Fire Sprinkler Inspection Report - duplicate

• Document No.

• Company's Name

• Company's Address (Street/Suite#/City/State/Zip)

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Information

• GFS Texas Order Number:

• Date and Time

  Date

• Report To:

• Site Inspection's Address (Street/Suite/City/State/Zip)

• Has the Building Owner be notified?

  Yes

  No

• Has Fire Marshall been Notified?

  Yes

  No

• Has the building's Security/Maintenance been notified of fire suppression system testing?

  Yes

  No

General Section (A)

• All General question to be answered by the Owner, Owner's Representative, if Owner is not present during Inspection leave question blank

• Is building occupied?

  Yes

  No

  N/A

• Have there been any changes in the occupancy classification or operation since last inspection?

  Yes

  No

  N/A

• Have there been any changes or repairs to the fire protection system since last inspection?

  Yes

  No

  N/A

• Has a fire occurred since last inspection?

  Yes

  No

  N/A

• Have damaged sprinkler components been replaced?

  Yes

  No

  N/A

• Are gravity, surface or pressure tanks protected from freezing?

  Yes

  No

  N/A

• Are the buildings areas protected by a wet system, heated, including the blind attic and perimeter areas, where accessible?

  Yes

  No

  N/A

• Have there been any irregularities in pump operation during weekly/monthly test? (If applicable)

  Yes

  No

  N/A

• Are any of the sprinkler heads 50 years old or older?

  Yes

  No

  N/A

1. General Section (B)

• To be answered by inspector

• Have the sprinkler systems been extended to all visible areas of the building?

  Yes

  No

  N/A

• Does there appear to be proper clearance between the top of all storage and the sprinkler deflector?

  Yes

  No

  N/A

• Are all visible exterior opening protected against the entrance of cold air?

  Yes

  No

  N/A

• Have all fire pumps been tested to their full capacity through the use of hose streams or flow meter within the past 12 months?

  Yes

  No

  N/A

2.Control Valves

• Are all sprinkler system control valves and all other valves in the appropriate open or closed position?

  Yes

  No

• Are all control valves sealed or supervised in the open position?

  Yes

  No

• City connection

Sectional Supply

• Title of city connections

• Type of valve

  OS&Y

  Butterfly

  NRS Valve

• Is valve "Easily Accessible"?

  Yes

  No

• Are signs visible and legible?

  Yes

  No

• Is the valve open?

  Yes

  No

• Is the valve secured

  Yes

  No

• How is it secured?

  Sealed

  Locked

  Supervised

• Is the tamper operational

  Yes

  No

• Fire pump assembly

fire pump assembly

• Title of fire pump

• Photos of Fire Pump

  Media

• Inlet valve

inlet valve

• Type of valve

  OS&Y

  Butterfly

  NRS Valve

• Is valve "Easily Accessible"?

  Yes

  No

• Are signs visible and legible?

  Yes

  No

• Is the valve open?

  Yes

  No

• Is the valve secured

  Yes

  No

• How is it secured?

  Sealed

  Locked

  Supervised

• Is the tamper operational

  Yes

  No

• Flow Meter bypass valve

Flow Meter bypass

• Type of valve

  OS&Y

  Butterfly

  NRS Valve

• Is valve "Easily Accessible"?

  Yes

  No

• Are signs visible and legible?

  Yes

  No

• Is the valve open?

  No

  Yes

• Is the valve secured

  Yes

  No

• How is it secured?

  Sealed

  Locked

  Supervised

• Is the tamper operational

  Yes

  No

• Test Header

Test Header

• Type of valve

  OS&Y

  Butterfly

  NRS Valve

• Is valve "Easily Accessible"?

  Yes

  No

• Are signs visible and legible?

  Yes

  No

• Is the valve open?

  No

  Yes

• Is the valve secured

  Yes

  No

• How is it secured?

  Sealed

  Locked

  Supervised

• Is the tamper operational

  Yes

  No
Discharge valve

• Type of valve

  OS&Y

  Butterfly

  NRS Valve

• Is valve "Easily Accessible"?

  Yes

  No

• Are signs visible and legible?

  Yes

  No

• Is the valve open?

  Yes

  No

• Is the valve secured

  Yes

  No

• How is it secured?

  Sealed

  Locked

  Supervised

• Is the tamper operational

  Yes

  No
Bypass valve

• Type of valve

  OS&Y

  Butterfly

  NRS Valve

• Is valve "Easily Accessible"?

  Yes

  No

• Are signs visible and legible?

  Yes

  No

• Is the valve open?

  Yes

  No

• Is the valve secured

  Yes

  No

• How is it secured?

  Sealed

  Locked

  Supervised

• Is the tamper operational

  Yes

  No
Sectional Supply

• Title of sectional supply

• Type of valve

  OS&Y

  Butterfly

  NRS Valve

• Is valve "Easily Accessible"?

  Yes

  No

• Are signs visible and legible?

  Yes

  No

• Is the valve open?

  Yes

  No

• Is the valve secured

  Yes

  No

• How is it secured?

  Sealed

  Locked

  Supervised

• Is the tamper operational

  Yes

  No

• Sectional Interior

Sectional Interior

• Title of sectional supply

• Type of valve

  OS&Y

  Butterfly

  NRS Valve

• Is valve "Easily Accessible"?

  Yes

  No

• Are signs visible and legible?

  Yes

  No

• Is the valve open?

  Yes

  No

• Is the valve secured

  Yes

  No

• How is it secured?

  Sealed

  Locked

  Supervised

• Is the tamper operational

  Yes

  No
System Riser

• Title of system Riser

• Type of valve

  OS&Y

  Butterfly

  NRS Valve

• Is valve "Easily Accessible"?

  Yes

  No

• Are signs visible and legible?

  Yes

  No

• Is the valve open?

  Yes

  No

• Is the valve secured

  Yes

  No

• How is it secured?

  Sealed

  Locked

  Supervised

• Is the tamper operational

  Yes

  No

• Photos of Riser

  Media
Alarm Line

• Title of alarm line

• Type of valve

  OS&Y

  Butterfly

  NRS Valve

• Is valve "Easily Accessible"?

  Yes

  No

• Are signs visible and legible?

  Yes

  No

• Is the valve open?

  Yes

  No

• Is the valve secured

  Yes

  No

• How is it secured?

  Sealed

  Locked

  Supervised

• Is the tamper operational

  Yes

  No
Backflow

• Title of Backflow

• Type of valve

  OS&Y

  Butterfly

  NRS Valve

• Is valve "Easily Accessible"?

  Yes

  No

• Are signs visible and legible?

  Yes

  No

• Is the valve open?

  Yes

  No

• Is the valve secured

  Yes

  No

• How is it secured?

  Sealed

  Locked

  Supervised

• Is the tamper operational

  Yes

  No

• Photos of Backflow

  Media

3. Water Supplies

• What type of water supply

  City

  Gravity Tank

  Other

• Other Type

• What is the (psi)?

• Test pipe

test pipe

• What is the test pipe location?

• what is the test pipe size? (inches)

• Static pressure before (psi)

• Flow pressure (psi)

• Statice pressure after (psi)

4.Tanks, Pumps, Fire Department Connections

• Do fire pumps,gravity,surface or pressure tanks appear to be in good external condition?

  Yes

  No

  N/A

• Are gravity surface and pressure tanks at the proper pressure and/or water level?

  Yes

  No

  N/A

• Are fire department connections is satisfactory condition, couplings free, caps/plugs in place, check valves tight?

  Yes

  No

  N/A

• Are fire department connections visible and accessible?

  Yes

  No

  N/A
Stairwell

• Title of Stairwell

Floor

• Which Level

Tamper

• Enter Time

  Date

• What color is the Tag

  Blue

  Yellow

  Red

• Deficiencies Notes

• Photo of Tamper

  Media

5.Wet Systems

• Total number of wet systems

• Wet system

wet system

• Photos of Riser

  Media

• Valve Make

• Valve Model

• Valve Size

• Valve Year

• What color tag is on the wet system?

  Blue

  Yellow

  Red

• (If a Yellow or Red tag is select) What is the deficiency?

• Have antifreeze solutions been tested?

  Yes

  No

  N/A

• Were the antifreeze test results satisfactory

  Yes

  No

  N/A

• Test Results

Select Type of Inspection

• Any "No" answer, test failures or other problems found with the sprinkler system must be explained in each comment section provide with the question

  Yes

  No

  N/A

• Weekly Inspection

Weekly

• Control valves supervised with seals in correct (open or closed) position

  Yes

  No

  N/A

• Are Backflow preventers valves in correct (open or closed) position?

  Yes

  No

  N/A

• Are Backflow preventers sealed, locked or supervised and accessible

  Yes

  No

  N/A

• Relief port on RPZ Device not Discharge?

  Yes

  No

  N/A

Regular Maintenance Items

• If sprinklers have been replaced, were they proper replacement

  Yes

  No

  N/A

• Used hose was cleaned, drained and dried before being placed back in service? Hoses exposed to hazardous materials was disposed of or decontaminated in an approved manner.

  Yes

  No

  N/A

• System normally filled with fresh water were drained and refilled twice if raw water got in the system?

  Yes

  No

  N/A

• If any of the following were discovered, was an obstruction investigation conducted?

  Yes

  No

  N/A

• If conditions were found that required flushing, was flushing of system conducted?

  Yes

  No

  N/A

• Monthly Inspection (in addition to previous inspection section)

Monthly

• Control valves with locks or electrical supervision in correct (open or closed) position

  Yes

  No

  N/A

• Sprinkler wrench with spare sprinklers?

  Yes

  No

  N/A

• Gauges in good condition and showing normal water supply pressure?

  Yes

  No

  N/A

• Alarm Valves: gauges show normal supply water pressure, free from physical damage, valves in correct (open or closed) position and no leakage from retarding chamber or drains

  Yes

  No

  N/A

• Quarterly Inspection (in addition to previous inspection section)

Quarterly

• Pressure reducing valves: in open position, not leaking, maintaining downstream pressure per design criteria and in good condition with handwheels not broken

  Yes

  No

  N/A

• Hydraulic nameplate securely attached to riser and legible

  Yes

  No

  N/A

• Fire Department connections: Visible, accessible, couplings and swivels not damaged and rotate smoothly, plugs or caps in place and undamaged, gaskets in place and in good condition, identification sign(s) in place, check valve is not leaking, clapper is in place and operating properly and automatic drain valve in place and operating properly?

  Yes

  No

  N/A

• If plugs or caps are not in place, inspect interior for obstructions.

• Alarm devices free from physical damage?

  Yes

  No

  N/A

Testing

• Mechanical waterflow alarm devices passed test by opening the inspector's test connection or bypass connection with alarms actuating and flow observed?

  Yes

  No

  N/A

• Post indicting valves opened until spring or torsion is felt in the rod, then closed back one quarter turn?

  Yes

  No

  N/A

• The following is main drain test for system downstream of backflow or pressure reducing valve:

• Record Static Pressure (psi)

• Record Residual Pressure (psi)

• Was flow observed?

  Yes

  No

  N/A

• Are results comparable to previous test?

  Yes

  No

  N/A

• Semi-Annual Inspection (in addition to previous inspection section)

Semi-Annual

• Valve supervisory switches indicate movement?

  Yes

  No

  N/A

• electrical waterflow alarm devices passed tests by opening the inspector's test connection or bypass connection with alarms actuating and flow obeserved?

  Yes

  No

  N/A
Annual Inspection (in addition to previous inspection section)

• Proper number and type of spare sprinklers?

  Yes

  No

  N/A

Visible sprinklers:

• Free of corrosion and physical damage

  Yes

  No

  N/A

• Free of obstructions to spray patterns

  Yes

  No

  N/A

• Free of foreign materials including paint?

  Yes

  No

  N/A

• Liquid in all glass bulb sprinklers

  Yes

  No

  N/A

Visible pipe:

• In good condition/no external corrosion?

  Yes

  No

  N/A

• No mechanical damage and no leaks?

  Yes

  No

  N/A

• Properly aligned and no external loads?

  Yes

  No

  N/A

• Visible pipe hangers and seismic braces not damaged or loose?

  Yes

  No

  N/A

• Hose, hose couplings and nozzles on sprinkler system passed inspection in accordance with NFPA 1962?

  Yes

  No

  N/A

• Is visible wet pipe In areas with adequate heat?

  Yes

  No

  N/A

• Has an internal inspection of the pipe been performed by removing the flushing connection and one sprinkler near the end of the branchline within the last five (5) years? (If not conduct an internal inspection) Take Pictures

  Yes

  No

Testing

• Main Drain Test: Record Static Pressure (psi)

  Yes

  No

  N/A

• Main Drain Test: Record Residual Pressure (psi)

  Yes

  No

  N/A

• Was the main drain flow observed?

  Yes

  No

  N/A

• Are the main drain results comparable to previous test?

  Yes

  No

  N/A

• Are all sprinkler dated 1920 or later?

  Yes

  No

  N/A

• Fast response sprinkler 20 or more years old replaced or successfully sample tested within last 10 years?

  Yes

  No

  N/A

• Standard response sprinkler 50 or more years old replaced or successfully sample tested within last 10 years?

  Yes

  No

  N/A

• Standard response sprinkler 70 or more years old replaced or successfully sample tested within last 5 years?

  Yes

  No

  N/A

• Dry-type sprinklers replaced or successfully sample tested within last 10 years?

  Yes

  No

  N/A

• Specific gravity of antifreeze correct?

  Yes

  No

  N/A

• All control valves operated through full range and returned to normal position

  Yes

  No

  N/A

• Backflow devices pass backflow test

  Yes

  No

  N/A

• Backflow devices pass full flow test?

  Yes

  No

  N/A

• Pressure reducing valves passed partial flow test?

  Yes

  No

  N/A

Test to be done every third year

• Hose (more than 5 years old) connected to the system has ben serviced tested in accordance with NFPA 1962. Water discharged and water flow alarms operated?

  Yes

  No

  N/A

Maintenance Items

• Operating stem of OS&Y valves lubricated, completely closed, and reopened?

  Yes

  No

  N/A

• Sprinkler and spray nozzles protecting commercial cooking equipment and ventilating systems replaced except for bulb-type which show no signs of grease buildup?

  Yes

  No

  N/A

• Fifth year inspection (in addition to previous inspection section)

Fifth year

• Alarm valves and their associated strainers, filters and restriction orifices passed internal inspection?

  Yes

  No

  N/A

• Check valves internally inspected and all parts operate properly move freely and are in good condition?

  Yes

  No

  N/A

Testing

• Sprinkler rated above High temperature tested?

  Yes

  No

  N/A

• Gauges checked by calibrated gauge or replaced?

  Yes

  No

  N/A

• Pressure reducing valves passed full flow test?

  Yes

  No

  N/A

• Additional Photos

  Media

• Additional Comments

7.Alarms

• Did the water motor gong operate during testing?

  Yes

  No

  N/A

• Did the electrical alarms operate during testing?

  Yes

  No

  N/A

• Did the supervisory alarms operate during testing?

  Yes

  No

  N/A

• Was the water flow alarm indicator and retard test satisfactory?

  Yes

  No

  N/A

• What was the time (seconds)

8.Special Systems

• Fire Extinguishers

• Is GFS Texas conducting inspections of Fire Extinguisher

  Yes

  No

  N/A

• Vent Hoods

• Is GFS Texas conducting inspections of Vent Hoods

  Yes

  No

  N/A

• Halon

• Is GFS Texas conducting inspections of Halon system(s)

  Yes

  No

  N/A

• FM-200

• Is GFS Texas conducting inspections of FM-200 system(s)

  Yes

  No

  N/A

• Deluge

• Is GFS Texas conducting inspections of Deluge system(s)

  Yes

  No

  N/A

• Pre-Action

• Is GFS Texas conducting inspections of Pre-action system(s)

  Yes

  No

  N/A

• Note: Before any Dry pipe, Deluge, or Pre-action valve is trip tested. the water supply lines should be throughly flushed. The two-inch drain below the valve should be opened wide and water at full pressure should be discharged long enough to clear pipe of any accumulation of scale or foreign material. the drip valve on the dry pipe valve should be checked before tripping the dry pipe valve to see that it is in operating condition.

• What inspection is being performed

  Select Weekly Monthly Quaterly Semi-Annual Annual Third Year Fifth Year Special

  • Weekly
  • Monthly
  • Quaterly
  • Semi-Annual
  • Annual
  • Third Year
  • Fifth Year
  • Special

• Add Pre-action system

Pre-action system

• System Title

• What area is the Pre-action system protecting?

• What Color tag is on the system?

  Blue

  Yellow

  Red

• If Yellow or Red Tag are on system what is the deficiency?

• What is the Valve Size (inches)

• Valve Manufacturer (Name)

• Valve Serial Number

• Controlling sprinklers in location

• Approximate number of sprinkler heads on system

• Did Alarms operate at trip test

  Yes

  No

• Static pressure of air (psi)

• Static pressure of water (psi)

• Is the condition of the interior body of the valve satisfactory?

  Pass

  Fail

• Are the conditions of the moving parts of the valve satisfactory?

  Pass

  Fail

• Is the conditions of the rubber gasket on the face of the valve satisfactory?

  Pass

  Fail

• Is the valve seat condition satifactory

  Pass

  Fail

• Is the valve seating properly?

  Pass

  Fail

• Does the valve reset properly?

  Pass

  Fail

• Overall valve performance

  Pass

  Fail

• Does the system have a supervisory "Low Air" device?

  Yes

  No

  N/A

• The Pre-Action operation is

  Pneumatic

  Electric

  Hydraulic

• What type of electric detection is the system

  Single Zone

  Cross Zone

• Does it operate are per manufacturer's guidelines

  Yes

  No

• The Pre-Action valve operation is

  Remote

  Manual

• Does it operate are per manufacturer's guidelines

  Yes

  No

• Maximum time to operate release (Minutes:Seconds)

• Was the priming line left open

  Yes

  No

  N/A

• Were the water and alarm lines left open

  Yes

  No

  N/A

Operating devices, actuators

• Device's Serial Number

• Device's year of manufacture

• What is the air pressure in the upper chamber? (psi)

• Did actuator device trip properly?

  Yes

  No

• Notes:

• Dry System

• Is GFS Texas conducting inspections of Dry System system(s)

  Yes

  No

  N/A

• Note: Before any Dry pipe, Deluge, or Pre-action valve is trip tested. the water supply lines should be throughly flushed. The two-inch drain below the valve should be opened wide and water at full pressure should be discharged long enough to clear pipe of any accumulation of scale or foreign material. the drip valve on the dry pipe valve should be checked before tripping the dry pipe valve to see that it is in operating condition.

• What inspection is being performed

  Select Weekly Monthly Quaterly Semi-Annual Annual Third Year Fifth Year Special

  • Weekly
  • Monthly
  • Quaterly
  • Semi-Annual
  • Annual
  • Third Year
  • Fifth Year
  • Special

• Add Dry system

Dry system

• System Title

• What area is the Dry system protecting?

• What Color tag is on the system?

  Blue

  Yellow

  Red

• If Yellow or Red Tag are on system what is the deficiency?

• What is the Valve Size (inches)

• Valve Manufacturer (Name)

• Valve Serial Number

• Controlling sprinklers in location

• Approximate number of sprinkler heads on system

• What is the air pressure before testing? (psi)

• What is the water pressure before testing (psi)

• Was the gate valve below dry valve open wide

  Yes

  No

• How many turns to open valve (360 degree = 1 turn)

• The valve was tripped at what air pressure (psi)

• The valve was tripped at what water pressure (psi)

• Time elapsed to trip valve (Minutes:Seconds)

• Was dry system flooded

  Yes

  No

• What time elapsed for water to reach test opening? (Minutes:Seconds)

• Is the condition of the interior body of the valve satisfactory?

  Pass

  Fail

• Are the conditions of the moving parts of the valve satisfactory?

  Pass

  Fail

• Is the conditions of the rubber gasket on the face of the valve satisfactory?

  Pass

  Fail

• Is the valve seat condition satifactory

  Pass

  Fail

• Is the valve seating properly?

  Pass

  Fail

• Does the valve reset properly?

  Pass

  Fail

• Overall valve performance

  Pass

  Fail

• Did alarms operate properly at trip test?

  Yes

  No

• All low point drains blown out

  Yes

  No

  N/A

• Was water control valve left open

  Yes

  No

  N/A

• Was the alarm control valves left open

  Yes

  No

  N/A

Quick Opening devices

• Device's Serial Number

• Device's manufacturer name

• What is the air pressure in the upper chamber? (psi)

• Did quick opening device operate properly?

  Pass

  Fail

• What pressure did the quick opening device trip (psi)

• How long did it take to trip? (seconds)

• Was the quick opening device left in service

  Yes

  No

• Was the control valve left open and sealed

  Yes

  No

• Notes:

• Other

• Specify Other systems

Conclusion

• Although these comments are not the result of and engineering review, the following improvements are recommended for code compliance

• Deficiencies and Recommendations

• Additional Photos

  Media

• Additional Notes

6. Dry System

• Total number of Dry systems

• Add Dry System

Dry System

• Photos of riser

  Media

• Valve Make

• Valve Model

• Valve Size

• Valve year

• Daily/Weekly Inspection

Weekly

• Control Valves supervised with seals in correct (open or closed) position?

  Yes

  No

  N/A

• Monthly Inspection (in addition to above inspection section)

Monthly

• Quarterly Inspection (in addition to above inspection section)

Quarterly

• Semi-Annual Inspection (in addition to above inspection section)

Semi-Annual

• Annual Inspection (in addition to above inspection section)

Annual Fifth Year Inspection (in addition to above inspection section)