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i <br /> Contractors Material and Test Certificate for Aboveground Piping <br /> PROCEDURE <br /> Upon completion of work.Inspection and test shall be made by the contractor's representative and witnessed by an owners representative <br /> All defects shall be corrected and system left in service before contractor's personel finally leave the job. <br /> A certificate shall be filled out and signed by both representatives.Copies shall be prepared for approving authorities,owners,and <br /> contractor.It is understood the owner's representative's signature in no way prejudices any ciain against contractor for faulty material,poor <br /> workmanship,or failure to•comply"Wit approving authority's requirements or local ordinances. <br /> Property name e6hyr C-o'mmQns S if Storage <br /> Property address 38011 Pretty PoWRd <br /> 14 AAccepted�approving authorities JCity of Zephyrhilis <br /> � duress ' <br /> Plans Installation conforms to accepted plans I A I Yes No <br /> Equipment used is approved F Yes No <br /> If no,explain deviations <br /> Has person in charge of fire equpiment been instructed as 0 Yes No <br /> to location of control valves and care and maintenance <br /> of this new equipment? <br /> If no,explain? <br /> Instructions <br /> Have copies of the following been left on the premises? Yes No <br /> 1 System components instruction FTI Yes No <br /> 2 Care and maintenance Instructions Yes No <br /> 3 NFPA 25 ELI Yes No <br /> Location of system Supplies building 11st Floor <br /> Year of Orfice Temperature <br /> Make Model manufacture size Quanity rating <br /> GLOBE GL8164 2020 314 250 155 <br /> Sprinklers <br /> Pipe and Type of pipe JSCHIO&SCH 40 <br /> fittings Type of fittings IGROOVED&CAST IRON THREADED <br /> Maximum time to operate <br /> Alarm Alarm device through test connection <br /> valve or Type Make Model Minutes Seconds <br /> flow FLOW SWITCH SYSTEM SENSOR WFD40 <br /> indicator I f <br /> Dry valve Q.O.D. <br /> Make Model Serial no. Make Model Serial no. <br /> Dry pipe Time to trip Time water Alarm <br /> operating through test Water Air Trip piont reached operated <br /> test connection pressure pressure air pressure test outlet properly <br /> Minutes Seconds psi psi psi Minutes I Seconds Yes No <br /> Without <br /> Q.O.D. <br /> With <br /> Q.O.D. <br /> if no,explain <br /> Operation <br /> Pneumatic 0 Electric Hydraulics <br /> Piping supervised Yes No Detecting media supervisedl lyes I JNo <br /> Does valve operate from the manual trip,remote,or both =Yes =No <br /> Deluge and control stations? <br /> preaction Is there an assessibie facility in each circuit if ne,explain <br /> valves for testing <br /> =Yes =No <br /> Does each circuit operate Does each circuit operate Maximum time to <br /> Make Model supervision loss alarm? valve release? operate release <br /> Yes No Yes No Minutes Seconds <br />