HomeMy WebLinkAboutCONTRACTOR MATERIAL - TEST CERTIFICATEL t-[oG-o5 �c f
Contractors Material and Test Certificate for Aboveground Piping
PROCEDURE
Upon completion of work. Inspection and test shall be made by the contractor's representative and witnessed by an owners representative S
All defects shall be corrected and system left in service before contractor's personal finally leave the Job.
A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and St. L
contractor. It is understood the owners representative's signature In no way prejudices any Clain against contractor for faulty material, poor
workmanship, or (allure to comply with approving authority's requirements or local ordinances.
Property name
DELIVERY STATION-DVBt
Property address
7440 COMMERCIAL CIRCLE
Accepted by approving authorities ST LUCIE COUNTY
Address
Plans
Installation conforms to accepted plans Yes No
Equipment used is approved Yes No
If no, explain deviations
Instructions
Has person in charge of fire equpiment been Instructed as �X Yes No
to location of control valves and care and maintenance
of this new equipment?
If no, explain?
Have copies of the following been left on the premises? Yes No
1 System components instruction Yes No
2 Care and maintenance instructions Yes No
0 4PA25 Yes No
Location of system
Supplies building lExisnNG BUILDING
Year of
Orfice
Temperature
Make
Model
manufacture
size
Quanity
rating
GLOBE
5661
2019
112
58
200
Sprinklers
GLOBE
G 5601
2 119
112
60
15
Ppe an
fittinge
Type of pipe
Type of fittings
SC 40 -
THREADED
Alarm
Alarm device
Maximum time to operate
through test connection
valve orType
I Make I
Model
Minutes Se enda
FI
flow
EXISTIN
Indicator
Dry valve Q.O.D.
Make
Model
Serial no.
Make
Model
Serial no.
Dry pipe
operating
lest
Time to trip
through test
connection
Water
pressure
Air
pressure
Trip plant
air pressure
Tmewater
reached
k test outlet
Alarm
operated
property
Minutes
Seconds
PSI
psi
psi
Minutes
Seconds
Yes
No
Wlmout
Q.O.D.
Wth
037—
.
If no, exp a n
Operation
=Pneumatic Electric Hydraulics
Piping Supervised I IYes I INO I Detecting media supervisedsuperviseall IYes I JNo
Deluge and
Does valve operate from the manual trip, remote, or both =Yes =No
control stations?
proaction Is
valves
there an assesslble facility in each circuit
for testing
Yes =No
It ne, explain
Make
Model
Does each circuit operate
supervision loss alarm?
Does eac circuit operate
valve release?
Maximum time to
operate release
Yes
1 o
Yes
No
Minutes
Secontls
ANNED
BY
cie County
Pressure
reducing
valve test
Test
description
Test
Blanktesgng
Location I Make and I setting
Flow rate
Residual pressure
Static pressure mnwinal
eve sate: pressure in excess Shall
1e0 psi (1 t n bar) for 2 hours. Dittemneai d pipe valve clappers shall be left
drostaec: Hydrostatic test sM1all be made at not less than 200 psi (13.6 bar) for 2 hours or SO psi (3.4 bar
an during the test to prevent damage. All aboveground piping It shall ho stopped.
teumaec: Establish 40 psi bar) air pressure and measure drop, which shall not exceed 1 psi (,Which shall
24 hours. Test pressure tanks at normal water level and air pressure and measure air pressurree drop,
rt exceed 1112 psi (0.1 bar) In 24 hours. psi ( bar) for Z 'hours If no, state reason
II piping hydrostatically tested at
ry piping pneumaticallyI�Yes tested
Iquipment operates properly
I�yes Iva am c is, so
rf Sodiumucertiysilicate.brine, or other corrosive clhemicals were not used for tesaddives and cc"t! systalms or stopping leaks?
l,ate or es
=Yes =No
Residual
located near water dual pressurwide valve in test
Drain Reading of gaugepsi ( bar) connection open wide PSI
d swtest connection
lead in connections to system risers pushed before connection made Other Explain
erground mains and
sprinkler piping
I�Yes
EXISTING
=No
rifled by copy of the U Form No. 86B
fished by Installer of underground
=Yes
I]No
uinkler piping
has
..I�Yes
No if no, explain
power driven fasteners are usedi n concrete,
�prssentagve sampletesgng he satisfactorily
WA
ompleted?
WA Number removed
lumber used Locations
gaskets
IIDNo Yes
Welding Plpl^9
I=Yes =No
D, as thesprinklercontractor atwelding procedures comply
-
least AWS Bt?
yi the reqfy
s
uirements
Yes =No
Welding _
Do you certiy that the welding was preformed by welders qualified In
with the requirements of at least AWS B2.17
=Yes =No
compliance
that awas l discs are retrieved, that oout in compliance with a penings led
that the
of
qp lity eont procedure to ensure
smooth, that slag and other welding residue are removed, and that
-
In piping are
the Internal diameters of piping are not penetrated?
=Yes =No
cutouts
Do you certify that you have a control feature to ensure that
(discs)
all cutouts (discs) are retrieved? if no, explain
Hydraulic
Nameplate provided . EXISTING
No
data
I=Yes I�X
nameplate
Date left In service with all control valves open
b ZGJ
Remarks
of sprinkler contractor COAST TO COAST FIRE PROTECTION, INC.
Name
Tests witnessed by
Title
Date
For property owner (signed)
Date
Title
0
6