Inspection Information

  • Project Name:

  • Project Location:

  • Permit #:

  • Date of Inspection:

Visual Inspection

  • FDC located within 100 feet of hydrant and facing fire lane:

  • Piping and joints are uncovered:

  • Size of piping is the same as indicated on approved plans:

  • Type of piping and bedding material is the same as indicated on approved plans:

  • Path and direction of piping is the same as approved plans:

  • Depth of piping is the same as indicated on approved plans:

  • Thrust blocks are at each change of direction:

  • Poly wrap of any ductile piping:

Visual Inspection Status

  • Visual Inspection Status:

  • Date of Completion:

Hydrostatic Test

  • Remote FDC line must hold a minimum of 200 psi for 2 hours.

  • Start pressure (psi):

  • Start time:

  • Pressure pump to be disconnected after remote FDC line is pressurized to 200 psi.

  • End pressure (psi):

  • End time:

  • Pressure relieved and gauge returns to zero psi:

Hydrostatic Test Status

  • Hydrostatic Test Status:

  • Date of Completion:

Remote FDC Line Flush

  • Flow through minimum of a 4 inch hose/pipe:

  • Hose/pipe restrained:

  • Observe flush until water is clear of all debris:

Remote FDC Line Flush Status

  • Remote FDC Line Flush Status:

  • Date of Completion:

Final Acceptance Test

  • 4 foot by 4 foot concrete pad, 4 inches thick:

  • 5 foot pathway, visible, and facing fire lane:

  • Sign, with 1 inch numbers, indicating which address(es) the remote FDC serves:

  • 5 inch Storz connection with a 30° downturn provided:

  • Storz connection 18 to 48 inches above finished grade:

  • Check valve(s) and ball drip, with meter if underground:

  • Knox caps on connection:

  • If subject to vehicular damage, protected by guard posts:

Final Acceptance Test Status

  • Final Acceptance Test Status:

  • Date of Completion:

Inspection Status

Additional Comments

  • Comments:

Inspection Summary

  • Visual Inspection:

  • Hydrostatic Test:

  • Remote FDC Line Flush:

  • Final Acceptance Test:

Inspection Status

  • On-site Inspector:

  • Inspection Status:

  • Next Inspection:

  • Date Completed:

Acknowledgement of Receipt

  • Persons who shall violate a provision of this code or shall fail to comply with any requirements thereof or who shall erect, install, alter, repair, or do work in violation of the approved construction documents or directive of the fire code official, or of a permit or certification used under provisions of this code, shall be guilty of a Class C Misdemeanor, punishable by a fine of not more than $2,000.00 dollars, or by imprisonment not to exceed 180 days, or both such fine and imprisonment. Each day that a violation continues after due notice has been served shall be deemed a separate offense.

    By signing below, I acknowledge that I have received, reviewed, and understand the code violations listed in this inspection report. I also agree to correct these code violations in the amount of time specified, in this document, by the Fire Marshal of the City of Rockwall.

  • Email Address:

  • Signature:

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