20200803-182827-VA_Hospital_Electric_Run_Checklist.pdf
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INSPECTION DETAILS
Date: 07/16/2020
Inspector Name Dan & Kevin
Location Name VA Hospital
Address 101 Veterans Drive
City White River Junction
State VT
Zip Code
Inspection Time 08:00 AM
Pump Room Locaton Basement room 15
Fire Sprinkler Contractor Unknown
GPS
Picture of Jobsite
RT Stearns
280 Heritage Ave, Unit F
Portsmouth, NH
03801
Date: 08/03/2020Electric Run Checklist
Submitted by Dan Hill at 08/03/2020 18:28 UTC Page: 1
Captured at 08/03/2020 18:28 UTC gocanvas.com
Submission ID: E93CA8B7-838F-4A5A-86F5-DA73178537B2 https://maps.google.com/?q=43.648869,-72.342850&z=14 https://www.gocanvas.com/?utm_source=canvas_pdf&utm_medium=pdf_link&utm_campaign=canvas_pdf_link
FIRE PUMP INFORMATION
Pump Manufacturer Aurora
Fire Pump Type Horizontal
Fire Pump Model 6-483-18B
Fire Pump Serial Number 79-65166
GPM Rating 1500
PSIG Rating 100% 100
PSIG Rating 150%
PSIG Rating 0% (Churn or Shutoff)
Pump RPM
Fire Pump Nameplate
RT Stearns
280 Heritage Ave, Unit F
Portsmouth, NH
03801
Date: 08/03/2020Electric Run Checklist
Submitted by Dan Hill at 08/03/2020 18:28 UTC Page: 2
Captured at 08/03/2020 18:28 UTC gocanvas.com
Submission ID: E93CA8B7-838F-4A5A-86F5-DA73178537B2
FIRE PUMPÊCONTROLLER INFORMATION
Fire Pump Controller Manufacturer SYLVANIA
Fire Pump Controller Model A10-308483
Fire Pump Controller Serial Number 297550-1-1
Fire Pump Controller Method of Start Primary Resist
Transfer switch? NO
Fire Pump Controller Voltage Rating 208/3/60
Fire Pump Controller Nameplate
RT Stearns
280 Heritage Ave, Unit F
Portsmouth, NH
03801
Date: 08/03/2020Electric Run Checklist
Submitted by Dan Hill at 08/03/2020 18:28 UTC Page: 3
Captured at 08/03/2020 18:28 UTC gocanvas.com
Submission ID: E93CA8B7-838F-4A5A-86F5-DA73178537B2
JOCKEY PUMP CONTROLLER INFORMATION
Jockey Pump Controller Manufacturer GE
Jockey Pump Controller Serial Number 335F1604S
Jockey Pump Controller Voltage Rating 460/3/60
Jockey Pump Controller Model 55-526374
Jockey Pump Controller Nameplate
RT Stearns
280 Heritage Ave, Unit F
Portsmouth, NH
03801
Date: 08/03/2020Electric Run Checklist
Submitted by Dan Hill at 08/03/2020 18:28 UTC Page: 4
Captured at 08/03/2020 18:28 UTC gocanvas.com
Submission ID: E93CA8B7-838F-4A5A-86F5-DA73178537B2
JOCKEY PUMP INFORMATION
Jockey Pump Manufacturer BURNS PUMPS
Jockey Pump Serial Number 179744
Jockey Pump Model Number 310CS5M
Jockey Pump Horsepower 1.0
Jockey Pump Nameplate
RT Stearns
280 Heritage Ave, Unit F
Portsmouth, NH
03801
Date: 08/03/2020Electric Run Checklist
Submitted by Dan Hill at 08/03/2020 18:28 UTC Page: 5
Captured at 08/03/2020 18:28 UTC gocanvas.com
Submission ID: E93CA8B7-838F-4A5A-86F5-DA73178537B2
FIRE PUMP MOTOR INFORMATION
Fire Pump Motor Manufacturer US Motors
Fire Pump Motor Model Number
Fire Pump Motor Serial Number
Fire Pump Motor Horsepower 200
Fire Pump Motor Service Factor 1.15
Fire Pump Motor Locked Rotor Code B
Fire Pump Design Letter G
Fire Pump Motor FLA 228
Fire Pump Motor Voltage 460/3/60
Fire Pump Motor RPM 1770
Fire Pump Motor Nameplate
RT Stearns
280 Heritage Ave, Unit F
Portsmouth, NH
03801
Date: 08/03/2020Electric Run Checklist
Submitted by Dan Hill at 08/03/2020 18:28 UTC Page: 6
Captured at 08/03/2020 18:28 UTC gocanvas.com
Submission ID: E93CA8B7-838F-4A5A-86F5-DA73178537B2
CHECKLIST ITEMS
Heat in pump room is 40*F or higher? YES
Controller pilot light (power on) is illuminated? BULB IS NOT WORKING
All alarm pilot lights off? N/A
Transfer switch normal power light is illuminated (if applicable)?
N/A
Phase-reversal alarm is not illuminated? ( If applicable ) N/A
Isolating lever for standby power is closed? ( If applicable )
NOT APPLICABLE
Pump suction, discharge and bypass valves are open? YES
All piping free of leaks? YES
Verified fire pump packing drip rate? ( Recommend 1 drip per second )
YES
Packing drain cups free of stoppage? YES
Suction pressure normal? YES
Discharge pressure normal? YES
Is test header control valve in the closed position? YES
Suction reservoir is full? ( If applicable ) NOT APPLICABLE
Power to jockey pump is provided? YES
Inspect and test circuit breakers? YES
Check operation of all applicable alarms associated with the fire pump ( not sprinkler system )
N/A
Are all normal operational lights illuminated on tank status panel? ( if applicable )
NOT APPLICABLE
Checked tank status panel floats for proper operation? ( if applicable and accessible )
NOT APPLICABLE
CLOSE OUT INFORMATION AND SIGNATURE
Fire Pump Cut In Pressure 130
Fire Pump Cut Out Pressure* 135
* Fire pump cut out value is the pressure at which the pressure switch is reset and does not represent an automatic stop pressure setting. The fire pump is a manual stop only, unless otherwise stated in this checklist.
Jockey Pump Cut In Pressure 160
Jockey Pump Cut Out Pressure 170
Fire Pump Left In Service YES
Alarms Operational at Time of Departure YES
This Report Reviewed and Witnessed by:
RT Stearns
280 Heritage Ave, Unit F
Portsmouth, NH
03801
Date: 08/03/2020Electric Run Checklist
Submitted by Dan Hill at 08/03/2020 18:28 UTC Page: 7
Captured at 08/03/2020 18:28 UTC gocanvas.com
Submission ID: E93CA8B7-838F-4A5A-86F5-DA73178537B2
Job Notes:
This is an annual Pump test only.
1. Power to the jockey pump controller is fed from the fire pump controller, NFPA does not allow that practice .
2. The jockey pump suction piping is in the wrong location, it should be on the city side of the fire pump control valve.
3. Jockey pump and fire pump sensing lines are shared, NFPA would have the separated and in different locations.
4. The recommended location for the test header is between the fire pump discharge check valve and the discharge control valve.
Please note that the fire pump test report data information is taken from the actual test data. We are unsure of the actual factory data for this fire pump due to the fact that the impeller was trimmed to achieve a different churn pressure. The only supplied data that we were given was the 1500 gpm at
100 psi rating and that was on a piece of paper affixed to the pump.
RT Stearns
280 Heritage Ave, Unit F
Portsmouth, NH
03801
Date: 08/03/2020Electric Run Checklist
Submitted by Dan Hill at 08/03/2020 18:28 UTC Page: 8
Captured at 08/03/2020 18:28 UTC gocanvas.com
Submission ID: E93CA8B7-838F-4A5A-86F5-DA73178537B2
File details come from the government source that posted it. Updated .