A1. Inspection and Testing Reports_Redacted.pdf
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- Fire Protection & Life Safety Inspection, Testing, and Certification (ITC) for Spokane WA VAMC
- Solicitation number
- 36C26024Q0901
About this file
This document appears to be Inspection and Testing Reports related to a federal contract opportunity for Fire Protection & Life Safety Inspection, Testing, and Certification (ITC) for the Spokane WA VAMC.
The key details are:
The federal contract opportunity has a Solicitation Number of 36C26024Q0901 and is a 100% Small Business Set-aside. The contract has a base period plus four option years. Interested vendors must submit Parts 1-4 as outlined in Section E.2 to be considered. The Basis of Award is detailed in Section E.6. The contracting agency is the Department of Veterans Affairs Veterans Health Administration Veterans Integrated Service Network 20. The contract is for services starting in FY25, subject to availability of funds.
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Other files
| File | Type | Posted |
|---|---|---|
| A9. FEX Inventory_without Spares.xlsx | XLSX spreadsheet | |
| A2. Campus Map.pdf | ||
| S06 36C26024Q0901 AMENDMENT 0002.pdf | ||
| A6. Spokane Fire Department Fees.pdf | ||
| A3. Panels_Annunciators_Redacted.pdf | ||
| S06 36C26024Q0901 AMENDMENT 0001.pdf | ||
| S02 RFQ 36C26024Q0901 Spokane Fire and Life Safety.pdf |
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MAINTENANCE REPORT FOR RESTAURANT HOOD SYSTEMS
Facility Name:
Date: Time:
Address:
City/State: Zip: Telephone Number:
Manufacturer: Model: Date last Hydro:
Master Cylinder size: Slave Cylinder Size:
List Cooking appliances left to right:
1. All appliances covered with correct nozzles? Yes No N/A
2. Duct Plenum covered with correct nozzles? Yes No N/A
3. Is Duct/Plenum covered with water wash system? Yes No N/A
4. Are all nozzles positioned correctly? Yes No N/A
5. Are all nozzles clear from obstructions? Yes No N/A
6. Are cartridges weights acceptable? Date: Yes No N/A
7. Is the cartridge gauge within operable range? Yes No N/A
8. Are the cartridge puncture seals in tact? Yes No N/A
9. Is the cylinder gauge within operable range? Yes No N/A
10. Is the cylinder mount acceptable? Yes No N/A
11. Is automan in acceptable conditions? Yes No N/A
12. Is automan in acceptable locations? Yes No N/A
13. System tested & Micro switch tested ok? Yes No N/A
14. Is system connected to fire alarm? Yes No N/A
15. Is gas valve operational? Yes No N/A
16. Is manual release operational? Yes No N/A
17. Are the filters baffle styles, per NFPA 96? Yes No N/A
18. Are there missing filters in hood? Yes No N/A
19. Is there 18” spacing between open flames/fryers? Yes No N/A
20. Is the exhaust hood in compliance with NFPA 96? Yes No N/A
21. Is the exhaust hood seams liquid tight? Yes No N/A
22. Is grease build up acceptable per NFPA 96? Yes No N/A
23. Is exhaust fan working properly? Yes No N/A
24. Is there a Class K extinguisher as required? Yes No N/A
25. Were Fusible links replaced? Yes No N/A
26. Is system in compliance with MFG manual? Yes No N/A
Comments:
Service & Certification tag on system All systems re-armed Is system UL 300 compliant? Yes No tomers Name:
tomers Signature:
VA Hospital- canteen kitchen 1 front
3:30
4815 N Assembly Spokane 99205 (509) 434-7416
Ansul R-102 2012
3 gallon N/a
10/18. 49 1/8oz
2@450
System test good
48" grill Fryer Fryer
WA
5/2/24
Date: Time:
Address:
City/State: Zip: Telephone Number:
Manufacturer: Model: Date last Hydro:
Master Cylinder size: Slave Cylinder Size:
List Cooking appliances left to right:
1. All appliances covered with correct nozzles? Yes No N/A
2. Duct Plenum covered with correct nozzles? Yes No N/A
3. Is Duct/Plenum covered with water wash system? Yes No N/A
4. Are all nozzles positioned correctly? Yes No N/A
5. Are all nozzles clear from obstructions? Yes No N/A
6. Are cartridges weights acceptable? Date: Yes No N/A
7. Is the cartridge gauge within operable range? Yes No N/A
8. Are the cartridge puncture seals in tact? Yes No N/A
9. Is the cylinder gauge within operable range? Yes No N/A
10. Is the cylinder mount acceptable? Yes No N/A
11. Is automan in acceptable conditions? Yes No N/A
12. Is automan in acceptable locations? Yes No N/A
13. System tested & Micro switch tested ok? Yes No N/A
14. Is system connected to fire alarm? Yes No N/A
15. Is gas valve operational? Yes No N/A
16. Is manual release operational? Yes No N/A
17. Are the filters baffle styles, per NFPA 96? Yes No N/A
18. Are there missing filters in hood? Yes No N/A
19. Is there 18” spacing between open flames/fryers? Yes No N/A
20. Is the exhaust hood in compliance with NFPA 96? Yes No N/A
21. Is the exhaust hood seams liquid tight? Yes No N/A
22. Is grease build up acceptable per NFPA 96? Yes No N/A
23. Is exhaust fan working properly? Yes No N/A
24. Is there a Class K extinguisher as required? Yes No N/A
25. Were Fusible links replaced? Yes No N/A
26. Is system in compliance with MFG manual? Yes No N/A
Comments:
Service & Certification tag on system All systems re-armed Is system UL 300 compliant? Yes No stomers Name:
stomers Signature:
VA Hospital- canteen kitchen 2 back
4815 N Assembly Spokane 99205 (509) 434-7416
Ansul R-102 2016
1.5 gallon N/a
10/18. 48 7/8oz
1@450
System test good
Oven 6 burner
Date: Time:
Address:
City/State: Zip: Telephone Number:
Manufacturer: Model: Date last Hydro:
Master Cylinder size: Slave Cylinder Size:
List Cooking appliances left to right:
1. All appliances covered with correct nozzles? Yes No N/A
2. Duct Plenum covered with correct nozzles? Yes No N/A
3. Is Duct/Plenum covered with water wash system? Yes No N/A
4. Are all nozzles positioned correctly? Yes No N/A
5. Are all nozzles clear from obstructions? Yes No N/A
6. Are cartridges weights acceptable? Date: Yes No N/A
7. Is the cartridge gauge within operable range? Yes No N/A
8. Are the cartridge puncture seals in tact? Yes No N/A
9. Is the cylinder gauge within operable range? Yes No N/A
10. Is the cylinder mount acceptable? Yes No N/A
11. Is automan in acceptable conditions? Yes No N/A
12. Is automan in acceptable locations? Yes No N/A
13. System tested & Micro switch tested ok? Yes No N/A
14. Is system connected to fire alarm? Yes No N/A
15. Is gas valve operational? Yes No N/A
16. Is manual release operational? Yes No N/A
17. Are the filters baffle styles, per NFPA 96? Yes No N/A
18. Are there missing filters in hood? Yes No N/A
19. Is there 18” spacing between open flames/fryers? Yes No N/A
20. Is the exhaust hood in compliance with NFPA 96? Yes No N/A
21. Is the exhaust hood seams liquid tight? Yes No N/A
22. Is grease build up acceptable per NFPA 96? Yes No N/A
23. Is exhaust fan working properly? Yes No N/A
24. Is there a Class K extinguisher as required? Yes No N/A
25. Were Fusible links replaced? Yes No N/A
26. Is system in compliance with MFG manual? Yes No N/A
Comments:
Service & Certification tag on system All systems re-armed Is system UL 300 compliant? Yes No stomers Name:
stomers Signature:
VA Hospital- basement kitchen
4815 N Assembly Spokane 99205 (509) 434-7416
Ansul R-102 18,17
3 gallon 3 gallon
12/18. 58 7/8oz
4@450
System test good
36" grill 6 burner Oven Oven
AUTOMATIC SPRINKLER SYSTEM INSPECTION REPORT
[X] Annual inspection [ ] 5-year inspection
ALL INSPECTION AND TESTING MUST BE PERFORMED IN ACCORDANCE WITH NFPA 25-2017
Name of Facility VA Hospital
Building Name or No. Main Bldg. Bldg. #1 Type of Occupancy Main Hospital
Address 4815 N Assembly City Spokane ZIP 99208
Telephone Dir./Adm. Conferred with Brad
Inspected by Title Service Inspector Date 4/6/2024.
Washington State Fire Sprinkler System Contractor License No.
Type of systems being tested: [X] Dry sprinkler system [ ] Preaction [X] Wet sprinkler system [ ] Dry – Partial Coverage [ ] Deluge
[ ] Wet – Partial Coverage [ ] Combination (Sprinkler and Standpipe - common riser) [ ] Other
AN INDIVIDUAL INSPECTION/TEST FORM AND FILING FEE ARE REQUIRED FOR EACH SYSTEM TESTED.
A FIRE SPRINKLER SYSTEM IS DEFINED AS INTEGRATED COMPONENTS SUCH AS PIPING, SPRINKLER HEADS, VALVES, AND OTHER RELATED EQUIPMENT THAT CAN OPERATE INDEPENDENTLY, SERVICES ALL OR A
PORTION OF A BUILDING, AND STEMS FROM A BACKFLOW PREVENTER ASSEMBLY.
NOTE TO OWNER / OCCUPANT:
All fire sprinkler systems are presumed and required to be fully operational and maintained at all times.
Fire sprinkler system deficiencies and malfunctions are the responsibility of the building/property owner and shall be repaired immediately.
A. OWNER’S SECTION (answers may be obtained from the owner or occupant)
1. Explain any occupancy hazard changes since the previous inspection. NONE
2. Describe fire protection modifications since the previous inspection. NONE
3. Describe any fires since previous inspection. NONE
4. Is the building currently occupied? YES _X__ NO ____ Are all sprinkler systems in service? YES _X__ NO ____
YES NO NA
4. TANKS, VALVES, PUMPS, FIRE DEPARTMENT CONNECTIONS
a. Was the fire department connection check valve cleaned and back flushed from check valve to FDC? ............................................................................................................... ____ _X _ ____
b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight? ....................................................................................... _X _ ____ ____
c. Are fire pumps, gravity tanks, reservoirs, and pressure tanks in good condition and properly maintained? .................................................................................................... _X___ ____ _ _
d. Are the fire department connections accessible and visible? ........................................ _X _ ____ ____
e. Was the backflow preventer properly flushed, tested, and maintained? ....................... ____ ____ _X _
5. PIPING, HANGERS AND BRACING
a. Does this system utilize any thin-wall piping? .......... Type?____________________ ____ _X _
b. Are all hangers, brackets, and bracing properly secured and connected? ...................... _X _ ____
c. Does the exterior condition of the sprinkler system appear satisfactory? .................... _X _ ____
d. Was the piping flushing procedure conducted as per NFPA 25? ................................. ____ ____ _X _ (Every 5 years or more often as necessary)
6. ALARM DEVICES
a. Did water motor and gong test satisfactorily? ............................................................... ____ ____ _X _
b. Did electric alarm test satisfactorily? ............................................................................ _X _ ____ ____
c. Did supervisory alarm test satisfactorily? ..................................................................... _X _ ____ ____
7. SPRINKLER HEADS (number of heads ___1200+____)
a. Are all sprinklers free from corrosion, damage, or obstruction to spray discharge? ..... _X _ ____ ____
b. Are heads installed in the proper orientation? ................................................................. _X _ ____ ____
c. Are standard sprinkler heads less than 50 years old, QR heads less than 20 years? ..... _ _ _X___ ____
d. Is appropriate stock of sprinkler heads available? ........................................................ _ _ _X___ ____
e. Are sprinkler temperature ratings appropriate for their locations? ............................... _X _ ____ ____
8. HEAT/SMOKE/FLAME RESPONSIVE DEVICES
a. Test Method N/A
b. Type of Equipment
c. Number of devices _________ Type_______________________ Test Results _________________________________
INDIVIDUAL RISER REPORTING FORM
For each sprinkler system, an individual riser reporting form shall be attached for each riser found within the system.
Multiple individual risers found within one system might include, as an example, two wet risers and one dry pipe riser.
Thus, we would require one sprinkler system report with three individual riser reports attached.
RISER IDENTIFICATION – Use a # or description unique to this individual riser
___Viking Dry Pipe Valve on Loading Dock Northeast
Corner_____________________________________________________________________________________________________
1. WET SYSTEM RISER YES NO NA
a. Are all valves and piping protected from freezing? ...................................................... ____ ____ _X _
b. Is this wet system equipped with a remote inspector’s test valve? ................................. ____ ____
c. Was water flowed through this remote inspector’s test? ................................................. ____ ____ _X _
2. DRY SYSTEM RISER
a. Is the dry valve in service? ............................................................................................ _X _ ____ ____
b. Are the air pressure and priming water level in accordance with the manufacturer’s instructions? .................................................................................................................. _X _ ____ ____
c. Has the operation of the air or nitrogen supply been tested? (Less than 10 psi/week loss) _X _ ____ ____
Is it in service? .............................................................................................................. _X _ ____ ____
d. Were low points drained and piping blown down during this inspection? .................... _X _ ____ ____
e. Did quick opening devices operate satisfactorily? ........................................................ ____ ____ _X _
f. Time required for water to be delivered to remote inspectors test connection ............... ____13 SEC_______
g. Did the dry valve trip properly during the trip pressure test? ....................................... _X _ ____ ____
h. Did the heating equipment in the dry-pipe valve room operate properly at the time of inspection? .................................................................................................................... _X _ ____ ____
i. Date dry-pipe valve trip tested (control valve partially open). (see “Control Valve Mainte-nance Table”) ................................................................................................................ 4/6/2024
j. Date dry-pipe valve trip tested (control valve completely open). (see “Control Valve Main-tenance Table”) ............................................................................................................. 9/17/2022
k. Date quick-opening device tested. (see “Control Valve Maintenance Table”) .............. X
3. COMBINATION SYSTEM (Sprinkler and Standpipe with a common riser)
a. With 500 GPM flowing at highest outlet, what was the PSI at that outlet? .................. X
4. SPECIAL SYSTEMS
a. Did the deluge or pre-action valves operate properly during testing? ........................... ____ ____ _X _
b. Did the heat responsive, smoke, or other initiation devices operate during testing? ..... ____ ____ _X _
c. Did the supervisory devices operate during testing? ..................................................... ____ ____ _X _
d. Date deluge or pre-action valve tested. (see “Control Valve Maintenance Table”) ...... X
e. For antifreeze systems, have antifreeze solutions been tested and found acceptable? .. ____ ____ _X _
For each sprinkler system, an individual riser reporting form shall be attached for each riser found within the system.
Multiple individual risers found within one system might include, as an example, two wet risers and one dry pipe riser.
___9th & 10th Floor in Penthouse on 8th floor south side end 3 OSY valves for riser_____________________________________________________________________________________________________
1. WET SYSTEM RISER YES NO NA
a. Are all valves and piping protected from freezing? ...................................................... _X _ ____ ____
b. Is this wet system equipped with a remote inspector’s test valve? ................................. _X _ ____
c. Was water flowed through this remote inspector’s test? ................................................. _X _ ____ ____
2. DRY SYSTEM RISER
a. Is the dry valve in service? ............................................................................................ ____ ____ _X _
b. Are the air pressure and priming water level in accordance with the manufacturer’s instructions? .................................................................................................................. ____ ____ _X _
c. Has the operation of the air or nitrogen supply been tested? (Less than 10 psi/week loss) ____ ____ _X _
Is it in service? .............................................................................................................. ____ ____ _X _
d. Were low points drained and piping blown down during this inspection? .................... ____ ____ _X _
e. Did quick opening devices operate satisfactorily? ........................................................ ____ ____ _X _
f. Time required for water to be delivered to remote inspectors test connection ............... __________________
g. Did the dry valve trip properly during the trip pressure test? ....................................... ____ ____ _X _
h. Did the heating equipment in the dry-pipe valve room operate properly at the time of inspection? .................................................................................................................... ____ ____ _X _
i. Date dry-pipe valve trip tested (control valve partially open). (see “Control Valve Mainte-nance Table”)
j. Date dry-pipe valve trip tested (control valve completely open). (see “Control Valve Main-tenance Table”) ............................................................................................................. X
k. Date quick-opening device tested. (see “Control Valve Maintenance Table”) .............. X
a. With 500 GPM flowing at highest outlet, what was the PSI at that outlet? .................. X
5. SPECIAL SYSTEMS
a. Did the deluge or pre-action valves operate properly during testing? ........................... ____ ____ _X _
b. Did the heat responsive, smoke, or other initiation devices operate during testing? ..... ____ ____ _X _
c. Did the supervisory devices operate during testing? ..................................................... ____ ____ _X _
e. For antifreeze systems, have antifreeze solutions been tested and found acceptable? .. ____ ____ _X _
For each sprinkler system, an individual riser reporting form shall be attached for each riser found within the system.
Multiple individual risers found within one system might include, as an example, two wet risers and one dry pipe riser.
___North End of hospital 1st thru 8th floors flows and tamper_____________________________________________________
1. WET SYSTEM RISER YES NO NA
a. Are all valves and piping protected from freezing? ...................................................... _X _ ____ ____
b. Is this wet system equipped with a remote inspector’s test valve? ................................. _X _ ____
c. Was water flowed through this remote inspector’s test? ................................................. _X _ ____ ____
2. DRY SYSTEM RISER
a. Is the dry valve in service? ............................................................................................ ____ ____ _X _
b. Are the air pressure and priming water level in accordance with the manufacturer’s instructions? .................................................................................................................. ____ ____ _X _
c. Has the operation of the air or nitrogen supply been tested? (Less than 10 psi/week loss) ____ ____ _X _
Is it in service? .............................................................................................................. ____ ____ _X _
d. Were low points drained and piping blown down during this inspection? .................... ____ ____ _X _
e. Did quick opening devices operate satisfactorily? ........................................................ ____ ____ _X _
f. Time required for water to be delivered to remote inspectors test connection ............... __________________
g. Did the dry valve trip properly during the trip pressure test? ....................................... ____ ____ _X _
h. Did the heating equipment in the dry-pipe valve room operate properly at the time of inspection? .................................................................................................................... ____ ____ _X _
i. Date dry-pipe valve trip tested (control valve partially open). (see “Control Valve Mainte-nance Table”)
j. Date dry-pipe valve trip tested (control valve completely open). (see “Control Valve Main-tenance Table”) ............................................................................................................. X
k. Date quick-opening device tested. (see “Control Valve Maintenance Table”) .............. X
a. With 500 GPM flowing at highest outlet, what was the PSI at that outlet? .................. X
6. SPECIAL SYSTEMS
a. Did the deluge or pre-action valves operate properly during testing? ........................... ____ ____ _X _
b. Did the heat responsive, smoke, or other initiation devices operate during testing? ..... ____ ____ _X _
c. Did the supervisory devices operate during testing? ..................................................... ____ ____ _X _
e. For antifreeze systems, have antifreeze solutions been tested and found acceptable? .. ____ ____ _X _
For each sprinkler system, an individual riser reporting form shall be attached for each riser found within the system.
Multiple individual risers found within one system might include, as an example, two wet risers and one dry pipe riser.
___Center section of Hospital 1st thru 8th floors by Elevator flows and tampers
1. WET SYSTEM RISER YES NO NA
a. Are all valves and piping protected from freezing? ...................................................... _X _ ____ ____
b. Is this wet system equipped with a remote inspector’s test valve? ................................. _X _ ____
c. Was water flowed through this remote inspector’s test? ................................................. _X _ ____ ____
2. DRY SYSTEM RISER
a. Is the dry valve in service? ............................................................................................ ____ ____ _X _
b. Are the air pressure and priming water level in accordance with the manufacturer’s instructions? .................................................................................................................. ____ ____ _X _
c. Has the operation of the air or nitrogen supply been tested? (Less than 10 psi/week loss) ____ ____ _X _
Is it in service? .............................................................................................................. ____ ____ _X _
d. Were low points drained and piping blown down during this inspection? .................... ____ ____ _X _
e. Did quick opening devices operate satisfactorily? ........................................................ ____ ____ _X _
f. Time required for water to be delivered to remote inspectors test connection ............... __________________
g. Did the dry valve trip properly during the trip pressure test? ....................................... ____ ____ _X _
h. Did the heating equipment in the dry-pipe valve room operate properly at the time of inspection? .................................................................................................................... ____ ____ _X _
i. Date dry-pipe valve trip tested (control valve partially open). (see “Control Valve Mainte-nance Table”)
j. Date dry-pipe valve trip tested (control valve completely open). (see “Control Valve Main-tenance Table”) ............................................................................................................. X
k. Date quick-opening device tested. (see “Control Valve Maintenance Table”) .............. X
a. With 500 GPM flowing at highest outlet, what was the PSI at that outlet? .................. X
7. SPECIAL SYSTEMS
a. Did the deluge or pre-action valves operate properly during testing? ........................... ____ ____ _X _
b. Did the heat responsive, smoke, or other initiation devices operate during testing? ..... ____ ____ _X _
c. Did the supervisory devices operate during testing? ..................................................... ____ ____ _X _
e. For antifreeze systems, have antifreeze solutions been tested and found acceptable? .. ____ ____ _X _
For each sprinkler system, an individual riser reporting form shall be attached for each riser found within the system.
Multiple individual risers found within one system might include, as an example, two wet risers and one dry pipe riser.
___South end of hospital 1st thru 8th floors flows and tampers
1. WET SYSTEM RISER YES NO NA
a. Are all valves and piping protected from freezing? ...................................................... _X _ ____ ____
b. Is this wet system equipped with a remote inspector’s test valve? ................................. _X _ ____
c. Was water flowed through this remote inspector’s test? ................................................. _X _ ____ ____
2. DRY SYSTEM RISER
a. Is the dry valve in service? ............................................................................................ ____ ____ _X _
b. Are the air pressure and priming water level in accordance with the manufacturer’s instructions? .................................................................................................................. ____ ____ _X _
c. Has the operation of the air or nitrogen supply been tested? (Less than 10 psi/week loss) ____ ____ _X _
Is it in service? .............................................................................................................. ____ ____ _X _
d. Were low points drained and piping blown down during this inspection? .................... ____ ____ _X _
e. Did quick opening devices operate satisfactorily? ........................................................ ____ ____ _X _
f. Time required for water to be delivered to remote inspectors test connection ............... __________________
g. Did the dry valve trip properly during the trip pressure test? ....................................... ____ ____ _X _
h. Did the heating equipment in the dry-pipe valve room operate properly at the time of inspection? .................................................................................................................... ____ ____ _X _
i. Date dry-pipe valve trip tested (control valve partially open). (see “Control Valve Mainte-nance Table”)
j. Date dry-pipe valve trip tested (control valve completely open). (see “Control Valve Main-tenance Table”) ............................................................................................................. X
k. Date quick-opening device tested. (see “Control Valve Maintenance Table”) .............. X
a. With 500 GPM flowing at highest outlet, what was the PSI at that outlet? .................. X
8. SPECIAL SYSTEMS
a. Did the deluge or pre-action valves operate properly during testing? ........................... ____ ____ _X _
b. Did the heat responsive, smoke, or other initiation devices operate during testing? ..... ____ ____ _X _
c. Did the supervisory devices operate during testing? ..................................................... ____ ____ _X _
e. For antifreeze systems, have antifreeze solutions been tested and found acceptable? .. ____ ____ _X _
For each sprinkler system, an individual riser reporting form shall be attached for each riser found within the system.
Multiple individual risers found within one system might include, as an example, two wet risers and one dry pipe riser.
___Basement Areas Northeast end crawl space, food storage room
1. WET SYSTEM RISER YES NO NA
a. Are all valves and piping protected from freezing? ...................................................... _X _ ____ ____
b. Is this wet system equipped with a remote inspector’s test valve? ................................. _X _ ____
c. Was water flowed through this remote inspector’s test? ................................................. _X _ ____ ____
2. DRY SYSTEM RISER
a. Is the dry valve in service? ............................................................................................ ____ ____ _X _
b. Are the air pressure and priming water level in accordance with the manufacturer’s instructions? .................................................................................................................. ____ ____ _X _
c. Has the operation of the air or nitrogen supply been tested? (Less than 10 psi/week loss) ____ ____ _X _
Is it in service? .............................................................................................................. ____ ____ _X _
d. Were low points drained and piping blown down during this inspection? .................... ____ ____ _X _
e. Did quick opening devices operate satisfactorily? ........................................................ ____ ____ _X _
f. Time required for water to be delivered to remote inspectors test connection ............... __________________
g. Did the dry valve trip properly during the trip pressure test? ....................................... ____ ____ _X _
h. Did the heating equipment in the dry-pipe valve room operate properly at the time of inspection? .................................................................................................................... ____ ____ _X _
i. Date dry-pipe valve trip tested (control valve partially open). (see “Control Valve Mainte-nance Table”)
j. Date dry-pipe valve trip tested (control valve completely open). (see “Control Valve Main-tenance Table”) ............................................................................................................. X
k. Date quick-opening device tested. (see “Control Valve Maintenance Table”) .............. X
a. With 500 GPM flowing at highest outlet, what was the PSI at that outlet? .................. X
9. SPECIAL SYSTEMS
a. Did the deluge or pre-action valves operate properly during testing? ........................... ____ ____ _X _
b. Did the heat responsive, smoke, or other initiation devices operate during testing? ..... ____ ____ _X _
c. Did the supervisory devices operate during testing? ..................................................... ____ ____ _X _
d. Date deluge or pre-action valve tested. (see “Control Valve Maintenance Table”) ...... X
e. For antifreeze systems, have antifreeze solutions been tested and found acceptable? .. ____ ____ _X _
INSPECTOR’S COMMENTS AND INSPECTION CERTIFICATION
1. Explain any “NO” answers and comments NONE
2. Adjustments or corrections made during this inspection. NONE
3. Although these comments are not the result of an engineering review, the following desirable improvements are recommended:
This is to certify that this automatic sprinkler system has been inspected in accordance with the standards adopted by the Washington State Fire Marshal, Spokane Fire Department, and NFPA Standards 13, 13A, and 25.
Name of inspecting firm
Fire Sprinkler Contractor License. # Expiration date On File
Mailing address
IT IS MANDATORY THAT THIS SECTION BE COMPLETED
All fire sprinkler systems are presumed and required to be fully operational and maintained at all times. Fire sprinkler system deficiencies and malfunctions are the responsibility of the building/property owner and shall be repaired immediately.
WERE ANY/ALL DEFICIENCIES CORRECTED? ___ YES ___ NO _X_ N/A EXPLAIN:
NO DEFICIENCIES
HAS THIS SYSTEM PASSED IN ACCORDANCE WITH STANDARDS ADOPTED BY THE WASHINGTON STATE FIRE MARSHAL, SPOKANE FIRE DEPARTMENT, AND N.F.P.A. STANDARDS 13, 13a, AND 25?
_X _ YES ___ NO IF “NO,” EXPLAIN ABOVE.
Date 4/6/2024.
Name of Facility VA Hospital
Building Name or No. Bldg. # 12 Type of Occupancy Nursing Home
Address 4815 N Assembly City Spokane ZIP 99205
Telephone Dir./Adm. Conferred with Brad
Date 4/6/2024
Type of systems being tested: [ ] Dry sprinkler system [ ] Preaction
[ ] Wet – Partial Coverage [ ] Combination (Sprinkler and Standpipe - common riser) [ ] Other
PORTION OF A BUILDING, AND STEMS FROM A BACKFLOW PREVENTER ASSEMBLY.
NOTE TO OWNER / OCCUPANT:
All fire sprinkler systems are presumed and required to be fully operational and maintained at all times.
Fire sprinkler system deficiencies and malfunctions are the responsibility of the building/property owner
4. Is the building currently occupied? YES _X__ NO ____ Are all sprinkler systems in service? YES _X__ NO ____
a. Was the fire department connection check valve cleaned and back flushed from check valve to FDC? ............................................................................................................... ____ _X _ ____
b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight? ....................................................................................... _X _ ____ ____
c. Are fire pumps, gravity tanks, reservoirs, and pressure tanks in good condition and properly maintained? .................................................................................................... _X _ ____ __
d. Are the fire department connections accessible and visible? ........................................ _X _ ____ ____
e. Was the backflow preventer properly flushed, tested, and maintained? ....................... ____ ____ _X _
5. PIPING, HANGERS AND BRACING
a. Does this system utilize any thin-wall piping? .......... Type?____________________ ____ _X _
b. Are all hangers, brackets, and bracing properly secured and connected? ...................... _X _ ____
c. Does the exterior condition of the sprinkler system appear satisfactory? .................... _X _ ____
d. Was the piping flushing procedure conducted as per NFPA 25 ? ................................ ____ ____ _X _ (every 5 years or more often as necessary)
a. Did water motor and gong test satisfactorily? ............................................................... ____ ____ _X _
b. Did electric alarm test satisfactorily? ............................................................................ _X___ _ _ ____
c. Did supervisory alarm test satisfactorily? ..................................................................... _X _ ____ ____
7. SPRINKLER HEADS (number of heads ___APP 300________)
a. Are all sprinklers free from corrosion, damage, or obstruction to spray discharge? ..... _X _ ____ ____
b. Are heads installed in the proper orientation? ................................................................. _X _ ____ ____
c. Are standard sprinkler heads less than 50 years old, QR heads less than 20 years? ..... _X _ ____ ____
d. Is appropriate stock of sprinkler heads available? ........................................................ _ X_ ____ ____
e. Are sprinkler temperature ratings appropriate for their locations? ............................... _X _ ____ ____
c. Number of devices _________ Type_______________________ Test Results _________________________________
For each sprinkler system, an individual riser reporting form shall be attached for each riser found within the system.
Multiple individual risers found within one system might include, as an example, two wet risers and one dry pipe riser.
_____MECH BOILER ROOM ON NORTHSIDE OF BLDG, CLOSET BY FRONT DESK, JANITORS CLOSET ON SOUTHWEST
OF FRONT DESK, IN PENTHOUSE, AND ABOVE CEILING IN ROOM 109 LOCKER ROOM ____
1. WET SYSTEM RISER YES NO NA
a. Are all valves and piping protected from freezing ? ..................................................... _X _ ____ ____
b. Is this wet system equipped with a remote inspector’s test valve? ................................. _X _ ____
c. Was water flowed through this remote inspector’s test? ................................................. _X _ ____ ____
2. DRY SYSTEM RISER
a. Is the dry valve in service? ............................................................................................ ____ ____ _X _
b. Are the air pressure and priming water level in accordance with the manufacturer’s instructions? .................................................................................................................. ____ ____ _X _
c. Has the operation of the air or nitrogen supply been tested? (less than 10 psi/week loss) ____ ____ _X _
Is it in service? .............................................................................................................. ____ ____ _X _
d. Were low points drained and piping blown down during this inspection? .................... ____ ____ _X _
e. Did quick opening devices operate satisfactorily? ........................................................ ____ ____ _X _
f. Time required for water to be delivered to remote inspectors test connection ............... ______________ X__
g. Did the dry valve trip properly during the trip pressure test? ....................................... ____ ____ _X _
h. Did the heating equipment in the dry-pipe valve room operate properly at the time of inspection? .................................................................................................................... ____ ____ _X _
i. Date dry-pipe valve trip tested (control valve partially open). (see “Control Valve Mainte-nance Table”) ................................................................................................................ X
j. Date dry-pipe valve trip tested (control valve completely open). (see “Control Valve Main-tenance Table”) ............................................................................................................. X
k. Date quick-opening device tested. (see “Control Valve Maintenance Table”) .............. X
a. With 500 GPM flowing at highest outlet, what was the PSI at that outlet? .................. X
a. Did the deluge or pre-action valves operate properly during testing? ........................... ____ ____ _X _
b. Did the heat responsive, smoke, or other initiation devices operate during testing? ..... ____ ____ _X _
c. Did the supervisory devices operate during testing? ..................................................... ____ ____ _X _
d. Date deluge or pre-action valve tested. (see “Control Valve Maintenance Table”) ..... X
e. For antifreeze systems, have antifreeze solutions been tested and found acceptable? .. ____ ____ _X _
1. Explain any “NO” answers and comments.
2. Adjustments or corrections made during this inspection. none
3. Although these comments are not the result of an engineering review, the following desirable improvements are recommended:
THE FDC WAS HYDRO TESTED PER NFPA 25 ON 7/22/2020
This is to certify that this automatic sprinkler system has been inspected in accordance with the standards adopted
IT IS MANDATORY THAT THIS SECTION BE COMPLETED
All fire sprinkler systems are presumed and required to be fully operational and maintained at all times. Fire sprinkler system deficiencies and malfunctions are the responsibility of the building/property owner and shall be repaired immediately.
WERE ANY/ALL DEFICIENCIES CORRECTED? _X__ YES ___ NO N/A EXPLAIN:
_X_ YES ___ NO IF “NO,” EXPLAIN ABOVE.
Name of Facility VA Hospital
Building Name or No. Laundry Bldg #2 Type of Occupancy Laundry Plant
Address 4815 N Assembly City Spokane ZIP 99208
Telephone Dir./Adm. Conferred with Brad
Type of systems being tested: [ ] Dry sprinkler system [ ] Preaction
[ ] Wet – Partial Coverage [ ] Combination (Sprinkler and Standpipe - common riser) [ ] Other
PORTION OF A BUILDING, AND STEMS FROM A BACKFLOW PREVENTER ASSEMBLY.
NOTE TO OWNER / OCCUPANT:
All fire sprinkler systems are presumed and required to be fully operational and maintained at all times.
Fire sprinkler system deficiencies and malfunctions are the responsibility of the building/property owner
4. Is the building currently occupied? YES _X__ NO ____ Are all sprinkler systems in service? YES _X__ NO ____
a. Was the fire department connection check valve cleaned and back flushed from check valve to FDC? ............................................................................................................... ____ _X _ ____
b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight? ....................................................................................... _X _ ____ ____
c. Are fire pumps, gravity tanks, reservoirs, and pressure tanks in good condition and properly maintained? .................................................................................................... _X _ ____ ____
d. Are the fire department connections accessible and visible? ........................................ _X _ ____ ____
e. Was the backflow preventer properly flushed, tested, and maintained? ....................... ____ ____ _X _
b. Are all hangers, brackets, and bracing properly secured and connected? ...................... _X _ ____
c. Does the exterior condition of the sprinkler system appear satisfactory? .................... _X _ ____
d. Was the piping flushing procedure conducted as per NFPA 25 ? ................................ ____ _X _ ____
a. Did water motor and gong test satisfactorily? ............................................................... ____ ____ _X _
b. Did electric alarm test satisfactorily? ............................................................................ _X _ ____ ____
c. Did supervisory alarm test satisfactorily? ..................................................................... _X _ ____ ____
7. SPRINKLER HEADS (number of heads ___APP 75_______)
a. Are all sprinklers free from corrosion, damage, or obstruction to spray discharge? ..... _X _ ____ ____
b. Are heads installed in the proper orientation? ................................................................. _X _ ____ ____
c. Are standard sprinkler heads less than 50 years old, QR heads less than 20 years? ..... _X _ ____ ____
d. Is appropriate stock of sprinkler heads available? ........................................................ _ X_ ____ ____
e. Are sprinkler temperature ratings appropriate for their locations? ............................... _X _ ____ ____
c. Number of devices _________ Type_______________________ Test Results _________________________________
For each sprinkler system, an individual riser reporting form shall be attached for each riser found within the system.
Multiple individual risers found within one system might include, as an example, two wet risers and one dry pipe riser.
_____North end of Laundry Building
1. WET SYSTEM RISER YES NO NA
a. Are all valves and piping protected from freezing ? ..................................................... _X _ ____ ____
b. Is this wet system equipped with a remote inspector’s test valve? ................................. _X _ ____
c. Was water flowed through this remote inspector’s test? ................................................. _X _ ____ ____
2. DRY SYSTEM RISER
a. Is the dry valve in service? ............................................................................................ ____ ____ _X _
b. Are the air pressure and priming water level in accordance with the manufacturer’s instructions? .................................................................................................................. ____ ____ _X _
c. Has the operation of the air or nitrogen supply been tested? (less than 10 psi/week loss) ____ ____ _X _
Is it in service? .............................................................................................................. ____ ____ _X _
d. Were low points drained and piping blown down during this inspection? .................... ____ ____ _X _
e. Did quick opening devices operate satisfactorily? ........................................................ ____ ____ _X _
f. Time required for water to be delivered to remote inspectors test connection ............... __________________
g. Did the dry valve trip properly during the trip pressure test? ........................................ ____ ____ _X _
h. Did the heating equipment in the dry-pipe valve room operate properly at the time of inspection? .................................................................................................................... ____ ____ _X _
i. Date dry-pipe valve trip tested (control valve partially open). (see “Control Valve Mainte-nance Table”) ................................................................................................................ X
j. Date dry-pipe valve trip tested (control valve completely open). (see “Control Valve Main-tenance Table”) ............................................................................................................. X
k. Date quick-opening device tested. (see “Control Valve Maintenance Table”) .............. X
a. With 500 GPM flowing at highest outlet, what was the PSI at that outlet? .................. X
a. Did the deluge or pre-action valves operate properly during testing? ........................... ____ ____ _X _
b. Did the heat responsive, smoke, or other initiation devices operate during testing? ..... ____ ____ _X _
c. Did the supervisory devices operate during testing? ..................................................... ____ ____ _X _
e. For antifreeze systems, have antifreeze solutions been tested and found acceptable? .. ____ ____ _X _
1. Explain any “NO” answers and comments. NONE
2. Adjustments or corrections made during this inspection. none
3. Although these comments are not the result of an engineering review, the following desirable improvements are recommended:
This is to certify that this automatic sprinkler system has been inspected in accordance with the standards adopted
IT IS MANDATORY THAT THIS SECTION BE COMPLETED
All fire sprinkler systems are presumed and required to be fully operational and maintained at all times. Fire sprinkler system deficiencies and malfunctions are the responsibility of the building/property owner and shall be repaired immediately.
WERE ANY/ALL DEFICIENCIES CORRECTED? ___ YES ___ NO _X _ N/A EXPLAIN:
_ X_ YES ___ NO IF “NO,” EXPLAIN ABOVE.
a. Was the fire department connection check valve cleaned and back flushed from check valve to FDC? ............................................................................................................... ____ _X__ ____
b. Are fire department connections in satisfactory condition, couplings free, caps in place, and check valves tight? ....................................................................................... _X__ ____ ____
c. Are fire pumps, gravity tanks, reservoirs, and pressure tanks in good condition and properly maintained? .................................................................................................... ___ ____ _X_
d. Are the fire department connections accessible and visible? ........................................ _X__ ____ ____
e. Was the backflow preventer properly flushed, tested, and maintained? ....................... ____ ____ _X_
a. Does this system utilize any thin-wall piping? .......... Type?____________________ ____ _X__
b. Are all hangers, brackets, and bracing properly secured and connected? ...................... _X__ ____
c. Does the exterior condition of the sprinkler system appear satisfactory? .................... _X__ ____
d. Was the piping flushing procedure conducted as per NFPA 25? ................................. ____ ____ _X_
a. Did water motor and gong test satisfactorily? ............................................................... _X__ ____ _
b. Did electric alarm test satisfactorily? .............................................................................. _X__ ____ ____
c. Did supervisory alarm test satisfactorily? ..................................................................... _X__ ____ ____
7. SPRINKLER HEADS (number of heads 100+_______)
a. Are all sprinklers free from corrosion, damage, or obstruction to spray discharge? ..... _X__ ____ ____
b. Are heads installed in the proper orientation? ................................................................. _X__ ____ ____
c. Are standard sprinkler heads less than 50 years old, QR heads less than 20 years? ..... _X__ ____ ____
d. Is appropriate stock of sprinkler heads available? ........................................................ _X__ ____ ____
e. Are sprinkler temperature ratings appropriate for their locations? ............................... _X__ ____ ____
a. Test Method
b. Type of Equipment N/A
c. Number of devices _________ Type_______________________ Test Results _________________________________
For each sprinkler system, an individual riser reporting form shall be attached for each riser found within the system.
Multiple individual risers found within one system might include, as an example, two wet risers and one dry pipe riser.
In Front west office
1. WET SYSTEM RISER YES NO NA
a. Are all valves and piping protected from freezing ? ..................................................... _X__ ____ ____
b. Is this wet system equipped with a remote inspector’s test valve? ................................. _X__ ____
c. Was water flowed through this remote inspector’s test? ................................................. _X__ ____ ____
2. DRY SYSTEM RISER
a. Is the dry valve in service? ............................................................................................ _X__ ____ _ _
b. Are the air pressure and priming water level in accordance with the manufacturer’s instructions? .................................................................................................................. _X__ ____ _
c. Has the operation of the air or nitrogen supply been tested? (less than 10 psi/week loss) _X__ ____ _ _
Is it in service? .............................................................................................................. _X__ ____ _ _
d. Were low points drained and piping blown down during this inspection? .................... _X__ ____ _
e. Did quick opening devices operate satisfactorily? ........................................................ ____ ____ _X_
f. Time required for water to be delivered to remote inspectors test connection ............... _______________X_
g. Did the dry valve trip properly during the trip pressure test? ........................................ _X__ ____ _ _
h. Did the heating equipment in the dry-pipe valve room operate properly at the time of inspection? .................................................................................................................... _X__ ____ _ _
i. Date dry-pipe valve trip tested (control valve partially open). (see “Control Valve Mainte-nance Table”) ................................................................................................................ 4/6/2024
j. Date dry-pipe valve trip tested (control valve completely open). (see “Control Valve Main-tenance Table”)
k. Date quick-opening device tested. (see “Control Valve Maintenance Table”) .............. X
a. With 500 GPM flowing at highest outlet, what was the PSI at that outlet? .................. X
a. Did the deluge or pre-action valves operate properly during testing? ........................... ____ ____ _X_
b. Did the heat responsive, smoke, or other initiation devices operate during testing? ..... ____ ____ _X_
c. Did the supervisory devices operate during testing? ..................................................... ____ ____ _X_
e. For antifreeze systems, have antifreeze solutions been tested and found acceptable? .. ____ ____ _X_
3. Although these comments are not the result of an engineering review, the following desirable improvements are recommended:
This is to certify that this automatic sprinkler system has been inspected in accordance with the standards adopted
IT IS MANDATORY…
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