HomeMy WebLinkAboutLetter-Ahern Fire Protection
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Ahern Fire Protection
A division of J. F. Ahern Co.
201 Morris Court, P.O. Box 1316. Fond du Lac, WI 54936.1316
TEL (920) 921-9020 . FAX (920) 921-8666 . www.ahernfire.com
Wisconsin' Illinois' Missouri' Nebraska' Iowa' Minnesota
RECEIVE
JAN 1 9 2006
DEPARTMENT OF
COMMUNITY DEVELOPMENT
January 17,2006
Building Inspector -- Brian Noe
City of Oshkosh
215 Church Avenue, -- PO Box 1130
Oshkos~ WI 54901
T -920/236-5051
F-920/236-1130
RE: FIRE PROTECTION SYSTEM INSTALLATION
MIDWEST GENERAL CONTRACTORS
2990 UNIVERSAL DmVE -~
OSHKOSH, WISCONSIN 54901
AHERN FIRE PROTECTION WORK ORDER No. 991971
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 ofJ. F. Ahem Co.
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JefIR. Batterman
Service Superintendent
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LFIREOI-I7-06.DOC
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 contra~or. 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 Midwest General Contractors AFP W.O. #: 991971 I DATE: December 9, 2005
PROPERTY ADDRESS 2990 Universal Street Oshkosh,VVl54901
ACCEPTED BY APPROVING AUTHORITIES (NAMES)
, 1. Oshkosh Fire Department (Battalion Chief -- Stu Schrottky)
2. City of Oshkosh (Building Inspector -- Brian Noe)
3.
4.
ADDRESS
Plans 1. 101 Court Street - Oshkosh, WI 54901
2. 215 Church Avenue -- PO Box 1130 - Oshkosh, WI 54901
3.
4. '"
INSTALLATION CONFORMS TO ACCEPTED PLANS ~YES DNO
EQUIPMENT USED IS APPROVED ;.erYES DNO
IF NO, EXPLAIN DEVIATIONS
i
HAS PERSON IN CHARGE OF FIRE EQUIPMENT BEEN INSTRUCTED AS TO LOCATrON I,Zl YES 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 win 1. SYSTEM COMPONENTS INSTRUCTION ~:ES DNO
be foowarded by AFP 2, CARE AND MAINTENANCE INSTRUCTIONS YES DNO
at closeout time.
3. NFPA 25 YES DNO
LOCATION OF SUPPLIES BUILDINGS
SYSTEM Entire
MAKE MODEL YEAR OF K- QUANTITY TEMPERATURE
MANUFACTURE FACTOR RATING
Vlkina Microfast QR VK350 Upright 3(4" Bronze 2005 8.0 87 200 Dea.
Vlkina Microfast QR VK305 HSW 1/Z' White 2005 5.6 9 - 155 Ceo.
SPRINKLERS
PIPE AND TYPE OF PIPE LiQhtwall Non-Threadable: Thinwall Threadable; Black
FITTINGS TYPE OF FITTINGS Grooved: Threaded: Welded Outlets: Mechanical Tees
FLOW ALARM DEVICE MAXIMUM TIME TO OPERATE
THROUGH TEST CONNECTION
TYPE MAKE MODEL MIN. SEC.
Water Flow Detector System Sensor WFD !-j .J-
N/A
EXPLAIN ANY ALARM PROBLEMS:
ALARM
DEVICES -C-. LOW AIR ALARM DEVICE AlARM OPERATED
TYPE T MAKE I MODEL PRESSURE PROPERLY
N/A [ I SETTING PSL I
YES NO
I
EXPLAIN ANY ALARM PROBLEMS:
CENTRAL MONITORING SIGNALS RECEIVED
ALARM SERVICE LOCATION(S)
TYPE OR PRESSURE
NAME OF REMOTE WATERFLOW LOW-AIR
SERVICE DETECTOR SWITCH SUPERVISORY OTHER
FLOW
SUPERVISING LOCA TION(S):
STATION
(ON-SITE)
REMOTE REMOTE NAME OF SERVICE: /J/
MONITORING /
ALARM SERVICE' ~
SIGNALING (OFF-SITE) . 1r ft/f2l1
PHONE:
OTHER: LOCA TION(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
CONNECTlON',2 PRESSURE PRESSURE OUTLET ',2 PROPERLY
01/ MIN. SEC. PSI PSI PSI MIN. SEC. YES NO
OPERA ING WITHOUT
TE T Q.O.O.
WITH
.Q.O.O.
I IF NO, EXPLAIN:
OPERATION: o PNEUMATIC o ELECTRIC o HYDRAULIC
-
PIPING SUPERVISED DYES ONO DETECTING MEDIA SUPERVISED DYES ONO
DOES VALVE OPERATE FROM THE MANUAL TRIP, REMOTE. OR BOTH CONTROL STATIONS DYES ONO
IS THERE AN ACCESSIBLE FACILITY IN EACH IF NO, EXPLAIN
OEwJ CIRCUIT FOR TESTING
PREACT ON DYES ONO
VALl ...
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
PRESStJRE FLOOR (FLOWING)
. INLET OUTLET INLET OUTLET FLOW
REDuq,NG . (PSI) (PSI) (PSI) . (PSI) (GPM)
VALVE ~ST .
Ahem Fire Protection
'.MEASURED FROM TIME INSPECTORS TEST CONNECTION IS OPENED.
2 NFPA 13 ONLY REQUIRES THE 6O-SECONO LIMITATION IN SPECIFIC SECTIONS.
2
TEST
. DESCRIPTION
TESTS
BLANK
TESTING
GASKETS
WELDING
CUTOUTS
DISCS
HYDRAULIC
DATA
NAMEPLATE
REMARKS
SIGNATURES
Ahern Fire Protection
ta\ic 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
of 1 2-bars) for two hours. Differential dry-pipe valve clappers shall be left open during test to prevent damage. All
un piping leakage shall be stopped. .
PNEUMATIC: Establish 4O-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 atnonnaJ .water level and air pressure and measure air pressure drop, which shall not exceed 1"1/2 psi (0.1 bars) in 24 hours.
ALL PIPING HYDROSTATICALLY TESTED A PSIL-Bar) for _ HRS. IF NO, STATE REASON
DRY PIPING PNEUMATICALLY TESTED 0 ES -EtNO
EQUIPMENT OPERATES PROPERLY -ErYES 0 NO
DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT ADDITIVES AND CORROSIVE CHEMICALS, SODIUM
SILICATE OR DERIVATIVES OR SODIUM SILICATE, BRINE, OR OTHER CORROSIVE CHEMICALS WERE NOT USED
FO TESTING SYSTEMS OR STOPPING LEAKS? .
YES 0 NO
DRAIN READING OF GAUGE LOCATE;P...~R WATER RESIDUAL PRESSURE WITH VALVE IN TEST
TEST SUPPLY TEST CONNECTION:~ PSI ( . Bar) CONNECTION OPEN WIDE: .5:5:. PSI LBar)
UNDERGROUND MAINS AND LEAD IN CONNECTIONS TO SYSTEM RISER OTHER EXPLAIN
FLUSHED BEFORE CONNECTION MADE TO SPRINKLER PIPING.
VERIFI ED BY COPY OF THE CONTRACTOR'S MATERIAL AND TEST
CERTIFICATE FOR UNDERGROUND PIPING. pES 0 NO
FLUSHED BY INSTALLER OF UNDERGROUND SPRINKLER PIPING rES 0 NO
IF POWDER-DRIVEN FASTENERS ARE USED IN CONCRETE, HAS IF NO, EXPLAIN
REPRESENTATIVE SAMPLE TESTING BEEN SATISFACTORILY COMPLETED?
! O~OOO
DO YOU CERTIFY AS THE SPRINKLER CONTRACTOR THAT WELDING
PROCEDURES COMPL YWITH THE REQUIREMENTS OF AT LEAST AWS B2.1?
DO YOU CERTIFY THAT THE WELDING WAS PERFORMED BY WELDERS IDES
QUALIFIED IN COMPLIANCE WITH THE REQUIREMENTS OF AT LEAST AWS B2.1?
LOCATIONS
VI S 0 NO
IF YES...
DO YOU CERTIFY THAT WELDING WAS CARRIED OUT IN COMPLIANCE WITH A
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 THATTHE INTERNAL
DIAMETERS OF PIPING ARE NOT PENETRATED?
DO YOU CERTIFY THAT YOU HAVE A CONTROL FEATURE TO ENSURE THAT All
CUTOUTS DISCS) ARE RETRIEVED?
NAME PLATE PROVIDED
~Y6S 0 NO
DATE lEFT IN SERVICE WITH ALL CONTROL VALVES OPEN:
NAME OF SPRINKLER CONTRACTOR
AHERN FIRE PROTECTION, 201 MORRIS COURT - FOND DU LAC, WI 54935
TESTS WITNESSED BY
FOR PROPERTY OWNER (SIGNED) TITLE
FOR SP~.J.N~'C~~~) _ TITLE
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3
NUMBER REMOVED
YES
ONO
ONO
ISl YES
ONO
YES 0 NO
IF NO, EXPLAIN
DATE
1./70'5
DATE
./- 9-&6
.-
.. >< \Visconsin
Department of Commerce
Requlated Obiect Number:
!-I.U. !::Sox t;:SU:l
Madison, WI 53707-7302
Fax: (608) 267-9723
TTY: (608) 264-8777
htlptlvmN.commerce.state.wi.us
htlp11vmN.wisconsin.gov
Personal information you provide may be used for secondary purposes [Privacy Law, s.1504 (1 )(m)).
Please print clearly in ballpoint pen. Additional information on back page. AFP #991971
Street Address
100 North Westhaven Drive, Suite B
Double Check/DC Detector
Performance Test
OWNER INFORMATION
Owner Name
Midwest General Contractors, Inc.
city
Oshkosh, WI 54904
FACILITY INFORMATION
Facility Name
Midwest General Contractors
City
Oshkosh, WI 54901
Assembly Location
Basement
State Zip Code
Owner's Contact Person
Gerry Frechette
Telephone Number
(920/426-2008)
Zip Code
Street Address
2990 Universal Street
County
Winnebago
Size 3"
Assembly Type
Model
350
o DC Detector
Manufacturer
Wilkins
DC
INITIAL TEST
1 ST check
~Iosed tight
CfLeaked
Static
FINAL TEST
o Closed tight
Static
2nd check
'i... ~Iosed tight rJ
I v ~~JQ_m__mmm_~~~;ked I r
PSID
PSID
o Closed tight
Static
PSID
DETECTOR BYPASS ASSEMBLY INITIAL TEST
1 ST check 2nd check
o Closed tight 0 Closed tight
o Leaked 0 Leaked
Static PSID Static
PSID
DETECTOR BYPASS ASSEMBLY FINAL TEST
o Closed tight 0 Closed tight
Static PSID Static
PSID
ASSEMBLIES IN FIRE PROTECTION SYSTEMS
Forward Flow Test
Designed flow rate 262.36 GPM
Indicatina Control Valves
o No. one control valve open 0 No. two control valve open
Part (s) Replaced/Comments /--- /74 rt 16.f/7"/'''-
Note: Include hose stream demand where applicable
Actual flow rate 5' ~; GPM
Valve supervision: 0 Tamper switch 0 Locked
5V"C?/fr1
I HEREBY CERTIFY THE TEST RESULTS ARE TRUE AND THE TEST WAS CONDUCTED BY ME PERSONALLY.
Tester Name (print) 1C' ~ RegistratiOnNo.~7Pp~ Time of Day //70
Tester Signature \ Phone No)? ~d ? 6tJ 67:[::5 Date t!- -(.,-tJ,b
"
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 ofthe 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 backflow 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 Connection 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.
J
DOUBLE CHECK VALVES AND DOUBLE DETECTOR CHECK VALVES INSTALLED IN FIRE
,-.
PROTECTION SYSTEMS ; ,
-,." .
--;r
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 Detector
. 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.