HomeMy WebLinkAboutSKM_C45820021314330////..� � �.:� �=� Noar�srAAF�AEPa�
SHAMBAUGH&SONFLP. ♦
MC��Iflz pN� Dalmatian A Orvisiox oi Snemenucx 8 Sox, LP
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Sprinkler Inspection Certificate
For
DSV Bldg- Pedcor - 61155
736 Hanover Way
Carmel, IN 46032
Tested [o NFPA 25 Standazds
This Inspection was perfarmed in accordance with app/icab/e NFPA Slandurds. The su6seyuenf yagce
of thls report provide performnnce measurements, [isAed ranges ofacc¢ptable ruults, and mmplete
documenmtlonofthein.spectlon. Wheneverdiscrepanciesexistbetweenaccep(ableperformance
standards and actua( fest resulls, notes and/or rerommended sa(utions have been proposed or provided
(or immediute review and approval.
Inspection D¢te
Feb70, 2020
Boilding:DSVUIdg-Pedcorv61155 Company:Dalma[ianFirc
Contact Mikc Polsmn Comacc losh Cooley
]'ille:Ma�ager ]'itle:Inryector
RELEASEO FOR CONSTRl1CTI0N
Subject to compliance with all regulations
of State and Local Codes
City of Carniel
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DATE: O2�Z5�ZO
Builtling:OSV Bldg-Petlm�-61155
ContacC Mike Pds�an
RELEASEO FOR CONSTRIlCTION
Subject to compliance with all regulations
of State and Local Codes
City of Carniel
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DATE: O2�Z5�ZO
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Executive Summary
ce�e.oeed ar: a�nmmxa�.�..nm
Building Information
BUIltling:DSVBItlg-Petlmr-6H55 ContacCMikeVolston
AAdrcaa: ]3fi Hanover Way PM1one:31]E90-0325
AtlEress: Faz:
CItyISGIeIZip: Carmel, IN 46032 Mobile:
Country: Unitetl Srotesof Amenca Email: mpolstan@pedmr.net
Inspec[ion Performed By
� Company:DalmalianFlre Inepec[or:JoshGooley
Atldress:56]OWest]3rtl5�reet Phone:31]-989-W61
Atltlrass: Fax:
Clty/Stetal2lp: Intlienepolis, IN 46218 Mobile:
Couniry:UnitedSlalesolAmenca EmalLjwoley@tlalmatianlre.nel
System ConVol Unit
Syalem Typa Syetem Lowlion Protedetl Area
Inspection Summary
CateBory:
varv.
TOUh
Company: Dalmatian Fire
Inapedor: Josh Cooley
TOGllhms SeniceA Paeeed
Uty % Ory % Oty %
a +ooaow a iaomx I a ioovox
� 100% 3 100.00% ] 100.00%
yii�ti
i
D�3
Fail¢tl/Otl18�
ary %
0 ow '
0 0%
�
oR110/202a
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Inspection & Testing
Genemtedby:Bui(dingAeparts.rom
�ing: DSV Bldg- Pedcor - 61155 _
i The Inspeotlon & Pu�ing sectian lists a(1 of�hel�ems insyeoted inYom building. ttem.v aregrouyed bYPaesed os
Fuifed/Othee /tems are lieted by Category. Eacfi irem includes rAe services➢e � rmed, and ehe rime & da�e at which ru�ing
curred.
IMWceTyp� ILocalbn �SeMca � Tlme �� Ua1e '�
Passed
Wet Pipe
BackllowPrevmtion Wa�erpumproom
Badcllow PrevenGon Waler pump room
BacMlow Preven�ion Water pump rown
RELEASEO FOR CONSTRl1CTI0N
Subject to compliance with all regulations
of State and Local Codes
City of Carniel
'�vmP.�''i'�o�V��
DATE: O2�Z5�ZO
Annual 9:18:16AM 02It012020
Annual 926'.03 AM 02I10/2020
Annual 9935AM 02I1012@0
0]/102020
/%� �� \�L�i
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Wet Pipe Fire Sprinkler Systems
ce�,e.o�re p�- uune„�zx�o.�,.�om
Building: DSV Bldg- Pedcor - 61155
TGi.v.rectinn (i.va. out al] �he devicei and compnnentt tAa� hwe been aasoaiated with a Wet Pipe S}wtvn and pra�iden deiaiis
on m type oJcumponenr, yies.rure.eadingr, .rsQome time. em. tja component has an OK cheakbox Poat is ehwkrd, then
�har aompartem was acmal/v res�ed. Howeveq for Pass/Fai! eese revuUs, sae ihe Invpeciian and Temfng.veceion.
Components
Backflow Prevenfion 1
ManNecYurer MotlelY Sise Type ServlceType InsWllUab
Wlkins 950XL T' Reducetl Pressure Irrigaiion 02I10I2�20
SwnID WeterPurveyor ILocatlon ,MHerAmouMM SerialNumbe� I
40503399 carmel Waterpumpmom �22]3] R320656
InItIalTeat
Chack Valva 1 Check Valw 2 Ralitl Valw Prossuro Vawum BneMr
].8 BA 2.8
Hsltl At ReOalrs or Notes
Testetl 10-P-09
FInalTest
ChecMValvei CheekVaHe2 ReliNValve PraevureVacuumBreaker
HaldAt CandltlonMCo�NolValvat CondMonAGontrolValveP 1
Closetl TIgM1t Qasetl TigM
BackFlow P�evention I
ManWacNrar 'Motlel# Sim Type ServicaType Ins411Dpb
Wilkins 9]5%L T' Ratlucetl PresSure Potabla 02/1012W0
ScanlD 'WnerPurvayor LxaUon MeterAceountN SerlalNumber I
4050339] wrmel Waterpumpmom 60566054 W252055
Inklel Tnt
CheckValvet CheckVaWa2 RCIiafValw PmeuroVxuumBreab�
9.0 8.9 3 9
flelE At 1RePaln or Notes _ _�
Tenetl 10-t"l-19
FInalTest I
CM1eckVelwt CheckVaNe2 'RNkfValve �PrpaurcVacuumBreaker
"-" "• CondXlon ofControl Valve 3
RELEA5E0 FOR CONSTRACTION ��a=���9��
Subject to compliance with all regulations
ofStateandLocalCodes =^"�TrP° I�"'�°��osa
City of Carniel
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DATE: O2�Z5�ZO
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Wilkins WS%L 2" Retlucetl Pressure
9canlD WalerPurveYor Locatlon
40503398 carmel Waterpompmom
IniGalTebt
CM1eck Valve 1 Lheck Valva 2 IReIiNValve
9A 8.9 3.9
HeIE At IRapeln orNolea
Tes�ed 10-1]-19
\��
Po�able 02/102020
IMarorAccouM# SeMalNumbar I
43408952 W1389356
Brcaker
Flnal Tnt
CM1ttkVelvet Ch�ekValw2 RaliNVahv Prce�uroVacuumBreaker
HaltlAt IContlitlono/Con4olValvN ICondltlonMConvdValve3
Cbsetl TgM CloseE TgFI
RELEASEO FOR CONSTRIlCTION
Subject to compliance with all regulations
of State and Local Codes
City of Carniel
'�vmP.�''i'�o�V��
DATE: O2�Z5�ZO
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Inventory & Warranty Report
4mero�edby: BuildinBReponsrom
Building: DSV Bldg- Pedcor - 61155
The Im�rnrory @ Wannnry Rrport 6.v+s eoch ojrFa de�cw ond (rems that are inc(uded Inyau./nspecnon Reyor[ 9
�ompleie Imemory cuum LY deWa ryPe mid co�eyory ir proNded. Grnw irumlfvd within ihalavt90 dayr. wiehln rhe la.rt
yeor, and deol�re Ir�.aa](edfnr two yearc or n�ore are grc+uv✓� �ose�herfo. eosy reJerenee
DpvieeorTYPe CateBory %oflnvantory Oue�rtlry
BaGfiowPreaen6on VaNe 100A0% 3
MviaTYPa ...iply Malel# TYPa IDeserlPHon InWNIOah
New (under 90 days)
wa� v��
BackflowPreventlon 1 350XL Retluced Pressure
BackilavPrevention 2 9]SXL RetlucedPressure
RELEASEO FOR CONSTRIlCTION
Subject to compliance with all regulations
of State and Local Codes
City of Carniel
'�vmP.�''i'�o�V��
DATE: O2�Z5�ZO
oviazozo
021102020
ov�azaza
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Notes & Recommendations
Gencreted 6y_ HuildingFeporss.wm
Building: DSV Bldg- Pedcor - 6l I55
ThuVo[ee & Recommendnfioru Report demiL� addrtiono! innpunon nntu made hy the /nvprcmrs durinR �de cuune uf(he
bulldirty (nspecNoa Noter megiouped by J�s(em(D.
Nofa Davip Typa I Loptlon CommaR SunID
IWetPipe
1 BackilowPrevention Wate�pumproom Passetl 405033W
TesteC 1U1]49
2 BackflowPreventlon Waterpumproom PasseO 40503398
Testetl 10-t]-18
, 9 BackllowPreventqn Weterpumproom Passed 405W399
Tested 10-1]-09
RELEASEO FOR CONSTRIlCTION
Subject to compliance with all regulations
of State and Local Codes
City of Carniel
'�vmP.�''i'�o�V��
DATE: O2�Z5�ZO
01/l012020
Mike Polston
from: Josh Cooley <jmoley@dalmatianfire.neb
Send Monday, February 10, 2020 10:00 AM
To: Mike Polston
Cc Cschmidt@dalmatianfire.net
SubjecC Fw: We have rxeived your response (or City of Carmel Backflow Test Porm
Thank you,
NICET 148603
lash Cooley � Servke Inspettlms & Sales � Dalmadan Flre
�� :,� 56>o West J3rE 5; IntlianaROlis, IN 9bD8
311299.3BB9 Cell31).969.09fi1
www.tlalnietianfire net
-- Forvierce4 0y JosM1 Coolcyl�o ma�ian�EMCOFGHOIIP on 01/t0202010llG HN �
F,om�. ca�i�cxnw�escNw�n�si.��.so..
10�. koderf�aaimznznnrenei
oa�e�. oviazasooe�.ssaM
suo�ecr. wan..erecervearo��reaponsem,aryoica�aiea�xn�rarro�
BE ADVISED - This email originated outside EMCOR.
TestersEmail jcooley@dalmatianfre.net
Select Tester From List SCHMIDT, CHAD_BF09-3884
Gaugelnformation 08151855
Phone Number (317) 299-3889
Cali6ration Date 09-04-2019
Selec[ Company or
�_,� Company
RELEASEO FOR CONSTRl1CTI0N
Subject to compliance with all regulations
of State and Local Codes
City of Carniel
'�vmP.�''i'�o�V��
DATE: O2�Z5�ZO
Address
Select Service Use
MANAGERNAMEor
COMMERCIAL
CUSTOMER NAME
Type a ques[ion
DEVICE LOCATION
ADDRE55
Street Address: 5670 West 73rd St
City: Indianapolis
State / Province: in
Postal / Zip Code:46278
Commercial
DSV Bldg
43408952
Street name: Hanover Place
House number:736
Ciry: Carmel
State:IN
Postalcode:46032
Country: United States
Eaisting New or
ReplacingDevice Ezisting
Device5erialNumber W2387356
Manufacturerof yyilkins
device
Device Size 2
ModelNumberOf g�5xl
Device
Type of protection Containment
Type Of Service Damestic
Typeaquestion WaterPumpRoom
Hazard Code RP
Passed or Failed PA55
DC
, c�kv.m.n xmuwn.�rim
�cm.arem
��F�
CM[kValveMXetlF[W�atV150
RELEASEO FOR CONSTRl1CTI0N
Subject to compliance with all regulations
of State and Local Codes
City of Carniel
'�vmP.�''i'�o�V��
DATE: O2�Z5�ZO
oc
�
Date
Time
RP
Date
7ime
RP
Passed or Failed
Tagged
Date
7me
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PI[SSUR WHlRMi1PlIklVdlVlOpeMERiWM1a[P510
maxoro�
PA55
YES
09/17/2019 9:20 AM
RELEA5E0 FOR CONSTRl1CTI0N
Subject to compliance with all regulations
of State and Local Codes
CityofCarniel ` 1 °
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DATE: O2�Z5�ZO
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AIRGAPONLVFinal mnwrcawninii.ne�.eoK s�pµ:�w�m.�
Test ResuRs °"°'"°""�m
AU Gap
Date
Time
Testers Full Name: Chad Schmidt
Date 02/10/20209:SOAM
Time
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RELEA5E0 FOR CONSTRl1CTI0N
Subject to compliance with all regulations
of State and Local Codes
City of Carniel
'�vmP.�''i'�o�V��
DATE: O2�Z5�ZO