2022 Annual FLS Testing Report Cottage 2495.pdf
PDF 204 KB Posted
- Solicitation number
- S-44300-00005148
- Issued by
- Union County, Oregon
About this file
This document is an NFPA 72 Report for an annual fire alarm system testing conducted by Siemens Industry, Inc. on behalf of the Oregon Health Authority for a property located at 2585 Westgate, Cottage 95 in Pendleton, Oregon. The report details the inspection and testing of the fire alarm control panel, secondary power, notification appliances, and initiating devices. All components were found to be functioning properly, with no failed equipment identified. The property representative, Aaron Williams of the Oregon Health Authority, accepted the test report.
The related state and local contract opportunity is a Request for Proposals (RFP) issued by the Oregon State Hospital to contract with an experienced and qualified contractor to perform fire protection system maintenance upgrades for three buildings located at 2585 Westgate in Pendleton, Oregon. The project involves the replacement of detection devices and system equipment based on a like-for-like swap of existing components to bring the current fire protection system up to code. The contract will be awarded to serve Umatilla County, Oregon.
View the file
Other files
| File | Type | Posted |
|---|---|---|
| 2022 Annual FLS Testing Report Cottage 2475.pdf | ||
| 2022 Annual FLS Testing Report LaneActivityCenter.pdf | ||
| CP-30 Troubleshooting guide.pdf | ||
| CP-30 data sheet.pdf | ||
| G - Responsibility Inquiry.doc | DOC document | |
| C2022842_RFP_CommunityLenderLoanLossReserveAccountProgram.docx | DOCX document | |
| A - Sample Contract~2.pdf | ||
| Bill of Materials - estimate.pdf | ||
| Drawing Lane Activity Center.pdf | ||
| Drawing Photo Cottage 2495.pdf | ||
| F - COBID outreach.doc | DOC document | |
| B - Disclosure Exemption Affidavit.doc | DOC document | |
| C- Proposer Info and Cert Sheet.pdf | ||
| E - Price Proposal.docx | DOCX document | |
| H - Background Check Form~1.pdf | ||
| D - Reference Check form.doc | DOC document | |
| Drawing Photo Cottage 2475.pdf | ||
| Intent to Award Notice.pdf | ||
| RFP S-44300-00005148~4.pdf |
Show all 19
On GovTribe
Work with this file
- Download the original file
- Contacts named in this file
- Similar government files
- Ask GovTribe AI about this file
Text version
NFPA 72 REPORT
© Siemens Industry, Inc., Smart Infrastructure Division, 2009-2022. All rights reserved.
This report was created by TechAdvance+™, a service of Siemens Industry, Inc. Page 1 of 7
SYSTEM RECORD OF INSPECTION AND TESTING
System Name: OHA PENDLETON SYSTEM 3 Cottage 95 Panel Name: 01 - OHA PENDLETON SYSTEM 3 Cottage 95
Inspection/Test Start Date/Time: 20 Sep 2022 0700 Inspection/Test Completion Date/Time: 20 Sep 2022 1500
Contract Info: OR1P-FIS-OSH Pendleton (2600114256) Notification Number: 5102303440
Supplemental Form(s) Attached: Yes
1. PROPERTY INFORMATION
Name of property: Oregon Health Authority 2585 Westgate (4433-97801-00014)
Address: Cottage 95 2585 Westgate Pendleton Or. 97801
Description of property:
Name of property representative: OREGON HEALTH AUTHORITY (30581098), None
Address: 2585 WESTGATE, PENDLETON, OR 97801
Phone: None Fax: None E-mail: None
2. TESTING AND MONITORING INFORMATION
Testing organization: SIEMENS
Address: 9755 SW Barnes Rd, Suite 205, Portland, OR 97225
Phone: 503 207 1900 Fax: 503 207 1901 E-mail: NA
Monitoring organization: Moon Security
Address: NA
Phone: 541-276-0295 Fax: NA E-mail: NA
Account number: 2585 Phone line 1: NA Phone line 2: NA
Means of transmission: Parallel Phone
Entity to which alarms are retransmitted: NA Phone: NA
3. DOCUMENTATION
On-site location of the required record documents and site-specific software: NA
4. DESCRIPTION OF SYSTEM OR SERVICE
4.1 Control Unit
System Name: OHA PENDLETON SYSTEM 3 Cottage 95 Panel Name: 01 - OHA PENDLETON SYSTEM 3 Cottage 95
Panel Location and Address: Fire panel room, Cottage 95 2585 Westgate, Pendleton Or. 97801
Manufacturer: Siemens Model number: System 3
4.2 Software and Firmware
Firmware revision number: NA
4.3 System Power
4.3.1 Primary (Main) Power
Nominal voltage: 120v Amps: 20a Location: Fire panel room
Overcurrent protection type: Breaker Amps: 20a
Disconnecting means location: House Panel
4.3.2 Secondary Power
Type: Storage Battery Location: Fire panel room
Battery type (if applicable): Sealed Lead Acid Manufactured Date: 01 Jan 2021
Calculated capacity of batteries to drive the system:
In standby mode (hours): 24 In alarm mode (minutes): 5
This report was created by TechAdvance+™, a service of Siemens Industry, Inc. Page 2 of 7
4.4 Notification Appliance Power Extender Panels
4.4.1 Primary Power
ID Location Input Volts
Panel Amps
Over-current Type
Over-current Amps
Primary Supply Location Disconnect Location
01:Bldg 95 FACP Room 120v Breaker House Panel
4.4.2 Secondary Power
ID Location Battery Type
Manufactured Date
Voltage Rating
Amp Rating
Standby Hours
Alarm Minutes
01:Bldg 95 FACP Room SLA Sep 1 2021 12v 8ah 24 5
5. NOTIFICATIONS MADE PRIOR TO TESTING
Monitoring organization Contact: Moon Security 541-276-0295 Time: 0700
Building management Contact: NA Time: NA
Building occupants Contact: Aaron Williams 541-310-0103 Time: 0700
Authority having jurisdiction (AHJ) Contact: NA Time: NA
Other, if required Contact: NA Time: NA
6. TESTING RESULTS
6.1 Control Unit and Related Equipment
Description Visual Inspection or Functional Test Comments
Control unit Functional None
Disconnect switches Functional None
Fuses Functional None
Ground-fault monitoring Functional None
Interface Equipment Functional None
Lamps/LEDs/LCDs Functional None
Local annunciator Functional N/A
Primary Power Functional None
Remote annunciators Functional N/A
Remote power panels Functional N/A
Supervision Functional None
Trouble signals Functional None
6.2 Secondary Power
Description Visual Inspection or Functional Test Comments
Battery condition Functional None
Charger test Functional None
Discharge test Functional None
Load voltage Functional None
Remote panel batteries Functional N/A
6.3 Notification Appliance Power Extender Panels Secondary Power
ID Location Battery Voltage
Battery Amps
Test Method
Pass/ Fail
01:Bldg 95 FACP Room Functional Pass
6.4 Alarm and Supervisory Alarm Initiating Device
Attach supplementary device test sheets for all initiating devices.
This report was created by TechAdvance+™, a service of Siemens Industry, Inc. Page 3 of 7
6.5 Notification Appliances
Attach supplementary appliance test sheets for all notification appliances.
6.6 Interface Equipment
Attach supplementary interface component test sheets for all interface components.
6.7 Supervising Station Monitoring
Description Received Time / Elapsed
Time Pass/Fail Comments
Alarm signal Yes NA / NA Pass None
Alarm restoration Yes NA / NA Pass None
Trouble signal Yes NA / NA Pass None
Trouble restoration Yes NA / NA Pass None
Supervisory signal Yes NA / NA Pass None
Supervisory restoration Yes NA / NA Pass None
6.8 Public Emergency Alarm Reporting System
Description Yes No Time Comments
Alarm signal NA NA
Alarm restoration NA NA
Trouble signal NA NA
Trouble restoration NA NA
Supervisory signal NA NA
Supervisory restoration NA NA
7. NOTIFICATIONS THAT TESTING IS COMPLETE
Monitoring organization Contact: Moon Security 541-276-0295 Time: 1500
Building management Contact: NA Time: NA
Building occupants Contact: Aaron Williams 541-310-0103 Time: 1500
Authority having jurisdiction (AHJ) Contact: NA Time: NA
Other, if required Contact: NA Time: NA
8. SYSTEM RESTORED TO NORMAL OPERATION
Date: 20 Sep 2022 Time: 1500
9. CERTIFICATION
This Testing Was Performed in Accordance with Applicable NFPA Standards.
Signed: Jason Carpenter Nicet #141882 Date: 09/20/2022
Printed name: Jason Carpenter Title: Technician License No.: Nicet #141882
Organization: SIEMENS Phone: 503 207 1900
Qualifications (refer to NFPA 72, Section 10.5.3): Inspection, Testing, Service, Programming
10. SUMMARY OF EQUIPMENT MARKED AS FAILED WHEN INSPECTED OR TESTED
11. ACCEPTANCE BY OWNER OR OWNER’S REPRESENTATIVE
The undersigned accepted the test report for the system as specified herein:
Signed: Printed name: Aaron Williams 541-310-0103 Date:
Organization: OREGON HEALTH AUTHORITY (30581098) Phone: None
Pursuant to applicable codes and standards, the owner or designated representative is responsible for proper maintenance and care of the system(s) identified in this report. During the site inspection, if Siemens has identified code deficiencies or impairments, Siemens will recommend certain corrective actions contained in this report. In the event the
This report was created by TechAdvance+™, a service of Siemens Industry, Inc. Page 4 of 7 owner fails to correct such deficiencies or impairments within the required time period per the code, Siemens may be required to report such deficiencies or impairments to the Local AHJ or Fire Marshall per regulatory requirements.
Customer shall hold Siemens harmless and releases Siemens of any and all liability due to Customer’s failure to correct such deficiencies or impairments.
12. OTHER
12.1 Special Procedures
Sensitivity test performed on all smoke detectors. 9/29/2020 Pass.
12.2 Comments
This report was created by TechAdvance+™, a service of Siemens Industry, Inc. Page 5 of 7
NOTIFICATION APPLIANCE SUPPLEMENTARY RECORD OF INSPECTION AND TESTING
1. PROPERTY INFORMATION
Name of property: Oregon Health Authority 2585 Westgate (4433-97801-00014)
Address: Cottage 95 2585 Westgate Pendleton Or. 97801
2. NOTIFICATION APPLIANCE TEST RESULTS
2.1 Notification Appliances Equipment Summary by Type
Total Qty
ALL
Functionally Tested Qty
ALL
Functionally Tested %
100%
Visually Tested
Qty
Visually Tested %
Failed Qty
Failed %
0%
Device or System Type
Horn / Strobes
2.2 Notification Appliances Testing Results by Type
See main System Record of Inspection and Testing for additional information, certifications, and approvals.
This report was created by TechAdvance+™, a service of Siemens Industry, Inc. Page 6 of 7
INITIATING DEVICE SUPPLEMENTARY RECORD OF INSPECTION AND TESTING
1. PROPERTY INFORMATION
Name of property: Oregon Health Authority 2585 Westgate (4433-97801-00014)
Address: Cottage 95 2585 Westgate Pendleton Or. 97801
2. INITIATING DEVICE TEST RESULTS
2.1 Initiating Devices Equipment Summary by Type
Total Qty Functionally Tested Qty
Functionally Tested %
Visually Tested
Qty
Visually Tested %
Failed Qty Failed % Device or System Type
1 1 100% 0 0% 0 0% Control Valve Switches
21 21 100% 0 0% 0 0% System Smoke Detectors (P)
1 1 100% 0 0% 0 0% Waterflow Devices
2.2 Initiating Devices Testing Results by Type
Control Valve Switches
Row Date Dev.# Location Visual/ Functional
Pass/
1 12/30/22 01-101-026 TAMPER SWITCH COTTAGE 95 Functional Pass
System Smoke Detectors (P)
Functional
Pass/ Fail
1 12/30/22 01-101-001 LIVING ROOM SMOKE COTTAGE 95 Functional Pass
2 12/30/22 01-101-002 LIVING ROOM PULL STATION COTTAGE 95 Functional Pass
3 12/30/22 01-101-003 KITCHEN SMOKE COTTAGE 95 Functional Pass
4 12/30/22 01-101-004 WEST BEDROOM SMOKE COTTAGE 95 Functional Pass
5 12/30/22 01-101-005 WEST BEDROOM SMOKE COTTAGE 95 Functional Pass
6 12/30/22 01-101-006 WEST BEDROOM SMOKE COTTAGE 95 Functional Pass
7 12/30/22 01-101-007 N.W. HALL SMOKE COTTAGE 95 Functional Pass
8 12/30/22 01-101-008 N.W. HALL SMOKE COTTAGE 95 Functional Pass
9 12/30/22 01-101-009 SOUTH BEDROOM SMOKE COTTAGE 95 Functional Pass
10 12/30/22 01-101-010 SOUTH BEDROOM SMOKE COTTAGE 95 Functional Pass
11 12/30/22 01-101-011 S.E. HALL SMOKE COTTAGE 95 Functional Pass
12 12/30/22 01-101-012 SOUTHEAST BEDROOM SMOKE COTTAGE 95 Functional Pass
13 12/30/22 01-101-013 SOUTHEAST BEDROOM SMOKE COTTAGE 95 Functional Pass
14 12/30/22 01-101-014 EAST EXIT PULL STATION COTTAGE 95 Functional Pass
15 12/30/22 01-101-015 HEAT JENNYS OFFICE COTTAGE 95 Functional Pass
16 12/30/22 01-101-016 N.W. EXIT PULL STATION COTTAGE 95 Functional Pass
17 12/30/22 01-101-017 N.W. HALL SMOKE COTTAGE 95 Functional Pass
18 12/30/22 01-101-018 NORTH BEDROOM SOKE COTTAGE 95 Functional Pass
19 12/30/22 01-101-019 NORTH BEDROOM SOKE COTTAGE 95 Functional Pass
20 12/30/22 01-101-020 NORTH CLOSET HEAT COTTAGE 95 Functional Pass
21 12/30/22 01-101-024 NORTH CLOSET HEAT COTTAGE 95 Functional Pass
Waterflow Devices
Functional
Pass/
1 12/30/22 01-101-025 WATERFLOW COTTAGE 95 Functional Pass
See main System Record of Inspection and Testing for additional information, certifications, and approvals.
This report was created by TechAdvance+™, a service of Siemens Industry, Inc. Page 7 of 7
File details come from the government source that posted it. Updated .