High Rise - Fire Sprinkler Inspection Report

• Document No.

• Company's Name

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

• Conducted on

  Date

• Prepared by

• Personnel

Information

• GFS Texas Order Number:

• Date and Time

  Date

• Report To:

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

• Is the building occupied?

  Yes

  No

  N/A

• Has the Building Owner been notified?

  Yes

  No

• Has the Fire Marshall been Notified? (If "No" does the FM need to notified to perform inspection)

  Yes

  No

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

  Yes

  No

General Section (A) - To only be answered by the Owner or Owner's Representative

• Is the Owner or Owner's Representative Present during inspection?

  Yes

  No

• Name, Title and Signature

  Sign

• 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

General Section (B)- to only be answered by Inspector

• Does there appear to be proper clearance between the top of all storage and the sprinklers' deflectors?

  Yes

  No

  N/A

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

  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

• What type of inspection has the Owner been performing on the fire suppression systems?

  Select Weekly Monthly Quaterly Semi-Annual Annual Third Year Fifth Year Special None

  • Weekly
  • Monthly
  • Quaterly
  • Semi-Annual
  • Annual
  • Third Year
  • Fifth Year
  • Special
  • None

• Are these inspection performed at normal intervals?

  Yes

  No

  N/A

General Inspection Questions

City Connection

• City Connection

Connection

• What type of water supply

  City

  Gravity Tank

  Other

• Other Type

Test Pipe

• What is the test pipe connection?

• What is the size of the test pipe? (inches)

• Static pressure before (psi)

• Flow Pressure (psi)

• Static pressure after (psi)

Backflow

• Title of Backflow

• What type are the valves?

• Are valves "Easily Accessible"?

  Yes

  No

  N/A

• Are signs visible and legible?

  Yes

  No

  N/A

• Are the valves open?

  Yes

  No

  N/A

• Are the valves secured?

  Yes

  No

  N/A

• Is the tamper operational?

  Yes

  No

  N/A

• Photo of Backflow

  Media

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

• Weekly Inspection

Weekly

• Are the 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

• If sprinklers have been replaced, were proper replacement used?

  Yes

  No

  N/A

• Monthly Inspection (in addition to previous inspection section)

Monthly

• Are 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?

  Yes

  No

  N/A

• Are 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

• Are the hydraulic nameplates securely attached to risers 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 on the Fire Department Connection, 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

• Did post indicting valves open until spring or torsion is felt in the rod? (then closed back one quarter turn)

  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 observed?

  Yes

  No

  N/A

• Annual Inspection (in addition to previous inspection section)

Annual

• 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

• Are visible pipe hangers and seismic braces damaged or loose?

  Yes

  No

  N/A

• Does VISIBLE wet pipe have 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

• 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

• 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

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

Fifth year

• 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

Wet Pipe

• Total Number of Wet Pipe Systems?

• Wet Systems

Wet System

• Title of System Riser

• Photo of System Riser

  Media

• Size of System Riser

• System Riser Valve Information (Make/Model/Year)

• Is the valve "Easily Accessible"?

  Yes

  No

  N/A

• Are signs visible and legible?

  Yes

  No

  N/A

• Is the valve open? (if no, is it supposed to be closed?)

  Yes

  No

• Is the valve secured?

  Yes

  No

  N/A

• Is the tamper operational?

  Yes

  No

  N/A

• What color tag was placed on riser after inspection? (If a Yellow or Red tag is select) What is the deficiency?

  Blue

  Yellow

  Red

• Does system use antifreeze solution?

  No

  Yes

• Test Results?

• Were the antifreeze test results satisfactory?

  Yes

  No

  N/A

• Type of valve (Make/Model/Year)

• Valve size (inches)

• Photo of Anti-Freeze Valve

  Media

• 1. Defective intake screen on pump with suction from open source.
  2. Obstructive material discharged during waterflow tests.
  3. Foreign materials found in dry-pipe valves, check valves or pumps.
  4. Foreign material in water during drain test or plugging of inspector's test connection.
  5. Plugging of pipe of sprinklers found during activation or alteration.
  6. Failure to flush yard piping or surrounding public mains following new installation or repair.
  7. Record of broken mains in the vicinity.
  8. Abnormally frequent false-tripping of dry-pipe valve.
  9. System is returned to service after extended period out of service (greater than 1 year).
  10. There is reason to believe the system contains sodium silicate or its derivatives or highly corrosive fluxes in copper pipe systems.

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

  Yes

  No

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

  Yes

  No

  N/A

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 satifactory?

  Yes

  No

  N/A

• What was the time (seconds)

General Wet-Pipe Inspection

• Gauges of wet-pipe system showing normal water supply?

  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

• Is this any Annual Inspection or Quarterly Inspection?

  Annual

  Quarterly

Main drain test

• Record Static Pressure (psi)

• Record Residual Pressure (psi)

• Are results comparable to previous test?

  Yes

  No

  N/A

• Was flow observed?

  Yes

  No

  N/A

6. Dry System

• Total number of Dry systems

• Add Dry System

Dry System

• Title of system riser

• Photos of system riser

  Media

• System Riser Valve Information (Make/Model/Year)

• System Riser Size

• Is the valve "Easily Accessible"?

  Yes

  No

  N/A

• Are signs visible and legible?

  Yes

  No

  N/A

• Is the valve open? (if no, is it supposed to be closed?)

  Yes

  No

  N/A

• Is the valve secured?

  Yes

  No

  N/A

• Is the tamper operational?

  Yes

  No

  N/A

• What color tag was placed on the riser after inspection? (If a Yellow or Red tag is select) What is the deficiency?

  Blue

  Yellow

  Red

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)

General Dry System 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

• Dry-Pipe Valve: enclosure around valves maintaining a minimum of 40F and gauge in good condition showing normal air and water pressure?

  Yes

  No

  N/A

• For freezer systems, is the gage near the compressor reading the same as the gage near the dry-pipe valve?

  Yes

  No

  N/A

• Dry Pipe Valve: free from physical damage, trim valves in appropriate (open or closed) position and no leakage from intermediate chamber?

  Yes

  No

  N/A

• Dry-pipe valves passed internal inspection?

  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 a branchline within the last 5 years? If the answer is "No" conduct an internal inspection

  Yes

  No

  N/A

• Low temperature alarms passed test?

  Yes

  No

  N/A

• Automatic air maintenance device passed test?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Air leaks in dry-pipe system resulting in air pressure lost more than 10psi/week repaired?

  Yes

  No

  N/A

• Dry pipe systems maintained in dry condition?

  Yes

  No

  N/A

• Have low point drains been emptied?

  Yes

  No

  N/A

• Interior of dry-pipe valve cleaned?

  Yes

  No

  N/A

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

  Yes

  No

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

  Yes

  No

  N/A

• 1. Defective intake screen on pump with suction from open source
  2. Obstructive material discharged during waterflow tests
  3. Foreign materials found in dry-pipe valves, check valves or pumps
  4. Foreign material in water during drain test or plugging of inspector's test connection
  5. Plugging of pipe of sprinklers found during activation or alteration
  6. Failure to flush yard piping or surrounding public mains following new installation or repair
  7. Record of broken mains in the vicinity
  8. Abnormally frequent false-tripping of dry-pipe valve
  9. System is returned to service after extended period out of service (greater than 1 year)
  10. There is reason to believe the system contains sodium silicate or its derivatives or highly corrosive fluxes in copper pipe systems

Testing

• Is the priming level correct and has the low air pressure signal passed its test?

  Yes

  No

  N/A

• Quick opening devices passed test?

  Yes

  No

  N/A

Main Drain Test

• 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

Dry-Pipe Valve Partial Flow Trip Test:

• Record initial air pressure (psi)

• Record initial water pressure (psi)

• Record tripping air pressure (psi)

• Record tripping time (seconds)

• Above results comparable to previous tests?

  Yes

  No

  N/A

Dry-Pipe Full Flow Trip Test:

• Record initial air pressure (psi)

• Record initial water pressure (psi)

• Record tripping air pressure (psi)

• Record tripping time (seconds)

• Record water delivery time (minutes:seconds)

• Water delivery time not required to be 60 seconds per NFPA 25

• Above results comparable to previous tests?

  Yes

  No

  N/A

• Additional Photos

  Media

• Additional Notes

Pre-Action Systems

• 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.

• Total Number of Pre-Action Systems?

• Pre-Action System

Pre-Action

• Title of Pre-Action System

• What area is the Pre-action system protecting?

• Approximate number of sprinkler heads on system?

• Pre-Action Valve Photos

  Media

• Pre-Action Valve Information (Make/Model/Year)

• Pre-Action Valve Size (inches)

• Is the Pre-action valve "Easily Accessible"?

  Yes

  No

  N/A

• Are signs visible and legible?

  Yes

  No

  N/A

• Is the valve open? (if no, is it supposed to be closed?)

  Yes

  No

  N/A

• Is the valve secured?

  Yes

  No

  N/A

• Is the tamper operational?

  Yes

  No

  N/A

• What color tag was placed on the riser after inspection? (If a Yellow or Red tag is select) What is the deficiency?

  Blue

  Yellow

  Red

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)

General Pre-Action 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

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

  Yes

  No

  N/A

• Valve enclosure maintaining at least 40F?

  Yes

  No

  N/A

• For freezer systems, is the gauge near the compressor reading the same as the gauge near the pre-action valve?

  Yes

  No

  N/A

• Valves free from physical damage, trim valve in appropriate (open or closed) position, no leak from valve seat, and all electrical components in sevice?

  Yes

  No

  N/A

• Is the priming level correct and has the low air pressure signal passed it's test?

  Yes

  No

  N/A

• Pre-Action valve that need to be opened to be reset passed internal inspections?

  Yes

  No

  N/A

• Low temperature alarms passed test?

  Yes

  No

  N/A

• Pipe through freezers free of ice blockage?

  Yes

  No

  N/A

• Has an internal inspection or the pipe been performed by removing the flushing connection and one sprinkler near the end of a branchline within the last five (5) years?(If the answer is "No," conduct an internal inspection)

  Yes

  No

  N/A

• Automatic air maintenance devices on preaction systems passed test?

  Yes

  No

  N/A

• Strainers, filters, restricted orifices and diaphragm chambers passed internal inspection?

  Yes

  No

  N/A

• Pre-action valve that can externally reset passed internal inspection?

  Yes

  No

  N/A

• Have low point drains been emptied?

  Yes

  No

  N/A

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

  Yes

  No

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

  Yes

  No

  N/A

• 1. Defective intake screen on pump with suction from open source
  2. Obstructive material discharged during waterflow tests
  3. Foreign materials found in dry-pipe valves, check valves or pumps
  4. Foreign material in water during drain test or plugging of inspector's test connection
  5. Plugging of pipe of sprinklers found during activation or alteration
  6. Failure to flush yard piping or surrounding public mains following new installation
  7. Record of broken mains in the vicinity
  8. Abnormally frequent false-tripping of dry-pipe valve
  9. System is returned to service after extended period out of service (greater than 1 year)
  10. There is reason to believe the system contains sodium silicate or its derivatives or highly corrosive fluxes in copper pipe systems

Testing

Main Drain Test:

• Record Static Pressure (psi)

• Recored Residual Pressure (psi)

• Was flow observed?

  Yes

  No

  N/A

• Are the results comparable to previous?

  Yes

  No

  N/A

Full Flow Trip Test: (not required where water can't be discharged. Test all systems together that will operate simultaneously.)

• Discharge from all nozzles unimpeded?

  Yes

  No

  N/A

• Pressure reading at hydraulically most remote nozzle? (psi)

• Residual pressure reading at valve? (psi)

• Above readings comparable to design valves?

  Yes

  No

  N/A

• Manual activation devices passed test?

  Yes

  No

  N/A

• Additional Notes

• Additional Photos

  Media

Deluge Systems

• Total Number of Deluge Systems?

• Deluge System

Deluge

• Title of Deluge System

• What area is the Deluge system protecting?

• Approximate number of sprinkler heads on system?

• Deluge Valve Photos

  Media

• Deluge Valve Information (Make/Model/Year)

• Deluge Valve Size (inches)

• Is the Deluge valve "Easily Accessible"?

  Yes

  No

  N/A

• Are signs visible and legible?

  Yes

  No

  N/A

• Is the valve open? (if no, is it supposed to be closed?)

  Yes

  No

  N/A

• Is the valve secured?

  Yes

  No

  N/A

• Is the tamper operational?

  Yes

  No

  N/A

• What color tag was placed on the riser after inspection? (If a Yellow or Red tag is select) What is the deficiency?

  Blue

  Yellow

  Red

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)

General Deluge 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

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

  Yes

  No

  N/A

• Valve enclosure maintaining at least 40F?

  Yes

  No

  N/A

• For freezer systems, is the gauge near the compressor reading the same as the gauge near the pre-action valve?

  Yes

  No

  N/A

• Valves free from physical damage, trim valve in appropriate (open or closed) position, no leak from valve seat, and all electrical components in sevice?

  Yes

  No

  N/A

• Is the priming level correct and has the low air pressure signal passed it's test?

  Yes

  No

  N/A

• Deluge valve that need to be opened to be reset passed internal inspections?

  Yes

  No

  N/A

• Low temperature alarms passed test?

  Yes

  No

  N/A

• Pipe through freezers free of ice blockage?

  Yes

  No

  N/A

• Has an internal inspection or the pipe been performed by removing the flushing connection and one sprinkler near the end of a branchline within the last five (5) years?(If the answer is "No," conduct an internal inspection)

  Yes

  No

  N/A

• Automatic air maintenance devices on dry-pipe and preaction systems passed test?

  Yes

  No

  N/A

• Strainers, filters, restricted orifices and diaphragm chambers passed internal inspection?

  Yes

  No

  N/A

• Deluge valve that can externally reset passed internal inspection?

  Yes

  No

  N/A

• Have low point drains been emptied?

  Yes

  No

  N/A

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

  Yes

  No

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

  Yes

  No

  N/A

• 1. Defective intake screen on pump with suction from open source
  2. Obstructive material discharged during waterflow tests
  3. Foreign materials found in dry-pipe valves, check valves or pumps
  4. Foreign material in water during drain test or plugging of inspector's test connection
  5. Plugging of pipe of sprinklers found during activation or alteration
  6. Failure to flush yard piping or surrounding public mains following new installation
  7. Record of broken mains in the vicinity
  8. Abnormally frequent false-tripping of dry-pipe valve
  9. System is returned to service after extended period out of service (greater than 1 year)
  10. There is reason to believe the system contains sodium silicate or its derivatives or highly corrosive fluxes in copper pipe systems

Testing

Main Drain Test:

• Record Static Pressure (psi)

• Recored Residual Pressure (psi)

• Was flow observed?

  Yes

  No

  N/A

• Are the results comparable to previous?

  Yes

  No

  N/A

Full Flow Trip Test: (not required where water can't be discharged. Test all systems together that will operate simultaneously.)

• Discharge from all nozzles unimpeded?

  Yes

  No

  N/A

• Pressure reading at hydraulically most remote nozzle? (psi)

• Residual pressure reading at valve? (psi)

• Above readings comparable to design valves?

  Yes

  No

  N/A

• Manual activation devices passed test?

  Yes

  No

  N/A

• Additional Notes

• Additional Photos

  Media

Fire Pump Assembly Information

• 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

Special Systems

• Were Fire Extinguisher tags currents?

  Yes

  No

  N/A

• Were Alarm panel tags currents?

  Yes

  No

  N/A

• Where vent hood tags currents?

  Yes

  No

  N/A

• Where there any other speciality systems?

Other

• What type of system?

• Where tags current?

  Yes

  No

  N/A

Fire Pump

• Fire Pump

Fire pump

• Title of Fire pump

• Photos of Fire Pump

  Media

• Manufacture of Fire pump

• Size of pump

• Inlet size

• Discharge size

• Weekly Inspection

Weekly

• Pump House/Room proper temperature (at least 70F for diesels without engine heater or 40F for other)?

  Yes

  No

  N/A

• Ventilating louvers free to operate?

  Yes

  No

  N/A

• Piping free from leaks?

  Yes

  No

  N/A

• Suction and system pressure gauges normal?

  Yes

  No

  N/A

• Suction Reservoir, if provide, full?

  Yes

  No

  N/A

• Circulation relief valve flowing water while pump churns?

  Yes

  No

  N/A

• Pressure relief valves operating with proper pressure downstream while pump is operational?

  Yes

  No

  N/A
Electric Motor Driven Pumps

• Controller indicting power on, transfer switch indicting normal situation and isolation?

  Yes

  No

  N/A

• Reverse phase alarm indicator off or normal phase rotation indicator on?

  Yes

  No

  N/A

• Oil level in vertical motor sight normal?

  Yes

  No

  N/A

Testing

• Pump started automatically?

  Yes

  No

  N/A

• Record starting pressure (psi)

• Pump run for at least 10 minutes?

  Yes

  No

  N/A

• Record suction pressure while running (psi)

• Record discharge pressure while running (psi)

• Pump packing gland showing slight discharge? (adjust if necessary)

  Yes

  No

  N/A

• Packing boxes, bearings and pump casing free from overheating?

  Yes

  No

  N/A

• Record time for motor to accelerate to full speed (seconds)

• For reduced voltage or reduced current starting, record time controller is on first step (seconds)

• For automatic stop controllers, record time pump runs after starting (seconds)

• All times and pressure are acceptable?

  Yes

  No

  N/A
Diesel Engine Driven Pump

• Fuel tanks at least two thirds full?

  Yes

  No

  N/A

• Controller selector switch in Auto position?

  Yes

  No

  N/A

• Battery voltage and charger readings normal?

  Yes

  No

  N/A

• Battery indicators on or failure indicators off?

  Yes

  No

  N/A

• All alarm indicators off?

  Yes

  No

  N/A

• Record engine running time meter reading

• Is the engine running time meter appropriately higher than previous reading?

  Yes

  No

  N/A

• Oil level in right angle gear drive normal?

  Yes

  No

  N/A

• Crankcase oil level normal?

  Yes

  No

  N/A

• Cooling water level normal?

  Yes

  No

  N/A

• Electrolyte level in batteries normal?

  Yes

  No

  N/A

• Battery terminals free from corrosion?

  Yes

  No

  N/A

• Water-jacket heater operating?

  Yes

  No

  N/A

Testing

• Pump start automatically?

  Yes

  No

  N/A

• Record starting pressure (psi)

• Did pump run for at least 30 minutes?

  Yes

  No

  N/A

• Record suction pressure while running (psi)

• Record discharge pressure while running (psi)

• Pump packing gland showing slight discharge? (adjust if necessary)

  Yes

  No

  N/A

• Free from unusual noises or vibrations?

  Yes

  No

  N/A

• Packing boxes, bearings and pump casing free from overheating?

  Yes

  No

  N/A

• Record time for engine to crank (seconds)

• Record time for engine to reach running speed (seconds)

• Engine oil pressure gauge, speed indicator, water and oil temperature indicators all reading normal?

  Yes

  No

  N/A

• Cooling water flowing from heat exchanger?

  Yes

  No

  N/A

• All times and pressures are acceptable?

  Yes

  No

  N/A

Maintenance

• Fuel tank level, tank flow switch, and solenoid valve operation acceptable?

  Yes

  No

  N/A

• Diesel fuel system free of water?

  Yes

  No

  N/A

• Flexible hoses and connectors in fuel and coolant systems acceptable?

  Yes

  No

  N/A

• Oil level and lube oil heater acceptable?

  Yes

  No

  N/A

• Is coolant level acceptable?

  Yes

  No

  N/A

• Water pump for coolant system operating?

  Yes

  No

  N/A

• Is jacket water heater for coolant system acceptable?

  Yes

  No

  N/A

• Exhaust system free of leakage?

  Yes

  No

  N/A

• Drain condensate trap on exhaust system operational?

  Yes

  No

  N/A

• Electrolyte level in batteries acceptable?

  Yes

  No

  N/A

• Connections to electrical system acceptable?

  Yes

  No

  N/A
Steam Turbine Driven Pumps

• Steam pressure gauge reading normal?

  Yes

  No

  N/A

Testing

• Record pump starting pressure(psi)

• Record suction pressure (psi)

• Record discharge pressure (psi)

• Pump packing gland showing slight discharge? (adjust if necessary)

  Yes

  No

  N/A

• Free from unusual noise or vibrations?

  Yes

  No

  N/A

• Packing boxes, bearings and pump casing free from overheating?

  Yes

  No

  N/A

• Record steam pressure gauge reading (psi)

• Record time for turbine to reach running speed (seconds)

• All times and pressure are acceptable?

  Yes

  No

  N/A

• Monthly Inspection

Monthly

Maintenance

• Isolation switch and circuit breaker exercised?

  Yes

  No

  N/A

• Battery case clean, dry and free of corrosion and battery's specific gravity or state of charge passed test?

  Yes

  No

  N/A

• Charger and charge rate passed visual inspection and batter charge being equalized?

  Yes

  No

  N/A

• Circuit breakers appear clean?

  Yes

  No

  N/A

• Quarterly Inspection

Quarterly

Maintenance

• Clean strainer, filter or dirt leg in diesel fuel system?

  Yes

  No

  N/A

• Cleaned or replaced crank case breather in lubrication system?

  Yes

  No

  N/A

• Cleaned water strainer in coolant system?

  Yes

  No

  N/A

• Battery terminals clean and tight?

  Yes

  No

  N/A

• Electric system free of wire chafing?

  Yes

  No

  N/A

• Semi-Annual Inspection

Semi-Annual

Maintenance

• Manual starting means on electrical systems operated and boxes panels and cabinets cleaned?

  Yes

  No

  N/A

• Antifreeze tested in coolant system?

  Yes

  No

  N/A

• Flexible exhaust section acceptable?

  Yes

  No

  N/A

• Alarms operated on electrical portions of diesel engine systems?

  Yes

  No

  N/A

• Annual Inspection

Annual

• Method A: Discharge of flow through hose streams. Flow readings taken at each hose stream.
  Method B: Discharge through by-pass flow meter to drain or suction reservoir. Flow readings taken by flow meter.
  Method C: Discharge through by-pass flow meeter directly returned to pump suction. Flow readings taken by flow meter.

• Select Method Type

  Method A

  Method B

  Method C

No Flow Results:

• Suction Pressure (psi)

• Discharge Pressure (psi)

• Pump Speed (RPM)

Rated Flow Results:

• Suction Pressure (psi)

• Discharge Pressure (psi)

• Flow (GPM)

• Electric Voltage and Current

• Pump Speed (RPM)

Peak Flow Results:

• Suction Pressure (psi)

• Discharge Pressure (psi)

• Flow (GPM)

• Electric Voltage and Current

• Pump Speed (RPM)

• Are the results above acceptable?

  Yes

  No

  N/A

• No-flow (churn) test run for 30 min?

  Yes

  No

  N/A

• Circulation relief valve and pressure relief valve operated properly during all flow test?

  Yes

  No

  N/A

• No alarm indicators or other visible abnormalities observed during the no flow test?

  Yes

  No

  N/A

• Suction screen cleaned after flow?

  Yes

  No

  N/A

Low Suction Throttling Device Test:

• Low suction pressure simulated?

  Yes

  No

  N/A

• Free from abnormalities in throttling action?

  Yes

  No

  N/A

• Free from abnormalities in return to full flow?

  Yes

  No

  N/A

Automatice Transfer Switch Test:

• Power failure simulated during peak flow?

  Yes

  No

  N/A

• Connection made alternate power source?

  Yes

  No

  N/A

• After termination of simulated power failure did motor reconnect to the normal power source?

  Yes

  No

  N/A

• All alarm conditions simulated?

  Yes

  No

  N/A

• All alarms operated?

  Yes

  No

  N/A

Maintenance

• Changed pump bearing lubrication?

  Yes

  No

  N/A

• Shaft end play acceptable?

  Yes

  No

  N/A

• Transmission coupling right angle gear drive and mechanical moving parts lubricated?

  Yes

  No

  N/A

• Circuit breakers passed trip test?

  Yes

  No

  N/A

• Emergency manual starting means operated without power?

  Yes

  No

  N/A

• Electrical connections secure?

  Yes

  No

  N/A

• Pressure switch settings calibrated?

  Yes

  No

  N/A

• Are motor bearings greased?

  Yes

  No

  N/A

• Fuel tank free of water and foreign material tank vents and overflow pipes free of obstructions, fuel piping acceptable, and oil and filters changed in diesel systems?

  Yes

  No

  N/A

• Has antifreeze been changed in coolant system?

  Yes

  No

  N/A

• Is heater exchanger clean and free of debris?

  Yes

  No

  N/A

• Are duct work and louvers (combustion air) acceptable?

  Yes

  No

  N/A

• Exhaust system free of back pressure?

  Yes

  No

  N/A

• Are exhaust system hangers and supports acceptable?

  Yes

  No

  N/A

• Is control and power wiring tight?

  Yes

  No

  N/A

• Suction, Discharge and Bypass valves open?

  Yes

  No

  N/A

Standpipe and Hose Systems

• Total number of standpipe systems

• Total number of hose systems

• Standpipe Systems

Standpipe

• Title of Standpipe System

• Photos of Standpipe

  Media

• Valve Information (Make/Model/Year)

• Riser Size

Select Type of Inspection:

• Daily/Weekly Inspection

Weekly

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

  Yes

  No

  N/A

• Relief port on reduced pressure backflow prevention assemblies not continuously discharging?

  Yes

  No

  N/A

• Gauges on dry system (no low pressure alarm) in good condintion showing normal air and water pressure?

  Yes

  No

  N/A

• Sealed control valves and valves on backflow assemblies in normal (open or closed) position, accessible, with seals in place, free from external leaks, and provided with appropritate identification?

  Yes

  No

  N/A

Maintenance

• Items found missing or in disrepair during inspection or testing?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Dry system being maintained in dry condition?

  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

• 1. Defective intake screen for pump taking suction from open sources.
  2. Obstructive material discharged during water flow.
  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 surroundings public mains following new installation or repairs.
  7.Record of broken mains in the vicinity.
  8.Abnormally frequent false tripping of dry-pipe valves.
  9.System is returned to service after an extend period out of service (greater than a year).
  10.There is reason to believe the system contains sodium silicate or it's derivativesIF con

• Monthly Inspection

Monthly

• Dry-pipe valve: enclosures around valves (with low temperature alarms) maintaining a minimum of 40F, free from physical damage, trim valves in appropriate (open or closed) position, and no leakage from intermediate chamber?

  Yes

  No

  N/A

Pressure Reducing Valves (Hose Connection)

• Handwheels in place and in good condition?

  Yes

  No

  N/A

• Hose threads in good condition?

  Yes

  No

  N/A

• Valves not leaking?

  Yes

  No

  N/A

• Reducers and caps in place and in good condition?

  Yes

  No

  N/A

Pressure Reducing Valves (Hose Rack)

• Handwheels in place and in good condition ?

  Yes

  No

  N/A

• Valves not leaking?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Control valves and valves on backflow assemblies (with locks or electric supervision) in normal (open or closed) position with locks or supervision in place, accessible, free from external leaks, provided with appropriate wrenches and provide with appropriate identification?

  Yes

  No

  N/A

• Alarm devices free from physical damage?

  Yes

  No

  N/A

• Alarm valves free from physical damage, valves in correct (open or closed) position, no leakage from retard chamber or drains, gauges indicating normal water pressure?

  Yes

  No

  N/A

• Quarterly Inspection

Quarterly

• Hose Valve Outlets: Valves not leaking and no visible obstructions with caps, hose connections, valve handle, cap gasket, restricting devices in place, undamaged and in good condition?

  Yes

  No

  N/A

• Visible pipe and supports in good condition?

  Yes

  No

  N/A

• Alarm devices free from physical damage?

  Yes

  No

  N/A

Testing

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Quick opening device passed test?

  Yes

  No

  N/A

Main Drain Test for system downstream of backflow or pressure reducing valve (automatic water supply)

• Record static pressure (psi)

• Record residual pressure (psi)

• Was flow observed?

  Yes

  No

  N/A

• Are the results comparable to previous test?

  Yes

  No

  N/A

• Semi-Annual Inspection

Semi-Annual

Testing

• Electrical waterflow alarm devices passed tests by opening the inspector's test connection or bypass connection?

  Yes

  No

  N/A

• Valve supervisory devices indicate movement?

  Yes

  No

  N/A

• Annual Inspection

Annual

• Hose free from mildew, cuts and deterioration, couplings of compatible threads and undamaged, gaskets in place and in good condition, hose connected?

  Yes

  No

  N/A

Hose Nozzles:

• Nozzles and gaskets in place and good condition?

  Yes

  No

  N/A

• No visible obstructions?

  Yes

  No

  N/A

• Nozzles operate smoothly?

  Yes

  No

  N/A

Hose Storage Devices

• Hose properly racked or rolled?

  Yes

  No

  N/A

• Nozzle clips in place and nozzles contained?

  Yes

  No

  N/A

• Undamaged, unobstructed and operable?

  Yes

  No

  N/A

• Will racks swing out of cabinet at least 90 degrees?

  Yes

  No

  N/A

Storage Cabinets:

• Cabinets have no corroded or damaged parts, are easy to fully, and are accessible and identified?

  Yes

  No

  N/A

• Door glazings in good condition?

  Yes

  No

  N/A

• Locks functioning in break-glass type cabinets?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

Testing:

System Main Drain Test: (automatic water supply)

• 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

• 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

• Low temperature alarms in dry pipe enclosures passed test?

  Yes

  No

  N/A

Dry-Pipe Valve Partial Flow Trip Test:

• Record initial air pressure (psi)

• Record initial water pressure (psi)

• Record tripping air pressure (psi)

• Record tripping time (seconds)

• Are the above results comparable to previous test?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Backflow device passed 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

Third Year Test

Dry-Pipe Valve Full Flow Trip Test:

• Record initial air pressure (psi)

• Record initial water pressure (psi)

• Record tripping air pressure (psi)

• Record tripping time (seconds)

• Was water delivered to inspector test connection?

• Are the above results comparable to previous test?

  Yes

  No

  N/A

• Is hose less than five years old?

  Yes

  No

  N/A

• If "No" has the hose been tested within three years?

  Yes

  No

  N/A

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

Maintenance

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

  Yes

  No

  N/A

• Hose reracked or rerolled so folds do not occur in same position?

  Yes

  No

  N/A

• Interior of dry-pipe valves cleaned?

  Yes

  No

  N/A

• Low points drained in dry systems prior to onset of freezing weather?

  Yes

  No

  N/A

• Fifth Year Inspection

Fifth Year

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

  Yes

  No

  N/A

• 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

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

  Yes

  No

  N/A

Test

• Gauges tested against calibrated one or replaced?

  Yes

  No

  N/A

Automatic Standpipe Systems Tested and Required Flows:

• Record Static Pressure (psi)

• Record Residual Pressure (psi)

• Record Total Flow (gpm)

• Above flow and pressures acceptable?

  Yes

  No

  N/A

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

  Yes

  No

  N/A

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

  Yes

  No

  N/A

• Add Stairwell

Stairwell

• Add Floor

Floor

• Which level

Tamper

• Photo of Tamper

  Media

• What color tag?

  Blue

  Yellow

  Red

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

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

• Inspector Signature

  Sign

• Do any the fire suppression inspected today need a "Fifth Year Obstruction Investigation"

  Yes

  No

• Did the owner decline the investigation?

  Yes

  No

• I the under signed have declined to have a fifth year obstruction investigation. I am completely aware and understand the risks associated with not having a fifth year obstruction investigation done. I do not hold GFS Texas responsible for anything that causes damage to personnel or property by an obstruction in the fire suppression system. (Type name and Title)

  Sign

• Disclaimer:
  
  The fire inspector believes the information contained within this "Fire Inspection" report to be correct at the time of printing. The fire inspector/GFS Texas does not accept responsibility for any consequences arising from the use of the information herein. The report is based on matters which were observed or came to the attention of the inspector during the day of the assessment and should not be relied upon as an exhaustive record of all possible risks or hazards that may exist or potential improvements that can be made.
  
  Fire suppression systems that are not properly maintained and serviced can present a risk to life safety and property. This inspection is to assist in maintaining the fire suppression system and should not be relied upon as the sole basis for maintaining the system inspected.
  
  As Per NFPA 25 14.2.1 "An inspection of piping and branch line condition shall be conducted every five (5) years by opening a flushing connection at the end of one main and by removing a sprinkler toward the end of one main and by removing a sprinkler toward the end of one branch line for the purpose of inspecting for the presence of foreign organic and inorganic material." This investigation is to insure that the fire suppression systems do not show any evidences of an obstruction that could impair the system.
  
  GFS Texas is not responsible for any damage, to life (or/and) property due to neglect of properly heating area with wet pipe fire suppression system or dry pipe/pre-action fire suppression system that contain water due to tripped valves and system not being completely drain afterwards.
  
  Confindetiality Statement:
  
  In order to maintain the integrity and credibility of the fire inspection processes and to protect the parties involved, it is understood that the fire inspector will not divulge to unauthorized persons any information obtained during this inpseciton unless legally obligated to do so.
  

• Owner's or Owner's Representative Signature (I have read the above disclaimer and understand its content)

  Sign
Witness

• Name - Title and Signature

  Sign