Fire Standpipe Inspection Report

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

• Owner:

• Owners Address:

• Property Being Inspected:

• Property Address:

• Date of Inspection

  Date

• This Inspection is:

  Annual

  Quarterly

  Preliminary

Part I - Owner's Section

• A. Is the building occupied?

  Yes

  No

  N/A

• B. Has the occupancy classification and hazard of contents remained the same since the last inspection?

  Yes

  No

  N/A

• C. Are all fire protection systems in service?

  Yes

  No

  N/A

• D. Has the system remained in service without modification since the last inspection?

  Yes

  No

  N/A

• E. Was the system free of actuation of devices or alarms since the last inspection?

  Yes

  No

  N/A

• Owner or Representative:

  Sign

Part II - Inspector's Section

A. Inspections

1. Daily Inspection Item

• Enclosures around dry-pipe valves (without low temperature alarms) maintaining a minimum of 40º F?

  Yes

  No

  N/A

2. Weekly Inspection Items.

• A. Relief port on reduced pressure backflow prevention assemblies free of continuos discharge

  Yes

  No

  N/A

• B. Gauges on dry systems (without low pressure alarm) in good condition & showing normal air and water pressure?

  Yes

  No

  N/A

• C. Sealed Control Valves and Valves on Backflow Assemblies:

• 1. In normal (open or closed) position?

  Yes

  No

  N/A

• 2. Accessible and with seals in place?

  Yes

  No

  N/A

• 3. Free from external leaks?

  Yes

  No

  N/A

• 4. Provided with appropriate identification?

  Yes

  No

  N/A

3. Monthly Inspection Item

• A. Dry-Pipe Valves:

• 1. Enclosures around valves (with low temperature alarms maintaining a minimum of 40º F?

  Yes

  No

  N/A

• 2. Free from physical damage?

  Yes

  No

  N/A

• 3. Trim valves in appropriate (open or closed) position?

  Yes

  No

  N/A

• 4. No leaking from intermediate chamber?

  Yes

  No

  N/A

• B. Hose Connection Pressure Valves:

• 1. Handwheels in place and in good condition?

  Yes

  No

  N/A

• 2. Hose threads in good condition?

  Yes

  No

  N/A

• 3. Valves not leaking?

  Yes

  No

  N/A

• 4. Reducers and caps in place and in good condition?

  Yes

  No

  N/A

• C. Hose Rack Assembly Pressure Regulating Vavles:

• 1. Handwheels in place and in good condition?

  Yes

  No

  N/A

• 2. Valves not leaking?

  Yes

  No

  N/A

• D. Gauges on dry system (with low pressure alarm) in good condition and showing normal air and water pressure?

  Yes

  No

  N/A

• E. Control Valves & Valves on Backflow Assemblies (with locks or electric supervision):

• 1. In normal (open or closed) position?

  Yes

  No

  N/A

• 2. Lock or supervision in place?

  Yes

  No

  N/A

• 3. Accessible and free from external leaks?

  Yes

  No

  N/A

• 4. Provided with appropriate wrenches?

  Yes

  No

  N/A

• 5. Provided with appropriate identification?

  Yes

  No

  N/A

• F. Gauges on wet pipe system in good condition and showing normal water supply pressure?

  Yes

  No

  N/A

• G. Alarm devices free from physical damage?

  Yes

  No

  N/A

• H. Alarm Valves:

• 1. Gauges indicating normal water pressure?

  Yes

  No

  N/A

• 2. Free from physical damage?

  Yes

  No

  N/A

• 3. Valves in correct (open or closed) position?

  Yes

  No

  N/A

• 4. No leakage from retard chamber or drains?

  Yes

  No

  N/A

4. Quarterly Inspection Items

• A. Hose Valve Outlets:

• 1. Caps, hose connections, valve handle, cap gasket, restricting devices in place, undamaged and in good condition?

  Yes

  No

  N/A

• 2. Valves not leaking and no visible obstructions?

  Yes

  No

  N/A

• B. Visible pipe and supports in good condition?

  Yes

  No

  N/A

• C. Alarm devices free from physical damage?

  Yes

  No

  N/A

• D. Fire Department Connections:

• 1. Visible, accessible and identified?

  Yes

  No

  N/A

• 2. Couplings and swivels not damaged and rotate smoothly?

  Yes

  No

  N/A

• 3. Plugs or caps in place and undamaged?

  Yes

  No

  N/A

• 4. Gaskets in place and in good condition?

  Yes

  No

  N/A

• 5. Check valves not leaking?

  Yes

  No

  N/A

• 6. Automatic drain valves in place and operating properly?

  Yes

  No

  N/A

• Note: If plugs or caps are not in place, inspect the the interior and verify that the valve clapper is operational over its full range.

5. Annual Inspection Items

• A. Hose:

• 1. Free from mildew, cuts and deterioration?

  Yes

  No

  N/A

• 2. Couplings of compatible threads and undamaged?

  Yes

  No

  N/A

• 3. Gaskets in place and in good condition?

  Yes

  No

  N/A

• 4. Hose connected?

  Yes

  No

  N/A

• B. Hose Nozzles:

• 1. Nozzles & gaskets in place and good condition?

  Yes

  No

  N/A

• 2. No visible obstructions?

  Yes

  No

  N/A

• 3. Nozzles operate smoothly?

  Yes

  No

  N/A

• C. Hose Storage Devices:

• 1. Hose properly racked or rolled?

  Yes

  No

  N/A

• 2. Nozzle clips in place and nozzles contained?

  Yes

  No

  N/A

• 3. Devices undamaged, unobstructed and operable?

  Yes

  No

  N/A

• 4. Will racks swing out of cabinet at least 90º?

  Yes

  No

  N/A

• D. Storage Cabinets:

• 1. Cabinets have no corroded or damaged parts?

  Yes

  No

  N/A

• 2. Cabinets easy to fully open?

  Yes

  No

  N/A

• 3. Door glazings in good condition?

  Yes

  No

  N/A

• 4. Locks functioning in break-glass type cabinets?

  Yes

  No

  N/A

• 5. Cabinets accessible and identified?

  Yes

  No

  N/A

• 6. All parts, valves, hoses and fire extinguishers accessible?

  Yes

  No

  N/A

• E. Adequate heat available to areas where wet pipe is located?

  Yes

  No

  N/A

• (Must be done before cold weather)

• F. Interior of dry-pipe valves (which must be open to be reset) passed internal inspection?

  Yes

  No

  N/A

6. Fifth Year Inspection Items

• A. Interior of dry-pipe valves (which can be reset without opening) passed internal inspection?

  Yes

  No

  N/A

• B. Alarm valves and their associated strainers, filters and restriction orifices passed internal inpsection?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• D. Strainers, filters, restricted orifices and diaphragm chambers on dry-pipe valves passed internal inspection?

  Yes

  No

  N/A

B. Testing

• The following tests are to be performed at the noted intervals. Report any failures on Part II of this form.

1. Quarterly Tests

• A. Main Drain Test

• 1. Record static pressure and residual pressure. (PSI)

• 2. Was flow observed?

  Yes

  No

  N/A

• 3. Are results comparable to pressures from last test?

  Yes

  No

  N/A

• B. Mechanical water flow alarm devices passed test?

  Yes

  No

  N/A

• 1. Inspectors test connection opened? (wet pipe when not in freezing weather)

  Yes

  No

  N/A

• 2. Bypass connection opened? (wet pipe systems in freezing weather or dry pipe)

  Yes

  No

  N/A

• 3. Alarms actuated?

  Yes

  No

  N/A

• 4. Was flow observed?

  Yes

  No

  N/A

• C. Control valved (except OS&Y and gear-operated indicating butterfly valves) opened until spring or torsion is felt in the rod, when closed back one quarter turn?

  Yes

  No

  N/A

• D. Priming water level (dry-pipe) passed test?

  Yes

  No

  N/A

• E. Low air pressure signal (dry-pipe) passed test?

  Yes

  No

  N/A

• F. Quick opening device passed test?

  Yes

  No

  N/A

• G. Valve supervisory devices indicate movement?

  Yes

  No

  N/A

2. Semiannual Test (in addition to the above items)

• A. Electrical waterflow alarm devices passed tests?

  Yes

  No

  N/A

• 1.Inspector's test connection opened?

  Yes

  No

  N/A

• 2. Bypass connection opened?

  Yes

  No

  N/A

• 3. Alarms actuated?

  Yes

  No

  N/A

• 4. Was flow observed?

  Yes

  No

  N/A

• B. Valve supervisory devices indicate movement?

  Yes

  No

  N/A

3. Annual Tests (in addition to above items)

• A. System Main Drain Test (automatic water supply)

  Yes

  No

  N/A

• 1. Record static pressure and residual (PSI)

• 2. Was flow observed?

  Yes

  No

  N/A

• 3. Are results comparable to previous test?

  Yes

  No

  N/A

• B. Specific gravity of antifreeze correct?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• D. Low temperature alarms in dry pipe enclosures passed test?

  Yes

  No

  N/A

• E. Dry-Pipe valve partial flow trip test:

• 1. Record initial air pressure and water pressure (PSI)

• 2. Record tripping air pressure and time. (PSI & SEC)

• 3. Above results comparable to previous tests?

  Yes

  No

  N/A

• F. Automatic air maintenance devices on dry-pipe system passed test?

  Yes

  No

  N/A

• G. Backflow devices passed backflow test?

  Yes

  No

  N/A

• H. Backflow devices passed full flow test?

  Yes

  No

  N/A

• I. Pressure reducing valves passed partial flow test?

  Yes

  No

  N/A

4. Third Year Tests (in addition to above items)

• A. Dry-Pipe valve full flow trip test:

• 1. Record initial air pressure and water pressure. (PSI)

• 2. Record tripping air pressure and time. (PSI) (SEC.)

• 3. Was water delivered to inspectors test connection?

  Yes

  No

  N/A

• 4. Above results comparable to previous tests?

  Yes

  No

  N/A

• B. Is hose less than five years old?

  Yes

  No

  N/A

• If "NO" has hose been tested within three years?

• If "NO" test hose now and every three years.

5. Fifth Year Tests

• A. Gauges tested against calibrated one or replaced?

  Yes

  No

  N/A

• B. Standpipe systems tested at required flows:

• 1. Record static pressure and residual pressure. (PSI)

• 2. Record total flow. (GPM)

• 3. Above flows and pressures acceptable?

  Yes

  No

  N/A

• C. Manual systems not part of a sprinkler/standpipe system passed hydrostatic test?

  Yes

  No

  N/A

• D. All hose connection and hose rack assembly pressure reducing and pressure control valves passed full flow test?

  Yes

  No

  N/A

C. Maintenance

• 1. Regular Maintenance Items

• A. Items found missing or in disrepair during inspection or testing repaired or replaced?

  Yes

  No

  N/A

• B. Air leaks in dry-pipe systems resulting in air pressure loss more than 10 psi/week repaired?

  Yes

  No

  N/A

• C. Dry systems being maintained in dry condition?

  Yes

  No

  N/A

• D. If any of the following were discovered, was an obstruction investigation conducted and the system flushed?

  Yes

  No

  N/A

Explain reasons and obstruction investigation findings in Part III.

• 1. Defective intake screen for pumps taking suction from open sources.

• 2. Obstructive material discharged during waterflow test?

• 3. Foreign materials found in dry-pipe valves, check valves or pumps.

• 4. Heavy discoloration of water during drain test or plugging of inspector's test connection.

• 5. Plugging found in piping dismantled during alterations.

• 6. Failure to flush yard piping or surrounding public mains following new installation or repairs.

• 7. Record or broken mains in the vicinity.

• 8. Abnormally frequent false tripping of dry-pipe valves.

• 9. System is returned to service after an extended period out of service (greater than one year).

• 10. There is reason to believe the system contains sodium silicates or its derivatives.

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

  Yes

  No

  N/A

2. Annual Maintenance Items (in addition to above items)

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

  Yes

  No

  N/A

• B. Hose repacked or rerolled so folds do not occur in same position?

  Yes

  No

  N/A

• C. Interior of dry-pipe valves cleaned?

  Yes

  No

  N/A

• D. Low points drained in dry systems prior to onset of freezing wether?

  Yes

  No

  N/A

Part III- Comments (Any "no" answers, test failures or other problems found with the standpipe and hose system must be explained here.)

• Notes:

Part IV - Inspector's Information

• Inspector:

• Company:

• Company Address:

• I state that the information on this form is correct at the time and place of inspection, and that all equipment tested at this time was left in operational condition upon completion of this inspection except as noted in Part III aboce.

• Inspector:

  Sign

• Select date

  Date

• License or Certification Number (if applicable):

  Sign

Backflow Preventer

• Tested for NFPA 25 Requirements ONLY. Certification DOSE NOT fall within the scope of this inspection.

Fire Alarm

• Inspection & Certification is to be performed by and Alarm Contractor.

Fire Extinguisher(s)

• Inspection & Certification is to be performed by Others.

NFPA 25 2008: 4.1.5 "Changes in Occupancy, Use, Process, or Materials"

• The property owner or occupant shall not make changes in the occupancy, the use or the material used or stored in the building without evaluation of the fire protection systems for their capability to protect the new occupancy, use or materials.

NFPA 25 2008: 4.1.6 "Addressing Changes in Hazard"

• Where changes in the occupancy, hazar, water supply, storage commodity, storage arrangement, building modification, or other condition that affects the installation criteria of the system are identified, the property owner or occupant shall promptly take steps, such as contacting a qualified contractor, consultant or engineer, and the authority having jurisdiction, to evaluate the adequate of the installed system in order to protect the building or hazard in question.,