6_-_EPB_Defeciency_Reports.pdf

Form AES 9 Sept. 3, 2013

Continuation Form California Code of Regulations - Title 19 for Inspection, Testing, and Maintenance 1 of 2

Deficiencies and Comments

Property Information

Contractor or Licensed Owner Information

Building Name Road Shop Name HCI Systems Inc

Address EPB 0755 Address 3742 W. Gettysburg Ave.

City Fresno St. CA Zip 93722

City El Portal License # 905493 Phone (559)233-2008

Contact Person Jeff McBride SFM Job # SV2308030045

Phone (410)668-8000 ■ CSLB Misc.

Type of System

■ Automatic Sprinkler System Water Storage Tank System Riser ID 1 Water Spray System

Standpipe & Hose System System Riser ID System Riser ID Foam-Water System

Private Water Supply System System Riser ID

D = Deficiency *C = Comment (Indicate type )

Item Date Riser D C Deficiencies and Comments Indicate all equipment, devices and parts that were repaired or replaced

2.1 09/14/23 1 ✔

Dry pendants in Laundry room & paint booths over 10 years old.

2.3 09/14/23 1 ✔ Ran ITV 2 minutes. Waterflow alarm never activated.

for Inspection, Testing, and Maintenance 2 of 2

Building Name Road Shop Name HCI Systems Inc Address EPB 0755 Job # SV2308030045 City El Portal

D = Deficiency C = Comment (Indicate type )

Item Date Riser D C Deficiencies and Comments (cont.)

See Correction Form AES 10 for corrected deficiencies. Number attached:

I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form.

Print Name Brian Thieme

Signature Brian Thieme Digitally signed by Brian Thieme Date 09/14/23 Date: 2023.10.13 10:26:08 -07'00'

Form AES 2.3 Sept. 3, 2013

Dry Pipe California Code of Regulations - Title 19 Quarterly and 1 of 3 Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report

Building Name Road Shop Name HCI Systems, Inc.

Address EPB 0755 Address 3742 W. Gettysburg Ave. Suite 102 City Fresno St. CA Zip 93722 City El Portal License # 905493 Phone (559)233-2008

Phone (410) 668-8000 ■ CSLB Misc.

Riser Information Main Drain Test (Annual)

Riser No. Location Riser

Diameter Main Drain Diameter

Initial Static Pressure

Residual Pressure

Final Static Pressure P,F,N/A

1 Internal East Bay 4" 2" 145 110 134 P

This building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached:

Quarterly Inspections

I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable

Item

Description NFPA 25 CA ed.

Reference

Date Date Date Date 09/14/23

1.1 I Control Valves – Identification Sign 13.3.1 P

1.2 I Control Valves – Inspection 13.3.2 P

1.3 I Waterflow Alarm Devices 5.2.5 P

1.4 I Supervisory Devices 5.2.5 P

1.5

I Gauges (Dry Pipe Systems)

Pass = Normal Pressures

5.2.4.2, 5.2.4.3 5.2.4.4

13.4.4.1.2

F

1.6 I

Air Pressure

5.2.4.2, 5.2.4.3 5.2.4.4

13.4.4.2.5.1 psi psi 135 psi psi

1.7 I Water Supply Pressure

5.2.4.2

13.4.4.2.5.1 psi psi 145 psi psi

1.8 I Hydraulic Design Information Sign

(for hydraulically designed systems) 5.2.6 P

1.9 I General Information Sign

(not required for system prior to 2007 edition of NFPA 13) 5.2.8

N/A

1.10 I Heat Tape 5.2.7 N/A

1.11 I Spare Sprinklers 5.2.1.4 F

1.12 I Fire Department Connections 13.7 P

1.13 I Dry Pipe Valves – Exterior Inspection 13.4.4.1.4 P

1.14 I Pressure Reducing Valves 13.5.1 N/A

1.15 Backflow Preventers 13.6.1 N/A

1.16 PRV – Fire Sprinkler Systems 13.5.1 N/A

Dry Pipe California Code of Regulations - Title 19 Quarterly and 2 of 3 Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report

ANNUAL INSPECTION, TESTING, AND MAINTENANCE

Include ALL Quarterly Inspections (See Previous Page) I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable

Item Description NFPA 25 CA ed.

Reference Date Comments Only P,F,N/A

1.17 I Buildings (Freeze Protection) 4.1.1.1 09/14/23 Owner’s Responsibility P

1.18 I Sprinklers 5.2.1 09/14/23 F

1.19 I Pipe and Fittings 5.2.2 09/14/23 F

1.20 I Hangers 5.2.3 N/A

1.21 I Seismic Braces 5.2.3 09/14/23 F

1.22 I Small Hose Connections* 13.5.6.2.2 N/A

2.1 T Field Service Test Required

(Send Report to Fire Code Official) 5.3.1 09/14/23 If REQUIRED, Enter 'F' until results are returned from Lab F

2.2 T Recalled Sprinklers

If not present = Pass; If present = Fail

Title 19 904.1(c) 09/14/23 P

2.3 T Water Flow Alarm Devices

90 sec. maximum - (Enter Time )

5.3.3

13.2.6 09/14/23 sec. F

2.4 T Main Drain Test

(Enter data on Page 1 of this form)

13.2.5

13.3.3.4 09/14/23 P

2.5 T Priming Water Level Test 13.4.4.2.1 N/A

2.6 T Dry Pipe Valve Trip Test

(Partial trip test is acceptable)

13.4.4.2.2 13.4.4.2.2.3 13.4.4.1.5

09/14/23

2.7 T Valve Trip Time 13.4.4.2.5.2 sec. N/A

2.8 T Trip Air Pressure 13.4.4.2.5.1 psi N/A

2.9 T Quick-Opening Device Test 13.4.4.2.4 N/A

2.10 T Low Air Pressure Alarm Test 13.4.4.2.6 N/A

2.11 T Low Temperature Alarm Test 13.4.4.2.7 N/A

2.12 T Automatic Air Pressure Maintenance Device Test 13.4.4.2.8 N/A

2.13 T Control Valve – Operation 13.3.3 09/14/23 P

2.14 T Valve Supervisory Devices 13.3.3.5 09/14/23 F

2.15 T Backflow Preventer Assemblies 13.6.2 N/A

2.16 T PRV – Partial Flow 13.5.1.3 N/A

* Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems.

Dry Pipe California Code of Regulations - Title 19 Quarterly and 3 of 3 Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report

Include ALL Quarterly Inspections (See Quarterly Inspections Page) I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable

Item Description NFPA 25 CA ed.

Reference Date Comments Only P,F,N/A

3.1 M Control Valves 13.3.4 N/A

3.2 M Maintenance 13.4.4.3 N/A

3.3 M Dry Pipe Valve Interior Cleaned 13.4.4.3.1 9/14/23 P

3.4 M Low Points in System Drained 13.4.4.3.2 N/A

3.5 M Backflow Preventer 13.6.3 N/A

3.6 M

Obstruction Investigation Required

(If “Yes”, see Deficiencies and Comments Section for Results.)

14.3 Yes

✔ No N/A

3.7 M System Returned to Service 4.5.3

15.7 9/14/23

Yes ✔ No F

Indicate all equipment, devices and parts that were repaired or replaced

1.5 09/14/23 1 X Both gauges outdated. Replace air gauge & water gauge on riser.

1.19 09/14/23 1 X Remove black power cord from sprinkler line in Black Opps Welding Shop.

1.19 9/14/23 1 X Handle broken on 2" angle valve at main drain on riser.

2.6 9/14/23 1 X 4" Viking Model E2 flange by groove dry valve not holding. System was tripped upon arrival. Valve off from compressor to riser. Unable to reset system to normal dry condition. Replace dry valve.

1.12 9/14/23 1 X Suggest labeling FDC with building identification.

1.18 9/14/23 1 X 9 painted 165* 401 style chrome dry pendants in paint booth.

2.14 9/14/23 1 X 1 1/2" butterfly valve on paint booth not transmitting to FACP during operation.

1.21 9/14/23 1 X 1 1/2" pipe feeding paint booth not braced.

1.21 9/14/23 1 X Add 1" plug to Auxiliary drain at paint booth.

1.11 9/14/23 1 X No spare dry pendant found at spare head box.

■ Check here if additional Deficiencies and Comments are listed on Form AES9 Number attached: 1

I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form.

Check box if Annual Inspection, Testing & Maintenance Items are Completed in the Indicated Quarter Quarter 1st Annual 2nd Annual 3rd ✔ Annual 4th Annual

Date 09/14/23

Print Name Brian Thieme

Signature Digitally signed by Brian Thieme

Brian Thieme Date: 2023.10.13 10:29:12 -07'00'

Inspection, Testing, and Maintenance Cover Sheet NFPA25 as amended by CCR, Title 19

Property Information:

Name: Covered Storage Lg & Sm Occupancy/Use:

Address:

EPB 0757/ 0794 Construction Type:

City:

El Portal No. Stories: 1

ZIP:

95389 Year Constructed:

Contact:

Jeff McBride

Telephone: (410) 668-8000

Contractor Information: Number of System Risers

Name:

Address:

HCI Systems, Inc.

3742 W. Gettysburg Ave.

Fresno

CA

Copy sent to:

Owner

Date:

City: Fire AHJ Date:

State: ✔ Contractor Date:

Telephone:

(559) 233-2008 NOTES:

1) For specific inspection, testing, and maintenance

CA License#:

905493 requirements and information, see NFPA 25, 2011 Edition as amended by California Code of Regulations, Title 19, §901 to §906.

Job #: SV2308030045

Performed by:

B. Thieme & J. Johnson

2) Inspection items may be performed by the owner in accordance with California Code of Regulations, Title 19, §904.1(a)

Check box for each system inspected and enter the number of forms used for inspection.

Check boxes (Fail or Pass) to indicate status of inspected system at end of inspection.

Forms Included with this Report NFPA 25 Chapter Number of Forms N/A Fail* Pass

✔ Automatic Sprinkler System 5 1

Standpipe and Hose System 6 0

Private Water Supply System 7 0

Fire Pump 8 0

Water Storage Tank 9 0

Water Spray System 10 0

Foam Water Sprinkler System 11 0

Water Mist System 12 0

Concerns that are not deficiencies (i.e. Non-Sprinklered Areas) Yes ✔ No

*See "Deficiencies and Comments" section at end of each respective form.

AES 1 September 3, 2013

Dry Pipe California Code of Regulations - Title 19 Quarterly and 1 of 3 Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report

Building Name Covered Storage Lg/Sm Name HCI Systems, Inc.

Address EPB 0757/ 0794 Address 3742 W. Gettysburg Ave. Suite 102 City Fresno St. CA Zip 93722 City El Portal License # 905493 Phone (559)233-2008

No. Location Riser

Diameter Main Drain Diameter

Initial Static Pressure

Residual Pressure

Final Static

1 Internal S/W wall of warehouse 6" 2" 125 90 122 P

This building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached:

Date Date Date Date 09/14/23

1.1 I Control Valves – Identification Sign 13.3.1 P

1.2 I Control Valves – Inspection 13.3.2 P

5.2.4.2, 5.2.4.3

P

5.2.4.2, 5.2.4.3 5.2.4.4

13.4.4.2.5.1 psi psi 46 psi psi

1.7 I Water Supply Pressure

5.2.4.2

13.4.4.2.5.1 psi psi 125 psi psi

1.8 I Hydraulic Design Information Sign

(for hydraulically designed systems) 5.2.6 P

1.9 I General Information Sign

1.12 I Fire Department Connections 13.7 P

1.13 I Dry Pipe Valves – Exterior Inspection 13.4.4.1.4 P

1.14 I Pressure Reducing Valves 13.5.1 P

Dry Pipe California Code of Regulations - Title 19 Quarterly and 2 of 3 Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report

Address EPB 0757/ 0794 Job # SV2308030045

I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable

Item Description NFPA 25 CA ed.

Reference Date Comments Only P,F,N/A

1.17 I Buildings (Freeze Protection) 4.1.1.1 09/14/23 Owner’s Responsibility P

1.18 I Sprinklers 5.2.1 09/14/23 P

1.19 I Pipe and Fittings 5.2.2 09/14/23 F

1.20 I Hangers 5.2.3 09/14/23 P

1.21 I Seismic Braces 5.2.3 09/14/23 P

1.22 I Small Hose Connections* 13.5.6.2.2 09/14/23 F

2.1 T Field Service Test Required

(Send Report to Fire Code Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab N/A

2.2 T Recalled Sprinklers

If not present = Pass; If present = Fail

Title 19 904.1(c) 09/14/23 P

2.3 T Water Flow Alarm Devices

90 sec. maximum - (Enter Time )

5.3.3

13.2.6 09/14/23 sec. P

2.4 T Main Drain Test

(Enter data on Page 1 of this form)

13.2.5

13.3.3.4 09/14/23 P

2.5 T Priming Water Level Test 13.4.4.2.1 N/A

2.6 T Dry Pipe Valve Trip Test

(Partial trip test is acceptable)

13.4.4.2.2 13.4.4.2.2.3

2.7 T Valve Trip Time 13.4.4.2.5.2 09/14/23 10 sec. P

2.8 T Trip Air Pressure 13.4.4.2.5.1 09/14/23 25 psi P

2.9 T Quick-Opening Device Test 13.4.4.2.4 09/14/23 P

2.10 T Low Air Pressure Alarm Test 13.4.4.2.6 P

2.11 T Low Temperature Alarm Test 13.4.4.2.7 N/A

2.12 T Automatic Air Pressure Maintenance Device Test 13.4.4.2.8 09/14/23 F

2.13 T Control Valve – Operation 13.3.3 09/14/23 F

2.14 T Valve Supervisory Devices 13.3.3.5 09/14/23 P

2.15 T Backflow Preventer Assemblies 13.6.2 N/A

2.16 T PRV – Partial Flow 13.5.1.3 N/A

* Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III

Dry Pipe California Code of Regulations - Title 19 Quarterly and 3 of 3 Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report

Address EPB 0757/ 0794 Job # SV2308030045

I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable

Item Description NFPA 25 CA ed.

Reference Date Comments Only P,F,N/A

3.1 M Control Valves 13.3.4 N/A

3.2 M Maintenance 13.4.4.3 9/14/23 P

3.3 M Dry Pipe Valve Interior Cleaned 13.4.4.3.1 9/14/23 P

3.4 M Low Points in System Drained 13.4.4.3.2 9/14/23 P

3.5 M Backflow Preventer 13.6.3 N/A

3.6 M

Obstruction Investigation Required

(If “Yes”, see Deficiencies and Comments Section for Results.)

14.3 Yes

✔ No N/A

3.7 M System Returned to Service 4.5.3

15.7 9/14/23 ✔ Yes

No P

Indicate all equipment, devices and parts that were repaired or replaced

1.5 09/14/23 1 X 2 air gauges & 1 water gauge outdated on riser. Replace or recalibrate every 5 years.

1.19 09/14/23 1 X Rotate 1 1/4" check valve to normal upright position below funnel on drain pipe.

1.12 9/14/23 1 X Air compressor not shutting off automatically. Had to turn knob on compressor to OFF then back to AUTO to stop compressor.

2.13 9/14/23 1 X 6" butterfly valve not holding. Pipe & valve are currently covered in aluminum sheeting for freeze protection. Unable to see if valve is flange or groove style.

1.1 9/14/23 1 X Add auxiliary drain sign at S/W corner of small storage.

1.19 9/14/23 1 X 2" band clamp on galvanized branch line at center of warehouse.

1.19 9/14/23 1 X Replace 3 damage 1" gate valves at hose stations around warehouse.

1.22 9/14/23 1 X 4- 100' single jacket 1 1/2" fire hoses outdated (May 1993).

1.19 9/14/23 1 X Add 1" X 3/4" bushing & broken 3/4" sprinkler to ITV at N/E corner.

I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form.

Check box if Annual Inspection, Testing & Maintenance Items are Completed in the Indicated Quarter Quarter 1st Annual 2nd Annual 3rd ✔ Annual 4th Annual

Date 09/14/23

Print Name Brian Thieme

Signature Digitally signed by Brian Thieme

Brian Thieme Date: 2023.10.18 07:14:36

AES 1 Sept. 3, 2013

Name: Admin Building Occupancy/Use:

Choose an item.

Address: EPB 0759 Construction Type: Choose an item.

City: El Portal No. Stories: 2

ZIP: 95389 Year Constructed 1995

Contact: Jeff McBride

Telephone: (410)668-8000

Contractor Information: Number of System Risers 3

Name: Owner Date:

Address

Fire AHJ Date:

Contractor Date: 9/12/23

State:

NOTES:

requirements and information, see NFPA 25, 2011 edition as amended by California Code of Regulations, accordance with California Code of Regulations, Title 19, §904.1(a)

Telephone:

CA License#: 905493

Performed by: B Thieme & J Johnson

Check box for each system inspected and enter the number of forms used for inspection. Check boxes (Fail or Pass) to indicate status of inspected system at end of inspection.

Forms Included with this Report NFPA 25

Automatic Sprinkler System 5 2

Standpipe and Hose System 6

Private Water Supply System 7

Fire Pump 8

Water Storage Tank 9

Water Spray System 10

Foam Water Sprinkler System 11

Water Mist System 12

Concerns that are Not Deficiencies (i.e. Non-Sprinklered Areas) Yes No

Wet Pipe Fire Sprinkler System

California Code of Regulations - Title 19 Inspection, Testing, and Maintenance

Quarterly and Annual Report

Building Admin Building

Address EPB 0759

City El Portal License # 905493 Contact Jeff McBride SFM Job # SV2308030045 Phone (410)668-8000 CSLB Misc.

Riser Information Main Drain Test (Annual) Riser No. Location

Riser Diameter

Main Drain Diameter

Initial Static Pressure

Residual Pressure

Final Static Pressure P,F,N/A

1 Mechanical Room (109) 6” 2” 125 65 123 P 2 Machine Shop 4” 2” 145 61 140 P 3 Janitorial Closet by restrooms 4” 2” 155 N/A N/A

This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached

I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable

Item Description NFPA 25 CA ed.

Reference

Date Date Date Date 9/12/23

1.1 I Control Valves – Identification Sign 13.3.1 P

1.2 I Control Valves – Inspection 13.3.2 P

1.3 I Waterflow Alarm Devices 5.2.5 F

1.4 I Supervisory Devices 5.2.5 P

1.5 I Gauges (Wet Pipe Systems) 5.2.4.1 F

1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi * psi psi

1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi * psi psi

1.8 I Pressure Readings Acceptable 5.2.4.1 P

1.9 I Hydraulic Design Information Sign

(For Hydraulically Designed Systems) 5.2.6 P

1.10 I General Information Sign

(Not Required for System prior to 2007 Edition of NFPA 13) 5.2.8 N/A

1.11 I Heat Tape 5.2.7 N/A

1.12 I Spare Sprinklers 5.2.1.4 F

1.13 I Fire Department Connections 13.7 F

1.14 I Alarm Valves – Exterior Inspection 13.4.1 P

1.15 I Pressure Reducing Valves 13.5.1.1 N/A

1.16 I Backflow Preventers 13.6.1 N/A

1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2

13.5.5.1

F

1.18 I PRV – Fire Sprinkler Systems 13.5.1.1 N/A

* Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe systems.

Fire Sprinkler System

California Code of Regulations - Title 19 Inspection, Testing, and Maintenance

Annual Report 2 of 3

Name

Address EPB 0759 Job # SV2308030045 City El Portal Misc.

Include ALL Quarterly Inspections

I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable

Item Description NFPA 25 CA ed.

Reference Date Comments Only P,F,N/A

1.19 I Sprinklers 5.2.1 9/12/23 F

1.20 I Buildings (Freeze Protection) 4.1.1.1 9/12/23 Owner’s Responsibility P

1.21 I Pipe and Fittings 5.2.2 9/12/23 F

1.22 I Hangers 5.2.3 9/12/23 P

1.23 I Seismic Braces 5.2.3 9/12/23 P

2.1 T Field Service Test Required (Send

Report to Fire Code Official) 5.3.1 9/12/23 If REQUIRED, Enter 'F' until results are returned from Lab F

2.2 T Recalled Sprinklers

If not present = Pass; If present = Fail Title 19 904.1(c) 9/12/23 F

2.3 T Water Flow Alarm Devices 90

sec. maximum - (Enter Time )

5.3.3

13.2.6 9/12/23 sec. P

2.4 T Main Drain Test

(Enter Data on Page 1 of this Form)

13.2.5

13.3.3.4 9/12/23 P

2.5 T Control Valve - Position 13.3.3.2 9/12/23 P

2.6 T Control Valve – Operation 13.3.3.1 9/12/23 P

2.7 T Supervisory Devices 13.3.3.5 9/12/23 P

2.8 T Backflow Preventer Assemblies 13.6.2 N/A

2.9 T

Small Hose Connections* w/PRV Hose Valves – Partial Flow Test

13.5.2.3

13.5.3.3 9/12/23 P

2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 N/A

3.1 M Control Valves 13.3.4 N/A

3.2 M Small Hose Connections* 13.5.6.3 9/12/23 P

3.3 M

Obstruction Investigation required

(If “Yes”, see Deficiencies and Comments Section for Results.)

14.3 Yes

No N/A

3.4 M System Returned to Service 4.5.3 9/12/23 Yes

No P

* Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe

Fire Sprinkler System

California Code of Regulations - Title 19 Inspection, Testing, and Maintenance

Annual Report 3 of 3

Indicate all equipment, devices and parts that were repaired or replaced

*****ANNUAL FIRE SPRINKLER INSPECTION*****

9/12/23 1 X NOTE: FACP showing 246 troubles upon arrival.

1.3 9/12/23 1 X 911 bell signs missing/faded on electric and water driven bell covers for riser 1.

1.19 9/12/23 1 X Missing chrome Viking E1 semi recessed escutcheon: 3 at Roads & Trails conference table area; Commissary (111); Roads& Trails warehouse low ceiling; outside FACP rm.

1.19 9/12/23 1 X Missing chrome Tyco semi recessed escutcheons: 3 in Dispatch Lobby; Property Mgmt.

1.21 9/12/23 1 X Remove drop for obsolete HSWs: outside 109 Mechanical Room; 3 at Property Mgmt.

1.5 9/12/23 1 X Both UL listed fire protection gauges outdated on riser.

1.12 9/12/23 1 X Existing head wrench in sparer head box at riser does not fit Viking 589A 155* SR ½” Chrome HSW, Star ¾” brass 212* LD2 upright, Star SG 722A ½” brass 155* SR pendant, Viking 589A Model M chrome 155* QR ¾” pendant. Add appropriate head wrenches for These heads. Note: pendant head wrenches must be socket style.

1.12 9/12/23 1 X 8” 212* brass dry pendant outdated in spare head box.

2.3 9/12/23 1 X Water motor gong and electric bell not ringing during waterflow.

1.19 9/12/23 1 X Obstructed 155* SR chrome semi recessed pendant by pillar in dispatch.

1.19 9/12/23 1 X Repair hole in sheetrock ceiling at Roads & Trails warehouse low ceiling storage area.

1.19 9/12/23 1 X Damaged 155* QREC chrome ¾” semi recessed pendant at Roads & Trails low ceiling.

1.19 9/12/23 1 X Unprotected areas: Server room by dispatch; over cold boxes at Commissary (111)

2.1 9/12/23 1 X 4- 8” 212* brass dry pendants outdated at Commissary (111) cold boxes.

1.17 9/12/23 1 X 5- 100’ single jacket 1 ½” fire hoses outdated (September 1994).

1.19 9/12/23 1 X Chrome Star style head cage missing at 1st floor East end mezzanine in warehouse.

1.19 9/12/23 1 X Painted 155* SR chrome ½” semi recessed pendant in Property Mgmt restroom.

1.19 9/12/23 1 X Painted chrome ½” semi recessed 165* link pendants: Soffit from Vehicle shop to

Property Mgmt (4); Central Lube; Parts room (4); Ladies restroom; Low ceiling in Vehicle Maintenance East end. 30’ ceiling.

1.21 9/12/23 2 X Large copper cable attached at base of riser & FDC

1.12 9/12/23 2 X Head wrench missing for ½” 200* SR GEM Model A upright & Star LD2 chrome ½” HSW.

1.5 9/12/23 2 X Both UL listed fire protection gauges outdated.

Check here if additional Deficiencies and Comments are listed on Form AES9.

See Correction Form AES 10 for corrected deficiencies.

Number attached 1 Number attached

I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form.

Check box if Annual Inspection, Testing & Maintenance Items are Completed in the Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual

Date 9/12/23 Print Name Brian Thieme

Signature for Inspection, Testing, and Maintenance 1 of 2

Building Name Admin Building Name HCI Systems Inc

Address EPB 0759 Address 3742 W. Gettysburg Ave.

City Fresno St. CA Zip 93722

City El Portal License # 905493 Phone (559)233-2008

Phone (410)688-8000 ■ CSLB Misc.

System Riser ID 1-3 Water Spray System

Standpipe & Hose System System Riser ID

1.13 09/12/23 1 ✔

Replace broken 2 1/2" FDC break Cap on Fire Department Connection.

1.5 09/12/23 1 ✔ 2 outdated UL listed fire protection gauges on riser.

1-3 09/12/23 1-3 ✔ Loaded heads throughout. Vacuum or blow out excess lint/debris from fire sprinkler heads.

2.2 09/12/23 3 ✔ Chrome semi recessed 155* SR 1/2" Central recalled GB pendants: Room 202A; outside 202A (2);

✔ Main hallway on 2nd floor (18); Room 217 (2) on 2nd floor.

1.19 09/12/23 3 ✔ No entry into room 208 on 2nd floor.

1.19 09/12/23 3 ✔ Missing chrome semi recessed Central escutcheon outside room 202A on 2nd floor.

1.19 09/12/23 3 ✔ Painted 155* SR semi recessed chrome pendant in mens restroom outside fire office on 2nd floor.

1.19 09/12/23 2 ✔ Painted chrome 1/2" 165* semi recessed pendants: Back external stairs by main hallway on 2nd floor; large break room on 2nd floor (2).

1.19 09/12/23 1 ✔ No entry into 262 H by elevator on 2nd floor.

1.1 09/12/23 1 ✔ Add 2 auxiliary drain signs & 2- 1" plugs to valves at sign shop on 2nd floor.

1.19 09/12/23 1 ✔ 6 painted brass 1/2" 165* uprights in room 265 on 2nd floor.

1.21 09/12/23 1 ✔ Corroded 1 1/4" pipe & 1 1/4" X 1 1/4" X 1/2" tee in room 264 B on 2nd floor.

1.19 09/12/23 1 ✔ Painted 165* 1/2" chrome semi recessed pendant at East stairs on 2nd floor.

1.17 09/12/23 2 & 3 ✔ 2- 100' single jacket 1 1/2" fire hoses outdated (September 1994)

Building Name Admin Building Name HCI Systems Inc

I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form.

Print Name Brian Thieme

Signature Brian Thieme Digitally signed by Brian Thieme Date 09/12/23 Date: 2023.10.19 08:11:46 -07'00' for Inspection, Testing, and Maintenance 1 of 2

Building Name Covered Parking Name HCI Systems Inc

Address EPB 0759 Address 3742 W. Gettysburg Ave.

City Fresno St. CA Zip 93722

City El Portal License # 905493 Phone (559)233-2008

Phone (410)668-8000 ■ CSLB Misc.

System Riser ID 1 Water Spray System

Standpipe & Hose System System Riser ID

1.1 09/12/23 1 ✔

Add Auxiliary Drain sign to drum drip by riser.

1.19 09/12/23 1 ✔ Air Regulator leaking air.

2.3 09/12/23 1 ✔ Water Motor Gong not ringing during water flow. Water motor gong leaks during operation.

1.18 09/12/23 1 ✔ Remove Paper from fire sprinkler head & wires from sprinkler pipe in Forestry Shop (175).

1.18 09/12/23 1 ✔ Replace painted 165* brass upright at 1st floor stairwell East side in Shops building.

Building Name Covered Parking Name HCI Systems Inc

I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form.

Print Name Brian Thieme

Signature Brian Thieme Digitally signed by Brian Thieme Date 09/12/23 Date: 2023.10.18 07:17:10 -07'00'

Name: RMS Occupancy/Use:

Choose an item.

Address: EPB 0797 Construction Type: Choose an item.

City: El Portal No. Stories: 2

ZIP: 95389 Year Constructed

Contact: Jeff McBride

Telephone: (410)668-8000

Contractor Information: Number of System Risers 1

Name: Owner Date:

Address

Fire AHJ Date:

Contractor Date: 9/12/23

State:

NOTES:

requirements and information, see NFPA 25, 2011 edition as amended by California Code of Regulations, accordance with California Code of Regulations, Title 19, §904.1(a)

Telephone:

CA License#: 905493

Performed by: B Thieme & J Johnson

Check box for each system inspected and enter the number of forms used for inspection. Check boxes (Fail or Pass) to indicate status of inspected system at end of inspection.

Forms Included with this Report NFPA 25

Automatic Sprinkler System 5 1

Standpipe and Hose System 6

Private Water Supply System 7

Fire Pump 8

Water Storage Tank 9

Water Spray System 10

Foam Water Sprinkler System 11

Water Mist System 12

Concerns that are Not Deficiencies (i.e. Non-Sprinklered Areas) Yes No

Fire Sprinkler System

California Code of Regulations - Title 19 Inspection, Testing, and Maintenance

Annual Report

Building RMS

Address EPB 0797

City El Portal License # 905493 Contact Jeff McBride SFM Job # SV2308030045 Phone (410)668-8000 CSLB Misc.

Riser Information Main Drain Test (Annual) Riser No. Location

Riser Diameter

Main Drain Diameter

Initial Static Pressure

Residual Pressure

Final Static

1 Internal Water Heater Closet 3” 1 ¼” 125 65 113 P

This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached

I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable

Item Description NFPA 25 CA ed.

Reference

Date Date Date Date 9/12/23

1.1 I Control Valves – Identification Sign 13.3.1 F

1.2 I Control Valves – Inspection 13.3.2 P

1.3 I Waterflow Alarm Devices 5.2.5 P

1.4 I Supervisory Devices 5.2.5 P

1.5 I Gauges (Wet Pipe Systems) 5.2.4.1 F

1.6 I Enter Water Supply Pressure Below Riser Check 5.2.4.1 psi psi 122 psi psi

1.7 I Enter Water Supply Pressure Above Riser Check 5.2.4.1 psi psi 125 psi psi

1.8 I Pressure Readings Acceptable 5.2.4.1 P

1.9 I Hydraulic Design Information Sign

(For Hydraulically Designed Systems) 5.2.6 P

1.10 I General Information Sign

(Not Required for System prior to 2007 Edition of NFPA 13) 5.2.8 N/A

1.11 I Heat Tape 5.2.7 N/A

1.12 I Spare Sprinklers 5.2.1.4 P

1.13 I Fire Department Connections 13.7 P

1.14 I Alarm Valves – Exterior Inspection 13.4.1 N/A

1.15 I Pressure Reducing Valves 13.5.1.1 N/A

1.16 I Backflow Preventers 13.6.1 N/A

1.17 I Small Hose Connections - Hose Valve* 5.1.6, 13.5.2

13.5.5.1

N/A

1.18 I PRV – Fire Sprinkler Systems 13.5.1.1 N/A

* Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe

Fire Sprinkler System

California Code of Regulations - Title 19 Inspection, Testing, and Maintenance

Annual Report 2 of 3

Address EPB 0797 Job # SV2308030045

Include ALL Quarterly Inspections

I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable

Item Description NFPA 25 CA ed.

Reference Date Comments Only P,F,N/A

1.19 I Sprinklers 5.2.1 9/12/23 F

1.20 I Buildings (Freeze Protection) 4.1.1.1 9/12/23 Owner’s Responsibility P

1.21 I Pipe and Fittings 5.2.2 9/12/23 P

1.22 I Hangers 5.2.3 9/12/23 P

1.23 I Seismic Braces 5.2.3 9/12/23 P

2.1 T Field Service Test Required (Send

Report to Fire Code Official) 5.3.1 If REQUIRED, Enter 'F' until results are returned from Lab N/A

2.2 T Recalled Sprinklers

If not present = Pass; If present = Fail Title 19 904.1(c) 9/12/23 P

2.3 T Water Flow Alarm Devices 90

sec. maximum - (Enter Time )

5.3.3

13.2.6 9/12/23 40 sec. P

2.4 T Main Drain Test

(Enter Data on Page 1 of this Form)

13.2.5

13.3.3.4 9/12/23 P

2.5 T Control Valve - Position 13.3.3.2 9/12/23 P

2.6 T Control Valve – Operation 13.3.3.1 9/12/23 P

2.7 T Supervisory Devices 13.3.3.5 9/12/23 P

2.8 T Backflow Preventer Assemblies 13.6.2 N/A

2.9 T

Small Hose Connections* w/PRV Hose Valves – Partial Flow Test

13.5.2.3 13.5.3.3

N/A

2.10 T PRV – Fire Sprinkler Systems 13.5.1.3 N/A

3.1 M Control Valves 13.3.4 N/A

3.2 M Small Hose Connections* 13.5.6.3 N/A

3.3 M

Obstruction Investigation required

(If “Yes”, see Deficiencies and Comments Section for Results.)

14.3 Yes

No N/A

3.4 M System Returned to Service 4.5.3 9/12/23 Yes

No P

* Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III standpipe

Fire Sprinkler System

California Code of Regulations - Title 19 Inspection, Testing, and Maintenance

Annual Report 3 of 3

Address EPB 0797 Job # SV2308030045

*****ANNUAL FIRE SPRINKLER INSPECTION*****

1.5 9/12/23 1 X Both UL listed fire protection gauges outdated on riser.

1.1 9/12/23 1 X Add Control Valve, Main Drain & Inspectors Test signs to riser.

1.19 9/12/23 1 X Replace missing chrome Tyco semi recessed escutcheons: by front entrance; 2nd floor Inside & outside Conference Room; Communications Closet on 2nd floor.

1.19 9/12/23 1 X Replace missing ceiling tiles in 2nd floor Communications Closet.

END OF REPORT

Check here if additional Deficiencies and Comments are listed on Form AES9.

See Correction Form AES 10 for corrected deficiencies.

I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form.

Check box if Annual Inspection, Testing & Maintenance Items are Completed in the Indicated Quarter Quarter 1st - Annual 2nd - Annual 3rd - Annual 4th - Annual

Date 9/12/23

Print Name Brian Thieme

Signature

Dry Pipe California Code of Regulations - Title 19 Quarterly and 1 of 3 Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report

Building Name Covered Parking Name HCI Systems, Inc.

Address EPB 0759 Address 3742 W. Gettysburg Ave Suite 102 City Fresno St. CA Zip 93722 City El Portal License # 905493 Phone (559)233-2008

No. Location Riser

Diameter Main Drain Diameter

Initial Static Pressure

Residual Pressure

Final Static

1 Internal S/E corner of covered parking 4" 2" 94 55 90 P

This building has more than 5 risers. See additional AES 2.9 form attached Number of AES 2.9 forms attached:

Date Date Date Date 09/12/23

1.1 I Control Valves – Identification Sign 13.3.1 F

1.2 I Control Valves – Inspection 13.3.2 P

5.2.4.2, 5.2.4.3

5.2.4.2, 5.2.4.3 5.2.4.4

13.4.4.2.5.1 psi psi 43 psi psi

1.7 I Water Supply Pressure

5.2.4.2

13.4.4.2.5.1 psi psi 94 psi psi

1.8 I Hydraulic Design Information Sign

(for hydraulically designed systems) 5.2.6 P

1.9 I General Information Sign

1.12 I Fire Department Connections 13.7 P

1.13 I Dry Pipe Valves – Exterior Inspection 13.4.4.1.4 P

1.14 I Pressure Reducing Valves 13.5.1 N/A

Dry Pipe California Code of Regulations - Title 19 Quarterly and 2 of 3 Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report

I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable

Item Description NFPA 25 CA ed.

Reference Date Comments Only P,F,N/A

1.17 I Buildings (Freeze Protection) 4.1.1.1 09/12/23 Owner’s Responsibility P

1.18 I Sprinklers 5.2.1 09/12/23 F

1.19 I Pipe and Fittings 5.2.2 09/12/23 F

1.20 I Hangers 5.2.3 09/12/23 P

1.21 I Seismic Braces 5.2.3 09/12/23 P

1.22 I Small Hose Connections* 13.5.6.2.2 N/A

2.1 T Field Service Test Required

(Send Report to Fire Code Official) 5.3.1 09/12/23 If REQUIRED, Enter 'F' until results are returned from Lab F

2.2 T Recalled Sprinklers

If not present = Pass; If present = Fail

Title 19 904.1(c) 09/12/23 P

2.3 T Water Flow Alarm Devices

90 sec. maximum - (Enter Time )

5.3.3

13.2.6 09/12/23 sec. F

2.4 T Main Drain Test

(Enter data on Page 1 of this form)

13.2.5

13.3.3.4 09/12/23 P

2.5 T Priming Water Level Test 13.4.4.2.1 N/A

2.6 T Dry Pipe Valve Trip Test

(Partial trip test is acceptable)

13.4.4.2.2 13.4.4.2.2.3

09/12/23

2.7 T Valve Trip Time 13.4.4.2.5.2 09/12/23 50 sec. P

2.8 T Trip Air Pressure 13.4.4.2.5.1 09/12/23 25 psi P

2.9 T Quick-Opening Device Test 13.4.4.2.4 09/12/23 F

2.10 T Low Air Pressure Alarm Test 13.4.4.2.6 N/A

2.11 T Low Temperature Alarm Test 13.4.4.2.7 N/A

2.12 T Automatic Air Pressure Maintenance Device Test 13.4.4.2.8 09/12/23 P

2.13 T Control Valve – Operation 13.3.3 09/12/23 P

2.14 T Valve Supervisory Devices 13.3.3.5 09/12/23 P

2.15 T Backflow Preventer Assemblies 13.6.2 N/A

2.16 T PRV – Partial Flow 13.5.1.3 N/A

* Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III

Dry Pipe California Code of Regulations - Title 19 Quarterly and 3 of 3 Fire Sprinkler System Inspection, Testing, and Maintenance Annual Report

I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable

Item Description NFPA 25 CA ed.

Reference Date Comments Only P,F,N/A

3.1 M Control Valves 13.3.4 9/12/23 P

3.2 M Maintenance 13.4.4.3 9/12/23 P

3.3 M Dry Pipe Valve Interior Cleaned 13.4.4.3.1 9/12/23 P

3.4 M Low Points in System Drained 13.4.4.3.2 9/12/23 P

3.5 M Backflow Preventer 13.6.3 N/A

3.6 M

Obstruction Investigation Required

(If “Yes”, see Deficiencies and Comments Section for Results.)

14.3 Yes

✔ No N/A

3.7 M System Returned to Service 4.5.3

15.7 9/12/23 ✔ Yes

No P

Indicate all equipment, devices and parts that were repaired or replaced

1.1 09/12/23 1 X Control Valve sign missing from 4" OS&Y valve.

1.5 09/12/23 1 X 2 air & 1 water gauge outdated. Must be replaced or recalibrated every 5 years.

1.11 9/12/23 1 X Add 1 chrome 165* 1/2" link style HSW & chrome 165* dry pendant to spare head box by riser.

1.12 9/12/23 1 X Suggest adding location identification label to FDC in planter box behind riser.

1.18 9/12/23 1 X Replace 2 corroded 1/2" 165* uprights around South corner section of covered parking.

2.3 9/12/23 1 X Water motor gong leaking inside building during waterflow. Repair or replace.

2.9 9/12/23 1 X 1/2" Accelerator valve leaking by during recharge of dry system. Ball valve to Accelerator valve was off upon arrival. Had to shut it off again to prevent system from tripping. System is reset as dry now with ball valve to accelerator off. System was tested with accelerator off.

2.1 9/12/23 1 X Chrome 165* dry pendants over 10 years old. Length unknown.

1.18 9/12/23 1 X Repair damaged stucco ceiling at covered parking.

I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable except as noted in the “Deficiencies and Comments” section of this form.

Check box if Annual Inspection, Testing & Maintenance Items are Completed in the Indicated Quarter Quarter 1st Annual 2nd Annual 3rd ✔ Annual 4th Annual

Date 09/12/23

Print Name Brian Thieme

Signature Digitally signed by Brian Thieme

Brian Thieme Date: 2023.10.18 07:16:33