Amendment 0002 Fire Inspection Reports.pdf

Date: Type of Inspection:

Job Number: Service Ticket Number:

Address: Method of Actuation:

Property: Shutdowns:

CONTROL PANEL:

Manufacturer

Model No.

Line Voltage

Battery Charge Level

Battery Load Test

Battery Amp

HR

Result

Audible & Visual Alarm

Audible & Visual

Trouble

Remote Indicators

Dis-charge Circuit

Service Lock-out

Remote Monitoring

Comment

Battery:

DATE: QUANTITY: SIZE:

OPERATING SEQUENCE:

Bells Horn Strobes Horn Voice

Message Chimes Remote Indicator

Remote Monitoring Comment #

QUANTITY

Alarm/ Pre-Alarm

Cross Zone (2nd Alarm)

Discharge

Manual Operation

Page of

Breaker Name/Location:

Form for Inspection and Testing of Fire Alarm Systems Information on this form covers the requirements of NFPA 72 2013 for fire alarm per

IFC 2009 and the State of Texas.

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

BLUE

01/29/2021 Annual

NA ST00153994

1133 N Shoreline House Corpus Christi, Tx. 78402 Automatic and Manual

Corpus Christi Federal Building Yes

Addressable

Simplex 4010 120 13.4 27.5 PASS PASS PASS PASS - - PASS

A512/115A 120 13.4 27.5 PASS

12V 115Ah

04/16 2 12V 115Ah

Strobes Speak Strobe

- 98 98 - - - - - -

S MC

S MC

1 8

INPUT DEVICES:

(DETECTORS, MANUAL PULL STATIONS, WATER FLOW AND PRESSURE SWITCHES Etc.)

Type Operation Test Graphic Location Sensitivity

Setting Remarks

Note: Sensitivity Testing is not included in a routine periodic inspection. It is a separately scheduled inspection; price is available upon request.

Manufacture/Part # Detector Photo:

Manufacture/Part # Detector ION:

Page of

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

Zone

M P M1-1 PULL By X-ray Scanner Basement Pullstation M P M1-4 PULL Elevator 1 Lobby Basement Pullstation M P M1-7 PULL By Mech Room Basement Pullstation PE P M1-10 SMOKE Parking Entrance Basement Smoke Detector PE P M1-11 SMOKE Switchgear Room Basement Smoke Detector DD P M1-16 DUCT AHU B1 Basement Supply Duct Detector WF P M1-19 WATER Flow in AHU Room Basement Waterflow TS P M1-21 SO Bypass Control Valve 4 (Suction) Sprinkler Monitor SUP P M1-25 FPUMP Fire Pump Running Basement PE P M1-43 SMOKE Center Lobby 1st Floor Smoke Detector M P M1-57 PULL Stair 5 1st Floor Manual Pullstation PE P M1-36 SMOKE Cell Block Cont 1st Floor Under Floor Smoke Detector PE P M1-40 SMOKE Elec Room by Elev 6. 1st Floor Smoke Detector PE P M1-44 SMOKE Center Lobby 1st Floor Smoke Detector PE P M1-49 SMOKE Elev 1 & 2 Lobby 1st Floor Smoke Detector M P M1-52 PULL Stair 4 2nd Floor Manual Pull Station M P M1-55 PULL Stair 2 2nd Floor Manual Pull Station PE P M1-58 SMOKE Atrium Beam Detector 2nd Floor Smoke Detector PE P M1-61 SMOKE Elevator 6 Lobby 2nd Floor Smoke Detector PE P M1-62 SMOKE Center Lobby 2nd Floor Smoke Detector PE P M1-63 SMOKE Center Lobby 2nd Floor Smoke Detector PE P M1-64 SMOKE Center Lobby 2nd Floor Smoke Detector TS P M1-73 TAMPER Tamper Stair 5 2nd Floor Sprinkler Monitor M P M1-76 M

PULL Stair 4 3rd Floor Manual Pullstation P M1-79 PULL Stair 5 3rd Floor Manual Pullstation

PE P M1-85 SMOKE Elevator 6 Lobby 3rd Floor Smoke Detector M P M1-36 PULL Freight Elevator Basement Manual Pullstation M P M1-64 PULL Parking Stair 5 Basement Manual Pullstation PE P M1-9 SMOKE Freight Elevator Basement Smoke Detector PE P M1-12 SMOKE Elevator 3 Lobby Basement Smoke Detector TS P M1-18 TAMPER Tamper In AHU Room Basement TS P M1-21 TAMPER Bypass Control Valve 3 Suction Basement Sprinkler Monitor PE VC M1-58 SMOKE Atrium Beam Detector 1st Floor Smoke Detector PS P M1-88 PULL Elevator 1 & 2 Lobby 1st Floor Manual Pullstaton PE VC M1- Cell Block Cont 1st Floor Under Floor Smoke Detector PE P M1-39 SMOKE Prison Elevator 4 1st Floor Smoke Detector DD VC M1-42 DUCT Lieber Unit Return Under Floor Duct Detector PE P M1-28 SMOKE Center Lobby 1st Floor Smoke Detector

Simplex 4098-9757

Simplex 4098-9403 Heat 200F

2 8

Type Operation Test Graphic Location Sensitivity

Setting Remarks

Note: Sensitivity Testing is not included in a routine periodic inspection. It is a separately scheduled inspection; price is available upon request.

Manufacture/Part # Detector Photo:

Manufacture/Part # Detector ION:

Page of

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

Zone

PE P SMOKE Center Lobby 1st Floor Smoke Detector PE P SMOKE Elevator 5 Lobby 1st Floor Smoke Detector M P PULL Stair 3 2nd Floor Manual Pullstation M P PULL Stair 5 2nd Floor Manual Pullstation M P PULL Stair 4 1st Floor Manual Pullstation PE P SMOKE Center Lobby 2nd Floor Smoke Detector PE P SMOKE Center Lobby 2nd Floor Smoke Detector PE P SMOKE Elev 1 & 2 Lobby 2nd Floor Smoke Detector PE P SMOKE Electrical Rm 220 2nd Floor Smoke Detector M P PULL Stair 2 3rd Manual Pullstation PE P SMOKE Center Lobby 3rd Floor Smoke Detector PE P SMOKE Center Lobby 3rd Floor Smoke Detector PE P SMOKE Center Lobby 3rd Floor Smoke Detector PE P SMOKE Elev 1 & 2 Lobby 3rd Floor Smoke Detector PE P SMOKE Elevator 3 Lobby 3rd Floor Smoke Detector WF P WATER Flow Stair 5 3rd Floor Waterflow Monitor PE P SMOKE Computer Room 219D 2nd Floor Smoke Detector M P PULL Stair 4 Parking Basement Manual Pullstation M P PULL Parking Entrance Basement Manual Pullstation M P PULL Stair 2 Basement Manual Pullstation PE P SMOKE Elevator 1 Lobby Basement Smoke Detector DD P DUCT AHU B2 Basement Supply Duct Detector DD P DUCT Chiller Room Exhaust Duct Detector

SUP P

SUP

WATER Control Valve 1 Discharge Basement Sprinkler Monitor P WATER Control Valve 2 Discharge Basement Sprinkler Monitor

M P PULL Photo Lab 1st Floor Manual Pullstation PE P SMOKE Nac 6 & 7 Room 3rd Floor Smoke Detector PE P SMOKE Elevator 6 Lobby 1st Floor Smoke Detector PE P SMOKE Center Lobby 1st Floor Smoke Detector PE P SMOKE Center Lobby 1st Floor Smoke Detector M P PULL Elevator 6 Lobby 2nd Floor Manual Pullstation M P PULL Elev 1 & 2 2nd Floor Manual Pullstation M P PULL Corridor 002R Basement Manual Pullstation PE P SMOKE Center Lobby 2nd Floor Smoke Detector PE P SMOKE Center Lobby 2nd Floor Smoke Detector PE P SMOKE Center Lobby 2nd Floor Smoke Detector PE P SMOKE Elevator 3 Lobby 2nd Floor Smoke Detector WF P WATER Flow Stair 5 2nd Floor Waterflow Monitor

Simplex 4098-9757

3 8

Type Operation Test Graphic Location Sensitivity

Setting Remarks

Note: Sensitivity Testing is not included in a routine periodic inspection. It is a separately scheduled inspection; price is available upon request.

Manufacture/Part # Detector Photo:

Manufacture/Part # Detector ION:

Page of

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

Circuit

M P PULL Elevator 6 Lobby 3rd Floor Manual Pullstation PE P SMOKE Elevator 4 Lobby 3rd Floor Smoke Detector PE P SMOKE Center Lobby 3rd Floor Smoke Detector PE P SMOKE Elevator 5 Lobby 3rd Floor Smoke Detector PE P SMOKE Center Lobby 3rd Floor Smoke Detector TS P TAMPER Tamper Stair 5 3rd Floor Sprinkler Monitor DD P DUCT AHU-5 Supply Mezzanine Duct Detector DD P DUCT AHU-5 Return Mezzanine Duct Detector DD P DUCT AHU-4 Supply Mezzanine Duct Dtector DD P DUCT AHU-4 Return Mezzanine Duct Detector DD P DUCT AHU-9 Supply Mezzanine Duct Detector DD P DUCT AHU-9 Return Mezzanine Duct Detector DD P DUCT AHU-10 Supply Mezzanine Duct Detector DD P DUCT AHU-10 Return Mezzanine Duct Detector DD P DUCT AHU-8 Supply Mezzanine Duct Detector DD P DUCT AHU-8 Return Mezzanine Duct Detector DD P DUCT AHU-7 Supply Mezzanine Duct Detector DD P DUCT AHU-7 Return Mezzanine Duct Detector DD P DUCT AHU-6 Supply Mezzanine Duct Detector DD P DUCT AHU-6 Return Mezzanine Duct Detector DD P DUCT AHU-1 Supply Mezzanine Duct Detector DD P DUCT AHU-1 Return Mezzanine Duct Detector DD P DUCT AHU-2 Supply Mezzanine Duct Detector

DD P

DD

DUCT AHU-2 Return Mezzanine Duct Detector P DUCT AHU-3 Supply Mezzanine Duct Detector

DD P DUCT AHU-3 Return Mezzanine Duct Detector TS P TAMPER Tamper Stair 4 Mezzanine Sprinkler Monitor WF P WATER Flow Stair 4 Mezzanine Waterflow Monitor DD VC DUCT Lieber Unit Supply Rm 219D 2nd Floor Duct Detector PE P SMOKE FACP Room 1st Floor Smoke Detector TS P TAMPER Tamper Mech Rm. 401 Mezzanine Sprinkler Monitor WF P WATER Flow Mech Rm 401 Mezzanine Waterflow Monitor PE VC SMOKE Beam Detector Courtroom 1st Floor Smoke Detector TS P TAMPER Tamper Stair 5 Mezzanine Sprinkler Monitor WF P WATER Flow Stair 5 Mezzanine Waterflow Monitor TS P TAMPER Tamper Mech Rm 407 Mezzanine Sprinkler Monitor WF P WATER Flow Mech Room 407 Mezzanine Waterflow Monitor TRR VC HEAT EMR-3 Room Basement Heat Detector

Simplex 4098-9757

4 8

Type Operation Test Graphic Location Sensitivity

Setting Remarks

Note: Sensitivity Testing is not included in a routine periodic inspection. It is a separately scheduled inspection; price is available upon request.

Manufacture/Part # Detector Photo:

Manufacture/Part # Detector ION:

Page of

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

Circuit

TRR VC HEAT Emer-4 & 6 Room Basement Heat Detector PE P SMOKE Emer-4 & 6 Room Smoke Detector TRR P HEAT Emer-5 Room Basment Heat Detector PE P SMOKE Emer-5 Room Basement Smoke Detector M P PULL Overhead Door Loading Refuse Manual Pullstation M P PULL Overhead Door Elev 5 & 6 Basement Manual Pullstation PE P SMOKE Elevator 4 Lobby Basement Smoke Detector TS P TAMPER Tamper Stair 5 1st Floor Sprinkler Montor WF P WATER Flow Stair 5 1st Floor Waterflow Monitor PE P SMOKE Tele/Comm Room by Elev 4 2nd Floor Smoke Detector PE P SMOKE Elevator 5 Lobby 2nd Floor Smoke Detector M P PULL Elevator 4 Lobby 3rd Floor Manual Pullstation M P PULL Elev 1 & 2 Lobby 3rd Floor Manual Pullstation TRR VC HEAT Emr-1 & 2 Room Roof Heat Detector M P PULL Stair 3 3rd Floor Manual Pullstation PE P SMOKE Emr-1 & 2 Room Roof Smoke Detector DD P DUCT AHU-11 Supply Mezzanine Duct Detector PE VC SMOKE Atrium Beam Detector 3rd Floor PE P SMOKE Beam Det Magistrate Court SW 3rd Floor Smoke Detector PE P SMOKE Beam Det District Court Jack 3rd Floor Smoke Detector PE P SMOKE Beam Det Det District Court Jack 3rd Floor Smoke Detector PE P SMOKE Beam Det Magistrate Court NW 3rd Floor Smoke Detector PE P SMOKE Beam Det District Court Head 3rd Floor Smoke Detector

PE P

PE

SMOKE

P SMOKE Beam Det Bankruptcy Court 2nd Floor Smoke Detector

M P PULL Task Force Coordinator 1st Floor Manual Pullstation M P PULL Entrance 1st Floor Manual Pullstation PE P SMOKE NAC 2 & 3 Room 1st Floor Smoke Detector M P PULL Outside NASAF Room 109R 1st Floor Manual Pullstation

Simplex 4098-9757

5 8

Battery/Power Supplies:

Location and Type Monitored

By Fire Alarm

Line Voltage

Charge Level

Battery Level

Battery Test

Results

Voltage

AH

Rating

Date Code

Audible & Visual

Trouble

Comments

Page of

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

Basement Electrical room 4009 IDNET YES 120 13.8 13.8 6.7 PASS N/A PASS 12V/12AH

13.8 13.8 4.6 PASS N/A PASS

3RD FLOOR ELECTRICAL 4009 IDNET YES 120 13.7 13.7 6.7 PASS 5/20 PASS 12V/12AH

13.7 13.7 4.6 PASS 5/20 PASS

3RD FLOOR ELECTRICAL 4009 IDNET YES 120 13.7 13.7 NEW PASS 1/21 PASS 12V/12AH

13.7 13.7 NEW PASS 1/21 PASS

2RD FLOOR ELECTRICAL 4009 IDNET YES 120 13.7 13.7 4.6 PASS N/A PASS 12V/12AH

NAC 4 13.7 13.7 4.6 PASS N/A PASS

2RD FLOOR ELECTRICAL 4009 IDNET YES 120 13.6 13.6 4.6 PASS 7/14 PASS 12V/12AH

NAC 5 13.6 13.6 5.3 PASS 7/14 PASS

2RD FLOOR ELECTRICAL 4009 IDNET YES 120 13.8 13.8 5.2 PASS N/A PASS 12V/12AH

NAC 3 13.8 13.8 5.0 PASS N/A PASS

2RD FLOOR ELECTRICAL 4009 IDNET YES 120 13.9 13.9 10.3 PASS 11/20 PASS 12V/12AH

NAC 2 13.9 13.9 9.6 PASS 11/20 PASS

6 8

Output Devices:

(Shutdowns, Closers, Releases, Etc.)

Type Operation Test Function Location Remarks

Page of

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

Zone

Output P Elev. Secondary M1-163 ELEV 1 ALT RECALL Output P Elev. Primary M1-164 ELEV 1 PRI RECALL Output P Elevator Shunt M1-165 ELEV 1 SHUNT TRIP Output P Elev. Secondary M1-166 ELEV 2 ALT RECALL Output P Elev. Primary M1-167 ELEV 2 PRI RECALL Output P Elevator Shunt M1-168 ELEV 2 SHUNT TRIP Output P Elevator Shunt M1-199 ELEV PENTHOUSE SHUTTER Output P Damper Closer M1-180 SMOKE CONTROL ZN B1 Output P Damper Closer M1-181 SMOKE CONTROL ZN B2 Output P Damper Closer M1-182 SMOKE CONTROL 2 SW Output P Damper Closer M1-183 SMOKE CONTROL ZN 3 SW Output P Damper Closer M1-184 SMOKE CONTROL ZN ATRIUM Output P Damper Closer M1-185 SMOKE CONTROL ZN 3 SE Output P Damper Closer M1-186 SMOKE CONTROL ZN 1 S Output P Damper Closer M1-187 SMOKE CONTROL ZN 3 NE Output P Damper Closer M1-188 SMOKE CONTROL ZN 1 N Output P Damper Closer M1-189 SMOKE CONTROL ZN 2 NE Output P Damper Closer M1-190 SMOKE CONTROL ZN 2 NW Output P Damper Closer M1-191 SMOKE CONTROL ZN 3NW Output P Damper Closer M1-192 SMOKE CONTROL ZN 2SE Output P Elev. Primary M1-149 ELEV 5 PRI RECALL Output P Elev. Secondary M1-148 ELEV 5 ALT RECALL Output P Elev. Primary M1-144 ELEV 6 PRI RECALL Output P Elev. Secondary M1-143 ELEV 6 ALT RECALL Output P Elevator Shunt M1-142 ELEV 4 SHUNT TRIP Output P Elev. Primary M1-141 ELEV 4 PRI RECALL Output P Elev. Secondary M1-140 ELEV 4 ALT RECALL Output P Elevator Shunt M1-145 ELEV 6 SHUNT TRIP Output P Elevator Shunt M1-137 ELEV 3 SHUNT TRIP Output P Elev. Primary M1-136 ELEV 3 PRI RECALL Output P Elev. Secondary M1-135 ELEV 3 ALT RECALL

7 8

DEFICIENCY:

LEGEND:

AS Air Sampling Detector MR Manual Release St SUP Supervisory VC Visual Check DD Duct Detector PE Photoelectric Smoke Detector WT Water Detector BT Bell Tone FD Flame Detector PS Pressure Switch PE/T Photo/Heat Combo CT Chime Tone

TFT Fixed Temperature Detector TRR Thermal Rate of Rise Detector P Pass LA Low Air Pressure Switch LP Agent Low Pressure TP Temporal Pattern (Code 3) NA Not Applicable

ABT Abort Switch GD Gas Detector V Voice Message NC Not Checked ION Ionization Smoke Detector TRC Thermal Rate of Compensation F Fail S Steady Tone M Manual Pull Station TL Thermal Line Type Detection B Required Adjustment TS Tamper Switch WF Water Flow Switch MC March Cadence

Inspector:

Inspector Signature:

Assisting Technicians/Trainees:

Client Name:

Client Signature:

AUX Auxiliary

Page of

System Restored To Normal Operation?

Monitoring Company Called and Signals Verified?

Monitoring Restored To Normal?

Date/Time:

Date/Time:

Date/Time:

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

RECOMMENDATIONS:

YES 1/29/21

YES 1/29/21

YES 1/29/21

Kris Gagnon

Jaime Alviar Sean Walsh

8 8

CITY OF CORPUS CHRISTI

SUBMIT TO: CITY OF CORPUS CHRISTI, DEVELOPMENT SERVICES DEPT.-

PLUMBING DIVISION (Regulatory Agency), BACKFLOW PREVENTION PROGRAM 2406 Leopard St. PO Box 9277 CORPUS CHRISTI, TX 78469-9277 (361-826-3253) City of Corpus Christi PWS 1-180003

ONLINE PAYMENT VERIFICATION

APPL. # _______________________

IS THE ASSEMBLY INSTALLED IN ACCORDANCE WITH MANUFACTURER RECOMMENDATIONS AND/OR LOCAL CODES?

YES NO

PHYSICAL LOCATION OF DEVICE:

(Example: Next to meter in back yard.)

MAKE OF DEVICE __________________________________

MODEL NUMBER ___________________________________

SERIAL NUMBER___________________________________

SIZE ______________________________________________

SERVES: __________________________________________

FIRE METER READ-

New irrigation system - Permit # _________________ Re-Cert. Re-Cert. (not prev. tested) Removed Replace backflow preventer only- Permit #

INITIAL TEST

Reduced Pressure Assembly RPDA Relief Value

Pressure Vacuum Breaker or SVB Double Check Assembly DCDA AIR INLET CHECK VALVE

1st Check 2nd Check

Opened at psid

Did Not Open

Held at psid

Leaked

DC- psid Closed tight RP- psid Leaked

Closed tight DC- psid

Leaked

Opened at psid

Did Not Open

REPAIRS AND

PARTS

TEST AFTER

REPAIR

DC- Closed tight RP- psid Closed tight Opened at psid Opened at psid Held at psid

The backflow prevention assembly detailed above has been tested and maintained as required by TCEQ regulations and is certified to be operating within acceptable parameters unless otherwise noted.

The information provided in this report is certified to be TEST RESULTS: (check one) PASSED FAILED true at the time of testing.

OWNER OF DEVICE:

OWNER’S NAME

OWNER’S MAILING ADDRESS

CITY/STATE/ZIP

DEVICE ADDRESS

PHONE- ___________________________________________

DATE-

TEST GAUGE MAKE_______________ MODEL__________________

S/N_____________________________ TEST DATE_______________

TEST DATE ________________Time__________AM______PM______

TESTER NAME _______________________________________________

TESTER SIGNATURE________________________________________

BPAT LIC. # ________________________________________________

LICENSE EXP. DATE __________________________________________

COMPANY NAME ____________________________________________

COMPANY ADDRESS _________________________________________

PHONE _______________________ FAX _______________________

OFFICE USE ONLY

Date Received: Date Entered: Entered by:

REV 12/02/2014

Backflow Prevention Assembly Test and Maintenance Report

1/6/2015

Watts

15934 1/2”

Fire Water Detector Line

Left side of building in Vault

1.6

1.8

1/28/21 2:00

U.S. Federal Courthouse Jaime Alviar

1133 N. Shoreline Blvd.

Corpus Christi TX 78402 BP0018121

1133 N. Shoreline Blvd. 11/17/23

361-765-1752 APS Fire C0

7407 Spencer Hwy Pasadena TX 77505

713-946-3311 N/A Unlimited Bac Flo 5

05170698 6/24/20

1/29/21

CITY OF CORPUS CHRISTI

SUBMIT TO: CITY OF CORPUS CHRISTI, DEVELOPMENT SERVICES DEPT.-

PLUMBING DIVISION (Regulatory Agency), BACKFLOW PREVENTION PROGRAM 2406 Leopard St. PO Box 9277 CORPUS CHRISTI, TX 78469-9277 (361-826-3253) City of Corpus Christi PWS 1-180003

ONLINE PAYMENT VERIFICATION

APPL. # _______________________

IS THE ASSEMBLY INSTALLED IN ACCORDANCE WITH MANUFACTURER RECOMMENDATIONS AND/OR LOCAL CODES?

YES NO

PHYSICAL LOCATION OF DEVICE:

(Example: Next to meter in back yard.)

MAKE OF DEVICE __________________________________

MODEL NUMBER ___________________________________

SERIAL NUMBER___________________________________

SIZE ______________________________________________

SERVES: __________________________________________

FIRE METER READ-

New irrigation system - Permit # _________________ Re-Cert. Re-Cert. (not prev. tested) Removed Replace backflow preventer only- Permit #

INITIAL TEST

Reduced Pressure Assembly RPDA Relief Value

Pressure Vacuum Breaker or SVB Double Check Assembly DCDA AIR INLET CHECK VALVE

1st Check 2nd Check

Opened at psid

Did Not Open

Held at psid

Leaked

DC- psid Closed tight RP- psid Leaked

Closed tight DC- psid

Leaked

Opened at psid

Did Not Open

REPAIRS AND

PARTS

TEST AFTER

REPAIR

DC- Closed tight RP- psid Closed tight Opened at psid Opened at psid Held at psid

The backflow prevention assembly detailed above has been tested and maintained as required by TCEQ regulations and is certified to be operating within acceptable parameters unless otherwise noted.

The information provided in this report is certified to be TEST RESULTS: (check one) PASSED FAILED true at the time of testing.

OWNER OF DEVICE:

OWNER’S NAME

OWNER’S MAILING ADDRESS

CITY/STATE/ZIP

DEVICE ADDRESS

PHONE- ___________________________________________

DATE-

TEST GAUGE MAKE_______________ MODEL__________________

S/N_____________________________ TEST DATE_______________

TEST DATE ________________Time__________AM______PM______

TESTER NAME _______________________________________________

TESTER SIGNATURE________________________________________

BPAT LIC. # ________________________________________________

LICENSE EXP. DATE __________________________________________

COMPANY NAME ____________________________________________

COMPANY ADDRESS _________________________________________

PHONE _______________________ FAX _______________________

OFFICE USE ONLY

Date Received: Date Entered: Entered by:

REV 12/02/2014

Backflow Prevention Assembly Test and Maintenance Report

1/6/2015

Unknown- Missing Plate Unknown - Missing Plate

Missing Plate 8”

Fire Water Line

Left side of building in Vault

1.8

2.2

1/28/21 2:00

U.S. Federal Courthouse Jaime Alviar

1133 N. Shoreline Blvd.

Corpus Christi TX 78402 BP0018121

1133 N. Shoreline Blvd. 11/17/23

361-765-1752 APS Fire C0

7407 Spencer Hwy Pasadena TX 77505

713-946-3311 N/A Unlimited Bac Flo 5

05170698 6/24/20

1/29/21

"Portable Fire Extinguisher Survey" Monthly Annual

Name Corpus Christi Federal Bldg. Date 1/29/21 Address 1133 North Shoreline Blvd

City/State/Zip Corpus Christi, TX 78401 Phone # Technician Jaime Alviar

1103 Center Street Pasadena, TX 77506 Lic# ECR-1170, SCR-0433 &

ACR-1043

Phone: 713-946-3311

ST00154029 Annual

Location No. Size

Type Mfg UL Rating Date Mfg

Last Hydro

Last 6 Yr

Next 6 Yr

Next Hydro

Comments

1ST FLOOR

Right Side of Main Lobby 1 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Corridor Entry by Room 1 2 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Hallway by Room 17 3 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Electrical Closet Room 17 4 5# ABC Kidde 3-A:40-B:C 2016 N/A N/A 2022 2028

Outside Restrooms by Room 37 5 5# ABC Kidde 3-A:40-B:C 2016 N/A N/A 2022 2028

Electrical Closet Room 39 6 5# ABC Kidde 3-A:40-B:C 2016 N/A N/A 2022 2028

By Room 49 7 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Marshal’s Office 8 5# ABC Ansul 3-A:40-B:C 2017 N/A N/A 2023 2029

2ND FLOOR

Outside Jury Assembly Room 9 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Clerks Office area 10 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Electrical Closet by Freight Elevator 11 5# ABC Kidde 3-A:40-B:C 2016 N/A N/A 2022 2028

Outside Restrooms by Copy Room 12 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Outside IT Room 13 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Electrical Room by IT Room 14 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

3RD FLOOR

Outside Jury Room South Corridor 15 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Outside Judge’s Entrance to Courtroom 16 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Electrical Closet by Judge’s Entrance 17 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

By Judge Head’s Chamber 18 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Electrical Closet by Freight Elevator 19 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Outside Judge Ramos Courtroom 20 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Jury Room North Corridor 21 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

MEZZANINE

AHU 6,7,8 22 10# ABC Amerex 4-A:80-B:C 2016 N/A N/A 2022 2028

AHU 9,10,11 23 10# ABC Amerex 4-A:80-B:C 2016 N/A N/A 2022 2028

AHU 1,2,3 24 10# ABC Amerex 4-A:80-B:C 2016 N/A N/A 2022 2028

AHU 4,5 25 10# ABC Amerex 4-A:80-B:C 2016 N/A N/A 2022 2028

ROOF

Elevator Room 26 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

BASEMENT

By Freight Elevator 27 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

By Loading Dock 28 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Exhaust Room Behind Security 29 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Parking Garage Stairwell 4 30 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Parking Garage Stairwell 5 31 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Elevator Lobby 32 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Elevator Room in Lobby 33 5# ABC Amerex 3-A:40-B:C 2013 N/A N/A 2019 2025

Fire Pump Room 34 10# ABC Ansul 4-A:80-B:C 2016 N/A N/A 2022 2028

Electrical Room 35 10# ABC Ansul 4-A:80-B:C 2016 N/A N/A 2022 2028

Tool Room 36 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

Gun Range 37 5# ABC Ansul 3-A:40-B:C 2012 N/A 2019 2030 2024

Chiller Plant 38 10# ABC Ansul 4-A:80-B:C 2017 N/A N/A 2023 2029

Elevator Room in Chiller Plant 39 5# ABC Kidde 3-A:40-B:C 2017 N/A N/A N/A N/A Disposable

Hallway Outside Stairwell 2 40 5# ABC Amerex 3-A:40-B:C 2012 N/A 2018 2030 2024

AHU B-1, B-2 41 10# ABC Ansul 4-A:80-B:C 2016 N/A N/A 2022 2028

SPARES

Spare in Tool Room SP1 10# ABC Ansul 4-A:80-B:C 2020 N/A N/A 2026 2032

Service Ticket:

Address:

Property:

Monthly Inspection Items:

1. Valves in correct (open/closed) position? Yes No N/A

2. Valves locked, supervised and accessible? Yes No N/A

3. Gauges appear to be in good condition Yes No N/A

4. Gauges showing normal pressure/pressures? Yes No N/A Quarterly Inspection Items:

1. Fire department connection not damaged? Yes No N/A

2. Alarm devices free of damage? Yes No N/A

3. Hose connection valve caps in place and undamaged? Yes No N/A

4. Hose valve handles in place and undamaged? Yes No N/A

5. All hose valves in operational order? Yes No N/A

6. All hose racks/reels in operational order? Yes No N/A

7. All hose cabinets in operational order? Yes No N/A

8. All hoses in operational order? Yes No N/A Annual Inspection Items:

1. Cabinet/Cabinets inspected in accordance with NFPA 1962? Yes No N/A

2. Hose storage devices inspected in accordance with NFPA 1962? Yes No N/A

3. Visible pipe free of corrosion or loads? Yes No N/A

4. Visible pipe free of damage and properly aligned? Yes No N/A

5. Visible pipe hangers and supports free of damage? Yes No N/A Five Year Inspection Items:

1. Alarm valves and associated strainers, filters and restricted orifices pass internal inspection? Yes No N/A

2. Check valves internally inspected, all parts operate, and move freely and in good condition? Yes No N/A Alarm Valve Information:

Manufacturer:

Alarm devices:

Valve size:

Year:

Quarterly Test Items:

Standpipe main drain test.

1. Record no flow static pressure.

2. Record full flow residual pressure.

3. Was full flow observed? Yes No N/A

4. Results comparable to last test? Yes No N/A

5. Valve supervisory switch operational? Yes No N/A Annual Test Items:

1. Hose nozzle/nozzles tested in accordance with NFPA 1962? Yes No N/A

2. Hose storage devices tested in accordance with NFPA 1962? Yes No N/A

3. Hoses tested in accordance with NFPA 1962? (3-year testing required) Yes No N/A

4. All control valves operated through full range and returned to normal position? Yes No N/A

5. All control valves operate properly? Yes No N/A

Form for Inspection, Testing and Maintenance of Standpipe System.

Information on this form covers the requirements of NFPA 25 2014 for fire sprinkler per

IFC 2009 and the State of Texas.

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

BLUE

1/29/21 ANNUAL

ST00153994

1133 N Shoreline House Corpus Christi, Tx. 78402 Corpus Christi Court House

Clow Waterflow Paddle Switch

6"

Five Year Test Items:

1. Gauges over 5 years old replaced or calibrated? Yes No N/A

2. Flow test performed? Yes No N/A

3. Number of standpipes flowed?

4. GPM flowed from most remote standpipe?

5. GPM flowed from standpipe #2

6. GPM flowed from standpipe #3

7. GPM flowed from standpipe #4 Maintenance Items:

1. Standpipe maintains 3 foot of clearance? Yes No N/A

2. Standpipe left in service? Yes No N/A

3. Was Standpipe system tagged? Yes No N/A

4. Type of tag?

Comments:

Inspector Assisting Technician/Trainee

License/Certification License/Certification

NA

NA

NA

NA

NA

BLUE

Jaime Alviar Kris Gagnon

Job Number: Service Ticket Number:

Address: Method of Actuation:

Property: Shutdowns:

CONTROL PANEL:

Manufacturer

Model No.

Line Voltage

Battery Charge Level

Battery Load Test

Battery Amp

HR

Result

Audible & Visual Alarm

Audible & Visual

Trouble

Remote Indicators

Dis-charge Circuit

Service Lock-out

Remote Monitoring

Comment

Battery:

DATE: QUANTITY: SIZE:

OPERATING SEQUENCE:

Bells Horn Strobes Horn Voice

Message Chimes Remote Indicator

Remote Monitoring Comment #

QUANTITY

Alarm/ Pre-Alarm

Cross Zone (2nd Alarm)

Discharge

Manual Operation

Page of

Breaker Name/Location:

Form for Inspection and Testing of Fire Alarm Systems Information on this form covers the requirements of NFPA 72 2013 for fire alarm per

IFC 2009 and the State of Texas.

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

BLUE

01/30/2021 Annual

NA ST00153995

312 S Main Victoria, Tx. 77904 Automatic and Manual

Victoria Federal Building No

Conventional

Simplex 120V 13.7 7.2 PASS PASS PASS PASS - - PASS

4002 13.7 6.1 PASS

05/18 2 12Vx20AH

Strobes Speakers

- 5 16 - - - - - Pass

- S MC - - - - - -

- S MC - - - - - -

1 4

Type Operation Test Graphic Location Sensitivity

Setting Remarks

Note: Sensitivity Testing is not included in a routine periodic inspection. It is a separately scheduled inspection; price is available upon request.

Manufacture/Part # Detector Photo:

Manufacture/Part # Detector ION:

Page of

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

Zone

M P 1 Pull Basement Man. Pullstation DD P 2 Duct Basement AHU #1 DD P 3 Duct Basement AHU #5 PE P 4 Smoke Basement Elevator Lobby M P 5 Pull Post Office Manual Pullstation PE P 6 Smoke Post Office Elevator Lobby Smoke WF P 7 Water Flow Basement Flow Switch TS P 8 Tamper Basement Tamper Switch 3 total M P 9 Pull 2nd Floor by Stairwell #1 PE P 10 Smoke 2nd Floor Elevator Lobby Smoke DD P 11 Duct 2nd Floor AHU#2 M P 12 Pull 3rd Floor by Stairwell #1 DD P 13 Duct 3rd Floor AHU #4 PE P 14 Smoke 3rd Floor Elevator Lobby Smoke M P 15 Pull 4th Floor by Stairwell #1 PE P 16 Smoke 4th Floor Elevator Lobby Smoke DD P 17 Duct Penthouse AHU #6 DD P 18 Duct Penthouse AHU #5 PE P 19 Smoke Penthouse Elevator Room 2 total M P 5 Pull 1st Floor Guard Station M P 5 Pull 1st Floor Elevator Lobby M P 5 Pull Main Post Office Floor North M P 5 Pull Main Post Office Floor South

PE P 10

M

Smoke 2nd Floor Hallway P 9 Pull 2nd Floor by Stairwell #2

M P 12 Pull 3rd Floor by Stairwell #2 PE P 14 Smoke 3rd Floor Lobby Smoke PE P 14 Smoke 3rd Floor Hallway PE P 16 Smoke 4th Floor Hallway PE P 16 Smoke 4th Floor Lobby Smoke M P 15 Pull 4th Floor by Stairwell #2 PE P 10 Smoke 2nd Floor Lobby Smoke PE P 4 Smoke Basement Lobby PE P 4 Smoke Basement Hallway M P 1 Pull Basement by Stairwell #1 M P 1 Pull Basement by Stairwell #2 TFT VC 19 Heat Penthouse TFT VC 19 Heat Penthouse

NA

2 4

Output Devices:

(Shutdowns, Closers, Releases, Etc.)

Type Operation Test Function Location Remarks

Page of

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

Zone

Output P AHU Shutdown 2 Basement AHU 1 Output P AHU Shutdown 3 Basement AHU 2 Output P AHU Shutdown 11 2nd Floor Output P AHU Shutdown 12 3rd Floor Output P AHU Shutdown 17 Penthouse AHU 6 Output P AHU Shutdown 18 Penthouse AHU 5

3 4

DEFICIENCY:

LEGEND:

AS Air Sampling Detector MR Manual Release St SUP Supervisory VC Visual Check DD Duct Detector PE Photoelectric Smoke Detector WT Water Detector BT Bell Tone FD Flame Detector PS Pressure Switch PE/T Photo/Heat Combo CT Chime Tone

TFT Fixed Temperature Detector TRR Thermal Rate of Rise Detector P Pass LA Low Air Pressure Switch LP Agent Low Pressure TP Temporal Pattern (Code 3) NA Not Applicable

ABT Abort Switch GD Gas Detector V Voice Message NC Not Checked ION Ionization Smoke Detector TRC Thermal Rate of Compensation F Fail S Steady Tone M Manual Pull Station TL Thermal Line Type Detection B Required Adjustment TS Tamper Switch WF Water Flow Switch MC March Cadence

Inspector:

Inspector Signature:

Assisting Technicians/Trainees:

Client Name:

Client Signature:

AUX Auxiliary

Page of

System Restored To Normal Operation?

Monitoring Company Called and Signals Verified?

Monitoring Restored To Normal?

Date/Time:

Date/Time:

Date/Time:

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

Recommend upgrading fire alarm system.

YES 1-30-2021 / 13:00

YES 1-30-2021 / 13:00

YES 1-30-2021 / 13:00

Kris Gagnon

Jaime Alviar Billy Miller

4 4

Service Ticket:

Address:

Property:

Note: All questions are to be answered Yes, No or Not Applicable. All ''No'' answers are to be explained in the comments portion of this form. All responses refer to the current inspection performed on the date shown above.

Owner's Section

1. Is the fire pump in service? Yes No

2. Has the fire pump remained in service? Yes No

3. Was the system (of which the fire pump is a part) free from actuation of alarms? Yes No

4. Have any building modifications or remodels taken place? Yes No

Explain any “NO” answers.

Owner or Representative Name- Owner or Representative Signature- Note to Owner: Periodic tests of transfer switches and emergency generators are to be performed by a qualified electrical contractor in accordance with NFPA 110.

Inspections-All to be performed weekly.

1. Pump house/room at least 40° F? Yes No N/A

2. Suction, discharge, and bypass valves open? Yes No N/A

3. Piping free from leaks? Yes No N/A

4. Suction and system pressure gauges normal? Yes No N/A

5. Suction reservoir, if provided, full? Yes No N/A

6. Controller indicating power on? Yes No N/A

7. Transfer switch indicating normal situation? Yes No N/A

8. Isolation switch closed? Yes No N/A

9. Reverse phase alarm indicator off or normal phase rotation indicator on? Yes No N/A

10. Controller selector switch in Auto position? Yes No N/A

11. All alarm indicators off? Yes No N/A

12. Circulation relief valve operating properly? Yes No N/A

13. Pressure relief valve operating properly? Yes No N/A Weekly Test Items Electrical Pumps

1. Pump started automatically? Yes No N/A

2. Record starting pressure. Psi

3. Pump run for at least 10 minutes? Yes No N/A

4. Record suction and discharge pressure while running.

5. Pump packing showing slight discharge? Yes No N/A

6. Free from unusual noises and vibrations? Adjust if necessary. Yes No N/A

7. Packing boxes, bearings, and pump free from overheating? Yes No N/A

8. Record time for motor to accelerate to full speed.

9. Record time controller on first step.

10. Times and pressures acceptable? Yes No N/A

Form for Inspection, Testing and Maintenance of Electric Fire Pumps Information on this form covers the requirements of NFPA 25 2014 for fire pumps per

IFC 2009 and the State of Texas.

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

Blue Tag

01/29/2021 Annual

ST00153994

1133 N Shoreline House Corpus Christi, Tx. 78402 Corpus Christi Federal Building

55 130

0 to 3

NA

Annual Test Annual pump test was run using the following method: (check one)

Method “A” Discharge of flow through hose streams. Flow readings taken at each hose stream.

Method “B” Discharge through by-pass flow meter to drain suction reservoir. Flow readings taken by flow meter.

Method “C” Discharge through by-pass flow meter directly returned to pump suction. Flow readings taken by flow meter.

Note: At least once every three years method “A” or “B” must be used.

No Flow Condition Rated (100%) Flow Peak (150%) Flow

Suction Pressure

Discharge Pressure

Flow GPM

Electric Amps

Pump RPM's

1. Are the values in the above table acceptable? Yes No N/A

2. No-flow (churn) test run for 10 minutes? Yes No N/A

3. Circulation relief valve and pressure relief? Yes No N/A

4. Valve operated properly during all flow tests? Yes No N/A

5. No alarm indicators or visible abnormalities observed during flow test? Yes No N/A Low Suction Throttling Device Test

1. Low suction pressure simulated? Yes No N/A

2. Free from abnormalities in throttling action? Yes No N/A

3. Free from abnormalities return to full flow? Yes No N/A Automatic Transfer Switch Test

1. Power failure simulated during peak flow? Yes No N/A

2. Connection made to alternate power source? Yes No N/A

3. After termination of simulated power failure did motor reconnect to normal power source? Yes No N/A

4. All alarm conditions simulated? Yes No N/A

5. All alarms operated? Yes No N/A Maintenance A maintenance schedule must be established in accordance with the manufacturer’s recommendations. In the absence of such a schedule, the following must be used:

Annual Maintenance Items

1. Changed pump bearing lubrication? Yes No N/A

2. Shaft end play acceptable? Yes No N/A

3. Pump coupling alignment acceptable? Yes No N/A

4. Transmission coupling, right angle gear drive and mechanical moving parts acceptable? Yes No N/A

5. Emergency manual starting means operated without power? Yes No N/A

6. Electrical connections secure? Yes No N/A

7. Pressure switch settings calibrated? Yes No N/A

8. Motor bearings greased? Yes No N/A

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

55 45 40

130 105 95

Churn 500 750

NA NA NA

1,792 1600 1,596

Pump:

Shaft Type:

Manufacturer: Approved: Yes No Shop/Serial:

Model/Type:

Rated G.P.M:

Rated R.P.M:

Rated Head-Ft.:

Suction From:

Tank Size:

Tank Height:

If Vertical Type:

Vertical distance of discharge to gauge:

Static Ft.:

Pumping Ft.:

Right Angle Gear Drive:

Manufacturer: Approved: Yes No Shop/Serial:

Model/Type:

Performance:

Driver:

Manufacturer: Approved: Yes No Shop/Serial:

Model/Type:

Rated H.P.:

Rated R.P.M

Motor/Engine Type:

Rated Volts:

Operating Volts:

Rated Fla Amps:

Amps At:

Phase:

Cycles:

Service Factor:

Pressure Governor Built In: Yes No N/A Independent: Yes No N/A Controller:

Manufacturer: Approved: Yes No N/A Shop/Serial:

Model/Type:

Start:

Manual:

Auto:

Pressure Drop:

Water Flow:

Jockey Pump:

Manufacturer: Approved: Yes No N/A Shop/Serial:

Model/Type:

Start:

Manual:

Auto:

Speed

RPM

Discharge Pressure

Suction Pressure

Net Head

Pressure

Streams Gallons Per Min

% of Rated

Capacity Volts Amps

No. Size Press

Comments:

Inspector Assisting Technician/Trainee

License/Certification License/Certification

2000 W. Detriot Broken Arrow, OK 74012 (918)258-9666 www.APSFireCoTulsa.com

AR # PF134, FSS130, E20050071; AZ # ROC259882;

CA # 737491; CO # 312; IL # SC0138; IA # FP-FP-178, C122584; KY #A-050S, A-0515C;

LA # F404, E2085, 37318; MD # NW-195, MSC-412; MI # 20838-C; MS # 1506;

MT # FPLBEL000133; NM # MS12; OK # 0062, 242; SC # FSC1091, F-13386; WI # 637-7

Horizontal

AP Aurora ■ 00-112538

481 FP H

City

NA

NA

NA

NA

NA

NA

NA

NA

Marathon ■

6VL 324TTDP4038BA L

TDS

Electric 230/460

88/44

1.15

■Firetrol

FTA1000-AE40B

Pass Pass Pass Pass

Baldor ■ 84.Z00009

35N185-037361

Pass Pass

1,792 130 55 75 Churn Churn Churn Churn Churn NA NA

1600 105 45 60 2 1.75 6.1 500 100% NA NA

1,596 95 40 55 2 1.75 12.8 750 150% NA NA

"Portable Fire Extinguisher Survey" Monthly Annual

Name Victoria Federal Building Date 1/30/21 Address 312 S. Main St.

City/State/Zip Victoria, TX 77904 Phone # Technician Jaime Alviar

1103 Center Street Pasadena, TX 77506 Lic# ECR-1170, SCR-0433 &

ACR-1043

Phone: 713-946-3311

ST00154030 Annual

Location No. Size

Type Mfg UL Rating Date Mfg

Last Hydro

Last 6 Yr

Next 6 Yr

Next Hydro

Comments

PENTHOUSE

AHR 4–1 1 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Elevator Room 2 10# ABC Ansul 4-A:80-B:C 2014 N/A 2021 2032 2026 6yr Performed

Elevator 1 & 2 3 10# ABC Ansul 4-A:80-B:C 2014 N/A 2021 2032 2026 6yr Performed

4TH FLOOR

Janitor Closet J-4-1 4 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Room 420 5 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Hallway FE 4-2 6 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

3RD FLOOR

Room T-3-1 FE 3-1 7 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Room 322 FE 3-2 8 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Room 314 3-3 9 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Room 318 AHR-3-1 10 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

2ND FLOOR

Room T-2-1 FE 2-1 11 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Room 226 FE 2-2 12 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Room 220 FE 2-4 AHR-2-1 13 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Room 216 FE 2-3 14 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

POST OFFICE

FE 1-1 15 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

FE 1-4 16 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Kitchen FE 1-10 17 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

FE 1-7 Center Beam 18 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

FE 1-8 Back Wall 19 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

FE 1-2 20 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

FE 1-6 21 10# ABC Buckeye 4-A:80-B:C 2010 N/A N/A 2016 2022

FE 1-11 Rm.136 22 10# ABC Amerex 4-A:60-B:C 2018 N/A N/A 2024 2030

SECURITY SHACK

Security Shack 23 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

BASEMENT

Freight Elevator FE-B-1 24 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Room B-114 FE-B-2 25 20# ABC Buckeye 10-A:120-B:C 2018 N/A N/A 2024 2030

Room B-117 FE-B-6 26 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Room B-116 FE-B-3 27 20# ABC Buckeye 10-A:120-B:C 2018 N/A N/A 2024 2030

By Men’s Restrooms FE-B-4 28 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030

Chiller Plant AHR-B1 29 20# ABC Buckeye 10-A:120-B:C 2018 N/A N/A 2024 2030

Maintenance Room B-1-11 30 20# ABC Buckeye 10-A:120-B:C 2018 N/A N/A 2024 2030

SPARES

Spare in Maintenance Room SP 10# ABC Buckeye 4-A:80-B:C 2018 N/A N/A 2024 2030 At Elevator 1 & 2 / Swap Out

Form for Inspection, Testing and Maintenance of Wet Pipe Sprinkler System Information on this form covers the requirements of NFPA 25 2014 for fire sprinkler per

IFC 2009 and the State of Texas.

Date: Type of Inspection:

Service Ticket:

Address:

Property:

Owner’s Section

1. Is the building occupied? Yes No

2. Have the occupancy and hazard of contents remained the same? Yes No

3. Are all fire protection systems in service? Yes No

4. Has the system remained in service without modification? Yes No

5. Was the system free of actuation of devices or alarms? Yes No

6. Have any building modifications or remodels taken place? Yes No

Explain any “NO” answers.

Owner or Representative Name- Owner or Representative Signature- Weekly Inspection Items:

1. Valves in correct (open/closed) position? Yes No N/A

2. Locked, supervised and accessible? Yes No N/A Monthly Inspection Items:

1. Sprinkler head wrench present? Yes No N/A

2. Gauges showing normal pressure? Yes No N/A

3. Alarm valve free of physical damage? Yes No N/A

4. Alarm valve trim in proper position? Yes No N/A

5. No leaks from valve retard or drain? Yes No N/A Quarterly Inspection Items:

1. Fire department connection not damaged? Yes No N/A

2. Alarm devices free of damage? Yes No N/A

3. Hydraulic name plate present and legible? Yes No N/A Annual Inspection Items:

1. Proper number and types of spare heads? Yes No N/A

2. Sprinklers free of corrosion or paint? Yes No N/A

3. Sprinkler free of obstruction or damage? Yes No N/A

4. Liquid present in glass bulb sprinklers? Yes No N/A

5. Visible pipe free of corrosion or loads? Yes No N/A

6. Visible pipe free of damage and alignment? Yes No N/A

7. Visible pipe hangers free of damage? Yes No N/A

8. Adequate heat in areas with wet piping? Yes No N/A

9. All escutcheon/cover plates are present? Yes No N/A

10. Is the sprinkler system monitored? Yes No N/A Five Year Inspection Items:

1. Alarm valves and associated strainers, filters and restricted orifices pass internal inspection? Yes No N/A

2. Check valves internally inspected, all parts operate, and move freely and in good condition? Yes No N/A Alarm Valve Information:

Manufacturer:

Alarm devices:

Valve size:

Year:

1103 Center St.

Pasadena, TX 77506

(713) 946-3311 www.APSFireCoHouston.com

TX #ECR-1170, ACR-1043, SCR-G-0433

BLUE

01/30/2021 ANNUAL

ST00153995

312 S Main Victoria, Tx. 77904 Victoria Federal Building

Billy Miller

Reliable System Sensor WFD-40 4"

Sprinkler Head Information:

Manufacturer Type Year Temp Glass Bulb?

Quarterly Test Items:

Sprinkler system main drain test.

1. Record no flow static pressure.

2. Record full flow residual pressure.

3. Was full flow observed? Yes No N/A

4. Results comparable to last test? Yes No N/A

5. Water flow alarm device passed test? Yes No N/A

6. Inspectors test connection open? Yes No N/A

7. Inspectors Test Location?

8. Bypass connection open? Yes No N/A

9. Valve supervisory switch operational? Yes No N/A Annual Test Items:

1. Standard heads less than 50 years old? Yes No N/A

2. Standard heads over 50 years old tested within last 10 years? Yes No N/A

3. Fast response heads less than 20 years old? Yes No N/A

4. Fast response heads over 20 years old tested within the last 10 years? Yes No N/A

5. All control valves operate properly? Yes No N/A

6. Anti-freeze specific gravity correct? Yes No N/A

7. Anti-freeze specific gravity reading?

Five Year Test Items:

1. Gauges over 5 years old replaced or calibrated? Yes No N/A

2. Heads rated for high temperature tested? Yes No N/A Maintenance Items:

1. Riser maintains 3 foot of clearance? Yes No N/A

2. System left in service? Yes No N/A

3. Was system tagged? Yes No N/A

4. Type of tag?

Comments:

Inspector Assisting Technician/Trainee

License/Certification License/Certification

Ascoa Upright 1989 165 NO

Ascoa Pendant 1989 165 NO

AHU ROOM

NA

BLUE

N/A NA