VA LAACC_351 E Temple St_ANN EPWR_09-11-24_Redacted 3.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:

09/11/2024

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:

10/31/2026

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:

09/17/2024 3:12 PM

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

Emergency Power Generator - Initial Test

Test Report Number

6301228

TRN 6301228 Printed Mon Sep 16 12:09:43 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

6301228

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

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Emergency Power Generator - 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

1 3.5 Transfer time to secondary power is within 10 seconds of primary power loss.

Fail

Transfer switch ☐PASS

2 3.9 All exit signs and directional exit signs were illuminated and clearly visible within 100ft of each sign in accordance with LAFD acceptance standards.

Fail

3rd floor by A328 broken face on sign. ☐PASS

INITIAL TEST PERFORMED BY

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

10/31/2026

PHONE NUMBER OF TESTING AGENCY: TESTING AGENCY: 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

6301228

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

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Emergency Power Generator - 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 110 and other approved publications.

ITEM # DESCRIPTION

Section II - EMERGENCY AND STANDBY POWER SYSTEMS - GENERATOR DESCRIPTION:

Manufacturer of Generator:

Marathon

Rating (KW):

Serial No.:

xm 3854767

Manufacturer of Engine Driver:

powerpack

Serial No.:

91237306

Type of Fuel for Driver:

diesel

Capacity of Main Fuel Tank:

Capacity of Day Tank:

Main Disconnect Location(s):

electrical room p-2

Remote Annunciator Location:

Number of Transfer Switches:

Required Life Safety Equipment Served By the Generator:

☒Emergency Exit & Directional Signs

☒Exit Path Lighting

☒Electric Fire Pump(s) Jockey Pump(s)

☐Stairwell Pressurization

☐Smoke Management

☒Fire Alarm

☐Window Washing Equipment

☐Circuits for Life Support (Red Plugs)

☒Elevator Cars

Exit Path Lighting Locations:

☒Stairwells

☒Garage Area

☒Corridors/Hallways

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

10/31/2026

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6301228

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

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Emergency Power Generator - Initial Test

ITEM # DESCRIPTION

Electric Fire Pump(s) Jockey Pump(s) Quantity:

Stairwell Pressurization - Number of:

Fire department connection (FDC) locations:

Emergency Power Generator Serves:

☒Entire building

☐Multiple buildings

☐Partial areas

If the Emergency Power Generator serves multiple buildings, give addresses:

If the Emergency Power Generator serves partial areas, give areas:

1.0 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 / PRE-START CHECK PASS FAIL N/A

2.1 Single line diagram provided by the owner/building representative. ☒ ☐ ☐

2.2 Operating instruction manual provided in a secure location near the equipment. ☒ ☐ ☐

2.3 Gauges on the control panel not damaged and appear to be in working order. ☒ ☐ ☐

2.4 Lamps/Lights are in place and appear to be undamaged. ☒ ☐ ☐

2.5 Lamps/Lights are lit or verified to be operational. ☒ ☐ ☐

2.6 Timer reading/meter checked and logged. ☒ ☐ ☐

2.7 Fluid levels checked, oil, water, fuel. ☒ ☐ ☐

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

2.9 Battery hydrometer check, water level & voltage readings. ☒ ☐ ☐

2.10 Generator is in the automatic mode. ☒ ☐ ☐

2.11 Generator is in a "Cold Start" condition (has not been started within 12 hours). ☒ ☐ ☐

3.0 OPERATIONAL TESTS PASS FAIL N/A

3.1 All "Life Safety" systems and equipment are running when test initiated. ☒ ☐ ☐

3.2 Main power was disconnected at the main disconnect/breaker. ☒ ☐ ☐

3.3 Delay of engine start one second minimum. ☒ ☐ ☐

Delay time:

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

10/31/2026

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6301228

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

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Emergency Power Generator - Initial Test

3.4 Battery cranking time is 45 seconds or less or 3 cycles of 15 seconds. ☒ ☐ ☐

3.5 Transfer time to secondary power is within 10 seconds of primary power loss. ☐ ☒ ☐

Transfer time:

11.5

3.6 Standby power up and operating within 60 seconds. ☒ ☐ ☐

3.7 All Life Safety systems continued to operate properly for the duration of the test. ☒ ☐ ☐

3.8 All exit path lighting was sufficient enough to readily find, distinguish, and safely use the exit path in accordance with LAFD acceptance standards. ☒ ☐ ☐

3.9 All exit signs and directional exit signs were illuminated and clearly visible within 100ft of each sign in accordance with LAFD acceptance standards. ☐ ☒ ☐

3.10 Exit signs illuminated from an external source measured 5 foot candles at the sign. ☒ ☐ ☐

3.11 Generator ran a minimum of 30 minutes. ☒ ☐ ☐

3.12 Delay on re-transfer from the secondary power to primary power is (minutes). ☒ ☐ ☐

50.0

3.13 Time delay on engine shut-down 5-minute minimum. ☒ ☐ ☐

3.14 Oil pressure ☒ ☐ ☐

3.15 Water temperature ☒ ☐ ☐

3.16 Fuel leaks ☒ ☐ ☐

3.17 Exhaust leaks ☒ ☐ ☐

3.18 Unusual noises ☒ ☐ ☐

4.0 AREAS TESTED PASS FAIL N/A

4.1 Storage areas ☒ ☐ ☐

4.2 Mechanical rooms ☒ ☐ ☐

4.3 Electrical rooms ☒ ☐ ☐

4.4 Conference rooms ☒ ☐ ☐

4.5 Restrooms ☒ ☐ ☐

4.6 Parking garage areas ☒ ☐ ☐

4.7 Exit corridors ☒ ☐ ☐

4.8 Stairwells ☒ ☐ ☐

4.9 Elevator lobbies ☒ ☐ ☐

4.10 Elevator cars ☒ ☐ ☐

4.11 Fire pump room ☒ ☐ ☐

4.12 Generator room ☒ ☐ ☐

4.13 Elevator machine rooms ☒ ☐ ☐

4.14 Fire control room ☒ ☐ ☐

4.16 Other ☐ ☐ ☐

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

10/31/2026

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6301228

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

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Emergency Power Generator - Initial Test

5.0 CHECKS AFTER SHUTDOWN PASS FAIL N/A

5.1 New timer reading checked and logged. ☒ ☐ ☐

5.2 Fuel tank(s) checked. ☒ ☐ ☐

5.3 Generator returned to auto mode. ☒ ☐ ☐

5.4 All controls returned to normal position. ☒ ☐ ☐

5.5 Entries have been made into the generator log. ☒ ☐ ☐

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:

10/31/2026

LOS ANGELES FIRE DEPARTMENT

FIRE PROTECTION EQUIPMENT PERFORMANCE REPORT

THIS PAGE BY ITSELF IS NOT A COMPLETE REPORT

Test Report Number

6301228

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

09/11/2024 351 E TEMPLE ST

EQUIPMENT TESTED:

Emergency Power Generator - Initial Test