LVD Bldg 62C Annual Device Testing - April 2025.rtf

Fire/Life Safety System Inspection, Testing and/or Maintenance Certificate For

LV62C

4951 Arroyo Rad

Livermore, CA 94550

This inspection was performed in accordance with NFPA 101, EDITION 2024, LIFE SAFETY CODE, NFPA 72, EDITION 2022, FIRE ALARM SYSTEMS and NFPA 90A, EDITION 2022, AIR CONDITIONING/VENTILATING SYSTEMS.

This inspection and testing service has been performed in compliance with The Joint Commission/VHA Standards. The inspection/testing frequencies adhered to for this service have been performed in accordance with the latest Joint Commission/VHA Clarification Memorandum on EC & LS Standards.

Annual Inspection Inspection Completion Date May 27, 2025 Building: LV62C Company: scDataCom Contact: Doug Gambrell Contact: Lara Gianmarkho Title: Manager Title: Fire Alarm Technician scDataCom

Download Date: 05/28/2025

Executive Summary Generated by: BuildingReports.com

Building Information Building: LV62C Contact: Doug Gambrell Address: 4951 Arroyo Rad Phone: 4403192479 Address:

Fax:

City/State/ZIP Code: Livermore, CA 94550 Mobile:

Country: United States of America Email: d.gambrell@scdatacom.net

Inspection Performed By Company: scDataCom Inspector: Lara Gianmarkho Address: 2700 Gregory St Ste 180 Phone: 650-362-4841 Address:

Fax:

City/State/ZIP Code: Savannah, GA 31404 Mobile:

Country: United States of America Email: gmarko@redwoodcityalarms.com

Inspection Completion Date: May 27, 2025 Building: LV62C

EC 02.03.05 EP 02

Semi-annual testing of water flow devices and valve tamper switches. NFPA 72 (2022) Table 14.4.3.2 (17)(10)(a) & (17)(11) Devices Tested This Quarter Pass Fail Tested YTD (2025) Untested YTD (2025) Total Quantity Tamper Switch Waterflow Switch

EC 02.03.05 EP 03

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors. NFPA 72 (2022) Table 14.4.3.2 (17) Devices Tested This Quarter Pass Fail Tested YTD (2025) Untested YTD (2025) Total Quantity Pull Station Smoke Detector

EC 02.03.05 EP 04

Annual test of visual and audible fire alarms, including speakers and door releasing devices. NFPA 72 (2022) Table 14.4.3.2 (22) Devices Tested This Quarter Pass Fail Tested YTD (2025) Untested YTD (2025) Total Quantity Speaker/Strobe

LS 02.01.34 EP 10

All other Life Safety Code fire alarm requirements related to NFPA 101-2024 18/19.3.4 Devices Tested This Quarter Pass Fail Tested YTD (2025) Untested YTD (2025) Total Quantity Annunciator Total Device Count: 18

Certification Company: scDataCom Building: LV62C Inspector: Lara Gianmarkho Contact: Doug Gambrell

Inspection & Testing

Building: LV62C The Inspection & Testing section lists all of the items inspected in your building, which are then categorized by the applicable code reference. The most recent inspection is listed in the far right column and is based on the Finish Date of that inspection. The latest inspection uploaded in each previous quarter appears in the four columns to the left.

Passed=P, Failed=F, Replaced=R

EC 02.03.05 EP 02

Semi-annual testing of water flow devices and valve tamper switches. NFPA 72 (2022) Table 14.4.3.2 (17)(10)(a) & (17)(11) Operate valve and verify signal receipt shall be verified to be within the first two revolutions of the hand wheel or within one-fifth of the travel distance, or per the manufacturer's published instructions. (NFPA 72-22 Table 14.4.3.2 (17)(10)(a)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Tamper Switch

Device Type Location ScanID Address Q2/24 Q2/25 Tamper Switch 1st at riser outside chiller bldg chiler bldg 10358116 05/21-P 05/27-P Device Total: 1

EC 02.03.05 EP 02

Semi-annual testing of water flow devices and valve tamper switches. NFPA 72 (2022) Table 14.4.3.2 (17)(10)(a) & (17)(11) Water shall be flowed through an inspector's test connection indicating the flow of water equal to that from a single sprinkler of the smallest orifice size installed in the system for wet-pipe systems, or an alarm test bypass connection for dry-pipe, pre-action, or deluge systems in accordance with NFPA 25-20. (NFPA 72-22 Table 14.4.3.2 (17)(11)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Waterflow Switch

Device Type Location ScanID Address Q2/24 Q2/25 Waterflow Switch 1st outside lower level chiller bldg 10358117 05/21-P 05/27-P Device Total: 1

EC 02.03.05 EP 03

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors. NFPA 72 (2022) Table 14.4.3.2 (17) Operate manual fire alarm boxes per the manufacturer's published instructions. Test both key-operated presignal and general alarm manual fire alarm boxes. (NFPA 72-22 Table 14.4.3.2 (17)(5)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Pull Station

Device Type Location ScanID Address Q2/24 Q2/25 Pull Station 62 mech bldg chiller 1163715 04/10-P 05/27-P Pull Station 62 mech bldg chiller 1163716 1-chlr f3 04/10-P 05/27-P Pull Station 62 mech bldg chiller 1163711 1-chlr f3 04/10-P 05/27-P Pull Station 62 mech bldg chiller lower level 1163693 1-chlr f3 04/10-P 05/27-P Pull Station 62 mech bldg lower level chiller 1163700 1-chlr f3 04/10-P 05/27-P Device Total: 5

EC 02.03.05 EP 03

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors. NFPA 72 (2022) Table 14.4.3.2 (17) Test smoke detectors in place to ensure smoke entry into the sensing chamber and an alarm response. (NFPA 72-22 Table 14.4.3.2 (17)(7)(a)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Smoke Detector

Device Type Location ScanID Address Q2/24 Q2/25 Smoke Detector 62 mech bldg chiller 12202506 1-chlr f3 04/10-P 05/27-P Smoke Detector 62 mech bldg chiller 10359007 1-chlr f3 04/10-P 05/27-P Smoke Detector 62 mech bldg chiller lower level 12202508 1-chlr f3 04/10-P 05/27-P Smoke Detector 62 mech bldg chiller lower level 12202507 1-chlr f3 04/10-P 05/27-P Smoke Detector 62 mech bldg chiller lower level 12202505 1-chlr f3 04/10-P 05/27-P Smoke Detector 62 mech bldg chiller lowet level 12202509 1-chlr f3 04/10-P 05/27-P Device Total: 6

EC 02.03.05 EP 04

Annual test of visual and audible fire alarms, including speakers and door releasing devices. NFPA 72 (2022) Table 14.4.3.2 (22) For periodic testing, verify the operation of the notification appliances. (NFPA 72-22 Table 14.4.3.2 (22)(2)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Speaker/Strobe

Device Type Location ScanID Address Q2/24 Q2/25 Speaker/Strobe 62 mech bldg chiller 12202552 04/10-P 05/27-P Speaker/Strobe 62 mech bldg chiller 1163714 04/10-P 05/27-P Speaker/Strobe 62 mech bldg lower level 1163699 04/10-P 05/27-P Speaker/Strobe 62 mech bldg chiller lower level 1163694 1-chlr f3 04/10-P 05/27-P Device Total: 4

LS 02.01.34 EP 10

All other Life Safety Code fire alarm requirements related to NFPA 101-2024 18/19.3.4 Verify the correct operation and identification of annunciators. If provided, verify the correct operation of annunciator under a fault condition. (NFPA 72-22 Table 14.4.3.2 (11)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Annunciator

Device Type Location ScanID Address Q2/24 Q2/25 Annunciator 62 mech bldg chiller 45206034 1-chlr f3 04/10-P 05/27-P Device Total: 1

Service Summary

Building: LV62C The Service Summary section provides an overview of the services performed in this report.

Device Type Service Quantity Passed Annunciator Tested Pull Station Tested Smoke Detector Tested/Cleaned Speaker/Strobe Tested Tamper Switch Tested Waterflow Switch Tested Total Grand Total

Inventory & Warranty Report

Building: LV62C Control Panel: 1 The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Device or Type Category % of Inventory Quantity Annunciator Control 5.56% Pull Station Initiating 27.78% Smoke Detector Initiating 33.33% Speaker/Strobe Indicating 22.22% Tamper Switch Supervisory 5.56% Waterflow Switch Initiating 5.56%

Type Qty Model # Description Install Date In Service - 5 Years to 10 Years Milwaukee Tamper Switch

08/20/2018 Potter Electric Waterflow Switch

08/20/2018

EST

Pull Station siga-272

03/13/2018 Speaker/Strobe

03/13/2018 est Annunciator siga-278

03/13/2018 Pull Station siga-278

03/13/2018 Smoke Detector siga-278

03/13/2018 Speaker/Strobe siga-278

03/13/2018

Zone Address Report

Building: LV62C Control Panel: 1 The Zone Address Report lists all of the devices and items that have an individual address, or are grouped together under a common zone. The device type, location, and description are included for your reference.

Address Device Type Location Type ScanID Zone/Circuit: chlr f3 Annunciator 62 mech bldg chiller

45206034 f3 Pull Station 62 mech bldg chiller

1163711 f3 Pull Station 62 mech bldg chiller

1163716 f3 Smoke Detector 62 mech bldg chiller

10359007 f3 Smoke Detector 62 mech bldg chiller

12202506 f3 Pull Station 62 mech bldg chiller lower level

1163693 f3 Smoke Detector 62 mech bldg chiller lower level

12202505 f3 Smoke Detector 62 mech bldg chiller lower level

12202507 f3 Smoke Detector 62 mech bldg chiller lower level

12202508 f3 Speaker/Strobe 62 mech bldg chiller lower level

1163694 f3 Smoke Detector 62 mech bldg chiller lowet level

12202509 f3 Pull Station 62 mech bldg lower level chiller

1163700