SV2401240151 - 351 E Temple St - ANN FP - 6-12-24_Redacted 8.pdf

TEST SITE INFORMATION

TEST SITE ADDRESS: (STREET) (CITY) (STATE) (ZIP) TEST SITE PHONE:

351 E TEMPLE ST LOS ANGELES CA 90012-3328

OCCUPANCY TYPE: NUMBER OF STORIES: YEAR BUILT: CONSTRUCTION TYPE: SQUARE FOOTAGE:

B - Business 5 1973 Type II 105000

RESPONSIBLE PARTY

NAME: (LAST, FIRST, MI) TITLE: FIRM OR D.B.A.:

HUNT, EDWARD RESPONSIBLE PERSON VA LAACC

MAILING ADDRESS: (STREET) (CITY) (STATE) (ZIP) PHONE:

351 E TEMPLE LOS ANGELES CA 90012 (818) 891-7711

TEST INFORMATION

INITIAL TEST DATE: TESTING AGENCY: PHONE:

06/12/2024

MAILING ADDRESS: (STREET) (CITY) (STATE) (ZIP)

TEST RESULTS

☒ PASS ☐ FAIL

All sections below shall be found in the following pages of this report.

SECTIONS:

I. BUILDING DESCRIPTION

II. SYSTEM DESCRIPTION

III. FINDINGS

IV. TESTING PROCEDURES/WORKSHEETS

I HEREBY CERTIFY THAT THE FIRE PROTECTION EQUIPMENT LISTED ABOVE HAS BEEN FULLY TESTED IN ACCORDANCE WITH THE CHIEF'S REGULATION NO. 4 OF THE LOS ANGELES FIRE CODE AND THAT THE RESULTS ARE ACCURATELY LISTED ABOVE AND THE

EQUIPMENT IS FULLY OPERABLE EXCEPT AS NOTED.

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: SIGNATURE:

LILES, JAMES R4565 12/31/2025

REPAIR AND RETEST: IF DEFECTS ARE FOUND IN EQUIPMENT TESTED, CORRECTION OF SUCH DEFECTS SHALL COMMENCE FORTHWITH AND SHALL BE COMPLETED AS SOON AS

POSSIBLE, BUT IN EVERY CASE WITHIN 30 DAYS OF INITIAL TEST. THE F-340RT SHALL BE USED TO DOCUMENT THE RETEST OF DEFECTS FOUND IN SCTION III. A COPY OF

SECTION III OF THIS REPORT SHALL BE ATTACHED TO THE F-340RT PRIOR TO SUBMITTING TO THE FIRE DEPARTMENT.

REPORT SUBMITTAL INFORMATION:

ALL REPORTS ARE REQUIRED TO BE SUBMITTED TO THE LOS ANGELES CITY FIRE DEPARTMENT VIA THE COMPLIANCE ENGINE

WITHIN 7 DAYS OF TEST COMPLETION.

ENTERED BY: ENTERED DATE: ENTERED TIME:

06/14/2024 7:56 AM

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

Fire Pump - Initial Test

Test Report Number

5892756

TRN 5892756 Printed Tue Jun 11 19:27:15 CDT 2024

Section I - Building Description:

CHARACTERISTICS

PRIMARY OCCUPANCY TYPE B - Business FIRE CONTROL ROOM: ☐YES ☒NO

SECONDARY OCCUPANCY TYPE I-2 ELEVATOR INFORMATION: CARS BANKS

TYPE OF BUSINESS CONDUCTED PASSENGER 4 1

☐ Apartment/Condo ☐ Museum

☐ Bar/Restaurant ☐ Parking Structure

☐ Church ☒ Office Space

☐ Schools ☐ Repair Garage

☐ Day Care ☐ Retail

☐ Detention Facility ☐ Skilled Nursing

☐ Group Home ☐ Telecommunications

☐ Hospital ☐ Theatre

☐ Hotel/Motel ☐ Warehouse

☒ Medical Office/Clinic ☒ Other: VETERANS

OUTPATIENT CLINIC

FREIGHT

PARKING 2 1

NUMBER OF STAIRWAYS: 5

FIRE PUMP(S): ☒YES ☐NO

LOCATION: P-2

EMERGENCY GENERATOR(S): ☒YES ☐NO

LOCATION: P-1

PARKING STRUCTURE:

☒ UNDERGROUND ☐ DETACHED ☒ ATTACHED

NUMBER OF LEVELS BELOW GROUND: 2

UNIQUE PROPERTY FEATURES: TYPES OF OCCUPANCIES BELOW GROUND:

FULLY SPRINKLERED OUTPATIENT VETERNAS CLINIC

WITH RISER AT SOUTH STAIR #5.

S-2, PARKING

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

5892756

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

06/12/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Fire Pump - Initial Test

The owner/owner(s) representative shall ensure that the appropriate permits have been secured prior to any repairs being performed.

A copy of this section shall accompany the F-340RT in all cases.

Section III - Findings: ☐SYSTEM DEFECTS FOUND ☒NO SYSTEM DEFECTS FOUND

GRAY AREAS SHALL BE FILLED OUT BY CERTIFIED TESTER PERFORMING RETEST

DEFECT # ITEM #

(SECTION IV) DESCRIPTION LOCATION RETEST

ONLY

INITIAL TEST PERFORMED BY

SIGNATURE:

STATE: ZIP:

RETEST DATE: RETEST PERFORMED BY

RE-TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: RE-TESTER'S SIGNATURE: PHONE NUMBER:

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

5892756

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

06/12/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Fire Pump - Initial Test

All testing procedures below were performed in accordance with the Los Angeles Fire Department Chief's Regulation No. 4 requirements, applicable sections of NFPA 25 and other approved publications.

ITEM # DESCRIPTION

SECTION II - SYSTEM DESCRIPTION: STATIONARY FIRE PUMP

Type of Fire Pump:

Horizontal Split Case

Pump ID Number:

Pump Manufacturer:

Patterson

Model#:

6x5 MAC

Serial#:

FP-C000224876-01-01

Pump: Rated Capacity (GPM/Flow):

Rated Head (Pressure/PSI):

Rated RPM (Speed):

Pump Configuration:

☐Single

☐Series

☐Parallel

Vertical Zones:

☐Low Zone

☐Mid Zone

☐High Zone

☒No

Type of Driver:

☐Diesel Engine

☒Electric Motor

☐Gasoline Engine

Driver Manufacturer:

WEG

Serial No.:

1078478151

Type of Controller:

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: PHONE NUMBER OF TESTING AGENCY:

12/31/2025

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

5892756

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

06/12/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Fire Pump - Initial Test

ITEM # DESCRIPTION

☐Diesel

☒Electric

Fire Pump Room/Location

P2 Level

Test Header Location:

N/A

Number of Test Header Hose Valve Outlets:

N/A

Test Header Discharge Location:

☐To Atmosphere

☐To Water Tank

Water Supply:

☒Public Main

☐Water Tank Above Ground

☐Water Tank Below Ground

Refill Valve(s):

☐Automatic

☐Manual

Pump Serves:

☐Sprinkler System Only

☒Combined Standpipe & Sprinkler

☐Class III Combination

Maintenence/Jockey Pump

☒Yes

☐No

Fire department connection (FDC) locations:

Temple St

Fire Pump Serves:

☒Entire building

☐Multiple buildings

☐Partial areas

If the Fire Pump serves multiple buildings, give addresses:

N/A

If the Fire Pump serves partial areas, give areas:

N/A

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: PHONE NUMBER OF TESTING AGENCY:

12/31/2025

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

5892756

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

06/12/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Fire Pump - Initial Test

All testing procedures below were performed in accordance with the Los Angeles Fire Department Chief's Regulation No. 4 requirements, applicable sections of NFPA 25 and other approved publications.

ITEM # DESCRIPTION

SECTION IV - TESTING PROCUEDURES: STATINOARY FIRE PUMP ASSEMBLY PASS FAIL N/A

1.O SCHEDULING/NOTIFICATION PASS FAIL N/A

1.1 Fire Department dispatch, supervising station & building occupants notified prior to the start of the test.

Yes

2.0 INSPECTION PASS FAIL N/A

2.1 Fire pump piping and valves are free of leaks and excessive corrosion. ☒ ☐ ☐

2.2 Fire pump controller and remote pump status panel (if applicable) indicates proper status. ☒ ☐ ☐

2.3 Fire pump water supply was available. ☒ ☐ ☐

2.4 Small drips of water was observed at the pump packing glands while pump is off. ☒ ☐ ☐

2.5 All gauges are not damaged and legible and in good working order. ☒ ☐ ☐

2.6 Gauges are accurate within 3% of full scale as determined by a calibrated comparison gauge. ☒ ☐ ☐

2.7 Pump rated capacity (Flow), head (pressure), and RPM was obtained from pump name plate. ☒ ☐ ☐

2.8 Batteries are free of physical damage, leaks, loose connections, and corrosion. ☐ ☐ ☒

2.9 Battery water level & voltage readings checked. ☐ ☐ ☒

2.10 Diesel driver oil, water, and fluid levels checked. ☐ ☐ ☒

3.0 OPERATIONAL TESTS PASS FAIL N/A

3.1 Six manual starts were conducted by use of a switch, push button, or manual start handle. ☒ ☐ ☐

3.2 Six automatic starts were conducted by dropping the pressures at the most remote location and the pressure sensing line. ☒ ☐ ☐

3.3 Churn test was conducted (0%) with the fire pump discharge outlets closed (except for minimum flow pump cooling) ☒ ☐ ☐

3.4 Fire pump discharge was tested at 50% of its rated capacity and pressure. ☒ ☐ ☐

3.5 Fire pump discharge was tested at 100% of its rated capacity and pressure. ☒ ☐ ☐

3.6 Fire pump discharge was tested at 150% of its rated capacity and pressure. ☒ ☐ ☐

Note: Where pump is unable to operate at 150% of its rated capacity due to lack of supply from the city main the maximum flow may be allowed with approval the LAFD.

3.7 Pump operated at less than 150% but operated at the maximum capacity allowed by

LAFD. ☒ ☐ ☐

3.8 At 150% of its rated capacity, the pump operated at 65% of its rated pressure/head. ☒ ☐ ☐

3.9 Pump is fed directly from a city main and the suction pressure did not fall below

20 psi at any point during flow testing. ☒ ☐ ☐

3.10 Pump is fed from a suction tank with its base at or above the same level as the pump and the suction pressure did not fall below -3 psi at any point during flow testing.

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: PHONE NUMBER OF TESTING AGENCY:

12/31/2025

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

5892756

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

06/12/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Fire Pump - Initial Test

ITEM # DESCRIPTION

3.11 Circulation relief valve operated properly. ☒ ☐ ☐

3.12 Pressure relief valve operated properly. ☐ ☐ ☒

3.13 Heat exchanger checked for proper operation. ☐ ☐ ☒

3.14 Pump was checked for unusual noises or vibrations. ☒ ☐ ☐

3.15 Packing box(s) bearings, and pump was checked for overheating. ☒ ☐ ☐

3.16 Diesel driven pump ran for a minimum of 30 minutes ☐ ☐ ☒

3.17 Electric motor driven pump ran for a minimum of 10 minutes. ☒ ☐ ☐

3.18 Pumps arranged to start in series started in intervals of 5 to 10 seconds. ☐ ☐ ☒

3.19 Water tank automatic refill valves were observed for proper operation. ☐ ☐ ☒

Attach - Fire pump worksheet and pump curve sheet.

3.20 LAFD fire pump worksheet and pump curve sheet is attached for the pump listed in Section II of this report.

Yes

AREAS/DEVICES/APPLIANCES NOT ACCESSIBLE FOR TESTING

A minimum of 90% of testing is required. If less than 90% testing is conducted do not submit this report.

Description:

END OF REPORT

ALL FINDINGS INDICATING “FAIL” ARE LISTED IN SECTION III (YELLOW SECTION) AND HAVE BEEN POPULATED WITH THE ITEM

DESCRIPTION, NUMBER AND LOCATION.

THE RESULTS ARE ACCURATELY LISTED AND THE EQUIPMENT IS FULLY OPERABLE EXCEPT AS NOTED. YOU ARE A CERTIFIED REGULATION NO. 4 TESTER WITH A VALID CERTIFICATION OR HAVE BEEN AUTHORIZED TO SUBMIT THE INFORMATION ON BEHALF

OF A CERTIFIED CHIEFS REGULATION NO. 4 TESTER.

I ACCEPT

☒Yes

TESTER'S NAME: CERTIFICATE #: EXPIRATION DATE: PHONE NUMBER OF TESTING AGENCY:

12/31/2025

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

5892756

INITIAL TEST DATE: TEST SITE ADDRESS: (STREET NUMBER AND STREET NAME)

06/12/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Fire Pump - Initial Test

LAFD Annual Fire Pump Assembly , F-340R 02-06-2015

LOS ANGELES FIRE DEPARTMENT

ANNUAL FIRE PUMP PERFORMANCE TEST WORK SHEET

THIS PAGE BY ITSELF IS NOT A COMPLETE DOCUMENT AND SHALL BE

ATTACHED TO THE F-340R ANNUAL FIRE PUMP REPORT

PAGE 1 Of TEST SITE ADDRESS: (street) (city) (state) (zip) (Phone

351 E TEMPLE ST LOS ANGELES CA 90012

EQUIPMENT TESTED:

FIRE PUMP

TEST DATE(S) FIRM OR D.B.A.

6-12-2024

FIRE PUMP INFORMATION: PUMP # 1 OF 1

MANUFACTURER

RATED

GPM

HEAD-FT.

RELIEF

VALVE PSI

TANK SIZE AND LOCATION (IF APPLICABLE)

Patterson 500 N/A N/A NA

MODEL

RATED

PSI

RATED

RPM

IMPELLER

SIZE

CITY SUPPLY PRESSURE

(IF SUPPLIED DIRECTLY BY CITY)

5xMAC3 75 3550 6.625 MIN 80 MAX (IF AVAILABLE)

TYPE OF PUMP

RELIEF VALVE SETTING

PUMP LOCATION

Horizontal Split Case N/A Fire Pump Room

DRIVER INFORMATION:

DIESEL

IF DIESEL DRIVEN, HOW MANY GALLONS OF FUEL ARE AVAILABLE (8 HOUR SUPPLY REQUIRED)?

500 GALLONS

ELECTRIC

IF ELECTRICALLY DRIVEN, HOW MANY GALLONS OF FUEL SUPPLY THE EMERGENCY GENERATOR?

CONTROLLER INFORMATION:

MANUFACTURER

AUTO

START

AUTO

STOP

MODEL

OVERRUN

TIME

JOCKEY PUMP (PSI)

Firetrol 135 155 FTA1930-AM30B 10 Mins ON 150 OFF 160

PERFORMANCE TEST:

CAPACITY

REQUIRED

NUMBER OF

OUTLETS

NOZZLE

ORIFICE

SIZE

REQUIRED

PITOT

PRESSURE

OBTAINED

SUCTON

PSI

DISCHARGE

SYSTEM

NET

PUMP SPEED

IN RPM

0% 0 0 0 0 0 80 161 160 81 3576

50% 250 1 6” FM 250 79 156 160 77 3570

100% 500 1 6” FM 500 79 154 160 75 3557

150% 750 1 6” FM 750 79 139 160 60 3551

AUTOMATIC STARTS: 6 MANUAL STARTS: 6

LOCATION(S) OF TEST FLOWS & REMOTE STARTS

STARTS

SATISFACTORY

RESULTS

STARTS

SATISFACTORY

RESULTS

Drain Valve 6

YES NO

YES NO

SYSTEM PRESSURE TAKEN AT:

At 150 percent of rated capacity, the net pump pressure shall be at least 65 percent of the rated pressure

PUMP RATED PRESSURE:75 PUMP NET PRESSURE:60

PUMP NET PRESSURE IS:80 %

Fire Pump Room

PASS FAIL

IS FIRE PUMP STATUS INFORMATION CORRECTLY

INDICATED IN THE FIRE CONTROL ROOM?

IF PREVIOUS RESULTS ARE AVAILABLE, IS THE NET PUMP

PRESSURE

WITHIN 5 % OF THE PREVIOUS RESULTS AT EACH POINT?

YES NO YES NO N/A

TESTER’S NAME & CERTIFICATE # EXPIRATION DATE

12-31-2025

TESTER’S SIGNATURE

FIRE DEPARTMENT WITNESS (SIGNATURE & ASSIGNMENT)

TOTAL HOURS