Inspection Information
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Project Name:
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Project Location:
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Permit #:
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Date of Inspection:
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Fire Inspector
Visual Inspection
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Approved plans on location:
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Piping and joints are uncovered:
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Size of piping same as indicated on approved plans:
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Type of piping and bedding material same as indicated on approved plans:
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Piping follows same path and direction as indicated on approved plans:
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Depth of piping is same as indicated on approved plans:
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Thrust blocks at each change of direction:
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Poly wrap of any ductile piping:
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Terminates no more than 5 feet inside the building:
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Terminates no more than 1 foot above finished floor:
Visual Inspection Status
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Visual Inspection Status:
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Date of Completion:
Utility Crossings / Encasement Inspection
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Piping placed in separate trench:
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Encasement provided at utility crossings within 10 feet:
Utility Crossing / Encasement Inspection Status
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Utility Crossing / Encasement Inspection Status:
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Date of Completion:
Hydrostatic Test
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Underground fire line must hold a minimum of 200 psi for 2 hours.
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Start pressure (psi):
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Start time:
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Pressure pump to be disconnected after underground fire line is pressurized to 200 psi.
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End pressure (psi):
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End time:
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Pressure relieved and gauge returns to zero psi:
Hydrostatic Test Status
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Hydrostatic Test Status:
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Date of Completion:
Underground Line Flush
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Flow through minimum of a 4 inch hose or pipe:
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Hose or pipe restrained:
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Observe flush until clear of all debris:
Underground Fire Line Flush Status
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Underground Fire Line Flush Status:
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Date of Completion:
Final Acceptance Test
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As built drawings for any changes made:
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Test certificate completed and copy provided:
Final Acceptance Test Status
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Final Acceptance Test Status:
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Date of Completion:
Inspection Status
Additional Comments
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Comments:
Inspection Summary
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Visual Inspection:
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Utility Crossing / Encasement Inspection:
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Hydrostatic Test:
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Underground Fire Line Flush:
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Final Inspection:
Inspection Status
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On-site Inspector:
- Yes
- No
- N/A
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Inspection Status:
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Next Inspection:
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Date Completed:
Acknowledgement of Receipt
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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 Kaufman . -
Email Address:
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Signature:
