MPD Bldg 352 Annual Device Testing - April 2025.rtf

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

MP Bldg 352

795 Willow Rd

Menlo Park, CA 94025

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 Apr 23, 2025 Building: MP Bldg 352 Company: Facility - Palo Alto VA Contact: Anthony Losito Contact: Olaf Soto Title: Electronics Shop Supervisor Title: Inspector

Facility - Palo Alto VA

Download Date: 04/24/2025

Executive Summary Generated by: BuildingReports.com

Building Information Building: MP Bldg 352 Contact: Anthony Losito Address: 795 Willow Rd Phone: 650-852-3437 Address:

Fax:

City/State/ZIP Code: Menlo Park, CA 94025 Mobile:

Country: United States of America Email:

Inspection Performed By Company: Facility - Palo Alto VA Inspector: Olaf Soto 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: olaf@redwoodcityalarms.com

System Control Unit Manufacturer: SimplexGrinnell Inspection Date: 04/23/2025 IDC Style:

Model Number: 4100 Install Date: 05/17/2017 SLC Style:

Software Version:

Version Date: 05/17/2017 NAC Style:

Location: 1st East Emergency Exit Current Protection:

Inspection Completion Date: Apr 23, 2025 Building: MP Bldg 352

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 Duct Detector Heat Detector 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 Releasing Device Speaker Strobe

EC 02.03.05 EP 19

Annual test of automatic smoke-detection shutdown devices for air-handling equipment. NFPA 90A (2024) 6.4.1 Devices Tested This Quarter Pass Fail Tested YTD (2025) Untested YTD (2025) Total Quantity Duct Detector

LS 02.01.34 EP 02

Protected master fire alarm control panel Devices Tested This Quarter Pass Fail Tested YTD (2025) Untested YTD (2025) Total Quantity Control Panel

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 Battery

LS 02.01.50 EP 07

Annual - Elevators are fully equipped and protected Devices Tested This Quarter Pass Fail Tested YTD (2025) Untested YTD (2025) Total Quantity Elevator Total Device Count: 72

Certification Company: Facility - Palo Alto VA Building: MP Bldg 352 Inspector: Olaf Soto Contact: Anthony Losito file_0.jpg

Signed: Apr 23, 2025 Signed:

Inspection & Testing

Building: MP Bldg 352 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 Q3/24 Q2/25 Tamper Switch 1st Elevator Control Room 12604247 05/28-P

04/23-P Tamper Switch 1st Outside 12604244 05/28-P

04/23-P Tamper Switch 1st Inside Mechanical Room 12603841 05/28-P

04/23-P Tamper Switch 1st Inside Mechanical Room 12603819 05/28-P

04/23-P Tamper Switch 1st Inside Mechanical Room 12603818 05/28-P

04/23-P Tamper Switch 2nd Closet Room 216 12603859 05/28-P

04/23-P Device Total: 6

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 Q3/24 Q2/25 Waterflow Switch 1st Inside Mechanical Room 12603861 05/28-P

04/23-P Waterflow Switch 2nd Closet Room 216 12603860 05/28-P

04/23-P Device Total: 2

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 duct smoke detectors that use sampling tubes to ensure that they will properly sample the airstream in the duct using a method acceptable to the manufacturer or in accordance with their published instructions. (NFPA 72-22 Table 14.4.3.2 (17)(7)(e)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Duct Detector

Device Type Location ScanID Address Q2/24 Q3/24 Q2/25 Duct Detector Roof ON AHU-SF1 MOUNTED OUTSIDE UNIT 45205267 05/20-P

04/23-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) Restorable: Perform heat test with a listed and labeled heat source or in accordance with the manufacturer's published instructions. Non-Restorable: Do not perform heat test. Test functionality mechanically and electrically. (NFPA 72-22 Table 14.4.3.2 (17)(4)(a)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Heat Detector

Device Type Location ScanID Address Q2/24 Q3/24 Q2/25 Heat Detector 1st Inside Mechanical Room 45205001 05/20-P

04/23-P Heat Detector 1st Kitchen 106 12603864 05/20-P

04/23-P Heat Detector 2nd SHAFT ELEVATOR SHAFT 45205277 05/20-P

04/23-P Device Total: 3

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 Q3/24 Q2/25 Pull Station 1st Electrical Room 45205002 05/20-P

04/23-P Pull Station 1st Main Lobby Entrance 12604236 05/20-P

04/23-P Pull Station 1st South Emergency Exit 12603862 05/20-P

04/23-P Pull Station 1st East Emergency Exit 12603823 05/20-P

04/23-P Pull Station 2nd Corridor 203 45211158 05/20-P

04/23-P Pull Station 2nd Entrance To Stairwell Outside RM 211 12603888 05/20-P

04/23-P Pull Station 2nd Corridor 220 12603856 05/20-P

04/23-P Device Total: 7

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 Q3/24 Q2/25 Smoke Detector 1st Elevator Control Room 45210373 05/20-P

04/23-P Smoke Detector 1st South Wing Ceiling Main Day Room 12604241 05/20-P

04/23-P Smoke Detector 1st South Wing Outside RM 101D 12603865 05/20-P

04/23-P Smoke Detector 1st Main Lobby Above Stair Entrance 12603853 05/20-P

04/23-P Smoke Detector 1st Main Lobby Above Elevator 12603852 05/20-P

04/23-P Smoke Detector 1st Main Lobby Entrance To East Wing 12603850 05/20-P

04/23-P Smoke Detector 1st South Wing Outside RM 111 12603849 05/20-P

04/23-P Smoke Detector 1st Main Lobby Entrance To South Wing 12603848 05/20-P

04/23-P Smoke Detector 1st East Wing Outside RM 117 12603845 05/20-P

04/23-P Smoke Detector 2nd SHAFT ELEVATOR SHAFT 45205276 05/20-P

04/23-P Smoke Detector 2nd East Wing Outside RM 213 12603893 05/20-P

04/23-P Smoke Detector 2nd Corridor 211 12603884 05/20-P

04/23-P Smoke Detector 2nd Corridor 213 12603882 05/20-P

04/23-P Smoke Detector 2nd Entrance to Stairwell Outside RM 211 12603881 05/20-P

04/23-P Device Total: 14

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) Test interface equipment connections by operating or simulating the equipment being supervised. Verify signals required to be transmitted are received at the control unit. (NFPA 72-22 Table 14.4.3.2 (20)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Releasing Device

Device Type Location ScanID Address Q2/24 Q3/24 Q2/25 Releasing Device 1st Double Doors To South Wing 12604238 05/20-P

04/23-P Releasing Device 1st Entrance To Stairwell 12604235 05/20-P

04/23-P Releasing Device 1st Double Doors To South Wing 12603871 05/20-P

04/23-P Releasing Device 1st Double Doors To East Wing 12603847 05/20-P

04/23-P Releasing Device 1st Double Doors To East Wing 12603846 05/20-P

04/23-P Releasing Device 2nd Double Doors To East Wing 12604246 05/20-P

04/23-P Releasing Device 2nd Double Doors To East Wing 12604245 05/20-P

04/23-P Releasing Device 2nd Stairwell 12603890 05/20-P

04/23-P Device Total: 8

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

Device Type Location ScanID Address Q2/24 Q3/24 Q2/25 Speaker 1st Main Lobby Ceiling 45205000 05/20-P

04/23-P Speaker 1st South Wing Outside RM 109 12603869 05/20-P

04/23-P Speaker 1st South Wing Outside RM 106 12603868 05/20-P

04/23-P Speaker 1st South Wing Ceiling Main Day Room 12603866 05/20-P

04/23-P Speaker 1st East Wing Outside RM 118 12603844 05/20-P

04/23-P Speaker 1st East Wing Outside RM 132 12603821 05/20-P

04/23-P Speaker 1st East Wing Outside RM 125 12603820 05/20-P

04/23-P Speaker 2nd Corridor 216 12603898 05/20-P

04/23-P Speaker 2nd East Wing Outside Room 213 12603892 05/20-P

04/23-P Speaker 2nd Corridor 219 12603891 05/20-P

04/23-P Speaker 2nd Corridor 204 12603887 05/20-P

04/23-P Speaker 2nd Corridor 206 12603886 05/20-P

04/23-P Speaker 2nd Corridor 211 12603883 05/20-P

04/23-P Device Total: 13

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 that each appliance flashes. (NFPA 72-22 Table 14.4.3.2 (22)(3)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Strobe

Device Type Location ScanID Address Q2/24 Q3/24 Q2/25 Strobe 1st South Wing Main Day Room 12604239 05/20-P

04/23-P Strobe 1st Main Lobby Entrance 12604237 05/20-P

04/23-P Strobe 1st South Emergency Exit 12603863 05/20-P

04/23-P Strobe 1st South Wing Outside RM 108 12603854 05/20-P

04/23-P Strobe 1st East Emergency Exit 12603822 05/20-P

04/23-P Strobe 2nd Stairwell To 1st Floor Outside RM 211 12603889 05/20-P

04/23-P Strobe 2nd Corridor 206 12603885 05/20-P

04/23-P Strobe 2nd Corridor 203 12603879 05/20-P

04/23-P Strobe 2nd Corridor 214 12603858 05/20-P

04/23-P Strobe 2nd Corridor 220 12603855 05/20-P

04/23-P Device Total: 10

EC 02.03.05 EP 19

Annual test of automatic smoke-detection shutdown devices for air-handling equipment. NFPA 90A (2024) 6.4.1 Test duct smoke detectors that use sampling tubes to ensure that they will properly sample the airstream in the duct using a method acceptable to the manufacturer or in accordance with their published instructions. (NFPA 72-22 Table 14.4.3.2 (17)(7)(e)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Duct Detector

Device Type Location ScanID Address Q2/24 Q3/24 Q2/25 Duct Detector Roof ON AHU-SF1 MOUNTED OUTSIDE UNIT 45205267 05/20-P

04/23-P Device Total: 1

LS 02.01.34 EP 02

Protected master fire alarm control panel Verify correct receipt of alarm, supervisory and trouble signals (inputs), operation of evacuation signals and auxiliary functions (outputs), circuit supervision including detection of open circuits and ground faults, and power supply supervision for detection of loss of ac power and disconnection of secondary batteries. (NFPA 72-22 Table 14.4.3.2 (2)(1)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Control Panel

Device Type Location ScanID Address Q2/24 Q3/24 Q2/25 Control Panel 1st East Emergency Exit 12603825 05/20-P

04/23-P Device Total: 1

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 Q3/24 Q2/25 Annunciator 1st East Emergency Exit 12603824 05/20-P

04/23-P Device Total: 1

LS 02.01.34 EP 10

All other Life Safety Code fire alarm requirements related to NFPA 101-2024 18/19.3.4 With the batteries fully charged and connected to the charger, measure the voltage across the batteries with a voltmeter. Then, with the battery charger disconnected, load test the batteries following the manufacturer's recommendations. (NFPA 72-22 Table 14.4.3.2 (9)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Battery

Device Type Location ScanID Address Q2/24 Q3/24 Q2/25 Battery 1st FIRE ALARM CONTROL Room 45210369

08/20-P 04/23-P Battery 1st Fire Alarm control panel Room 45210368

08/20-P 04/23-P Device Total: 2

LS 02.01.50 EP 07

Annual - Elevators are fully equipped and protected Test interface equipment connections by operating or simulating the equipment being supervised. Verify signals required to be transmitted are received at the control unit. (NFPA 72-22 Table 14.4.3.2 (20)) Devices Tested Q2/25 Pass Q2/25 Fail Q2/25 Tested YTD (2025) Total Quantity Elevator

Device Type Location ScanID Address Q2/24 Q3/24 Q2/25 Elevator 1st Elevator Control Room 45210374 05/20-P

04/23-P Elevator 1st Elevator Control Room 45210372 05/20-P

04/23-P Elevator 1st Elevator Control Room 45210371 05/20-P

04/23-P Elevator 1st Elevator Control Room 45210370 05/20-P

04/23-P Device Total: 4

Service Summary

Building: MP Bldg 352 The Service Summary section provides an overview of the services performed in this report.

Device Type Service Quantity Passed Annunciator Tested Battery Tested Control Panel Tested Duct Detector Tested Elevator Tested Heat Detector Tested Pull Station Tested Releasing Device Tested Smoke Detector Tested/Cleaned Speaker Tested Strobe Tested Tamper Switch Tested Waterflow Switch Tested Total Grand Total

Auxiliary Functions Testing

Building: MP Bldg 352 Control Panel: 0 - SimplexGrinnell 4100 The Auxiliary Functions Testing section lists each of the ancillary items, systems, and emergency equipment that are controlled by the system control unit. Items are grouped by Passed or Failed/Other. The items are listed by device type, and a check box is provided to indicate if the test conducted was simulated.

Type Location Comment ScanID Simulated Passed Elevator

1st Elevator Control Room Passed 45210370

1st Elevator Control Room Passed 45210371

1st Elevator Control Room Passed 45210372

1st Elevator Control Room Passed 45210374 Releasing Device

1st Double Doors To East Wing Passed 12603846

1st Double Doors To East Wing Passed 12603847

1st Double Doors To South Wing Passed 12603871

1st Double Doors To South Wing Passed 12604238

1st Entrance To Stairwell Passed 12604235

2nd Double Doors To East Wing Passed 12604245

2nd Double Doors To East Wing Passed 12604246

2nd Stairwell Passed 12603890

Battery & Power Supply Testing

Building: MP Bldg 352 Control Panel: 0 - SimplexGrinnell 4100 The Battery & Power Supply Testing section details the readings and measurements of batteries and power supplies used to provide power to the fire alarm and life safety systems. Items are grouped by Passed or Failed/Other.

Battery Type Location Rated Ah Rated Volts Pre Test Post Test Min Ah Tested Ah Passed Sealed Lead Acid 1st FIRE ALARM CONTROL Room

35-NB

Sealed Lead Acid 1st Fire Alarm control panel Room

35-NB

Inventory & Warranty Report

Building: MP Bldg 352 Control Panel: 0 - SimplexGrinnell 4100 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 1.39% Battery Control 2.78% Control Panel Control 1.39% Duct Detector Initiating 1.39% Elevator Auxiliary 5.56% Heat Detector Initiating 4.17% Pull Station Initiating 9.72% Releasing Device Auxiliary 11.11% Smoke Detector Initiating 19.44% Speaker Indicating 18.06% Strobe Indicating 13.89% Tamper Switch Supervisory 8.33% Waterflow Switch Initiating 2.78%

Type Qty Model # Description Install Date In Service - 3 Years to 5 Years Power-Sonic Battery

PS-12350-NB

Sealed Lead Acid 05/14/2020 In Service - 5 Years to 10 Years

SIMPLEX

Duct Detector

SIMPLEX

05/16/2018 Aleum Company Tamper Switch

BFG

10/16/2017 Tamper Switch

BFG

05/17/2017 Potter Electric Tamper Switch

OSYSU-2

05/17/2017 Pyrotronics Heat Detector

EZDT

05/17/2017 Heat Detector

FT-200-F

05/17/2017 Simplex Heat Detector

FT-200-F

05/17/2017 SimplexGrinnell Annunciator

05/17/2017 Control Panel

05/17/2017 Elevator

05/17/2017 Pull Station 2088-97-68

05/17/2017 Pull Station 2099-9768

05/17/2017 Releasing Device

Releasing Device 4902-9707

05/17/2017 Smoke Detector 2098-9201

05/17/2017 Smoke Detector 298-9021

05/17/2017 Smoke Detector 298-9201

05/17/2017 Speaker 12603821

05/17/2017 Speaker 4902-9607

05/17/2017 Speaker 4902-9707

05/17/2017 Strobe

Strobe

LSM-24-VFR

05/17/2017 System Sensor Tamper Switch

OSY2

05/17/2017 Tamper Switch

PIBV2

05/17/2017 Waterflow Switch

WFD40