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

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

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Report of Inspection
&
Testing
of Wet Pipe Fire Protection Systems
Monthly / Quarterly / Semiannual
ALL QUESTIONS ARE TO BE FULLY ANSWERED
ANO ALL BLANKS TO BE FILLED
Customer:
System ID
Address:
Inspector Name:
Date
Inspection Frequency:
QUARTERLY REPORT OF INSPECTION
OF
WET PIPE SPRINKLER SYSTEM
(For a Quarterly Inspection, complete all items listed on FORM
94-106A "Report of Inspection - Monthly Items To Be Reviewed"
AND
the items listed below.)
5.2 Hydraulic nameplate attached
5.2
Exterior alarms properly identified
13.7 FDC plainly visible
13.7 FDC easily accessible
13.7 FDC swivels non-binding rotation
13.7 FDC caps/plugs in place
13.7 FDC gaskets/signs in place
13.7 FDC ball drip drain drip free
COMMENTS:
QUARTERLY
TESTING REQUIREMENTS FOR
WET PIPE SPRINKLER SYSTEM
5.2
Spkr. Supply Gauge
psi
5.2
Spkr. System Gauge
psi
5.2
Supply Gauge
Main Drain Flow:
psi
5.2
System Gauge Main Drain Flow
psi
5.3
Inspector's Test Flow
psi
5.3
Time to ring alarm from
Alarm Check Valve
min.
sec.
5.3
Time to ring alarm from Flow Switch
min
sec
5.3
Time to ring alarm from Pressure Switch
sec
y
N/A
N
5.3 Gauges appear operating properly
5.1 Did alarm Supervisory Company receive
signal properly?
5.1 Did Alarm Panel reset properly?
5.1 ALARM PANEL CLEAR
SYSTEM LEFT IN SERVICE
COMMENTS
I acknowledge that the listed deficiencies have been discussed with me
I am requesting a quote for the repair of said deficiencies.
Owner/Rep signature:
DAT
E
INSPECTOR 'S
SIGNATURE:
All "NO" answers
must
be
fully
explained.
N
N/A
Y
MFS location:
Monthly
Quarterly Inspection job #:
min
888-762-7642
Semiannual
GATEWAY CENTER COLLINSVILLE
One gateway dr
COLLINSVILLE
IL
62234
St. Louis
Kevin Hergenroeder, Tony Witt
03/19/2021 01:00pm CDT
20702582
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
142
142
130
130
130
19
A Witt
03/19/2021 01:00pm CDT
Paul Phipps
✔
Report of Inspection
&
Testing
of Wet Pipe Fire Protection Systems
Monthly / Quarterly / Semiannual
ALL QUESTIONS ARE TO BE FULLY ANSWERED
ANO ALL BLANKS TO BE FILLED
Customer:
System ID
Address:
Inspector Name:
Date
Inspection Frequency:
QUARTERLY REPORT OF INSPECTION
OF
WET PIPE SPRINKLER SYSTEM
(For a Quarterly Inspection, complete all items listed on FORM
94-106A "Report of Inspection - Monthly Items To Be Reviewed"
AND
the items listed below.)
5.2 Hydraulic nameplate attached
5.2
Exterior alarms properly identified
13.7 FDC plainly visible
13.7 FDC easily accessible
13.7 FDC swivels non-binding rotation
13.7 FDC caps/plugs in place
13.7 FDC gaskets/signs in place
13.7 FDC ball drip drain drip free
COMMENTS:
QUARTERLY
TESTING REQUIREMENTS FOR
WET PIPE SPRINKLER SYSTEM
5.2
Spkr. Supply Gauge
psi
5.2
Spkr. System Gauge
psi
5.2
Supply Gauge
Main Drain Flow:
psi
5.2
System Gauge Main Drain Flow
psi
5.3
Inspector's Test Flow
psi
5.3
Time to ring alarm from
Alarm Check Valve
min.
sec.
5.3
Time to ring alarm from Flow Switch
min
sec
5.3
Time to ring alarm from Pressure Switch
sec
y
N/A
N
5.3 Gauges appear operating properly
5.1 Did alarm Supervisory Company receive
signal properly?
5.1 Did Alarm Panel reset properly?
5.1 ALARM PANEL CLEAR
SYSTEM LEFT IN SERVICE
COMMENTS
I acknowledge that the listed deficiencies have been discussed with me
I am requesting a quote for the repair of said deficiencies.
Owner/Rep signature:
DAT
E
INSPECTOR 'S
SIGNATURE:
All "NO" answers
must
be
fully
explained.
N
N/A
Y
MFS location:
Monthly
Quarterly Inspection job #:
min
888-762-7642
Semiannual
GATEWAY CENTER COLLINSVILLE
One gateway dr
COLLINSVILLE
IL
62234
St. Louis
Kevin Hergenroeder, Tony Witt
03/19/2021 01:00pm CDT
20702582
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
142
142
130
130
130
36
A Witt
03/19/2021 01:00pm CDT
Paul Phipps
✔
Report of Inspection
&
Testing
of Wet Pipe Fire Protection Systems
Monthly / Quarterly / Semiannual
ALL QUESTIONS ARE TO BE FULLY ANSWERED
ANO ALL BLANKS TO BE FILLED
Customer:
System ID
Address:
Inspector Name:
Date
Inspection Frequency:
QUARTERLY REPORT OF INSPECTION
OF
WET PIPE SPRINKLER SYSTEM
(For a Quarterly Inspection, complete all items listed on FORM
94-106A "Report of Inspection - Monthly Items To Be Reviewed"
AND
the items listed below.)
5.2 Hydraulic nameplate attached
5.2
Exterior alarms properly identified
13.7 FDC plainly visible
13.7 FDC easily accessible
13.7 FDC swivels non-binding rotation
13.7 FDC caps/plugs in place
13.7 FDC gaskets/signs in place
13.7 FDC ball drip drain drip free
COMMENTS:
QUARTERLY
TESTING REQUIREMENTS FOR
WET PIPE SPRINKLER SYSTEM
5.2
Spkr. Supply Gauge
psi
5.2
Spkr. System Gauge
psi
5.2
Supply Gauge
Main Drain Flow:
psi
5.2
System Gauge Main Drain Flow
psi
5.3
Inspector's Test Flow
psi
5.3
Time to ring alarm from
Alarm Check Valve
min.
sec.
5.3
Time to ring alarm from Flow Switch
min
sec
5.3
Time to ring alarm from Pressure Switch
sec
y
N/A
N
5.3 Gauges appear operating properly
5.1 Did alarm Supervisory Company receive
signal properly?
5.1 Did Alarm Panel reset properly?
5.1 ALARM PANEL CLEAR
SYSTEM LEFT IN SERVICE
COMMENTS
I acknowledge that the listed deficiencies have been discussed with me
I am requesting a quote for the repair of said deficiencies.
Owner/Rep signature:
DAT
E
INSPECTOR 'S
SIGNATURE:
All "NO" answers
must
be
fully
explained.
N
N/A
Y
MFS location:
Monthly
Quarterly Inspection job #:
min
888-762-7642
Semiannual
GATEWAY CENTER COLLINSVILLE
One gateway dr
COLLINSVILLE
IL
62234
St. Louis
Kevin Hergenroeder, Tony Witt
03/19/2021 01:00pm CDT
20702582
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
140
140
128
128
128
52
A Witt
03/19/2021 01:00pm CDT
Paul Phipps
✔
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Report of Inspection Testing of Wet Pipe Fire (City of Oakland)

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Completed 22 March 2021

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