HomeMy WebLinkAbout10585 N. Meridian Back FlowRev. 3.3
Date:Phone #:
Time In:5:15 AM Time Out:10:30 AM
Inspector:
Inspector:SO#
Time:5:20 AM
Operator:
A.Has there been any modifications to the system since last inspection?
B.Have there been any occupant/hazard changes since last inspection?
C.Was there an actuation of a device or alarm since last inspection?
D.Is building completely sprinkled?
E.Are all systems in service?
F.Has piping been checked for stoppage?
G.Do low points exist?
*All answers in this section are based on the customer's knowledge of the system
Comments for A-G:
1)General
A. Is there proper clearance between sprinklers and storage -- 18in?
B.In area protected by wet system does building appear to be properly heated?
C.If required, is hydraulic nameplate in place?
D.Is building occupied?
E.Are there proper signs on all valves and switches?
2)
A.Are all control valves and other valves in the open position and in good condition?
B.Are all control valves locked sealed or supervised?
C.Were all OS&Y valves lubricated?
3)Tanks, Pumps, Fire Department Connections
A.Are fire pumps, gravity tanks, reservoirs and pressure tanks in good condition and
required test performed if needed?
B.Are fire department connections in good condition, couplings free and caps in place?
C.Are fire department connections accessible and visible?
4)Antifreeze Systems
A.Are cold weather valves in proper position?
B.This system does not have an antifreeze loop.°F
M&J Wilkow
CMS Panel Code:
Owner / Occupant
Last 5-year IPI performed 6/3/2020 by Koorsen Fire and Security (next due June-2025)
Inspector's Section (All responses reference current inspections)
Control Valves
Does Not Apply
S. Flater 3833996
System on Test Monitoring Company:Koorsen
N. Childers Indianapolis, IN 46290
Inspection & Test Report
Inspection Type:Wet/Dry Sprinkler
Frequency:Annual
January 28, 2021 317-542-1800 M&J Wilkow
10585 N Meridian
Yes No
NoYes
Yes No
NoYes
Yes No
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Yes NoN/A
Yes NoN/A
Yes NoN/A
Yes NoN/A
Yes NoN/A
Yes NoN/A
Yes No
N/A
Pass Fail
NoYesN/A
Some areas were unable to be inspected at this time.
Sprinkler Test Inspection Report Page 1 of 4
5)Dry Systems
A.Are the air pressure and priming water levels normal?
B.Has the air or nitrogen supply system been checked for proper operation?
C.Were the low points drained?
D.Did quick-opening devices operate satisfactory?
E.Is dry valve in a properly heated area?
6)Alarms
A.Did water motor gong and/or electric bell test satisfactorily?
B.Did electric alarm send signals to the fire alarm panel?
C.Did supervisory devices work ?
D.Were alarm, trouble, and supervisory signals verified with central station?
7)Sprinklers/Piping/Gauges
A.Do sprinklers appear to be free from corrosion, loading, or obstruction?
B.If standard sprinklers are over 50 years are they being tested?
C.If quick response sprinkler are over 20 years are they being tested?
D.Is stock of spare sprinklers and wrench available?
E.Does the exterior condition of the sprinkler system appear to be in good condition?
F.Are gauges in good condition and reading proper pressure?
Manufacturers date or date last tested 2018
8)Stand Pipe / Hose Systems
A.Type:Wet No.Combined No.Dry No.
Water Supply:
B.Are stand pipe and hose systems in good condition?
9)Special Systems / Test Type:
A.If occupancy has special systems, have they been tested as required?
B.Are they in good condition and were tests satisfactory?
C.If testing was required, see attached form or system tags?
Time to Alarm Signs
Drain Size Static PSI Residual PSI Static PSI
Although these comments are not the result of an engineering review, the following improvements are
recommended:
Time:10:25 AM
Operator:
M&J Wilkow
CMS Panel Code:
System Back In Service Monitoring Company:Koorsen
See Multi Riser Report
Explain any "No" answers:
Adjustments or corrections made during this inspections:No corrections made at this time.
No recommendations at this time.
Possible replace OSY valve on system send quotes
Main Drain
Location Result Comparable Signs
Location Alarm Report Orifice Results Comparable
Does Not Apply
Inspector's test Smooth Bore
Does Not Apply
Does Not Apply
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
NoYes
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
NoYesN/A
NoYesN/A
NoYesN/A
N/A
N/A
N/A
Multiple Inspector's Test
Multiple Risers
Some sprinklers are unable to be visually inspected at this time.
NoYesN/A
NoYesN/A
NoYesN/A
Sprinkler Test Inspection Report Page 2 of 4
SO#
Rev. 3.3
Previous Present
Vlv Type Static /
Residual
Static /
Residual
Butterfly 100/75 80/65
Butterfly 95/70 110/95
Butterfly 90/70 115/95
Inspected by:
Total Qty of Risers Inspected:3Inspected by:
S. Flater
N. Childers
M&J Wilkow
10585 N Meridian
Indianapolis, IN 46290
3833996
1st FL Hallway
Riser Location
3rd FL Hallway
2nd FL Hallway
39 sec.
January 28, 2021
48 sec
Time to
Alarm (Sec)
Next to Valve
MULTI RISER REPORT
52 sec.
ITV Location
Next to Valve
Next to Valve
Multi Wet Riser Report Page 3 of 4
Ph: # 317-542-1800
Indianapolis,Indiana SO#Page Qty:1
7
Zone or
Address Valve Type Size Pass / Fail Sealed
59 OSY 4"Pass
57 OSY 4"Pass
55 OSY 4"Pass
60 PCVS-2 4"Pass
58 POTTER VSR-D 4"Pass
56 POTTER VSR-D 4"Pass
54 POTTER VSR-D 4"Pass1FL Hallway Water Flow
3FL Bastian Solutions Break Room
2 fl Indie Asset Far Left Office
Above Window
Outside electrical in hall
2 fl Indie Asset Far Left Office Tamper Switch
3FL Bastian Solutions Break Room Tamper Switch Above Window seal
Inside Far left office above window seal
Tamper Switch WPIV
Inside Far left office above window
O/S BACK DOOR BY MAIN
Water Flow
Water Flow
Tamper Switch1FL Hallway
M&J Wilkow
10585 N Meridian
Total devices inspected
Indianapolis, IN 46290
Comments
January 28, 20212719 N. Arlington Ave
Type
3833996
DETECTION INSPECTION REPORT
Device(s) failed during this inspection
Device Location
Sensitivity and Detection Inspection Report Page 4