
r
/Rep signature:
DATE
INSPECTOR 'S
SIGNATURE:
All "NO" answers must be fully explained
Report of Inspection
&
Testing
of Dry Pipe Fire Protection Systems
Quarterly Items to be Reviewed
ALL QUESTI ONS ARE TO BE FULLY ANSWERED
AND ALL BLANKS TO BE FILLED
Customer:
Inspection job #
Address:
Inspector Name
Date
Inspection Frequency:
Monthly
Quarterly
Dry Pipe Sprinkler System Inspection
Quarterly Testing
Requirements for a
Dry Pipe
Sprinkler System
13.4
System in service on inspection
13.4
Trim valves in appropriate position
13.7 FDC easily accessible
13.7 FDC swivels non-binding rotation
13.4 Quick opening devices tested during
semi-annual inspections
13.4 Quick opening device test date
13.4 Priming water at proper level
Y N/A
N
13.4 Alarm test valve closed
13.4
Intermediate chamber leak tight
13.4
Valve enclosure secured
13.4
Heater operational
13.4
Compressor operational
13.4
Oil level full
13.4
High/1ow pressure switches
operaitonal
13.4
Auto, air main!. devices operational
13.3 Control valve locked/tamper open
13.3 Backflow valve locked open/tamper
Comments:
13.7 FDC caps/plugs in place
13.7 FDC gaskest/signsin place
13.7 FDC ball drip drain drip free
5.2
Exterior alarms properly identified
5.2
Extra heads in spare head cabinet
13.4 Low point drum drips drained
(as f
requently as needed)
4.1
All valves identified with signage
5.2
Hydraulic nameplate attached
13.2 Main drain flow
test with
valve full open
13.4 Sprinkler supply gauge:
13.4
Sprinkler supply gauge with
main drain flow
13.4 Gauges operating
13.2 Interior building alarms operate
13.2 Exterioralarmsoperate
5.1
Did alarm supervisory company
receive signal?
Did alarm panel reset?
Alarm panel clear
in.
psi
psi
Y N/A N
System
l
e
ft
in
serv
i
c
e
Comments:
Y N/A
N
13.3
Valve area accessible
13.3
Control valves accessible
13.4
Air pressure gauge
psi
13.4
Qui ck opening device gauge
p si
13.4
Water pressure gauge
psi
1 3.4
Water supply gauge psi
A-5.7
Main check valve holding pressure
Y N/A N
13.7 FDC plainly visible
System ID:
MFS location:
888-462-7642
100
2/11/21
49
✔
N/a
100
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
2
100
80
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
2/11/21
20702578
HILLCREST CARE
Riser #1
1108 CLARK ST
DESOTO
MO
Kevin Hergenroeder
St. Louis
MO
Kevin Hergenroeder
I acknowledge that the listed deficiencies have been discussed with me
I am requesting a quote for the repair of said deficiencies.
O wne
r
/Rep signature:
DATE
INSPECTOR 'S
SIGNATURE:
All "NO" answers must be fully explained
Report of Inspection
&
Testing
of Dry Pipe Fire Protection Systems
Quarterly Items to be Reviewed
ALL QUESTI ONS ARE TO BE FULLY ANSWERED
AND ALL BLANKS TO BE FILLED
Customer:
Inspection job #
Address:
Inspector Name
Date
Inspection Frequency:
Monthly
Quarterly
Dry Pipe Sprinkler System Inspection
Quarterly Testing
Requirements for a
Dry Pipe
Sprinkler System
13.4
System in service on inspection
13.4
Trim valves in appropriate position
13.7 FDC easily accessible
13.7 FDC swivels non-binding rotation
13.4 Quick opening devices tested during
semi-annual inspections
13.4 Quick opening device test date
13.4 Priming water at proper level
Y N/A
N
13.4 Alarm test valve closed
13.4
Intermediate chamber leak tight
13.4
Valve enclosure secured
13.4
Heater operational
13.4
Compressor operational
13.4
Oil level full
13.4
High/1ow pressure switches
operaitonal
13.4
Auto, air main!. devices operational
13.3 Control valve locked/tamper open
13.3 Backflow valve locked open/tamper
Comments:
13.7 FDC caps/plugs in place
13.7 FDC gaskest/signsin place
13.7 FDC ball drip drain drip free
5.2
Exterior alarms properly identified
5.2
Extra heads in spare head cabinet
13.4 Low point drum drips drained
(as f
requently as needed)
4.1
All valves identified with signage
5.2
Hydraulic nameplate attached
13.2 Main drain flow
test with
valve full open
13.4 Sprinkler supply gauge:
13.4
Sprinkler supply gauge with
main drain flow
13.4 Gauges operating
13.2 Interior building alarms operate
13.2 Exterioralarmsoperate
5.1
Did alarm supervisory company
receive signal?
Did alarm panel reset?
Alarm panel clear
in.
psi
psi
Y N/A N
System
l
e
ft
in
serv
i
c
e
Comments:
Y N/A
N
13.3
Valve area accessible
13.3
Control valves accessible
13.4
Air pressure gauge
psi
13.4
Qui ck opening device gauge
p si
13.4
Water pressure gauge
psi
1 3.4
Water supply gauge psi
A-5.7
Main check valve holding pressure
Y N/A N
13.7 FDC plainly visible
System ID:
MFS location:
888-462-7642
100
2/11/21
40
✔
N/a
100
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
2
100
80
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
2/11/21
✔
20702578
HILLCREST CARE
Riser #2
1108 CLARK ST
DESOTO
MO
Kevin Hergenroeder
St. Louis
MO
Kevin Hergenroeder
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Report of Inspection Testing of Dry Pipe Fire (City of Oakland)

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Completed 11 March 2022

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