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Home My WebLink AboutLetter-Fire Protection System Installation J. F. AHERN CO. MECHANICAL & FIRE PROTECTION CONTRACTORS 201 Morris Court, P.O. Box 1316 Fond du Lac, WI 54936-1316 (920) 921-9020 P · (920) 921-8666 f www.jfahern.com May 15,2007 Building Inspector -- Brian Noe City of Oshkosh 215 Church Avenue -- PO Box 1130 Oshkosh, WI 54901 T -920/236-5051 F-920/236-1130 RE: FIRE PROTECTION SYSTEM INSTALLATION SHOOTERS 1014 OHIO STREET OSHKOSH, WISCONSIN 54902 AHERN FIRE PROTECTION CONTRACT No. 490586 Dear Brian: Enclosed is a copy of the Contractor's Material and Test Certificates covering the above-referenced Fire Protection System Installation for your files. Very truly yours, AHERN FIRE PROTECTION A division 00. F.Ahern Co. ~9l$~ Mark L. Jozefowski, Superintendent MLJ/ksj LCITYOS-1S-2007.DOC R I MAY 1 7 2007 DEPARTMENT OF COMMUNITY DEVELOPMENT INSPECTION SERVICES DIVISION Building the Midwest Since 1880 An Equal Opportunity Employer AHERN FIRE PROTECTION Contractor's Material and Test Certificate for Aboveground Piping PROCEDURE Upon completion of work, inspection and tests shall be made by the contractor's representative and witnessed by an owner's representative. All defects shall be corrected and system left in service before contractor's personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is understood the owner's representative's signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving authoritv's reauirements or local ordinances. PROPERTY NAME Shooter Bar & Niqhtclub AFP Contract #: 490586 I DATE: February 22, 2007 PROPERTY ADDRESS 1014 Ohio Street Oshkosh, WI 54903 ACCEPTED BY APPROVING AUTHORITIES (NAMES) 1. City of Oshkosh (Building Inspector -- Brian Noe) 2. Oshkosh Fire Department (Battalion Chief -- Stu Schrottky) 3. 4. ADDRESS Plans 1. 215 Church Avenue -- PO Box 1130 -- Oshkosh, WI 54901 2. 101 Court Street -- Oshkosh, WI 54901 3. 4. INSTALLATION CONFORMS TO ACCEPTED PLANS DYES DNO EQUIPMENT USED IS APPROVED DYES DNO IF NO, EXPLAIN DEVIATIONS HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATION DYES DNO OF CONTROL VALVES AND CARE AND MAINTENANCE OF THIS NEW EQUIPMENT? INSTRUCTIONS IF NO, EXPLAIN HAVE COPIES OF THE FOLLOWING BEEN LEFT ON THE PREMISES: Item No.'s 2 & 3 will 1. SYSTEM COMPONENTS INSTRUCTION DYES DNO be forwarded by AFP 2. CARE AND MAINTENANCE INSTRUCTIONS DYES DNO at closeout time. 3. NFPA 25 DYES DNO LOCATION OF SUPPLIES BUILDINGS SYSTEM System #1 MAKE MODEL YEAR OF K- QUANTITY TEMPERATURE MANUFACTURE FACTOR RATING Vikina Microfast M QR VK300 Uoriaht 1/2" Brass 2007 5.6 70 155 Dec. Viking Microfast M QR VK300 Upright 1/2" Brass 2007 5.6 65 200 Dec. Vikina Microfast M QR VK302 Pendent 1/2" Chrome 2007 5.6 17 155 Dea. SPRINKLERS Vikina Drv QR VK176 Drv Pendent 1/2" Chrome 2007 5.6 3 155 Dea. .. -. PIPE AND TYPE OF PIPE Uohtwall Non-Threadable: Thinwall Threadable: Black FITTINGS TYPE OF FITTINGS Flanoed: Grooved: Threaded: Welded Outlets: Mechanical Tees - MAXIMUM TIME TO OPERATE FLOW ALARM DEVICE THROUGH TEST CONNECTION TYPE MAKE MODEL MIN. SEC. Water Flow Detector System Sensor WFD -yg N/A EXPLAIN ANY ALARM PROBLEMS: ALARM ALARM OPERATED DEVICES LOW AIR ALARM DEVICE I MAKE I MODEL PRESSURE PRO PERL Y TYPE SETTING PSI N/A . .... - '" "_Ill. __ I--YES I NO Kr-I ...~I\'t- II I I EXPLAIN ANY ALARM PROBLEMS: - .....-- MAY 1 7 Z007 --- 11H..'lHl COMMUNITY DEVELOPMENT INSPECTION SERVICES DIVISION ~, ,;. Ahern Fire Protection CENTRAL MONITORING SIGNALS RECEIVED ALARM SERVICE LOCA TION(S) TYPE OR PRESSURE NAME OF REMOTE WATERFLOW SWITCH LOW-AIR OTHER SERVICE DETECTOR FLOW SUPERVISORY SUPERVISING LOCATION(S): STATION (ON-SITE) REMOTE Rf.:MOTE NAME OF SERVICE: MONITORING ALARM SERVICE SIGNALING (OFF-SITE) PHONE: OTHER: LOCATION(S): EXPLAIN ANY ALARM SIGNALING PROBLEMS: DRY VALVE Q.O.D. MAKE MODEL SERIAL NO. MAKE MODEL SERIAL NO. TIME TO TRIP WATER TRIP POINT AIR TIME WATER ALARM THROUGH TEST AIR PRESSURE REACHED TEST OPERATED CONNECTION',2 PRESSURE PRESSURE OUTLET ',2 PROPERLY DRY PIPE MIN. SEC. PSI PSI PSI MIN. SEC. YES NO OPERATING WITHOUT TEST Q.O.D. WITH Q,O,D. IF NO, EXPLAIN: OPERATION: o PNEUMATIC 0 ELECTRIC o HYDRAULIC PIPING SUPERVISED DYES DNO DETECTING MEDIA SUPERVISED DYES DNO DOES VALVE OPERATE FROM THE MANUAL TRIP, REMOTE, OR BOTH CONTROL STATIONS DYES DNO IS THERE AN ACCESSIBLE FACILITY IN EACH IF NO, EXPLAIN DELUGE & CIRCUIT FOR TESTING PREACTION DYES DNO VALVES DOES EACH CIRCUIT DOES EACH CIRCUIT MAXIMUM TIME TO OPERATE SUPERVISION OPERATE VALVE RELEASE OPERATE RELEASE MAKE MODEL LOSS ALARM YES NO YES NO MIN. SEC. LOCATION & MAKE & MODEL SETTING STATIC PRESSURE RESIDUAL PRESSURE FLOW RATE FLOOR (FLOWING) PRESSURE INLET OUTLET INLET OUTLET FLOW REDUCING (PSI) (PSI) (PSI) (PSI) (GPM) VALVE TEST , MEASURED FROM TIME INSPECTORS TEST CONNECTION IS OPENED. 2 NFPA 13 ONLY REQUIRES THE 60:SECOND LIMITATION IN SPECIFIC SECTIONS. 2 Ahern Fire Protection / .... HYDROSTATIC: Hydrostatic tests shall be made at not less than 200 psi (13.6 bars) for two hours or 50 psi (3.4 bars) above static pressure in TEST excess of 150 psi (10.2 bars) for two .hours. Differential dry-pipe valve clappers shall be left open during test to prevent damage. All aboveground piping leakage shall be stopped. ' DESCRIPTION PNEUMA TIC: Establish 40-psi (2.7 bars) air pressure and measure drop, which shall not exceed 1-1/2 psi (0.1 bars) in 24 hours. Test . pressure tanks at normal water level and air pressure and measure air pressure drop, which shall not exceed 1-1/2 psi (0.1 bars) in 24 hours. AI.L PIPING HYDROSTA TICALL Y TESTED A T ~ PSI <-Bar) for --Z.:- HRS. IF NO, STATE REASON DRY PIPING PNEUMA TICALL Y TESTED 0 YES 0 NO EQUIPMENT OPERATES PROPERLY DYES DNO [)O YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM $ILlCATE OR DERIVATIVES OR SODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED FOR TESTING SYSTEMS OR STOPPING LEAKS? . tJ YES DNO DRAIN I READING OF GAUGE LOCAT'f'OEAR WATER I RESIDUAL PRESSURE WIT~VE IN TEST _ TEST SUPPLY TEST CONNECTION: A . PSI ( Bar) CONNECTION OPEN WIDE> PSI LBar) TESTS UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISER OTHER EXPLAIN FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING. VERIFIED BY COPY OF THE CONTRACTOR'S MATERIAL AND TEST CERTIFICATE FOR UNDERGROUND PIPING. DYESDNO FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING DYES 0 NO IF POWDER-DRIVEN FASTENERS ARE USED IN CONCRETE, HAS IF NO, EXPLAIN REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED? DYESD NO BLANK NUMBER USED LOCATIONS NUMBER REMOVED TESTING GASKETS WELDED PIPING DYES DNO IF YES... . DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING DYES DNO PROCEDURES COMPLY WITH THE REQUIREMENTS OF AT LEAST AWS B2.1? DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS DYES DNO WELDING QUALIFIED INCOMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS B2.1? DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A DYES DNO DOCUMENTED QUALITY CONTROL PROCEDURE TO ENSURE THAT ALL DISCS ARE RETRIEVED, THAT OPENINGS IN PIPING ARE SMOOTH, THAT SLAG AND OTHER WELDING RESIDUE ARE REMOVED, AND THAT THE INTERNAL DIAMETERS OF PIPING ARE NOT PENETRATED? CUTOUTS DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT ALL DYES DNO (DISCS) CUTOUTS (DISCS) ARE RETRIEVED? , HYDRAULIC NAME PLATE PROVIDED IF NO, EXPLAIN DATA DYES DNO NAMEPLATE REMARKS DATE LEFT IN SERVICE WITH ALL CONTROL VALVES OPEN: Lp-c- / k' - ;;')j) l? NAME OF SPRINKLER CONTRACTOR AHERN FIRE PROTECTION, 201 MORRIS COURT - FOND DU LAC, WI 54935 '"' TESTS WITNESSED BY . Awm' HA~URISDICTION (SIGNED) TITLE 5i;~) SIGNATURES ~. -" L 4=-t'1.~r?c 0 ~ FOR PROPERTY OWNER (SIGNED) TITLE DATE F~PRIN~R~SIGNED) TITLE DATE ~/t:"""ei;.t-'1 3' - 28 -0 ''=1- ADDITIONAL EX~NA TION AND NOTES: 3 ~scons;n Department of Commerce ReQulated Obiect Number: Safety and Buildings Division P.O. Box 7302 Madison, WI 53707-7302 Fax: (608) 267-9723 TTY: (608) 264-8777 http://www.commerce.state.wi.us http://www.wisconsin.gov Personal information you provide may be used for secondary purposes [Privacy Law, s.1504 (1 )(m)J. Please print clearl in ballpoint pen. Additional information on back page. AFP #490586 Street Address Double Check/DC Detector Performance Test OWNER INFORMATION Owner Name City State Zip Code Owner's Contact Person Brett Y oungsworth FACILITY INFORMATION Facility Name Shooter Bar & Nightclub City Oshkosh, WI 54902 Assembly Location Riser Closet Manufacturer Wilkins Telephone Number (920/420-7581 ) Zip Code Street Address 1014 Ohio Street County Winnebago Size 4" Assembly Type M DC Model 350 o DC Detector Serial Number L1 09 c>J.(J INITIAL TEST 1 ST check o Closed tight o Leaked 4. ( - Static - \0 FINAL TEST o Closed tight Static 2nd check o Closed tight o Leaked i 0 PSID Static _- ---------------------------- PSID ------------------------------------------------------------------ PSID o Closed tight Static PSID DETECTOR BYPASS ASSEMBLY INITIAL TEST 1 ST check 2nd check o Closed tight 0 Closed tight RE .. VE D o Leaked 0 Leaked I Static PSID Static PSID -- - n - - - - _n - - - n - - - - - - - - - - - -- - - nu n -- - - n - - un - - - - - - - - - - - -- - - U - -'- - ~n _n - - - n__ - uu_u - - - - - - - u - - - - - n - - -- - --~" "-MAY - t -1-l0tr7 _ _ n __ __ _ __, DETECTOR BYPASS ASSEMBLY FINAL TEST o Closed tight 0 Closed tight DEPARTMENT OF Static PSID Static PSID "c:OMMUNITY DEVELOPMENT 11\J~t-'t:L llUN SERVICES DIVISION ASSEMBLIES IN FIRE PROTECTION SYSTEMS Note: Include hose stream demand where applicable Forward Flow Test '7 / Designed flow rate 307.15 GPM Actual flow rate .....,::) Ol GPM ------1-- icatfn---c-onirofVaiVe-s------------------------------------------------------------------------------------------------------------------------------- o. one control valve 0 en No. two control valve open Valve supervision: 0 Tam er switch 0 Locked Part (s) Replaced/Comments ~ I :;/f tI (A, T ft1t11V /J71JttrV (d /3 fJ 5 ) Tester Name (print) Tester Signature TEST RESULTS ARE TRUE AND THE TEST WAS CONDUCTED BY ME PERSONALLY. Registration No.~ Sgyf Time of Day 5':CXJ P'1 Phone NO.C(bO -.3 FJ!o Date 3-02~ . 0 7 SBD-10754 N.12/02 Distributed to the fol/owing: Owner and tester :~'-' "';" OWNER INFORMATION The backflow preventer is a mechanical device designed to protect the potable water supply system from being contaminated. There is a physical connection to equipment or water of either unknown or questionable quality, thereby requiring the installation of the backflow preventer. In order to ensure that this device is working as designed, it must be periodically tested. A test shall be 'conducted on each baekflow preventer prior to it being put into service, after any repairs, and a minimum of once a year thereafter, It is the responsibility of the owner to make sure the device is tested. The test shall be performed by a department registered Cross Co.nnection Control Device tester. OWNER'S CONTACT PERSON: The owner's contact person is the name of the person responsible for the backflow preventer maintenance and records. (Note: Please provide full name,) OLD VALVE REPLACEMENT INFORMATION If this test is for a replacement valve, please include all information for the replacement valve on this form. The manufacturer, model no., serial no., size, and the assembly type of the "old" valve must included on the comment line of this form. . DOUBLE CHECK VALVES AND DOUBLE DETECTOR CHECK VALVES INSTALLED IN FIRE. PROTECTION SYSTEMS A copy of this completed test must be attached to or located near the double check valve or double . detector check valve. "'. MINIMUM REQUIREMENTS FOR PASSING TEST DC and DC, D,etector · The first check must close tight, and have a minimum static 1 PSID. · The second check must close tight, and have a minimum static 1 PSID. Do not send a copy of this report to the Department of Commerce, Safety and Buildings Division. Copies of this report shall be distributed to the following: Owner and tester as indicated on the bottom of each page. 5BD-10754 N.12/02 Distributed to the following: Owner and tester