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HomeMy WebLinkAboutF2022-0164 - Misc (2)Contractor's Material and Test Certificate for Aboveground Piping PROCEDURE Upon completion ol work, Inspection and tests shall be made by theoontractor s representative and witnessed by the property ownor or their authorized agent. All defects shall be corrected and system left in service before contractor's personnel finally leave the job. A certificate shall be filled cut and signed by Wit representatives. Copies shall be prepared for approving authorities, owners, and contractor. 11 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 authority's requirements or local ordinances. Property name one Hoag Leadership Center Dale 22/23 Property address 1 Hoag Dr., Newport Beach, CA 92663 New installation? • 1li Yes UN, Modification? If yes, complete applicable portions of the form. La Yes a No Provide a description of the scope ol work on page 3. Accepted by approving authorities (names) City of Newport Beach Fire Department Plans Adclnass 100 Civic Center Dr., Newport Beach, CA 92660 Installation conforms to accepted plans a Yes U No Equipment used Is approved a Yes [3 No If no, explain deviations Has person in charge of fire equipment been instructed as Zi Yes UNo to location of control valves and care anti maintenance of this new equipment? II no, explain Instructions - Have copies of the following been left on the premises? a Yes :I No 1. Systern components instructions a Yes [:, No 2. Care and maintenance instructions Zj Yes :IN° 3. NFPA 25 ID Yes Zill No Location of system Supplies buildings . Make Model Year of manufacture Orifice size Quantity Temperature rating Tyco TY323 2022 1/2" 33 200 F Sprinklers Tyco TY313 9o77 1f2" 156 200F Tyco TY5237 2022 3/4" 9 200 F Tyco TY5522 2022 200F Tyco TY3031 2022 1/2" 73 200 F Pipe and Type of pipe Schedule 10, Schedule 40, VctauIlc flex fittings Type ot fittiPgs DJ. screw. VIctaulic groove Alarm Alarm device Maximum time to operate through test connection valve or flow Type Mako Model Minutes Seconds indicator Sow ‚ Potter VSR Dry valve Make Model Serial no. Make Model. Dry pipe , h t connectiona,0 VVater Air pressure Trip ure e reached lest outlet a, b Alarm operated properly operating test Minutes Seconds psi psi Minutes Seconds Yes No WithoAA With Q.O.D. aMe A 13on a n "ri o nnection is opened. N A ) y r h e 'milation in specific sections. , W2010 National Fire Protection Association. This form may be copied for Individual use otherthan for resale. It may not be copied for commercial sale or dIseibulktn. No other reproduction or transmission in any form perrnitted without written permission of NFPA. For inquiries or 10 report unauthorized use, contact licensing nfpa.org. Contractor's Material and Test Certificate for Aboveground Piping (continued) Operation LI Pneumatic El Electric 01Hydraulias _Piping supervised ZiYes CiNo Detecting media supervised • JNo D?eperate frorn the manual trip, remote, or both control stations? DI Yes Li No Deluge and reaction Is there n acce facifily in each circuit for basting? j No If . - i 4' 7n valises Make Does e—• •cuit Model supervesi operate .-. -Iarm9. each circuit operale vaive release?. Maximum time to operate release Yes Yes t4o Minutes Seconds Pressure - reducing valve test Location and floor Make and model - Semng Static pressure Residual pressure (flowing) Row rate Inlet psi) Outlet (psi i 11tlet• (gpm) Indicate means used for forward flow test of backllow device: When means to test device was opened was system flow demand created? CI Yes El No Lj N/A Hydrostatic: Hydrostatic tests shah be made at not less than 200 psi (13.8 bar) for 2 hours or 50 psi (3.4 bar) Test description above static pressure in excess of 150 psi (10.3 bar) for 2 hours. Differential dry pipe valve clappers shall be left to open during the test prevent damage. Ail aboveground piping leakage shall be stopped. Pneumatic: Establish 40 psi (2.7 bar) air pressure and measure drop, which shall not exceed 11/2 psi (0.1 bar) in 24 hours. Test pressure tanks al normal water level arid air pressure and measure air pressure drop, which shall not exceed 11/2 psi (0.1 bar) in 24 hours. All piping hydrostatically tested at psi (—.— bar) for 2L__ hours If no state reason Dry piping pneumatically tested 0 Yes @ No Equipment operates property LJ Yes 1.7.11 No NI/A Do you certify as the sprinkler contractor that additives and corrosive chemicals, soditim silicate or derivatives of sodium silicate, brine, or other corrosive chemicals were not used for testing systems or stopping leaks? 0 Yes j.INo Tests Drain test Reading of gauge located near water supply test connection ISO psi (_ Residual pressure with valve In test connection open wide: 55 psi ( bar) Underground sprinkler Verified by Certificate Flushed by mains and lead-in connections to system risers flushed piping copy of the Contractors Material and Test D Yes tor Underground Piping. installer of underground sprinkler piping ta Yes before connection [..3 No CI No _ made to Other Explain It powder -driven fasteners are used in concrete, N 0 es a o Y has representative sample testing been satisfactorily completed? If no, explain WA Blank testing gaskets Number used Locations Number removed Welding piping [:I Yes L:1 No II yes ... Welding Do you certify as the sprirdder contractor that welding procedures used complied with Ves ; the minimum requirements of AWS B2.1, ASME Section IX Weking and Brazing Qualifications, or other applicable qualification standard as required by the AHJ? Do you certify that all welding was performed by welders or welding operators CI Yes J No qualified in accordance with the minimum requirements of AWS B2.1, ASME Section IX Welding and Brazing Qualifications, or other applicable qualification standard as required by the AHJ? Do you certify that the welcing was conducted in compliance with a documented ['Yes Li No quality control procedure to ensure that (1) all discs are retrieved; (2) that openings in piping are smooth, that slag and other welding residue are removed; (3) the internal diameters of piping are not penetrated; (4) completed welds are free from cracks, incomplete fusion, surface porosity greater than 1/16 in. (1.13 mm) diameter, undercut deeper than the lesser of 25% of the wall thickness or Vax in. (0.8 nvn); and (5) completed circumferential butt weld reinforcement does not exceed 3h2 in. (2.4 mm)? NFPA 13 (p. 2 of 3) 1:11 0 2018 National Fire Protection Association. This form may be copied for Individual use other than for resale. It may not be copied for commercial sale or distnbution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to repon.unauthorized use, contact licenstrig@rdpa.org. Contractors Material and Test Certificate for Aboveground Piping (continued) Cutouts (discs) Do you certify that you have a control feature ta ensure that all cutouts (discs) are retrieved? [ja Yes UNo Hydraulic data nameplate Nameplate provided ZI Yes [a No If no, explain Sprinkler contractor removed all caps and straps? [Li Yes r21 No Remarks Date lett In service with all control valves open Signatures Name of sprinkler contractor A& D Fire Tests witnessed The property owner or their authorized agent (signed) Title Date Fornkler coritract.: ',.1..." -- Title CUT)er iniea tient Date 13123173 Additional explanations and notes NFPA 13 (p.3 of 3) [;1CO 2018 Na0onal Fire Rolm, on Association. This farm may be copied for Individual 1188 otherlhan for resale. 11 may not be copied for commercial satip or distribution. No other reproduction or transmission in any form perrnitted without written permission of NFPA. For Inquiries or to report unauthorized use, contact fIcensing@rdpa.org. Contractor's Material and Test Certificate for Underground Piping PROCEDURE Upon completion of work, inspection and tests shall be made by the contractors representative and witnessed by an owners representative: All defects shall be corrected and system leftinservice 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, orfatiure to comply with approving authority's requirements or local ordinances. Property name One Hoag Leadership Center Date 3122/23 Properly address 1 Hoag Dr., Newport. Beach, CA 92663 Plans Accepted by approving authonties (names) Cityof Newport Beach Fire Department Address 100 Civic Center Dr, Newport Beach, CA 92660 Installation conforms to accepted plans ❑ Yes ❑ No Equipment used is approved a Yes ❑: No If no, state deviations Instructions Has person in charge of fire equipment been instructed as to location of ❑ Yes ❑ No control valves and care and maintenance of this new equipment? If no, explain Have copies of appropriate instructions and care and maintenance ❑ Yes ❑ No charts been left on premises? If no, explain Location Supplies buildings. One HoadLeadership Center Underground pipes and joints Pipeaypes and sass PVC C-900, C.L. Type joint Pipe conforms to NFPA24 standard ❑ Yes ❑ No ❑ Yes ❑ No Fittings conform to NFPA 24 standard If no, explain Joints needing anchorage clamped,. strapped, or blocked in accordance with NFPA 24 . standard ❑ Yes ❑ No If no, explain Test description Flushing: flow the required rate until water is clear as indicated by no collection of foreign material in burlapbags at outlets such as of 6.10.2,1.3. working pressure shall be hydrostatically tested at 200 psi whichever is greater, and shall maintain that pressure ±5 psi the system to maintain the test pressures required by 6.10.2.2.1, of the following equation (for metric equation, see 6.10,2.2.6): water), in gallons per hour feet pipe, in inches during the hydrostatic test, in pounds per square inch (gauge) hydrants and blow -offs. Flush in accordance with the requirements Hydrostatic: All piping and attached appurtenances subjected to system 113.8 bar) or 50 psi (3.4 bar) in excess of the system working pressure, (0.34 bar) for 2 hours. Hydrostatic Testing Allowance Where additional water is added to the amount of water shall be measured and shall not exceed the limits L = testing allowance (makeup SDJP S = length of pipe tested, in L = 149,000 D = nominal diameter of the P = average test pressure Flushing tests New underground piping flushed according to NFPA24 standard by (company) Yes ❑ No If no, explain How flushing flow was obtained ❑ Public water ❑ Tank or reservoir ❑ Fire pump Through what type opening ❑ Hydrant butt ❑ Open pipe Lead-ins flushed according to standard by (company) ❑ Yes ❑ No If no. explain How flushing flow was obtained Public water ❑ Tank or reservoir ❑. Fire pump Through what type opening 1J Y connection to flange ❑ Open pipe and spigot NFPA 13 (p. 1 of 2) r1 ® 2018 National Fire Protection Association. This form may be copied for individual use other than for resale. It may not be copied for commercial sale or distribution. NFIl1C No other reproduction or transmission in any form permitted without written permission of NFPA. Forinquiries or to report unauthorized use, contact licensing@nfpa.org. Contractor's Material and Test Certificate for Underground Piping (continued) Hydrostatft c test undergroundAll new piping rosl 'tested at psi for hours Joints covered Yes [J No Leakage test Total amount oi Jeakage measured gallons 0 Aflowable teakage gallons hours Forward fl test of backflow preventer est performed in accordance wl 8.10.2.5.2: [21 Yes fp No Hydrants Number installed Type and- make All operate sa isfactork 1:1 Yes Control valves Water ves Ieft widee Yes No tfnostatereason Hose threads of fire department connections and hydrants interchangeable with Yes LI No those of fire department answering alarm \ Remarks Date lett in service Signatures Name of installing contractor Tests ' ITY For property owner (signed) Title Dateitt n -'''' - r: . s .4 .. • Title Date S in I Mdit. lanatton and notes NFPA 13 (p. 2 ol 2) 2018 National Fire Protection Association. This form may be ("ivied for Individual use other then for resale. It may not be copied for commercial sale or distribution. No other reproduction or transmission in any form permitted without written permission of NFPA. For inquiries or to report unauthorized use, contact licensing@nfpa.org.