Attachment_7-2010_to_2021_Grounds_Complex_inspections_0001.pdf

VSC Fire & Security, Inc.

10640 Iron Bridge Rd., Suite G

Jessup, MD 20794

(301) 575-1500 Office

(301) 575-1571 www.vscfs.com

Inspector: James Ivison Inspection date: 10/25/16

Inspection performed in accordance with NFPA 25 Standard for the Inspection, Testing, and Maintenance of

Water-Based Fire Protection Systems

Annual Fire Sprinkler System Inspection

Inspection conducted at location:

Grounds Maint Complex & Warehouse Building #19288 1801918-02 11 North 4th Street

St. Louis, MO 63102

Phone: (410) 668-8000 Fax:

For Customer:

EBL Engineers, LLC 01088E0191 8005 Harford Rd

Baltimore, MD 21234 Phone: Fax:

Jeff McBride JMcBride@EBLEngineers.com

Page 1 of 4Grounds Maint Complex & Warehouse Building #19288

Notifications Prior to Testing Monitoring entity notified? Yes

Who was notified at Monitoring entity? Arrowhead Dispatch

Building occupants notified? Yes

Who of the building occupants were notified? All

Building management notified? Yes

Who in Building Management was notified? All

Building management time notified 7:15 AM

Notifications After Testing Building management Yes

Who in Building Management was notified? ALL

Monitoring agency Yes

Who at Monitoring Agency was notified? Arrowhead dispatch

Building occupants Yes

Who of building occupants was notified? All

Date system restored to normal operation. 10/25/2016

Time system restored to normal operation. 2:30 PM

System Summary Number of Systems at Site

Items Total Systems

Wet Sprinkler System 1

Wet Riser Main Drain/No Check valve - 1 gauge

Exterior of connection in good condition and gauge operable? Yes

Static Pressure before valve opened 65

Residual Pressure with valve open 55

Static Pressure after valve closed 75

Record time (seconds) for supply water pressure to return to original static pressure. 2

Gauges on valve, when compared to calibrated gauge is error less than 3% full or gauge has been recalibrated or replaced? No

Main Drain Test Pressures less than 10% reduction in flow from original acceptance test or previous test results? Pass

Is there adequate drainage available? Yes

New tag color or seal #. N/A

Wet Sprinkler System Inspection

Sprinkler heads free of corrosion, foreign material, paint or damage, no signs of leakage and heads installed in proper orientation? Yes

Minimum clearance maintained below all sprinklers? Yes

# replacement sprinkler heads per number installed in the head box comply: 6 per 1-300: 12 per 301 to 1,000: 24 per > 1,000? Yes

Sprinkler head wrench for each type head provided in head box? Yes

System piping free of mechanical damage, leaks, corrosion, misalignment, or other loads or pipe hung from system? Yes

Pipe hangers and seismic braces secure and undamaged? Yes

Adequate heat to maintain minimum building temperature of 40 deg F, and building free of conditions exposing pipe to freezing? Yes

All sprinklers in this building been manufactured after 1920? Yes

All sprinklers in building less than 50 years old or, if fast response, less than 20 years old, or if older, representative samples tested within the last 10 years? Yes

If dry sprinklers are installed in building, and have been in service for 10 years, have they been replaced or a representative sample tested? No

Wet Sprinkler System

Page 2 of 4Grounds Maint Complex & Warehouse Building #19288

Waterflow Alarm Switch

Area/Location Flow switch free of damage with its electrical connections secure?

Water flow activate alarm when open test connection/bypass?

Secs. to activate

M1-24 Main fire service Label- waterflow Pass Pass 24

Hydraulic Nameplate

Area/Location Nameplate securely attached to sprinkler riser & is legible?

Yes

Control Valves

Type Area/Location Condition Position Secured Size Exercised Seal

Control valves Backflow Discharge No Yes Yes 4" Yes N/A

Control valves Backflow Suction No Yes Yes 4" Yes N/A

Control valves System Control No Yes Yes 4" Yes N/A

Other Components

Fire Department Connection

FDC visible and accessible, without damage and signs in place? Pass

Couplings and swivels free of damage and rotate smoothly? Pass

Caps, plugs and gaskets in place and free from damage? Pass

Check valve clapper free from leaks and automatic drain valve in place and operating properly? Fail

Internal Pipe Exam

Internal pipe exam - System free of evidence of foreign organic and inorganic material needing to be removed by checking flushing connection end of one main and removing one sprinkler near end of branch line? No

Enter date of last pipe exam performed. no

Tamper Switch

Area/Location Visual Functional

M1-25 System Control Label- Water Tamper Pass Pass

M1-29 Backflow Disc. label- PIV Valve Pass Pass

M1-30 Backflow Suc. label- PIV Valve 2 Pass Pass

Comments

Deficiencies Fire Department Connection

Check valve clapper free from leaks and automatic drain valve in place and operating properly?

Technician Response: NO AUTOMATIC DRAIN ON FDC

Deficiencies not covered in Questions

Deficiencies found, in addition to standard questions.

Technician Response: Found 4 missing escutcheon plates 2 in confernce room by main entry 1 in offices too the left of the main entry 1 in 2nd floor storage room

Wet Sprinkler System Inspection

Page 3 of 4Grounds Maint Complex & Warehouse Building #19288

Liability Release Statement:

The owner and/or designated representative acknowledges the responsibility of the operating condition of the component parts at the time of this inspection. It is agreed that the inspection service provided by the contractor as prescribed herein is limited to performing a visual inspection and/or routine testing, and any investigation or unscheduled testing, modification, maintenance, repair, etc., of the component parts is not included as part of the inspection work performed. It is further understood that all information contained herein is provided to the best of the knowledge of the party providing such information.

Customer: JEFF-19288 GROUNDS & MAINT. COMPLEX

10/25/16 10/25/16

Technician: James Ivison

If dry sprinklers are installed in building, and have been in service for 10 years, have they been replaced or a representative sample tested?

Technician Response: 2 dry sidewalls at loading dock and 1 in spare head box are older than 10 years old dated 2002 should be sent off for testing or be replaced

Internal Pipe Exam

Internal pipe exam - System free of evidence of foreign organic and inorganic material needing to be removed by checking flushing connection end of one main and removing one sprinkler near end of branch line?

Technician Response: FIVE YEAR SERVICES ARE NOT INCLUDED IN CONTRACT/INSPECTION - SHOULD YOU DESIRE TO HAVE

THIS SERVICE PERFORMED, PLEASE CALL FOR AN ESTIMATE

Wet Riser Main Drain/No Check valve - 1 gauge

Gauges on valve, when compared to calibrated gauge is error less than 3% full or gauge has been recalibrated or replaced?

Technician Response: FIVE YEAR SERVICES ARE NOT INCLUDED IN CONTRACT/INSPECTION - SHOULD YOU DESIRE TO HAVE

THIS SERVICE PERFORMED, PLEASE CALL FOR AN ESTIMATE

Control valves Backflow Discharge Kennedy OS&Y OS&Y

Valve have proper signs, accessible and free of leaks, provided with the appropriate wrenches, if needed?

Technician Response: SIGNS MISSING

Control valves Backflow Suction Kennedy OS&Y OS&Y

Valve have proper signs, accessible and free of leaks, provided with the appropriate wrenches, if needed?

Technician Response: SIGNS MISSING

Control valves System Control Victaulic Butterfly Butterfly

Valve have proper signs, accessible and free of leaks, provided with the appropriate wrenches, if needed?

Technician Response: SIGNS MISSING

Page 4 of 4Grounds Maint Complex & Warehouse Building #19288

VSC Fire & Security, Inc.

10640 Iron Bridge Rd., Suite G

Jessup, MD 20794

(301) 575-1500 Office

(301) 575-1571 www.vscfs.com

Inspector: Daniel Bowen Inspection date: 10/31/16

Inspection conducted at location:

Grounds Maint Complex & Warehouse Building #19288 1801918A-03 11 North 4th Street

St. Louis, MO 63102

Phone: (410) 668-8000 Fax:

For Customer:

EBL Engineers, LLC 01088E0191 8005 Harford Rd

Baltimore, MD 21234 Phone: Fax:

Inspection performed in accordance with NFPA 72 National Fire Alarm Code

Annual Fire Alarm System Inspection

Jeff McBride JMcBride@EBLEngineers.com

Grounds Maint Complex & Warehouse Building #19288 Page 1 of 7

Batteries

Type Area/Location Visual Insp

Battery Voltage

Charge Test

Charger Voltage

Discharge Test

Install Date

Funct.

Test

Fire Alarm Battery - Sealed Lead Acid FACP Pass 12.18 Pass 30.05 Fail

INSTALLE

D

10/24/2008 Fail

Fire Alarm Battery - Sealed Lead Acid FACP Pass 12.93 Pass 30.05 Fail

INSTALLE

D

10/24/2008 Fail

Prior To Any Testing Monitoring entity notified? Yes

Who was notified at Monitoring entity? ARROWHEAD DISPATCH

Building occupants notified? Yes

Who of the building occupants were notified? ALL

Building management notified? Yes

Who in Building Management was notified? RICK KILLINGSWORTH

Building management time notified 10:00 AM

Specify other N/A

Other who N/A

Name of AHJ (notified) of any impairments

OWNER/OWNER'S REP. NOTIFIED IF ANY

IMPAIRMENTS FOUND

AHJ (notified) of any impairments time OWNER MUST NOTIFY AHJ OF ANY IMPAIRMENTS

Notifications Testing Is Complete Monitoring agency Yes

Who at Monitoring Agency was notified? ARROWHEAD DISPATCH.

Building management Yes

Who in Building Management was notified? RICK KILLINGSWORTH

Building occupants Yes

Who of building occupants was notified? ALL

Specify what other was notified N/A

List any devices that did not operate correctly, (enter N/A if all working properly). DEFICIENCIES, IF ANY, LISTED IN DEFICIENCY

SECTION.

Date system restored to normal operation. 10/25/2016

Time system restored to normal operation. 2:00 PM

Control Panel and Power Devices Main Fire Alarm Panel

BASEMENT ELEC. RM. SIMPLEX 4010

Lights/LEDs function properly? Pass Acknowledge/silence button functions properly? Pass Panel labels correct? Pass Central station interface - alarm signals Fail Central station interface - trouble signals Fail Central station interface - supervisory signals Fail Proper # of portable handsets for comm. system? N/A Portable handsets operate properly? N/A Ground fault detection connected? Pass Fire panel free from all grounds? Pass Batteries installed and operating properly? Fail Panel Addressable? Addressable Operating instructions posted? Pass Correct fuses installed? Pass Disconnect switches operating properly? Pass

Grounds Maint Complex & Warehouse Building #19288 Page 2 of 7

Duct Detectors

Type Address Area/Location Visual Insp Functional Test

Sensitivity Test Test Method

Duct Detector M1-18 AHU RETURN Pass Pass N/A N/A

Duct Detector M1-19 AHU SUPPLY Pass Pass N/A N/A

Smoke Detectors

Type Address Area/Location Visual Insp Functional Test

Smoke Detector Without Sensitivity M1-1 1ST FL. ELEC. RM. @ FACP Pass Pass

Smoke Detector Without Sensitivity M1-10 SUPPLY ROOM Pass Pass

Smoke Detector Without Sensitivity M1-15 2ND FL. ELEV. LOBBY Pass Pass

Smoke Detector Without Sensitivity M1-16 ELEVATOR SHAFT Pass Pass

Smoke Detector Without Sensitivity M1-2 1ST FL. ELEV. MACH. RM. Pass Pass

Smoke Detector Without Sensitivity M1-4 1ST FL. ELEV. LOBBY Pass Pass

Smoke Detector Without Sensitivity M1-8 JANITORS CLOSET Pass Pass

Heat Detectors

Type Address Area/Location Visual Insp Functional Test

Heat Detector M1-17 ELEVATOR SHAFT Pass Pass

Heat Detector M1-3 1ST FL. ELEV. MACH. RM. Pass Pass

Pull Stations

Type Area/Location Visual Insp Functional Test

Pull Station - Manual M1-11 2ND FL. MAIN FL. Pass Pass

Pull Station - Manual M1-12 TRUCK BAY Pass Pass

Pull Station - Manual M1-13 WAREHOUSE STAIRS Pass Pass

Pull Station - Manual M1-14 WAREHOUSE ENTRY Pass Pass

Pull Station - Manual M1-5 1ST FL. MECH. RM. Pass Pass

Pull Station - Manual M1-6 1ST FL. CORRIDOR Pass Pass

Pull Station - Manual M1-7 1ST FL. WAREHOUSE Pass Pass

Pull Station - Manual M1-9 2ND FL. STAIR Pass Pass

Device Summary Items Total Devices Total Inspected Total Failed

Duct Detectors 2 2 0

Fire Alarm Box Devices 8 8 0

Heat and Other Detectors 2 2 0

Miscellaneous Devices 3 3 3

Smoke Detectors-No Sensitivity 7 7 0

Total 22 22 3

Miscellaneous Devices

Type Area/Location Functional Test

Elevator Fire Hat Fail

Elevator Recall Fail

Elevator Shunt Trip Fail

Grounds Maint Complex & Warehouse Building #19288 Page 3 of 7

Comments

Grounds Maint Complex & Warehouse Building #19288 Page 4 of 7

Deficiencies Additional Deficiencies not covered in Questions

Enter information about deficiency; list name of device first, then explanation.

Technician Response: ACTIVATION OF ELEVATOR MACHINE ROOM, HOISTWAY, OR ELEVATOR LOBBY DEVICES FAILED TO INIATE EITHER ELEVATOR RECALL OR SHUNT TRIP FUNCTIONS. SHOULD BE INVESTIGATED AND RECTIFIED ASAP.

Elevator Recall

Functional Test

Technician Response: ELEVATOR CAB DID NOT RECALL ON ACTIVATION OF MACHINE ROOM, LOBBY OR HOISTWAY SMOKE

DETECTORS.

Elevator Shunt Trip

Technician Response: ELEVATOR FAILED TO SHUNT TRIP UPON ACTIVATION OF MACHINE ROOM OR HOISTWAY HEAT

DETECTORS.

Elevator Fire Hat

Technician Response: FAILED TO OPERATE.

Main Fire Alarm Panel

BASEMENT ELEC. RM. SIMPLEX 4010 4010 -

Central station interface - alarm signals

Technician Response: SIGNAL NOT RECIEVED AT ARROWHEAD DISPATCH.

Main Fire Alarm Panel

BASEMENT ELEC. RM. SIMPLEX 4010 4010 -

Central station interface - trouble signals

Technician Response: SIGNAL NOT RECIEVED AT ARROWHEAD DISPATCH.

Main Fire Alarm Panel

BASEMENT ELEC. RM. SIMPLEX 4010 4010 -

Central station interface - supervisory signals

Technician Response: SIGNAL NOT RECIEVED AT ARROWHEAD DISPATCH.

Main Fire Alarm Panel

BASEMENT ELEC. RM. SIMPLEX 4010 4010 -

Batteries installed and operating properly?

Technician Response: BATTERIES HAVE INSUFFICIENT CURRENT AND/OR VOLTAGE - REPLACEMENT NECESSARY

BATTERIES INSTALLED 10/24/2008.

Fire Alarm Battery - Sealed Lead Acid

FACP -

Discharge test

Technician Response: BATTERIES HAVE INSUFFICIENT CURRENT AND/OR VOLTAGE - REPLACEMENT NECESSARY

BATTERIES OUT OF DATE.

Fire Alarm Battery - Sealed Lead Acid

FACP -

Did battery pass or fail overall functional test?

Technician Response: BATTERIES HAVE INSUFFICIENT CURRENT AND/OR VOLTAGE - REPLACEMENT NECESSARY

BATTERIES OUT OF DATE.

Fire Alarm Battery - Sealed Lead Acid

FACP -

Discharge test

Technician Response: BATTERIES HAVE INSUFFICIENT CURRENT AND/OR VOLTAGE - REPLACEMENT NECESSARY

BATTERIES OUT OF DATE.

Grounds Maint Complex & Warehouse Building #19288 Page 5 of 7

Fire Alarm Battery - Sealed Lead Acid

FACP -

Did battery pass or fail overall functional test?

Technician Response: BATTERIES HAVE INSUFFICIENT CURRENT AND/OR VOLTAGE - REPLACEMENT NECESSARY

BATTERIES OUT OF DATE.

Grounds Maint Complex & Warehouse Building #19288 Page 6 of 7

The owner and/or designated representative acknowledges the responsibility of the operating condition of the component parts at the time of this inspection. It is agreed that the inspection service provided by the contractor as prescribed herein is limited to performing a visual inspection and/or routine testing, and any investigation or unscheduled testing, modification, maintenance, repair, etc., of the component parts is not included as part of the inspection work performed. It is further understood that all information contained herein is provided to the best of the knowledge of the party providing such information.

Customer: NPS-JEFF GROUNDS/MAINTENANCE #19288

10/25/16 10/25/16

Technician: Daniel Bowen

Grounds Maint Complex & Warehouse Building #19288 Page 7 of 7

Century Fire Sprinklers, Inc.

27 Cassens Ct.

Fenton, MO 63026 (314)692-8011 Office (314)692-8012 Fax

City State:

System #

Contract #

Owner's Section Y N/A N

Owner (Print Name):

Y N/A N Y N/A N Gauges' -Normal air and water pressure maintained Control Valves in the correct (open or closed) position Control Valves Sealed, Locked or supervised Control Valves are accessible Control Valves are free from damage or leaks Control Valves are properly identified Alarm Valves are free of damage Alarm Valves are accessible

Y N/A N Alarm Devices free of physical damage Hydraulic nameplate, if provided, securely attached. Pressure reducing valve maintaining downstream pressure

Y N/A N Proper number & type of spare sprinklers Y N/A N Proper Spare Sprinkler wrench

Visible Sprinklers free of obstruction to spray pattern?

Visible Sprinklers free of foreign materials including paint Visible Sprinklers free of physical damage

Y N/A N

Visible Pipe has no external corrosion

Inspections to be done every 5 years Alarm Valves, strainers, filters and restricted orifice pass internal inspection

Check Valves internally inspected and all parts operate properly, move freely and are in good condition

Riser FDC Check Valve is not leaking

Visible Pipe in good condition Visible Pipe free of mechanical damage & not leaking

Electrical components in service

Pressure reducing valve in good condition

Zip Code

Fire Department Connection

FDC is visible and accessible FDC swivels/couplings undamaged/rotate smoothly

Annual Inspections

Visible Sprinklers free of corrosion

Piping

Visible Pipe is properly aligned Visible Pipe has no external loads Visible pipe hangers and seismic braces not damaged or loose

Pressure Reducing Valve

FDC caps in place & undamaged FDC gaskets in place and in good condition FDC Identification sign in place FDC automatic drain valve in place and operating properly FDC free of obstructions

Sprinklers

Pressure reducing valve in open position /not leaking

Annual Report of Inspection, Testing & Maintenance of Wet Pipe Fire Sprinkler Systems

Has system remained in service without modification since last inspection?

Was the system free of actuation's devices or alarms since the last inspection?

Are all fire protection systems in service?

Address:

Has the occupancy classification and hazard of contents remained the same since last inspection?

Name of Inspected Property:

Is the building occupied?

Signature & Date

Arch Grounds Building

201 Poplar St.

St. Louis Mo 63102

Craig McGraw

3-17-17

Fenton, MO 63026 (314)692-8011 Office (314)692-8012 Fax

Y N/A N Y N/A N psi psi

Y N/A N Y N/A N

Y N/A N

Y N/A N

Y N/A N Y N/A N

Y N/A N Extra High, Very High & Ultra High Temp Sprinklers Tested Gauges checked against calibrated gauge or replaced

Y N/A N Y N/A N

Y N/A N Obstructive material discharged during waterflow test Foreign material found in dry-pipe valves, check valves or pumps Heavy discoloration of water during drain test or plugging of inspectors test Plugging of sprinklers found during activation or alteration Plugging found in piping dismantled during alterations

Record of broken main in vicinity.

abnormally frequent false-tripping of dry pipe valves

Y N/A N System is returned to service after an extended period out of service.

ALARM PANEL CLEAR

SYSTEM RETURNED TO SERVICE

PIV opened until spring or torsion is felt in rod, then turned back 1/4 turn

Fast response sprinklers in service less than 20 yrs or tested within last 10 yrs

Standard response sprinklers less than 50 yrs old or tested within last 10 years

Standard response sprinklers 75 or more years old passed test or tested within last 5 years

Sprinklers and spray nozzles protecting commercial cooking equipment and ventilating systems replaced except for bulb-type which show signs of grease buildup

Defective intake screen for pump

Annual Maintenance

If sprinklers have been replaced, were they proper replacements

Backflow devices passed full flow test Test to be done every 5 years

Main Drain test conducted downstream of backflow Supply water gauge reading before flow (static) Gauge reading during stable flow (residual)

Sprinklers Are all sprinklers in service dated 1920 or later

Annual Testing Main Drain Alarm Devices

Valve Supervisory Switches indicate movement Water Flow (Vane Type & Pressure) tested and is operational Mechanical Water flow alarm (other than vane type) tested and is operational

Backflow Preventer Backflow devices passed backflow test

All control valves operated through full range and returned to normal position

Pressure regulating control valves

Are results comparable to previous test

Adequate drainage provided before flow testing

Test conducted with inspector's test connection Antifreeze Loop

Specific gravity of antifreeze correct Control Valves

All sprinkler regulating control valves pass full flow test Post Indicator Valves

If any of the following were discovered, was an obstruction investigation conducted and the system flushed

Failure to flush yard piping or surrounding public mains following new installation or repairs.

There is reason to believe the system contains sodium silicate or its derivatives

Obstruction investigation findings to be explained in comments

Operating stem of all OS&Y valves lubricated, completely closed and reopened

60 ✔

Fenton, MO 63026 (314)692-8011 Office

(314)692-8012 Fax

Company: Century Fire Sprinklers, Inc.

Company Address: 27 Cassens Ct., Fenton, MO I state that the information on this form is correct at the time and place of my inspection and that all equipment tested at this time was left in operational condition upon completion of this inspection except as noted in the comments section above.

Printed name of inspector:

Signature of Inspector

Date of inspection: License or Certification number (if applicable)

Inspector Information

Comments (any "No" answers, test failures or other problems found with the sprinkler system must be explained here)

1) there are dry sidewalls from 2002.

Water flow alarm time: 28 sec.

Cory Schulte

Additional Comments

Fenton, MO 63026 (314)692-8011 Office (314)692-8012 Fax

Model: Size: Serial Number: Air Gap

DC RP PVB

Application Device Protected

____ Hazard Class ____ Freezing ____ in ____ Pass

____ ____ Flooding ____ in ____ Fail

Date of Test Describe the Equipment that the Back-Flow Device Services

Number New ____ Existing ____ Fire Suppression ____ Process ____

Lawn Irrigation ____ Plumbing ____

Yes ____ No ____ Other

Passed Failed INITIAL TEST FINAL TEST Passed Failed

Double Check Valve Assembly:

1st CHECK held in direction of flow 1st CHECK held in direction of flow

PSID (5 PSID or more) ____ ____ _______ PSID (1 PSID or more) ____ ____

RELIEF VALVE opened at 2nd CHECK held backpressure ____ ____

____ PSID (2 PSID or more) ____ ____ No. 2 Shut Off Valve leak tight ____ ____

DIFFERENCE (1st check-relief) 2nd CHECK held in direction of flow

____ PSID (3 PSID or more) ____ ____ _______ PSID (1 PSID or more) ____ ____

2nd CHECK held backpressure ____ ____ INITIAL TEST ____ FINAL TEST ____ Passed Failed

No. 2 Shut Off Valve leak tight ____ ____ Pressure Vacuum Assembly

OPTIONAL TEST Test #1 Shutoff Valve

Relief Valve (exercised to open position) ____ ____ - held pressure tight ____ ____

Test CHECK VALVE held in direction

Comments: of flow ____ PSID (1 PSID or more) ____ ____

Test AIR INLET VALVE to open

____ PSID (1 PSID or more) ____ ____

PVB may not be repaired, must be replaced

Repaired by: (Print name and provide Signature)

Final Test By: (Print name and provide Signature)

Owner or Owner's Representative Date

Company: Century Fire Sprinklers, Inc.

Certification Number and Expiration Date:

THE ABOVE REPORT IS CERTIFIED TO BE TRUE, ACCURATE AND COMPLETE

Tested By: (Print name and provide signature)

Reduced Pressure Assembly

INITIAL TEST FINAL TEST

Is the assembly properly tagged?

Type of System

_______________________Permit Date _____________________

Century Fire SprinklersContractor

Height Off Floor

Permit Information Installation Status

Containment

Isolation Hazard Item

Fire Protection Sprinkler System

Supply

Gap

(from MO part 10.CSR 11.010) Air Gap (2xSuppy Diameter)

BACKFLOW PREVENTION ASSEMBLY TEST DATA AND MAINTENANCE REPORT

Manufacturer: Type of Device:

Describe physical location of Backflow Device:

Customer:

Address: City: Zip Code:

Address of Location of Backflow:

Arch Grounds Building

201 Poplar St. St. Louis 63102

Same

In the lower level by the loading dock.

Colt 200 4" 1226321001 ✔

2 ✔

2 ✔

3-17-17 1'-0"

1.6

1.8

Cory Schulte

07-0175 1-31-2018

Ames

Building Owner/Representative Has building occupancy, hazard, water supply or building arrangement affecting system effectiveness remained the same since last inspection (4.1.6.) Yes

Areas containing water-filled piping used for fire sprinkler systems, maintain a minimum temperature of 40°F (4°C), and are not exposed to freezing conditions. (4.1.1.1) Yes

Owner/Representative Signature

System Summary Number of Systems at Site Items Total Systems

Wet System 1

Wet System Wet System Inspection

Sprinkler heads free of leakage, corrosion, external loading, damage or loss of fluid in glass bulb element, and pointed in proper direction. (5.2.1.1.1) Pass

Escutcheons and coverplates in place, if applicable. (5.2.1.1.5) Fail Minimum clearance maintained below all sprinklers. (5.2.1.2) Pass Replacement sprinkler heads per number of installed sprinklers available in head box. (5.4.1.5.4) Fail Sprinkler head wrench for each type head provided in head box (5.4.1.6) Fail List of sprinklers installed on the property posted on head box. (5.4.1.5.6) Pass System piping free of mechanical damage, leaks, corrosion, & without external loads on or hung from piping. (5.2.2.1 & 5.2.2.2) Pass

Pipe hangars, braces & supports not damaged, loose or unattached. (5.2.3) Pass Sprinklers in the building in service for 50 years, have been replaced or sample tested. (5.3.1.1.1) N/A Sprinklers with fast-response elements in service for 20 years have been replaced or sample tested.

(5.3.1.1.1.3) N/A

Dry sprinklers in service for 10 years have been replaced or sample taken (if dry sprinklers present).

(5.3.1.1.1.6) No

Wet System Wet Riser Main Drain/No Check Valve

Wet System Riser Room Valves & trim free of physical damage, & valves in normal position. (13.4.1.1) Pass Pressure (psi) shown on System side pressure gauge. 60 Hydraulic nameplate, if applicable, securely attached and is legible (5.2.5) Pass Size of main drain 2" Pressure (psi) shown on Supply Water pressure gauge. (13.2.5) 60 Residual Pressure with valve open (13.2.5) 50 Static Pressure after valve closed (13.2.5) 75 Main Drain Test Pressure less than 10% reduction in flow from original acceptance test or previous test results (13.2.5.3) Pass

Valve Status Test - Valves open when returned to service. (13.3.3.4) Pass Gauge on valve, when compared to calibrated gauge is error less than 3% full or gauge has been recalibrated or replaced. (13.2.7.2 & 13.2.7.3)) N/I

Inspector's Test Connection Area/Location Operates properly

Wet System Maintenance @ Personel Door Pass

Grounds Bldg. Wet AIP Page 2 of 4 Powered by ASURiO Inspection Systems, Copyright 2010. All Rights Reserved ASURiO

Supervisory Devices Type Area/Location Visual Insp Functional Test

Tamper Switch Backflow #1 Riser Room Pass Pass

Tamper Switch Backflow #2 Riser Room Pass Pass

Tamper Switch Wet System Basement @ Laoding Docks Pass Pass

Control Valves Type Area/Location Model

Size Accessible Condition Secured Exercised Seal Valve Test

Control Valve -locked/tamper

Backflow #1 Riser Room

OS and Y 4" Pass Pass Pass Pass NA Pass

Control Valve -locked/tamper

Backflow #2 Riser Room

OS and Y 4" Pass Pass Pass Pass NA Pass

Control Valve -locked/tamper

Wet System Riser Room Butterfly 4" Pass Pass Pass Pass NA Pass

Alarm Devices Type Area/Location Visual Insp Functional Test

Horn/Strobe Pass Pass

Waterflow Alarm - Vane Type Wet System Basement @ Laoding Docks Pass Pass 22 Seconds

Comments

Common Components

FDC visible and accessible, and signs in place. (13.8.1) Pass Couplings and swivels free of damage and rotate smoothly. (13.8.1) Pass Caps, plugs and gaskets in place and free from damage. (13.8.1) Pass Check valve free from leaks, automatic drain valve and clapper in place and operating properly. (13.8.1) Pass Interior of the connection free of obstructions. (13.8.1) Pass Visible piping supplying FDC undamaged. (13.8.1) Pass Internal inspection of check valve - components operate properly, cleaned/repaired as needed. (13.4.2.1) N/I Hydrostatic test results of piping from FDC to check valve acceptable. (13.8.5) N/I

Deficiencies *PAR response indicated "Pass After Repair". Technician notes a deficiency of a device, and repairs the deficiency during inspection.

Wet System Inspection

Ques: Escutcheons and coverplates in place, if applicable. (5.2.1.1.5)

Technician Response: Escutcheon - Missing 4 may need to lower heads for prpoer fit.

Ques: Replacement sprinkler heads per number of installed sprinklers available in head box. (5.4.1.5.4) Technician Response: Missing Sidewall heads at garage doors.

Grounds Bldg. Wet AIP Page 3 of 4

The owner and/or designated representative acknowledges the responsibility of the operating condition of the component parts at the time of this inspection. It is agreed that the inspection service provided by the contractor as prescribed herein is limited to performing a visual inspection and/or routine testing, and any investigation or unscheduled testing, modification, maintenance, repair, etc., of the component parts is not included as part of the inspection work performed. It is further understood that all information contained herein is provided to the best of the knowledge of the party providing such information.

Customer: Bruce Cook

4/10/18 4/10/18

Tech: Andy Laskowsky

Not Inspected

Question: Internal inspection of check valve - components operate properly, cleaned/repaired as needed. (13.4.2.1) Technician Response: Review records and schedule as needed. Five year services are not part of contract. Please Call if a proposal is desired.

Question: Hydrostatic test results of piping from FDC to check valve acceptable. (13.8.5) Technician Response: Review records and schedule as needed. Five year services are not part of contract. Please Call if a proposal is desired.

Wet Riser Main Drain/No Check Valve Wet System Riser Room Question: Gauge on valve, when compared to calibrated gauge is error less than 3% full or gauge has been recalibrated or replaced. (13.2.7.2 & 13.2.7.3)) Technician Response: Review records and schedule as needed. Five year services are not part of contract. Please Call if a proposal is desired.

Wet System Inspection

Ques: Sprinkler head wrench for each type head provided in head box (5.4.1.6)

Technician Response: See photo. Wiil need wrench for sidewall head.

Ques: Dry sprinklers in service for 10 years have been replaced or sample taken (if dry sprinklers present).

(5.3.1.1.1.6)

Technician Response: Review sidewall head at man door loading docks

Grounds Bldg. Wet AIP Page 4 of 4

2425 Amann Drive

Boyer Fire Protection

Belleville, IL 62220 www.boyerfire.com

Phone: 618-222-1500 Fax: 618-222-1502

Inspection date: 04/15/2018

Deficiencies *PAR response indicated "Pass After Repair". Technician notes a deficiency of a device, and repairs the deficiency during inspection.

Ques: Escutcheons and coverplates in place, if applicable. (5.2.1.1.5)

Technician Response: Escutcheon - Missing 4 may need to lower heads for prpoer fit.

Ques: Replacement sprinkler heads per number of installed sprinklers available in head box. (5.4.1.5.4)

Technician Response: Missing Sidewall heads at garage doors.

Ques: Sprinkler head wrench for each type head provided in head box (5.4.1.6)

Technician Response: See photo. Wiil need wrench for sidewall head.

Deficiency Report

Inspection Location Grounds Building JEF04-2

201 Poplar Street

St. Louis, MO 63102

Phone: Fax:

Customer Gateway Arch National Park JEF04

11 N. 4th Street

St. Louis, MO 63102

Phone: Fax:

Grounds Bldg. Wet AIP Page 1 of 2

The owner and/or designated representative acknowledges the responsibility of the operating condition of the component parts at the time of this inspection. It is agreed that the inspection service provided by the contractor as prescribed herein is limited to performing a visual inspection and/or routine testing, and any investigation or unscheduled testing, modification, maintenance, repair, etc., of the component parts is not included as part of the inspection work performed. It is further understood that all information contained herein is provided to the best of the knowledge of the party providing such information.

Customer: Bruce Cook

4/10/18 4/10/18

Tech: Andy Laskowsky

Ques: Dry sprinklers in service for 10 years have been replaced or sample taken (if dry sprinklers present). (5.3.1.1.1.6)

Technician Response: Review sidewall head at man door loading docks

Grounds Bldg. Wet AIP Page 2 of 2

ST. LOUIS CITY

BACKFLOW DEVICE TEST REPORT

Address: ______________________________________________________________________

Company Name: _______________________________________________________________

Contractor: __________________________ Date Tested: _____________________________

Certified Tester: ______________________ License No: ______________________________

Make & Model Serial Number Size

Detailed Location

Check Valve #1 Check Valve #2 Relief Valve

Initial Test Leaked ______________ ( )

Closed Tight _________ ( )

Leaked ______________ ( )

Closed Tight _________ ( )

Opened at ___________PSI Reduced pressure

Did Not Open ________ ( )

Final Test Closed Tight _________ ( ) Closed Tight _________ ( ) Opened at ___________PSI Reduced Pressure

Contact Person: ________________________________________________________________

2425 Amann Dr., Belleville, IL 62220 5555 West Park Drive, St. Louis, MO 63110

IL Phone: (618) 222-1500 Fax: (618) 222-1502

MO Phone: (314) 241-9944 Website: www.boyerfire.com

Fire Backflow Testing

201 Poplar Street, St. Louis, MO 63101

Gateway Arch National Park - Grounds Building

Boyer Fire Protection

Andy Laskowsky 07-2995

4"

Report of Inspection/Test General Questions

OWNER SECTION

Is the building occupied? Yes

No

NA

Has the occupancy classification, hazard of contents, and/or storage method remained the same since the last inspection?

Yes

No

NA

Are all fire protection systems in service? Yes

No

NA

Has the system remained in service without modification since the last inspection?

Yes

No

NA

Was the system free of actuations of devices or alarms since the last inspection?

Yes

No

NA

FIRE DEPARTMENT CONNECTION

Is the FDC plainly visible and easily accessible? Yes

No

NA

Is the FDC easily accessible? Yes

No

NA

Are the FDC swivels and couplings not damaged? Yes

No

NA

Are the FDC caps and plugs in place and undamaged? Yes

No

NA

Are the FDC gaskets in place? Yes

No

NA

Is the FDC check valve free of leaks? Yes

No

NA

Is the clapper and automatic drain valve in place and properly operating?

Yes

No

NA

Is the FDC identification sign(s) in place? Yes

No

NA

Has the interior of the FDC been inspected for obstructions?

Yes

No

NA

Is the visible piping supplying the FDC undamaged? Yes

No

NA

If locking caps/plugs are in place, has an internal inspections been conducted?

Yes

No

NA

Was the connection free of obstructions? Yes

No

NA

SPRINKLER HEADS

Are there the proper number and type of spare sprinklers with a list in place?

Yes

No

NA

Are visible sprinklers in the proper position: upright, pendent, sidewall?

Yes

No

NA

Are visible sprinklers free of corrosion and physical damage?

Yes

No

NA

Is there proper clearance below the sprinklers? Yes

No

NA

Are visible sprinklers free of foreign materials including foreign paint?

Yes

No

NA

Is there liquid in all visible glass bulb sprinklers? Yes

No

NA

Page 1 of 6Copyright 2021 Inspect Point

Report of Inspection/Test Annual NFPA 25

2021-06-14 Property Gateway Arch Ranger Station 201 Poplar Street St. Louis MO 63102 Eric Turner 314-655-1714 Print Date: 2021-06-16 Inspection Ref #: C001325

Conducted by: Dan Love

Boyer Fire Protection 5555 W Park Ave St Louis MO 63110 314-241-9944 or 618-222-1500 inspect@boyerfire.com

Are there spare sprinklers and a sprinkler wrench? Yes

No

NA

Is the information sign attached and legible? Yes

No

NA

Are all the sprinklers dated 1920 or later? Yes

No

NA

PIPES

Are the visible pipe and fittings in good condition with no external corrosion?

Yes

No

NA

Do visible pipe and fittings have no mechanical damage or leaks?

Yes

No

NA

Does visible pipe have no external loads? Yes

No

NA

Are visible pipe hangers and seismic braces not damaged or loose?

Yes

No

NA

CONTROL VALVE AREA

Are the control valves with electrical supervision in correct (open or closed) position?

Yes

No

NA

Are the control valves with electrical supervision locked or is supervision in place?

Yes

No

NA

Are the control valves with electrical supervision accessible?

Yes

No

NA

Are the control valves with electrical supervision free from any leaks?

Yes

No

NA

Are the control valves with electrical supervision have the appropriate wrenches?

Yes

No

NA

Are the control valves with electrical supervision properly identified?

Yes

No

NA

VALVE AREA

Are all check valves externally inspected, operating properly, and are in good condition?

Yes

No

NA

Are the gauges on system operable and in good working condition?

Yes

No

NA

Are the gauges on system showing normal water supply pressure?

Yes

No

NA

Is the hydraulic name plate (calculated systems) attached securely to the riser and legible?

Yes

No

NA

Do valve supervisory switches indicate movement? Yes

No

NA

The electrical waterflow alarm devices passed test by opening inspector's test connection/bypass connection with alarms actuating and flow observed?

Yes

No

NA

All control valves operated through full range and returned to normal position?

Yes

No

NA

BACKFLOW PREVENTERS

ALARMS

Are alarms and supervisory devices not damaged? Yes

No

NA

Page 2 of 6Copyright 2021 Inspect Point

Report of Inspection/Test Annual NFPA 25

2021-06-14 Property Gateway Arch Ranger Station 201 Poplar Street St. Louis MO 63102 Eric Turner 314-655-1714 Print Date: 2021-06-16 Inspection Ref #: C001325

Conducted by: Dan Love

Boyer Fire Protection 5555 W Park Ave St Louis MO 63110

MAINTENANCE

Was a drain test conducted after opening any closed valve?

Yes

No

NA

Page 3 of 6Copyright 2021 Inspect Point

Report of Inspection/Test Annual NFPA 25

2021-06-14 Property Gateway Arch Ranger Station 201 Poplar Street St. Louis MO 63102 Eric Turner 314-655-1714 Print Date: 2021-06-16 Inspection Ref #: C001325

Conducted by: Dan Love

Boyer Fire Protection 5555 W Park Ave St Louis MO 63110

MAIN DRAIN FLOW TESTS

System Initial static Residual Static Seconds to Return to

Initial Static

Flow Observed?

Did waterflow alarm operate?

Are results comparable to previous test?

Wet system 80 65 73 1 Yes Yes Yes

INSPECTORS TEST CONNECTION

System Location Description Time to

Alarm (seconds)

Reported? Smooth Orifice

Easily Accessible

Signs? Pass?

Wet system Riser room ITV 35 Yes Yes Yes Yes Yes

VALVES

System Description Location Valve Type Size Secured Open

Easily Accessible Signs Exercised

Stems Lubricated

# of Turns

Wet system BF2 Riser room Butterfly 4 " Supervision Yes Yes Yes Yes N/A 7.5

Wet system BF2 Riser room Butterfly 4 " Supervision Yes Yes Yes Yes N/A 7.5

Page 4 of 6Copyright 2021 Inspect Point

Report of Inspection/Test Annual NFPA 25

2021-06-14 Property Gateway Arch Ranger Station 201 Poplar Street St. Louis MO 63102 Eric Turner 314-655-1714 Print Date: 2021-06-16 Inspection Ref #: C001325

Conducted by: Dan Love

Boyer Fire Protection 5555 W Park Ave St Louis MO 63110

Deficiencies - General Questions

None

Deficiencies - General Wet System Questions

None

Deficiencies - Wet system

None

Deficiencies - BF

None

Deficiencies - Inspectors Test Connection

None

Deficiencies - Valves

None

Page 5 of 6Copyright 2021 Inspect Point

Report of Inspection/Test Annual NFPA 25

2021-06-14 Property Gateway Arch Ranger Station 201 Poplar Street St. Louis MO 63102 Eric Turner 314-655-1714 Print Date: 2021-06-16 Inspection Ref #: C001325

Conducted by: Dan Love

Boyer Fire Protection 5555 W Park Ave St Louis MO 63110

Inspector Signature

I state that the information on this form is correct at the time and place of my inspection, and all equipment tested at this time was left in operational condition upon completion of this inspection except as noted.

Inspector Name Signature Date Completed

Dan Love 2021-06-14

Client Signature

I state that the information on this form is correct at the time and place of my inspection, and all equipment tested at this time was left in operational condition upon completion of this inspection except as noted.

Client Name Signature Date Completed

Joe Brennan 2021-06-14

Page 6 of 6Copyright 2021 Inspect Point

Report of Inspection/Test Annual NFPA 25

2021-06-14 Property Gateway Arch Ranger Station 201 Poplar Street St. Louis MO 63102 Eric Turner 314-655-1714 Print Date: 2021-06-16 Inspection Ref #: C001325

Conducted by: Dan Love

Boyer Fire Protection 5555 W Park Ave St Louis MO 63110

StLCO Form: Test Rpt 0305b

C:\Documents and Settings\pw0l0b.000\Desktop\0305b Backflow Form.doc

BACKFLOW PREVENTION ASSEMBLY TEST DATA AND MAINTENANCE REPORT

Customer:

City and State: Zip Code

Address of Location of Back-Flow Device:

Describe physical location of Back-Flow Device:

Manufacturer: Model: Size: Serial Number: Type Of Device: ________ Air Gap

_______ DC _______ RP ________ PVB

Application :

__________ Containment

__________ Isolation

(from MO part 10.CSR 11.010):

Hazard Class _________

Hazard Item _________

Device protected from:

_____ Freezing

_____ Flooding

Air Gap (2 x Supply Diameter)

Supply ________ in _______ Pass

Gap ___________in _______ Fail

Date Of Test Describe the Equipment that the Back-Flow Device Services Height Off Floor

________________(FT/IN)

Permit Information

Number_________________________

Contractor____________________________

Permit Date___________________________

Installation Status

New_____ Existing_______

Is the assembly properly tagged?

Yes______ No________

Type Of System

Fire Suppression _____ Process Piping ____

Lawn Irrigation ______ Plumbing _______

Other _______________________________

INITIAL TEST_____ FINAL TEST______ PASSED FAILED

Reduced Pressure Assembly:

1st CHECK held in direction of flow

_____ PSID (5 PSID or more) ________ _______

RELIEF VALVE opened at

_____ PSID (2 PSID or more) ________ _______

DIFFERENCE (1st check-relief)

_____ PSID (3 PSID or more) ________ _______

2nd CHECK held backpressure ________ _______

No. 2 Shut-off Valve leak tight ________ _______

OPTIONAL TEST

Relief Valve (exercised to open Position) ________ _______

Comments:

INITIAL TEST____ FINAL TEST_____ PASSED FAILED

Double Check Valve Assembly:

1st CHECK held in direction of flow

______ PSID (1 PSID or more) ________ _______

2nd CHECK held backpressure ________ _______

No. 2 Shut-off Valve leak tight ________ _______

2nd CHECK held in direction of flow

______ PSID (1 PSID or more) ________ _______

FINAL TEST _______ PASSED _______ FAILED

Pressure Vacuum Breaker Assembly:

Test #1 Shutoff Valve

- held pressure tight. ________ _______

Test CHECK VALVE held in direction of flow ________ PSID (1 PSID or more) ________ _______

Test AIR INLET VALVE to open

________ PSID (1 PSID or more) ________ _______

PVB may not be repaired, must be replaced

THE ABOVE REPORT IS CERTIFIED TO BE TRUE, ACCURATE AND COMPLETE

Tested By: (Print name and provide Signature) Repaired By: (Print name and provide Signature)

Company Final Test By: (Print name and provide Signature)

Certification Number And Expiration Date Owner Or Owner’s Representative Date

1. This form is to be used and sent to St. Louis County for a failed test as well as a passed test.

Do not use one form for both the failed and passed test. Use a separate form for each.

2. This form must be filed within 30 days of test per state regulations and St. Louis County Ordinance.

3. Tester must sign this form.

Boyer Fire Protection 5555 West Park Ave.

St. Louis, MO 63110 Phone: 314-241-9944

Ames

Bike storage room

63102St. Louis, MO201 Poplar Street

Gateway Arch Ranger Station

3.8

PH-0104 ✔

✔ II

3.4 ✔

6-11-2021 Fire protection 2

Daniel Love

Boyer Fire Protection Daniel Love

SF-7372 06/30/21 6-11-2021

4Colt 200

StLCO Form: Test Rpt 0305b

C:\Documents and Settings\pw0l0b.000\Desktop\0305b Backflow Form.doc

BACKFLOW PREVENTION ASSEMBLY TEST DATA AND MAINTENANCE REPORT

Customer:

City and State: Zip Code

Address of Location of Back-Flow Device:

Describe physical location of Back-Flow Device:

Manufacturer: Model: Size: Serial Number: Type Of Device: ________ Air Gap

_______ DC _______ RP ________ PVB

Application :

__________ Containment

__________ Isolation

(from MO part 10.CSR 11.010):

Hazard Class _________

Hazard Item _________

Device protected from:

_____ Freezing

_____ Flooding

Air Gap (2 x Supply Diameter)

Supply ________ in _______ Pass

Gap ___________in _______ Fail

Date Of Test Describe the Equipment that the Back-Flow Device Services Height Off Floor

________________(FT/IN)

Permit Information

Number_________________________

Contractor____________________________

Permit Date___________________________

Installation Status

New_____ Existing_______

Is the assembly properly tagged?

Yes______ No________

Type Of System

Fire Suppression _____ Process Piping ____

Lawn Irrigation ______ Plumbing _______

Other _______________________________

INITIAL TEST_____ FINAL TEST______ PASSED FAILED

Reduced Pressure Assembly:

1st CHECK held in direction of flow

_____ PSID (5 PSID or more) ________ _______

RELIEF VALVE opened at

_____ PSID (2 PSID or more) ________ _______

DIFFERENCE (1st check-relief)

_____ PSID (3 PSID or more) ________ _______

2nd CHECK held backpressure ________ _______

No. 2 Shut-off Valve leak tight ________ _______

OPTIONAL TEST

Relief Valve (exercised to open Position) ________ _______

Comments:

INITIAL TEST____ FINAL TEST_____ PASSED FAILED

Double Check Valve Assembly:

1st CHECK held in direction of flow

______ PSID (1 PSID or more) ________ _______

2nd CHECK held backpressure ________ _______

No. 2 Shut-off Valve leak tight ________ _______

2nd CHECK held in direction of flow

______ PSID (1 PSID or more) ________ _______

FINAL TEST _______ PASSED _______ FAILED

Pressure Vacuum Breaker Assembly:

Test #1 Shutoff Valve

- held pressure tight. ________ _______

Test CHECK VALVE held in direction of flow ________ PSID (1 PSID or more) ________ _______

Test AIR INLET VALVE to open

________ PSID (1 PSID or more) ________ _______

PVB may not be repaired, must be replaced

THE ABOVE REPORT IS CERTIFIED TO BE TRUE, ACCURATE AND COMPLETE

Tested By: (Print name and provide Signature) Repaired By: (Print name and provide Signature)

Company Final Test By: (Print name and provide Signature)

Certification Number And Expiration Date Owner Or Owner’s Representative Date

1. This form is to be used and sent to St. Louis County for a failed test as well as a passed test.

Do not use one form for both the failed and passed test. Use a separate form for each.

2. This form must be filed within 30 days of test per state regulations and St. Louis County Ordinance.

3. Tester must sign this form.

Boyer Fire Protection 5555 West Park Ave.

St. Louis, MO 63110 Phone: 314-241-9944

Ames

Bike storage room

63102St. Louis, MO201 Poplar Street

Gateway Arch Ranger Station

3.8

PH-0104 ✔

✔ II

3.4 ✔

6-11-2021 Fire protection 2

Daniel Love

Boyer Fire Protection Daniel Love

SF-7372 06/30/21 6-11-2021

4Colt 200