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Home My WebLink About25 44th Ave NECONTRACTOR'S MATERIAL & TEST CERTIFICATE FOR ABOVEGROUND PIPING PROCEDURE UPON COMPLETION OF WORK, INSPECTION AND TESTS SHALL BE MADE BY THE CONTRACTOR'S REPRESENTATIVE AND WITNESSED BY AN OWNER'S REPRESENTATIVE. ALL DEFECTS SHALL BE CORRECTED AND SYSTEM LEFT IN SERVICE BEFORE CONTRACTOR'S PERSONNEL FINALLY LEAVE THE JOB. A CERTIFICATE SHALL BE FILLED OUT AND SIGNED BY BOTH REPRESENTATIVES. COPIES SHALL BE PREPARED FOR APPROVING AUTHORITIES, OWNERS, AND CONTRACTOR. IT IS UNDERSTOOD THE OWNER'S REPRESENTATIVE'S SIGNATURE IN NO WAY PREJUDICES ANY CLAIM AGAINST CONTRACTOR FOR FAULTY MATERIAL, POOR WORKMANSHIP, OR FAILURE TO COMPLY WITH APPROVING AUTHORITY'S REQUIREMENTS OR LOCAL ORDINANCES. PROPERTY NAME DATE Genereal Mills 2/01/06 PROPERTY ADDRESS 25 44"' ave NE Fridley, MN ACCEPTED BY APPROVING AUTHORITY(S) NAMES Fridley ADDRESS PLANS 6431 University ave NE Fridley, MN 55432 INSTALLATION CONFORMS TO ACCEPTED PLANS OYES NO EQUIPMENT USED IS APPROVED ®YES []NO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION OF ONO YES CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? INSTRUCTIONS IF NO, EXPLAIN HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: j@YES NO 1. SYSTEM COMPONENTS INSTRUCTIONS OYES []NO 2. CARE AND MAINTENANCE INSTRUCTIONS OYES ONO 3. NFPA 25 OYES []NO LOCATION OF SUPPLIES BLDGS. SYSTEM Dry System MAKE MODEL YEAR OF ORIFICE SIZE QUANTITY TEMPERATURE MANUFACTURE RATING Viking VK108 2005 1/2" 180 2860 SPRINKLERS o 0 0 0 TYPE OF PIPE Galvanized Schedule 40 PIPE AND FITTINGS TYPE OF FITTINGS Grooved and Screwed ALARM VALVE ALARM DEVICE MAXIMUM TIME TO OPERATE THROUGH TEST CONNECTION OR FLOW enk TYPE MAKE MODEL MIN. SEC. INDICATOR . c I V DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. TYCO DPV -1 :Ls Srs TIME TO TRIP WATER AIR TRIP POINT TIME WATER ALARM THRU TEST PRESSURE PRESSURE AIR REACHED OPERATED DRY PIPE CONNECTION PRESSURE TEST OUTLET PROPERLY OPERATING MIN. SEC. PSI PSI PSI MIN. SEC. YES NO TEST WITHOUT Q.O.D. ► S �0 40 AS WITH Q.O.D. IF NO, EXPLAIN GENERAL INFORMATION AUDI I IONAL LAF'LANA I ION AND NOTES: 1 I OPERATION OPNEUMATIC ❑ELECTRIC ❑HYDRAULIC PIPING SUPERVISED OYES ONO DETECTING MEDIA SUPERVISED ❑YES ❑NO DOES VALVE OPERATE FROM THE MANUAL TRIP AND /OR REMOTE CONTROL STATIONS OYES ONO DELUGE & IS THERE AN ACCESSIBLE FACILITY IN EACH CIRCUIT FOR IF NO, EXPLAIN PREACTION TESTING ❑YES ONO VALVES DOES EACH CIRCUIT OPERATE DOES EACH CIRCUIT MAXIMUM TIME TO OPERATE MAKE MODEL SUPERVISION LOSS ALARM OPERATE VALVE RELEASE RELEASE YES NO YES NO MIN. SEC. PRESSURE LOCATION & FLOOR MAKE & MODEL SETTING STATIC PRESSURE RESIDUAL PRESSURE FLOWING FLOW RATE REDUCING INLET (PSI) OUTLET (PSI) INLET (PSI) OUTLET (PSI) FLOW GPM VALVE TEST HYDROSTATIC: HYDROSTATIC TESTS SHALL BE MADE AT NOT LESS THAN 200 PSI (13.6 BARS) FOR TWO HOURS OR 60 PSI (3.4 BARS) ABOVE STATIC PRESSURE IN EXCESS OF 150 PSI (10.2 BARS) FOR TWO HOURS. DIFFERENTIAL DRY -PIPE VALVE CLAPPERS SHALL BE LEFT OPEN DURING TEST TO PREVENT DAMAGE. ALL ABOVE GROUND PIPING LEAKAGE TEST SHALL BE STOPPED. DESCRIPTION PNEUMATIC: ESTABLISH 40 PSI (2.7 BARS) AIR PRESSURE AND MEASURE DROP WHICH SHALL NOT EXCEED 1 -1/2 PSI (0.1 BARS) IN 24 HOURS. TEST PRESSURE TANKS AT NORMAL WATER LEVEL AND AIR PRESSURE AND MEASURE AIR PRESSURE DROP WHICH SHALL NOTE EXCEED 1 -1/2 PSI 0.1 BARS IN 24 HOURS. ALL PIPING HYDROSTATICALLY TESTED AT 200 PSI FOR 2 HOURS. DRY PIPING PNEUMATICALLY TESTED OYES ONO IF NO, STATE REASON EQUIPMENT OPERATES PROPERLY OYES ONO DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM SILICATE OR DERIVATIVES OF SODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? YES ONO DRAIN TEST READING OF GAGE LOCATED NEAR WATER SUPPLY TEST CONNECTION: SO PSI I RESIDUAL PRESSURE WITH VALVE IN TEST CONNECTION OPEN WIDE R$ PSI UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISERS FLUSHED BEFORE CONNECTION MADE TO TESTS SPRINKLER PIPING VERIFIED BY COPY OF THE U FORM NO.85B DYES ONO OTHER EXPLAIN FLUSHED BY INSTALLER FOR UNDERGROUND SPRINKLER PIPING OYES ONO IF POWDER DRIVEN FASTENERS ARE USED IN ®YES ❑NO IF NO, EXPLAIN CONCRETE, HAS REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? BLANK NUMBER USED LOCATIONS NUMBER REMOVED TESTING NONE GASKETS WELDED PIPING OYES ONO IF YES... DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING PROCEDURES ®YES NO COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS D10.9 LEVEL AR -3? WELDING DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS QUALIFIED IN OYES ONO COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS D10.9 LEVEL AR -3? DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DOCUMENTED QUALITY CONTROL PROCEDURE TO INSURE THAT ALL DISCS ARE RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED ? ®YES ONO CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL DISCS CUTOUTS DISCS ARE RETRIEVED? OYES ❑NO HYDRAULIC NAMEPLATE PROVIDED ZYES ONO IF NO, EXPLAIN DATA NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN:ti NAME OF SPRINKLER CONTRACTOR NEWMECH COMPANIES, INC. LICENSE #000017 SIGNATURES TEST WITNESSED BY NER SI NED) TITL4L DATES Z, Q& F R SP INKL O (SIGNED) �yTITLE 011 DATE AUDI I IONAL LAF'LANA I ION AND NOTES: 1 I