Attachment 17 - US VA medical center Miles City fire sprinkler 3-11-25.pdf

REPORT OF SPRINKLER INSPECTION

TASK #

SR# Date: March 11, 2025

CUSTOMER US VA Medical Center INSPECTOR NAME Justin Huffines BUILDING / LOCATION 210 South Winchester JCI OFFICE Dist. 483 (Helena, MT) STREET 210 South Winchester STREET 600 Lola Street CITY / ST/PROV / ZIP/PC Miles City, MT 59301 CITY / ST/PROV / ZIP/PC Helena, MT 59601

ATTN: PHONE # 406-443-3660

PHONE # LICENSE #

1. GENERAL (To be answered by Customer.) YES N/A NO

a. Have there been any changes in the occupancy classification, machinery or operations since the last inspection?

b. Have there been any changes or repairs to the fire protection systems since the last inspection?

c. Have the sprinkler systems been extended to all areas of the building?

d. If a fire has occurred since the last inspection, have all damaged sprinkler system components been replaced?

e. Has the piping in all dry systems been checked for proper pitch within the past five years?

Date last checked: (check recommended at least every 5 years)

f. Has the piping in all systems been checked for obstructive materials per NFPA 25 - 14.2.1?

Date last checked: 2021 (check required at least every 5 years)

g. Have all fire pumps been tested to full capacity using hose streams or flow meters within the past 12 months?

h. Are gravity, surface or pressure tanks protected from freezing?

i. Since the last inspection, has there been any structural changes (walls, ceilings, addit./remodels) to the building?

j. Are any extra high temperature solder sprinklers regularly exposed to temperatures near 300˚F?

l. Are the building areas protected by a wet system heated, including its blind attics and perimeter areas?

m. Are all exterior openings protected against the entrance of cold air?

n. Does customer know the location(s) of all low point drains?

If answered "yes" to a-n above, list changes in Section 13.

2. SPRINKLER TESTING OR REPLACEMENT YES N/A NO

Does facility have the following types of sprinklers?

a. Standard Sprinklers in service for 50 years? (Sprinklers manufactured prior to 1920 shall be replaced.)

Date of Manufacture:

b. Quick Response Sprinklers in service for 20 years?

Date of Manufacture:

c. Dry Sprinklers in service for 10 years?

Date of Manufacture: (if unknown, please explain in Section 13.)

d. Corroded, Painted, Damaged, Signs of Leakage, Loaded, Improper Orientation? (replacment required)

e. Any sprinklers subject to recall? (replacement required)

If answered "yes" to a, b, c, d, or e, list quantity and description in Supplemental Report.

f. Have gauges been tested, calibrated or replaced in the last 5 years? 25-5.3.2 Date 2021

g. Alarm valves and associated trim been internally inspected past 5 years? 25-13.4.1 Date 2021

h. Check valves internally inspected in the last 5 years? 25-13.4.2.1 Date 2021

i. Has the private fire main been flow tested in last 5 years? 25-7.2.1 Date

j. Have master pressure reducing valves been tested at full flow within the past 5 years?

REPORT OF SPRINKLER INSPECTION

600 Lola Street Helena, MT 59601 Ph: (406)443-3660

Fax: (406)449-3704

210 South Winchester

3. STANDPIPE YES N/A NO

a. Dry standpipe hydrostatic test (5 Year) Date

b. Wet Standpipe Flow test Date

c. Dry Standpipe Flow Test Date

d. Hose hydrostatic test Date

e. Pressure control valve test (5 Year) Date

f. Are cold weather valves in the appropriate open or closed position?

If closed, has piping been drained?

g. Have pressure reducing valves been tested at full flow within the past 5 years? Date

4. CONTROL VALVES YES N/A NO

a. Are all sprinkler system main control valves and all other valves in the appropriate open or closed position?

b. Are all control valves sealed or supervised in the appropriate position?

c. Are all valves identified with signs?

Control Valves # of

Valves Type

Easily Accessible Signs Valve Open

Secured?

If Yes, How?

(Sealed?)

(Locked?)

(Supvd.?)

Supervision Operational

YES NO YES NO YES NO YES NO YES NO

Backflow 2 OS&Y Supervised

Dry 1 Butterfly Supervised

PIV 3 PIV Supervised

Control valves 20 OS&Y Supervised

Location of Valves:

There is attached sheet with locations of all valves

All valves are supervised and tested good

5. WATER SUPPLIES

a. Water supply sources? City Gravity Tank Pressure Fire Pump Tank Pond

Main Drain Test Results Made During This Inspection

Test Pipe

Located

Size Test Pipe

Static Supply Pressure Before

Residual Pressure

Return time to Static Pressure

Test Pipe

Located

Size Test Pipe

Static Supply Pressure Before

Residual Pressure

Return time to Static Pressure

Dry 1.25 60 50 2Sec

Original 2” 60 50 2Sec

Carpenter 2” 65 50 2Sec

Nursing home 2” 60 50 2Sec

Old boiler 1.25 65 50 2Sec

6. TANKS, PUMPS, FIRE DEPT. CONNECTIONS YES N/A NO

a. Do fire pumps, gravity, surface or pressure tanks appear to be in good external conditions?

b. Are gravity, surface and pressure tanks at the proper pressure and/or water levels?

c. Has the storage tank been internally inspected in the last 3 yrs. (unlined) or 5 yrs. (lined)?

d. Are fire dept. connections in satisfactory condition, couplings free, caps or plugs in place and check valves tight?

e. Are fire dept. connections visible and accessible?

7. WET SYSTEMS YES N/A NO

a. No. of systems: 4 Make & Model: (2) 4”(1) 6” wet with paddle type flow alarm/ 4” with alarm check with pressure switch

b. Has the Customer been advised that cold weather valves are not recommended?

c. Did alarm valves, waterflow alarm devices, and retards test satisfactorily? Riser # BLR Sec. 23

Riser # 4” Sec. 35 Riser # CLC Sec. 33 Riser # CRP Sec. 60

d. Have the sprinkler pressure relief valves been inspected and tested? (annual testing required)

8. ANTIFREEZE SYSTEM(S) YES N/A NO

The antifreeze tests indicated protection to: (Note temp & type for each.)

System 1) System 2)

System 3) System 4)

System 5) System 6)

a. Has the customer been consulted on antifreeze requirements? Given the NFPA AF Alert?

b. If antifreeze system does not meet new standards, has the customer been given the "Customer Acknow. Form"?

9. DRY SYSTEMS

a. No. of systems: 1 Make & Model: 2.5” Reliable Model A dry pipe valve

b. Date last trip tested:

Partial: 9/14/23 (annual required)

Water pressure: 60 psi Air pressure: 35 psi

Tripping air pressure: 5 psi Trip Time: Part sec

Full: 9/18/24 (refer to Dry Trip Report)

c. Was a two-hour pressure test performed?

1. Date of last two-hour pressure test: 2024 (required every 3 years)

d. Are the air pressure and priming water levels normal?

e. Did the low-air switch operate correctly? Alarm pressure: 18 psi

1. If not installed, was the customer informed of the importance of this device?

f. Did the air compressor operate satisfactorily?

g. Air compressor oil checked? Belt? Tank Drain?

h. Were auxiliary/low point drains drained during this inspection? No. of Drains: 2

i. Is a low point drain location drawing provided and located at system riser?

i. Did all quick opening devices operate? Make: Model:

j. Did all the dry valves operate satisfactorily during this inspection?

k. Did the flow alarm switch operate satisfactorily? Riser # Sec.

Riser # 1 Sec. 2 Riser # Sec. Riser # Sec.

l. Did the supervisory alarms operate during testing?

n. Do dry valves appear to be protected from freezing?

10. SPECIAL SYSTEMS YES N/A NO

a. No. of systems: None Make & Model:

Type:

b. Were valves tested as required?

c. Did all heat responsive systems operate satisfactorily?

d. Did the flow alarm switch operate satisfactorily?

Riser # Sec. Riser # Sec. Riser # Sec. Riser # Sec.

e. Did the supervisory features operate during testing?

f. Has a supplemental test form for this system been completed and provided to the customer? (Please attach)

g. Auxiliary equipment: No. Type:

Location

Test results

11. ALARMS YES N/A NO

a. Did the fire alarm panel indicate waterflow alarm during testing?

b. Did the fire alarm panel indicate supervisory alarm during testing?

c. Did the monitoring company record flow and supervisory alarms correctly?

12. SPRINKLERS - PIPING YES N/A NO

a. Do sprinklers generally appear to be in good external condition?

b. Do sprinklers generally appear to be free of corrosion, paint, or loading and visible obstructions?

c. Are extra sprinklers and sprinkler wrench available on the premises?

If no, list number, size, finish, temp, and brand of spare heads? (List on Deficiency Material List)

d. Does the exposed exterior condition of piping, drain valves, check valves, hangers, pressure gauges, open sprinklers and strainers appear to be satisfactory?

e. Does the hand hose on the sprinkler system appear to be in satisfactory condition?

f. Does there appear to be proper clearance between the top of all storage and the sprinkler deflector?

13. FIRE SPRINKLER BACKFLOW PREVENTION ASSEMBLY YES N/A NO

a. Number of backflow(s)? 1

b. Are all backflows up to date on their certifications? (required annually)

b. Was a full forward flow test completed?

c. Was test conducted at the designed flow rate?

If answered "no", explain: Desigin flow rate not known at time of inspection

14. EXPLANATION OF "NO" ANSWERS AND DEFICIENCIES. (Sections 1 thru 13):

No access to crawl space.

15. THE INSPECTOR SUGGESTS THE FOLLOWING NECESSARY IMPROVEMENTS. THESE SUGGESTIONS ARE NOT THE

RESULT OF AN ENGINEERING SURVEY AND DO NOT REFLECT CONDITIONS ABOVE CEILINGS OR IN CONCEALED SPACES:

I suggest adding sprinkler protection throughout the entire building as of now it’s just first, second and none on third and forth floors.

PIV for carpenter shop needs replaced, it is very difficult to shut, and does not shut all the way.

16. ADJUSTMENTS OR CORRECTIONS MADE:

Tested flows and alarms /drained low points/ I tested the flow alarms that could be tested by inspectors test, and I tested the rest

Electronically only. See attached sheet for delay times

17. LIST CHANGES IN OCCUPANCY, HAZARD OR FIRE PROTECTION SYSTEM, AS ADVISED BY CUSTOMER IN SECTION 1 a-n:

5 year internal inspection 6-17-21

18. INSPECTION DEFICIENCIES AND SUGGESTED IMPROVEMENTS WERE DISCUSSED WITH THE CUSTOMER / YES NO

CUSTOMER REPRESENTATIVE?

If No, explain.

IMPORTANT NOTICE TO CUSTOMER Customer acknowledges and agrees that, in the absence of a Service Agreement between the parties, services hereunder are performed pursuant to the terms and conditions of this Report, agrees that the services have been completed to Customer’s satisfaction and that the system is in good working order and repair, unless services performed were of a temporary nature, in which case Customer acknowledges that part of customer’s system may have been bypassed or is otherwise inoperable until service can be completed. CUSTOMER’S ATTENTION IS DIRECTED TO THE LIMITATION OF LIABILITY, WARRANTY, INDEMNITY AND OTHER CONDITIONS AT THE REVERSE SIDE/END OF THIS REPORT. This Agreement has been drawn up and executed in English at the request of and with the full concurrence of Customer. Ce contract a été rédigé en anglais à la demande et avec l’assentiment du client.

CUSTOMER Date: March 11, 2025

PRINT NAME Dustin Hilliard INSPECTOR SIGNATURE

DUPLICATE TO:

STREET:

CITY, STATE AND ZIP:

ATTN:

TERMS AND CONDITIONS

1. Limitation Of Liability; Limitations Of Remedy. It is understood and agreed by the Customer that Company is not an insurer and that insurance coverage, if any, shall be obtained by the Customer and that amounts payable to Company hereunder are based upon the value of the services and the scope of liability set forth in this agreement and are unrelated to the value of the Customer’s property and the property of others located on the premises.

Customer agrees to look exclusively to the Customer’s insurer to recover for injuries or damage in the event of any loss or injury and that Customer releases and waives all right of recovery against Company arising by way of subrogation. Company makes no guaranty or Warranty, including any implied warranty of merchantability or fitness for a particular purpose that equipment or services supplied by Company will detect or avert occurrences or the consequences therefrom that the equipment or service was designed to detect or avert.

It is impractical and extremely difficult to fix the actual damages, if any, which may proximately result from failure on the part of Company to perform any of its obligations under this agreement. Accordingly, Customer agrees that, Company shall be exempt from liability for any loss, damage or injury arising directly or indirectly from occurrences, or the consequences therefrom, which the equipment or service was designed to detect or avert. Should Company be found liable for any loss, damage or injury arising from a failure of the equipment or service in any respect, Company’s liability shall be limited to an amount equal to the agreement price (as increased by the price for any additional work) or where the time and material payment term is selected, Customer’s time and material payments to Company. Where this agreement covers multiple sites, liability shall be limited to the amount of the payments allocable to the site where the incident occurred. Such sum shall be complete and exclusive. If Customer desires Company to assume greater liability, the parties shall amend this agreement by attaching a rider setting forth the amount of additional liability and the additional amount payable by the Customer for the assumption by Company of such greater liability, provided however that such rider shall in no way be interpreted to hold Company as an insurer. IN NO EVENT SHALL COMPANY BE LIABLE FOR ANY DAMAGE, LOSS, INJURY, OR ANY OTHER CLAIM ARISING FROM ANY SERVICING, ALTERATIONS, MODIFICATIONS, CHANGES, OR MOVEMENTS OF THE COVERED SYSTEM(S) OR ANY OF ITS COMPONENT PARTS BY THE CUSTOMER OR ANY THIRD PARTY. COMPANY SHALL NOT BE LIABLE FOR INDIRECT, INCIDENTAL OR CONSEQUENTIAL DAMAGES OF ANY KIND, INCLUDING BUT NOT LIMITED TO DAMAGES ARISING FROM THE USE, LOSS OF THE USE, PERFORMANCE, OR FAILURE OF THE COVERED SYSTEM(S) TO PERFORM. The limitations of liability set forth in this agreement shall inure to the benefit of all parents, subsidiaries and affiliates of Company, whether direct or indirect, Company’s employees, agents, officers and directors.

2. Limited Warranty. COMPANY WARRANTS THAT ITS WORKMANSHIP AND MATERIAL FURNISHED UNDER THIS AGREEMENT WILL BE FREE FROM DEFECTS FOR A PERIOD OF NINETY (90) DAYS FROM THE DATE OF FURNISHING. Where Company provides product or equipment of others, Company will warrant the product or equipment only to the extent warranted by such third party. EXCEPT AS EXPRESSLY SET FORTH HEREIN, COMPANY DISCLAIMS ALL WARRANTIES, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO ANY IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE WITH RESPECT TO THE SERVICES PERFORMED OR THE PRODUCTS, SYSTEMS OR EQUIPMENT, IF ANY, SUPPORTED HEREUNDER. COMPANY MAKES NO WARRANTY OR REPRESENTATION, AND UNDERTAKES NO OBLIGATION TO ENSURE BY THE SERVICES PERFORMED UNDER THIS AGREEMENT, THAT COMPANY’S PRODUCTS OR THE SYSTEMS OR EQUIPMENT OF THE CUSTOMER WILL CORRECTLY HANDLE THE PROCESSING OF CALENDAR DATES BEFORE OR AFTER DECEMBER 31, 1999.

3. Indemnity. Customer agrees to indemnify, hold harmless and defend Company against any and all losses, damages, costs, including expert fees and costs, and expenses including reasonable defense costs, arising from any and all third party claims for personal injury, death, property damage or economic loss, including specifically any damages resulting from the exposure of workers to Hazardous Conditions whether or not Customer pre-notifies Company of the existence of said hazardous conditions, arising in any way from any act or omission of Customer or Company relating in any way to this agreement, including but not limited to the Services under this agreement, whether such claims are based upon contract, warranty, tort (including but not limited to active or passive negligence), strict liability or otherwise. Company reserves the right to select counsel to represent it in any such action.

4. Hazardous Materials. Customer represents that, except to the extent that Company has been given written notice of the following hazards prior to the execution of this agreement, to the best of Customer’s knowledge there is no:

d.“permit confined space,” as defined by OSHA, e.risk of infectious disease, f.need for air monitoring, respiratory protection, or other medical risk, g.asbestos, asbestos-containing material, formaldehyde or other potentially toxic or otherwise hazardous material contained in or on the surface of the floors, walls, ceilings, insulation or other structural components of the area of any building where work is required to be performed under this agreement.

All of the above are hereinafter referred to as “Hazardous Conditions”.

Company shall have the right to rely on the representations listed above. If hazardous conditions are encountered by Company during the course of Company’s work, the discovery of such conditions shall constitute an event beyond Company’s control and Company shall have no obligation to further perform in the area where the hazardous conditions exist until the area has been made safe by Customer as certified in writing by an independent testing agency, and Customer shall pay disruption expenses and re-mobilization expenses as determined by Company.

This agreement does not provide for the cost of capture, containment or disposal of any hazardous waste materials, or hazardous materials, encountered in any of the Covered System(s) and/or during performance of the Services. Said materials shall at all times remain the responsibility and property of Customer. Company shall not be responsible for the testing, removal or disposal of such hazardous materials.

5. Equipment Disconnections. This represents Company’s notice to you that the system(s)/device(s) listed on the face of this agreement as temporarily or permanently disconnected are no longer in service and, thus, cannot detect, perform and/or report occurrences or transmit signals.

6. General. Unless otherwise specified, work shall be done between the hours of 8:00 AM and 5:00 PM, exclusive of Saturdays, Sundays and Company holidays.

All work is subject to review and rebilling in accordance with the terms and conditions of Customer’s agreement/contract with Company, if one is in effect. Company shall not be responsible for failure to render services due to causes beyond its control, including but not limited to material shortages, work stoppages, fires, civil disobedience or unrest, severe weather, fire or any other cause beyond the control of Company. Customer is aware that the Limitation of Liability and other provisions set forth in any existing agreement/contract, if one is in effect, or set forth above, apply to services performed and materials supplied. The terms of this agreement shall govern notwithstanding any inconsistent or additional terms and conditions in any purchase order or other document submitted by Customer.