Attachment 8 - Fire Alarm FA Certs and IT Codes of practice.pdf

Fire Alarm and Life Safety System Inspection Certificate

For

MP Bldg 329 795 Willow Rd.

Menlo Park, CA 94025

This inspection was performed in accordance with NFPA 101, EDITION 2018, LIFE SAFETY CODE and NFPA 72, EDITION 2019, FIRE ALARM SYSTEMS.

This Inspection was performed in accordance with applicable NFPA Standards. The subsequent pages of this report provide performance measurements, listed ranges of acceptable results, and complete documentation of the inspection. Whenever discrepancies exist between acceptable performance standards and actual test results, notes and/or recommended solutions have been proposed or provided for immediate review and approval.

Annual Inspection Inspection Completion Date Feb 9, 2021

Building: MP Bldg 329 Company: HurtVet Subcontracting LLC Contact: Christopher Jocson Contact: Anthony Oropeza Title: Electronics Supervisor Title: Siemens

HurtVet Subcontracting LLC 1 Download Date: 07/09/2021

Executive Summary

Generated by: BuildingReports.com

Building Information

Building: MP Bldg 329 Contact: Christopher Jocson

Address: 795 Willow Rd. Phone: 650-852-3437

Address: Fax:

City/State/Zip: Menlo Park, CA 94025 Mobile:

Country: United States of America Email: christopher.jocson@va.gov

Inspection Performed By

Company: HurtVet Subcontracting LLC Inspector: Anthony Oropeza

Address: 1200 Club House Dr. Phone: 510.783.6000

Address: Fax:

City/State/Zip: Lillian, Alabama 36549 Mobile: 510.303.2286

Country: United States Email: anthony.oropeza@siemens.com

System Control Unit

Manufacturer: simplex Inspection Date: 02/09/2021 IDC Style:

Model Number: 4100 Install Date: 11/05/2015 SLC Style:

Software Version: Version Date: 02/16/2018 NAC Style:

Location: 1st room 177 outside bldg boiler rm Current Protection:

Monitoring

Company: Phone: Account #:

Central Station Signal Verification

Type: Mfg: Model #:

Test Time/Date: Restore Time: Note:

HurtVet Subcontracting LLC 2 Download Date: 07/09/2021

Inspection Completion Date: Feb 9, 2021

Building: MP Bldg 329

EC 02.03.05 EP 02

Semi-annual testing of water flow devices and valve tamper switches

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD (2021) Total Quantity

Waterflow Switch 1 1 0 1 0 1

EC 02.03.05 EP 03

Annual testing of duct detectors, heat detectors, manual fire alarm boxes, and smoke detectors

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD (2021) Total Quantity

Duct Detector 7 7 0 7 0 7

Heat Detector 2 2 0 2 0 2

Pull Station 8 8 0 8 0 8

Smoke Detector 3 3 0 3 0 3

EC 02.03.05 EP 04

Annual test of visual and audible fire alarms, including speakers and door releasing devices.

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD (2021) Total Quantity

Speaker 1 1 0 1 0 1

Speaker/Strobe 30 30 0 30 0 30

Strobe 1 1 0 1 0 1

Voice Evacuation 1 1 0 1 0 1

EC 02.03.05 EP 19

Annual test of automatic smoke-detection shutdown devices for air-handling equipment per NFPA 90A-2021

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD

Duct Detector 7 7 0 7 0 7

LS 02.01.34 EP 02

Protected master fire alarm control panel

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD

Control Panel 2 2 0 2 0 2

LS 02.01.34 EP 10

All other Life Safety Code fire alarm requirements related to NFPA 101-2021 18/19.3.4

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD (2021) Total Quantity

Annunciator 1 1 0 1 0 1

Battery 4 2 2 4 0 4

Total Device Count: 61

HurtVet Subcontracting LLC 3 Download Date: 07/09/2021

Certification Company: HurtVet Subcontracting LLC Building: MP Bldg 329

Inspector: Anthony Oropeza Contact: Christopher Jocson

Signed: Feb 9, 2021 10:45:50 AM Signed:

HurtVet Subcontracting LLC 4 Download Date: 07/09/2021

Discrepancy Report

Building: MP Bldg 329 Control Panel: 1

The Discrepancy Report consolidates each discrepancy listed within the various Testing sections of your Inspection.

Discrepancies are listed by Category, and grouped by device type. The description of the problem is provided and where appropriate, code references are listed for your convenience. Any item that was inspected that is subject to a recall or part of a manufacturer's replacement/upgrade program is included.

Device Type Manufacturer ModelNumber Date Qty

Items listed for Recall or Replacement/Upgrade No items found during this inspection.

ScanID Location Problem Address Reference

LS 02.01.34 EP 10 All other Life Safety Code fire alarm requirements related to NFPA 101-2021 18/19.3.4

Battery 45213182 1st outside left of facp Failed Test 1 45213183 1st outside left of facp Failed Test 1

HurtVet Subcontracting LLC 5 Download Date: 07/09/2021

Proposed Solutions Report

The Proposed Solution Report provides a solution for each discrepancy listed on the Discrepancy Report. Provide a check mark where indicated to approve repairs listed within the report. Items listed as T/M are available for repair on a Time and Materials basis.

ScanID Location Solution Model # Cost Fix

Battery

45213182 1st outside left of facp Replace PS 12350 NB T/M 45213183 1st outside left of facp Replace PS 12120 NB T/M

PO #: (none) T/M

HurtVet Subcontracting LLC 6 Download Date: 07/09/2021

Notes & Recommendations

The Notes & Recommendations Report details additional inspection notes made by the Inspectors during the course of the building inspection.

ScanID Note Device Type Location Comment

LS 02.01.34 EP 10 All other Life Safety Code fire alarm requirements related to NFPA 101-2021 18/19.3.4

45213182 1 Battery 1st outside left of facp Failed Test

W.O. EX210211-004

45213183 2 Battery 1st outside left of facp Failed Test

W.O. EX210211-004

HurtVet Subcontracting LLC 7 Download Date: 07/09/2021

Inspection & Testing

The Inspection & Testing section lists all of the items inspected in your building, which are then categorized by the applicable code reference. The most recent inspection is listed in the far right column and is based on the Finish Date of that inspection. The latest inspection uploaded in each previous quarter appears in the four columns to the left.

Passed=P, Failed=F, Replaced=R

Water shall be flowed through an inspector's test connection indicating the flow of water equal to that from a single sprinkler of the smallest orifice size installed in the system for wet-pipe systems, or an alarm test bypass connection for dry-pipe, pre-action, or deluge systems in accordance with NFPA 25-20. (NFPA 72-19 Table 14.4.3.2 (17)(11))

Devices Tested Q1/21 Pass Q1/21 Fail Q1/21 Tested YTD (2021) Total Quantity

Waterflow Switch 1 1 0 1 1

Device Type Location ScanID Address Q1/20 Q3/20 Q1/21

Waterflow Switch 1st floor In FACP Room 2 ITV'S tied to this 1 riser

45213179 1-M125 02/10-P 08/13-P 02/09-P

Device Total: 1

HurtVet Subcontracting LLC 8 Download Date: 07/09/2021

Test duct smoke detectors that use sampling tubes to ensure that they will properly sample the airstream in the duct using a method acceptable to the manufacturer or in accordance with their published instructions. (NFPA 72-19 Table 14.4.3.2 (17)(7)(e))

Duct Detector 7 7 0 7 7

Duct Detector 1st MECH RM 172 Building 329 Warwhouse

45206009 1 02/10-P

02/09-P

Duct Detector 1st Building 329 Roof AC1 12622647 1-1 M20 02/10-P

Duct Detector 1st Building 329 Roof AC1 12622646 1-1 M23 02/10-P

Duct Detector 1st Building 329 warehouse 12622540 1 02/10-P

Duct Detector roof roof ac 2 test switchkitchen hallway wall

12622645 1-1 M21 02/10-P

12622644 1-1 M22 02/10-P

Duct Detector 1st floor inside back warehouse 12622518 1 02/10-P

Device Total: 7

HurtVet Subcontracting LLC 9 Download Date: 07/09/2021

Restorable: Perform heat test with a listed and labeled heat source or in accordance with the manufacturer's published instructions.

Non-Restorable: Do not perform heat test. Test functionality mechanically and electrically. (NFPA 72-19 Table 14.4.3.2 (17)(4)(a))

Heat Detector 2 2 0 2 2

Heat Detector 1st Boiler rm 12622650 1 02/10-P

Heat Detector Outside boiler rm 12622648 1 02/10-P

Device Total: 2

HurtVet Subcontracting LLC 10 Download Date: 07/09/2021

Operate manual fire alarm boxes per the manufacturer's published instructions. Test both key-operated presignal and general alarm manual fire alarm boxes. (NFPA 72-19 Table 14.4.3.2 (17)(5))

Pull Station 8 8 0 8 8

Pull Station 1st outside boiler rm entrance 12622633 1 02/10-P

Pull Station 1st Building 329 loading dock exit 12622631 1 02/10-P

Pull Station 1st Building 329 rear exit to loading dock kitchen

12622558 1 02/10-P

Pull Station 1st Building 329 data closet exterior

12622537 1 02/10-P

Pull Station 1st Building 329 outside room 100 12622525 1 02/10-P

Pull Station 1st Building 329 outside room 185 12622521 1

Pull Station 1st Building 329 outside room 100 12604477 1 02/10-P

Pull Station 1st Building 329 room 140 outside hallway to loading dock

12603565 1 02/10-P

Device Total: 8

HurtVet Subcontracting LLC 11 Download Date: 07/09/2021

Test smoke detectors in place to ensure smoke entry into the sensing chamber and an alarm response. (NFPA 72-19 Table 14.4.3.2 (17)(7)(a))

Smoke Detector 3 3 0 3 3

Smoke Detector 1st Building 329 data closet 12622528 1 02/10-P

Smoke Detector 1st Building 329 room 178 outside next to facp room

12604475 1 02/12-P

Smoke Detector outside boiler rm 12622649 1 02/10-P

Device Total: 3

HurtVet Subcontracting LLC 12 Download Date: 07/09/2021

For periodic testing, verify the operation of the notification appliances. (NFPA 72-19 Table 14.4.3.2 (22)(2))

Speaker 1 1 0 1 1

Speaker 1st Building 329 outside loading dock

12622542 1 02/10-P

HurtVet Subcontracting LLC 13 Download Date: 07/09/2021

For periodic testing, verify the operation of the notification appliances. (NFPA 72-19 Table 14.4.3.2 (22)(2))

Speaker/Strobe 30 30 0 30 30

Speaker/Strobe 1st Building 329 room 166 45213320 1 02/10-P

Speaker/Strobe 1st Building 329 room 166 45213319 1 02/10-P

Speaker/Strobe 1st Building 329 room 164A1 45213318 1 02/10-P

Speaker/Strobe 1st Building 329 room 164A1 45213317 1 02/10-P

Speaker/Strobe 1st Building 329 loading dock exit 12622630 1 02/10-P

Speaker/Strobe 1st main electrical room outside loading dock

12622625 1 02/10-P

Speaker/Strobe 1st Building 329 outside room 143 kitchen

12622559 1 02/10-P

Speaker/Strobe 1st Building 329 rear exit to loading dock kitchen

12622557 1 02/10-P

Speaker/Strobe 1st Building 329 room 140 outside hallway to loading dock

12622556 1 02/10-P

Speaker/Strobe 1st Building 329 rear prep area

12622555 1 02/10-P

Speaker/Strobe 1st Building 329 outside 168 12622541 1 02/10-P

Speaker/Strobe 1st Building 329 pantry 12622539 1 02/10-P

Speaker/Strobe 1st Building 329 pantry 12622538 1 02/10-P

Speaker/Strobe 1st Building 329 data closet 12622536 1 02/10-P

Speaker/Strobe 1st Building 329 room 190 12622531 1 02/10-P

Speaker/Strobe 1st Building 329 pantry 12622530 1 02/10-P

Speaker/Strobe 1st Building 329 room 185 12622529 1 02/10-P

Speaker/Strobe 1st Building 329 c08 corridor to

12622527 1 02/10-P

Speaker/Strobe 1st Building 329 outside room 100 12622526 1 02/10-P

Speaker/Strobe 1st Building 329 room 195 12622524 1 02/10-P

Speaker/Strobe 1st Building 329 room 187 12622523 1 02/10-P

Speaker/Strobe 1st Building 329 outside 185 12622522 1 02/10-P

Speaker/Strobe 1st Building 329 kitchen 12622519 1 02/10-P

Speaker/Strobe 1st Building 329 outside room 178 12604476 1 02/10-P

Speaker/Strobe 1st Building 329 outside employee lounge kitchen

12603659 1 02/10-P

Speaker/Strobe 1st Building 329 outside room 106 12603658 1 02/10-P

Speaker/Strobe 1st Building 329 food stage area

12603657 1 02/10-P

Speaker/Strobe 1st Building 329 prep room kitchen 12603656 1 02/10-P

Speaker/Strobe 1st Building 329 employee lounge

12603655 1 02/10-P

Speaker/Strobe outside boiler rm 12622632 1 02/10-P

Device Total: 30

HurtVet Subcontracting LLC 14 Download Date: 07/09/2021

For periodic testing, verify that each appliance flashes. (NFPA 72-19 Table 14.4.3.2 (22)(3))

Strobe 1 1 0 1 1

Strobe 1st Building 329 outside room 110 12622520 1 02/10-P

HurtVet Subcontracting LLC 15 Download Date: 07/09/2021

For periodic testing, verify the operation of the notification appliances. (NFPA 72-19 Table 14.4.3.2 (22)(2))

Voice Evacuation 1 1 0 1 1

Voice Evacuation 1st Room 4 12603519 1 02/10-P

HurtVet Subcontracting LLC 16 Download Date: 07/09/2021

90A-2021

Test duct smoke detectors that use sampling tubes to ensure that they will properly sample the airstream in the duct using a method acceptable to the manufacturer or in accordance with their published instructions. (NFPA 72-19 Table 14.4.3.2 (17)(7)(e))

Duct Detector 7 7 0 7 7

Duct Detector 1st MECH RM 172 Building 329 Warwhouse

45206009 1 02/10-P

Duct Detector 1st Building 329 Roof AC1 12622647 1-1 M20 02/10-P

Duct Detector 1st Building 329 Roof AC1 12622646 1-1 M23 02/10-P

Duct Detector 1st Building 329 warehouse 12622540 1 02/10-P

12622645 1-1 M21 02/10-P

12622644 1-1 M22 02/10-P

Duct Detector 1st floor inside back warehouse 12622518 1 02/10-P

Device Total: 7

HurtVet Subcontracting LLC 17 Download Date: 07/09/2021

Verify correct receipt of alarm, supervisory and trouble signals (inputs), operation of evacuation signals and auxiliary functions (outputs), circuit supervision including detection of open circuits and ground faults, and power supply supervision for detection of loss of ac power and disconnection of secondary batteries. (NFPA 72-19 Table 14.4.3.2 (2)(1))

Control Panel 2 2 0 2 2

Control Panel 1st room 177 outside bldg boiler rm

45213184 2 02/10-P 08/13-P 02/09-P

Control Panel 1st outside left of facp 45213181 3 02/10-P 08/13-P 02/09-P

Device Total: 2

HurtVet Subcontracting LLC 18 Download Date: 07/09/2021

Verify the correct operation and identification of annunciators. If provided, verify the correct operation of annunciator under a fault condition. (NFPA 72-19 Table 14.4.3.2 (11))

Annunciator 1 1 0 1 1

Annunciator 1st Building 329 Entrance 12622606 1 02/10-P 08/13-P 02/09-P

HurtVet Subcontracting LLC 19 Download Date: 07/09/2021

With the batteries fully charged and connected to the charger, measure the voltage across the batteries with a voltmeter. Then, with the battery charger disconnected, load test the batteries following the manufacturer's recommendations. (NFPA 72-19 Table 14.4.3.2 (9))

Battery 4 2 2 4 4

Battery 1st outside left of facp 45213180 1 02/10-P 08/13-P 02/09-P

Battery 1st outside left of facp 45213178 1 02/10-P 08/13-P 02/09-P

Battery 1st outside left of facp 45213183 1 02/10-P 08/13-P 02/09-F

Battery 1st outside left of facp 45213182 1 02/10-P 08/13-P 02/09-F

Device Total: 4

HurtVet Subcontracting LLC 20 Download Date: 07/09/2021

Service Summary

The Service Summary section provides an overview of the services performed in this report.

Device Type Service Quantity

Failed/Other

Battery Tested 2

Total 2

Passed

Annunciator Tested 1

Battery Tested 2

Control Panel Tested 2

Duct Detector Tested 7

Heat Detector Tested 2

Pull Station Tested 8

Smoke Detector Tested/Cleaned 3

Speaker/Strobe Tested 30

Speaker Tested 1

Strobe Visually Checked 1

Voice Evacuation Tested 1

Waterflow Switch Tested 1

Total 59

Grand Total 61

HurtVet Subcontracting LLC 21 Download Date: 07/09/2021

Auxiliary Functions Testing

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

Type Location Comment ScanID Simulated

Passed

Duct Detector

Smoke Compartment 1st MECH RM 172 Building 329 Warwhouse Passed 45206009

Smoke Compartment 1st Building 329 Roof AC1 Passed 12622646

Smoke Compartment 1st Building 329 Roof AC1 Passed 12622647

Smoke Compartment 1st Building 329 warehouse Passed 12622540

Smoke Compartment roof roof ac 2 test switchkitchen hallway wall Passed 12622644

Smoke Compartment roof roof ac 2 test switchkitchen hallway wall Passed 12622645

Smoke Compartment 1st floor inside back warehouse Passed 12622518

Smoke Detector

Smoke Compartment 1st Building 329 data closet Passed 12622528

HurtVet Subcontracting LLC 22 Download Date: 07/09/2021

Time, Temperature & Level Testing

The Time, Temperature, & Level Testing section details the measurements taken from various devices that are designed to respond in a certain amount of time, respond at a certain temperature, or respond within the acceptable range of volume or level. Items are grouped by Passed or Failed/Other.

Type Location Comment Sec Deg Lvl ScanID

Passed Waterflow Switch

1st floor In FACP Room 2 ITV'S tied to this 1 riser

Passed 55 n/a n/a 45213179

HurtVet Subcontracting LLC 23 Download Date: 07/09/2021

Battery & Power Supply Testing

The Battery & Power Supply Testing section details the readings and measurements of batteries and power supplies used to provide power to the fire alarm and life safety systems. Items are grouped by Passed or Failed/Other.

Battery

Type Location Rated Ah

Rated Volts

Pre Test

Post Test

Min Ah

Tested Ah

Passed Sealed Lead Acid 1st outside left of facp 35 12 28

Sealed Lead Acid 1st outside left of facp 35 12 30

Failed/Other Sealed Lead Acid 1st outside left of facp 12 12 4

Sealed Lead Acid 1st outside left of facp 12 12 5

HurtVet Subcontracting LLC 24 Download Date: 07/09/2021

Inventory & Warranty Report

Building: MP Bldg 329 Control Panel: 1

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Device or Type Category % of Inventory Quantity

Waterflow Switch Initiating 1.64% 1

Voice Evacuation Control 1.64% 1

Strobe Indicating 1.64% 1

Speaker/Strobe Indicating 49.18% 30

Speaker Indicating 1.64% 1

Smoke Detector Initiating 4.92% 3

Pull Station Initiating 13.11% 8

Heat Detector Initiating 3.28% 2

Duct Detector Initiating 11.48% 7

Battery Control 6.56% 4

Annunciator Control 1.64% 1

Control Panel Control 3.28% 2

Type Qty Model # Description Install Date

In Service - 3 Years to 5 Years

SimplexGrinnell

Heat Detector 1

Rate-of-Rise 02/16/2018

Smoke Detector 1

Photoelectric 02/16/2018

Speaker/Strobe 1

02/16/2018

Hochiki

Duct Detector 2 4098.9756 Photoelectric 05/23/2017

Voice Evacuation 1 4100

05/23/2017

Pull Station 1 4903-9357

05/22/2017

Pull Station 1 4907-9357 Single Action 05/22/2017

Pull Station 1 nbg-12lx

Pull Station 1 nbg-12lx Single Action 05/22/2017

Speaker/Strobe 9 4903-9357

Speaker/Strobe 1 4904-9357

Speaker/Strobe 10 4907-9357

Speaker/Strobe 1 AH-24wp-R 24wdc

Duct Detector 2

Photoelectric 05/22/2017 simplex

Annunciator 1 4903-9357 LCD Display 05/22/2017

HurtVet Subcontracting LLC 25 Download Date: 07/09/2021

Duct Detector 1 4098.9756 Photoelectric 05/22/2017

Duct Detector 1 4907-9357 Photoelectric 05/22/2017

Pull Station 1

Single Action 05/22/2017

Pull Station 1 4907-9357 Single Action 05/22/2017

Pull Station 1 nbg-lx12 Single Action 05/22/2017

Smoke Detector 2 FSP-851 Photoelectric 05/22/2017

Speaker 1 AH-24wp-R 24wdc

Speaker/Strobe 1

Speaker/Strobe 3 4903-9357

Speaker/Strobe 3 4907-9357

Speaker/Strobe 1 nbg-12lx

Strobe 1 nbg-12lx

Duct Detector 1

Photoelectric 05/18/2017

Notifier

Waterflow Switch 1 WFD-4

05/18/2017

In Service - 5 Years to 10 Years

Power Sonic

Battery 1 PS 12120 NB Sealed Lead Acid 02/23/2016

Battery 1 PS 12350 NB Sealed Lead Acid 02/23/2016

Battery 2 PS 12350 NB Sealed Lead Acid 11/05/2015

Simplex

Heat Detector 1 4098-9733 Rate-of-Rise 11/05/2015

Pull Station 1

Single Action 11/05/2015

Building: MP Bldg 329 Control Panel: 2 - simplex 4100

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Type Qty Model # Description Install Date

In Service - 5 Years to 10 Years

Control Panel 1 4100

11/05/2015

Control Panel: 3 - simplex 4009 nac extender

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last year, and devices installed for two years or more are grouped together for easy reference.

Type Qty Model # Description Install Date

In Service - 5 Years to 10 Years

Control Panel 1 4009 nac extender

11/05/2015

HurtVet Subcontracting LLC 26 Download Date: 07/09/2021

Zone Address Report

The Zone Address Report lists all of the devices and items that have an individual address, or are grouped together under a common zone. The device type, location, and description are included for your reference.

Address Device Type Location Type ScanID

Zone/Circuit: 1 M20 Duct Detector 1st Building 329 Roof AC1 Photoelectric 12622647 M21 Duct Detector roof roof ac 2 test switchkitchen hallway wall Photoelectric 12622645

M22 Duct Detector roof roof ac 2 test switchkitchen hallway wall

Photoelectric 12622644

M23 Duct Detector 1st Building 329 Roof AC1 Photoelectric 12622646

Zone/Circuit: M125 Waterflow Switch 1st floor In FACP Room 2 ITV'S tied to this 1 riser 45213179

For

MP Bldg 331 795 Willow Rd.

Menlo Park, CA 94025

This inspection was performed in accordance with NFPA 101, EDITION 2018, LIFE SAFETY CODE and NFPA 72, EDITION 2019, FIRE ALARM SYSTEMS.

This Inspection was performed in accordance with applicable NFPA Standards. The subsequent pages of this report provide performance measurements, listed ranges of acceptable results, and complete documentation of the inspection. Whenever discrepancies exist between acceptable performance standards and actual test results, notes and/or recommended solutions have been proposed or provided for immediate review and approval.

Annual Inspection Inspection Completion Date Feb 9, 2021

Building: MP Bldg 331 Company: HurtVet Subcontracting LLC Contact: Christopher Jocson Contact: Anthony Oropeza Title: Electronics Supervisor Title: Siemens

Building: MP Bldg 331 Contact: Christopher Jocson

Address: 795 Willow Rd. Phone: 650-852-3437

Address: Fax:

Company: HurtVet Subcontracting LLC Inspector: Anthony Oropeza

Address: 1200 Club House Dr. Phone: 510.783.6000

Address: Fax:

City/State/Zip: Lillian, Alabama 36549 Mobile: 510.303.2286

Country: United States Email: anthony.oropeza@siemens.com

Manufacturer: SimplexGrinnell Inspection Date: 02/09/2021 IDC Style:

Model Number: 4100 Install Date: 05/19/2017 SLC Style: 2

Software Version: Version Date: 05/19/2017 NAC Style: Y

Location: 1st Mechanical Room Current Protection: Breaker

Type: Mfg: SimplexGrinnell Model #:

Test Time/Date: 2/9/21 9:30:27 AM Restore Time: Note:

Inspection Completion Date: Feb 9, 2021

Building: MP Bldg 331

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD (2021) Total Quantity

Tamper Switch 6 6 0 6 0 6

Waterflow Switch 6 6 0 6 0 6

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD (2021) Total Quantity

Duct Detector 15 15 0 15 0 15

Heat Detector 1 1 0 1 0 1

Pull Station 22 22 0 22 0 22

Smoke Detector 65 65 0 65 0 65

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD (2021) Total Quantity

Releasing Device 18 18 0 18 0 18

Speaker 18 18 0 18 0 18

Speaker/Strobe 13 13 0 13 0 13

Strobe 41 41 0 41 0 41

Voice Evacuation 1 1 0 1 0 1

EC 02.03.05 EP 05

Annual test of fire alarm equipment for notifying off-site fire responders

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD

Communicator 1 1 0 1 0 1

90A-2021

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD

Duct Detector 15 15 0 15 0 15

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD

Control Panel 1 1 0 1 0 1

Devices

Tested This Quarter Pass Fail

Tested YTD (2021)

Untested YTD (2021) Total Quantity

Annunciator 3 3 0 3 0 3

Battery 10 10 0 10 0 10

Expander Panel 12 12 0 12 0 12

Power Supply 1 1 0 1 0 1

Special Control 3 3 0 3 0 3

Total Device Count: 237

Company: HurtVet Subcontracting LLC Building: MP Bldg 331

Inspector: Anthony Oropeza Contact: Christopher Jocson

Signed: Feb 9, 2021 10:46:39 AM Signed:

The Inspection & Testing section lists all of the items inspected in your building, which are then categorized by the applicable code reference. The most recent inspection is listed in the far right column and is based on the Finish Date of that inspection. The latest inspection uploaded in each previous quarter appears in the four columns to the left.

Operate valve and verify signal receipt shall be verified to be within the first two revolutions of the hand wheel or within one-fifth of the travel distance, or per the manufacturer's published instructions. (NFPA 72-19 Table 14.4.3.2 (17)(10)(a))

Tamper Switch 6 6 0 6 6

Tamper Switch Ground floor Electrical room A106 12603061 1-M1 30 02/11-P 08/20-P 02/09-P

Tamper Switch Ground floor Near D Wing Courtyard Exit Ceiling

12602973 1-M4 30 02/11-P 08/20-P 02/09-P

Tamper Switch Ground floor Near C Wing Courtyard Exit Ceiling

12602768 1-M3 06 02/11-P 08/20-P 02/09-P

Tamper Switch Ground floor Electrical room A106 12535808 1-M1 31 02/11-P 08/20-P 02/09-P

Tamper Switch Ground floor B Corr C1-4 Valve 45211321 1-M2 15 02/11-P 08/18-P 02/09-P

Tamper Switch Garden Outdoor Inside A Oxygen Storage Room

12602986 1-M1 39 02/11-P 08/20-P 02/09-P

Device Total: 6

Water shall be flowed through an inspector's test connection indicating the flow of water equal to that from a single sprinkler of the smallest orifice size installed in the system for wet-pipe systems, or an alarm test bypass connection for dry-pipe, pre-action, or deluge systems in accordance with NFPA 25-20. (NFPA 72-19 Table 14.4.3.2 (17)(11))

Waterflow Switch 6 6 0 6 6

Waterflow Switch Ground floor Electrical room A106 45211323 1-M1 04 02/11-P 08/18-P 02/09-P

Waterflow Switch Ground floor Electrical room A106 Wing A Mech room

45211322 1-M1 03 02/11-P 08/18-P 02/09-P

Waterflow Switch Ground floor Behind B Wing 45211320 1-M2 16 02/11-P 08/18-P 02/09-P

Waterflow Switch Ground floor Behind D Wing 45211319 1-M4 05 02/11-P 08/18-P 02/09-P

Waterflow Switch Ground floor Behind D Wing 45211318 1-M3 05 02/11-P 08/18-P 02/09-P

Waterflow Switch Garden Outdoor Inside A Oxygen Storage Room

45211317 1-M1 38 02/11-P 08/20-P 02/09-P

Device Total: 6

Test duct smoke detectors that use sampling tubes to ensure that they will properly sample the airstream in the duct using a method acceptable to the manufacturer or in accordance with their published instructions. (NFPA 72-19 Table 14.4.3.2 (17)(7)(e))

Duct Detector 15 15 0 15 15

Duct Detector 1st Mechanical Room 45213140 1-56 02/11-P

Duct Detector 1st Room B-136 Shower 45210863 1-2 34 02/11-P

Duct Detector 1st Mechanical Room 45208528 1-57 02/11-P

Duct Detector 1st C WING C136 EMS RM 44230121 3-M 21 02/11-P

Duct Detector 1st Corridor B-116 12602978 1-2-36 02/11-P

Duct Detector Roof BLDG B AHU 2 ROOF 45208529 2-38 02/11-P

Duct Detector Roof Return BLDG D AHU 4 RETURN 12602991 4-37 03/09-P

Duct Detector Ground D WING SHOWER D 136 44230275 1-M4 34 02/11-P

Duct Detector Ground C-Wing Corridor Outside C-160

12602964 1-M4 37 02/11-P

Duct Detector Ground C-Wing Room C-160 12602963 1-3 13 02/11-P

C-136

12602770 1-M3 40 02/11-P

C-116

12602769 1-M3 -36 02/11-P

Duct Detector Ground D-Wing Corridor Outside D-160

12602972 1-M4 35 02/11-P

D-114

12602970 1-M4 33 02/11-P

Duct Detector Ground B-Wing Corridor Outside B160

12602977 1-M4 35 02/11-P

Device Total: 15

Restorable: Perform heat test with a listed and labeled heat source or in accordance with the manufacturer's published instructions.

Non-Restorable: Do not perform heat test. Test functionality mechanically and electrically. (NFPA 72-19 Table 14.4.3.2 (17)(4)(a))

Heat Detector 1 1 0 1 1

Heat Detector 1st Mechanical A-106

45205866 1 02/11-P

Operate manual fire alarm boxes per the manufacturer's published instructions. Test both key-operated presignal and general alarm manual fire alarm boxes. (NFPA 72-19 Table 14.4.3.2 (17)(5))

Pull Station 22 22 0 22 22

Pull Station 1st Mechanical Room Near Exit

45212985 1 02/11-P

Pull Station 1st Hallway Outside Room A-122 45211488 1-M1 45 02/11-P

Pull Station 1st Main Entrance Outside RM A-101

45211484 1-M1 47 02/11-P

Pull Station 1st Inside Room A-134 45205880 1-M1 49 02/11-P

Pull Station 1st Inside Room A-139 45205852 1-M1 48 02/11-P

Pull Station 1st Corridor B-166 12603173 1 02/11-P

Pull Station 1st Corridor B-118 12603106 1 02/11-P

Pull Station 1st FACP Closet RM 111 12603089 1-M1 35 02/11-P

Pull Station 1st Corridor A-129 12603083 1 02/11-P

Pull Station 1st Room A-142 12603078 1 02/11-P

Pull Station 1st Outside Compressor Room 12602989 1-M1 02/11-P

Pull Station 1st Corridor B-132 12535809 1 02/11-P

Pull Station 1st Corridor B-156 12603178 1 02/11-P

Pull Station 1st Corridor B-106 12603098 1 02/11-P

Pull Station Ground C-Wing Corridor Outside C-118

12603196 1-M3 -34 02/11-P

C-105/Exit to Courtyard

12603188 1-M3 -24 02/11-P

C-156

12603179 1-M3 -12 02/11-P

Pull Station Ground D-Wing Reception Exit to Courtyard (Left)

12603164 1-M4 -3 02/11-P

Pull Station Ground D-Wing Exit to Courtyard/ Right of Reception/ Before En

12603158 1-M4 -31 02/11-P

Pull Station Ground D-Wing Corridor Outside D-118

12603149 1-M4 -24 02/11-P

Pull Station Ground C-Wing Left of Reception/By Exit to Courtyard

12603137 1-M3 -2 02/11-P

Pull Station Ground D-Wing Corridor Outside D-156

12603127 1-M4 -13 02/11-P

Device Total: 22

Test smoke detectors in place to ensure smoke entry into the sensing chamber and an alarm response. (NFPA 72-19 Table 14.4.3.2 (17)(7)(a))

Smoke Detector 65 65 0 65 65

Smoke Detector 1st Mechanical Room 45212979 1 02/11-P

Smoke Detector 1st Outside Compressor Room 45210892 1-M1 02/11-P

Smoke Detector 1st Corridor D-166 45205850 1 02/11-P

Smoke Detector 1st Corridor B-156 12603176 1 02/11-P

Smoke Detector 1st Corridor B-162 12603175 1 02/11-P

Smoke Detector 1st Corridor B-166 12603174 1 02/11-P

Smoke Detector 1st Corridor B-138 12603172 1 02/11-P

Smoke Detector 1st Corridor B-101 12603171 1 02/11-P

Smoke Detector 1st Corridor B-100 12603120 1 02/11-P

Smoke Detector 1st Corridor B-148 12603119 1 02/11-P

Smoke Detector 1st Corridor B-140 12603118 1 02/11-P

Smoke Detector 1st Corridor B-139 12603117 1 02/11-P

Smoke Detector 1st Corridor B-136 12603115 1 02/11-P

Smoke Detector 1st Corridor B-134 12603112 1 02/11-P

Smoke Detector 1st Corridor B-132 12603111 1 02/11-P

Smoke Detector 1st Corridor B-126 12603109 1 02/11-P

Smoke Detector 1st Corridor B-122 12603108 1 02/11-P

Smoke Detector 1st Corridor B-112 12603105 1 02/11-P

Smoke Detector 1st Corridor B-106 12603101 1 02/11-P

Smoke Detector 1st Room B-169 12602981 1 02/11-P

Smoke Detector 1st Room B-139 12602975 1 02/11-P

Smoke Detector 1st Corridor B-100 12535456 1-1 02/11-P

Smoke Detector 1st Corridor B-105 45205872 1-M1 52 02/11-P

Smoke Detector 1st Corridor B-105 45205888 1-M1 53 02/11-P

Smoke Detector Ground D-Wing Partition Doors to A-Wing (D-Wing Side)

45212988 1-M1 -51 02/11-P

Smoke Detector Ground Mechanical Room A-105 45210855 1-1 5 02/11-P

Smoke Detector Ground D-Wing Corridor Outside D-134

14603145 1 02/11-P

Smoke Detector Ground C-Wing Corridor Outside

12603203 1-M3 -35 02/11-P

C-134

12603200 1 02/11-P

C-132

12603198 1 02/11-P

C-126

12603197 1-M3 -30 02/11-P

12603194 1-M3 -33 02/11-P

C-112

12603193 1 02/11-P

C-106

12603191 1-M3 -25 02/11-P

C-105

12603186 1-M3 -23 02/11-P

C-139

12603184 1-M3 -15 02/11-P

C-142

12603183 1 02/11-P

C-148

12603182 1 02/11-P

Smoke Detector Ground C-Wing Corridor Outside 12603181 1 02/11-P

HurtVet Subcontracting LLC 10 Download Date: 07/09/2021

C-158

Smoke Detector Ground D-Wing Corridor Outside Reception (Left)

12603162 1-M4 -2 02/11-P

Smoke Detector Ground D-Wing D-100 Linen 12603161 1 02/11-P

D-105

12603160 1-M4 -25 02/11-P

Smoke Detector Ground D-Wing Partition Door to C-Wing (D-Wing Side)

12603159 1-M4 -29 02/11-P

D-106

12603154 1-M4 -18 02/11-P

D-112

12603152 1-M4 -22 02/11-P

D-116

12603151 1-M4 -23 02/11-P

D-126

12603148 1-M4 -20 02/11-P

D-132

12603147 1-M4 -15 02/11-P

Smoke Detector Ground D-Wing Corridor 134 12603145 1-M4 02/11-P

Nurse Station (Right of Recepti

12603142 1-M4 -26 02/11-P

Smoke Detector Ground C-Wing Corridor by Partition Doors to D-Wing

12603139 1 02/11-P

Smoke Detector Ground C-Wing Corridor by Partition Doors to D-Wing/Left of Ex

12603138 1 02/11-P

C-103

12603135 1-M3 -22 02/11-P

C-161

12603134 1-M3 -8 02/11-P

C-166

12603133 1-M3 -7 02/11-P

D-166

12603130 1-M4 -6 02/11-P

D-162

12603128 1-M4 -9 02/11-P

D-158

12603126 1-M1 -51 02/11-P

D-148

12603125 1-M4 -11 02/11-P

D-142

12603123 1-M4 -14 02/11-P

Smoke Detector Ground D-Wing D-110 Supply 12602969 1 02/11-P

Smoke Detector Ground D-Wing Room D-169 12602968 1-1 02/11-P

Smoke Detector Ground C-Wing Room C-101 12602774 1 02/11-P

Smoke Detector Ground C-Wing Room C-139 Supply

12602772 1 02/11-P

Smoke Detector Ground C-Wing Room C-169 12602766 1-1 02/11-P

Device Total: 65

HurtVet Subcontracting LLC 11 Download Date: 07/09/2021

Test interface equipment connections by operating or simulating the equipment being supervised. Verify signals required to be transmitted are received at the control unit. (NFPA 72-19 Table 14.4.3.2 (20))

Releasing Device 18 18 0 18 18

Releasing Device Ground D-Wing Partition Doors to A-Wing (A-Wing Side on Floor)

45212987 1 02/11-P

Releasing Device Ground D-Wing Partition Doors to A-Wing (D-Wing Side)

45212986 1 02/11-P

Releasing Device Ground C-Wing Corridor Outside C-134

12603202 1 02/11-P

Releasing Device Ground C-Wing DBL DOOR IN

FRONT OF RM C136

12603201 1-1 02/11-P

FRONT OF RM C106

12603190 1-1 02/11-P

FRONT OF RM C106

12603189 1-1 02/11-P

Releasing Device Ground D-Wing By Room D-106 12603156 1 02/11-P

Releasing Device Ground D-Wing By Room D-106 12603155 1-1 02/11-P

Releasing Device Ground DBL DOOR ACROSS FROM

RM D-134 D WING

12603144 1-1 02/11-P

Releasing Device Ground DBL DOOR ACROSS FROM

RM D-134 D WING

12603143 1-1 02/11-P

Releasing Device Ground C-Wing Entry 12603141 1-1 02/11-P

Releasing Device Ground C-Wing Entry 12603140 1-1 02/11-P

Releasing Device Ground B-Wing B136 12603114 1-1 02/11-P

Releasing Device Ground B-Wing B136 12603113 1-1 02/11-P

Releasing Device Ground B-Wing Entry 12603103 1-1 02/11-P

Releasing Device Ground B-Wing Entry 12603102 1-1 02/11-P

Releasing Device Ground B-Wing Entry 44230274 1-1 02/11-P

Releasing Device Ground B-Wing Entry 44230273 1-1 02/11-P

Device Total: 18

HurtVet Subcontracting LLC 12 Download Date: 07/09/2021

For periodic testing, verify the operation of the notification appliances. (NFPA 72-19 Table 14.4.3.2 (22)(2))

Speaker 18 18 0 18 18

Speaker 1st Corridor B-138 12604719 1 02/11-P

Speaker 1st Corridor B-156 12604718 1 02/11-P

Speaker 1st Corridor B-142 12604717 1 02/11-P

Speaker 1st Corridor B-130 12604716 1 02/11-P

Speaker 1st Corridor B-116 12604715 1 02/11-P

Speaker 1st Corridor B-106 12604714 1 02/11-P

Speaker 1st Corridor D-106 12604695 1 02/11-P

Speaker 1st Corridor D-166 12604471 1 02/11-P

Speaker Ground C-Wing Corridor Outside

12604706 1 02/11-P

C-158

12604705 1 02/11-P

C-103/Left of Reception

12604704 1 02/11-P

Speaker Ground D-Wing Corridor Outside D-158

12604699 1 02/11-P

D-140

12604698 1 02/11-P

12604697 1 02/11-P

D-116

12604696 1 02/11-P

C-130

12604694 1 02/11-P

12604693 1 02/11-P

12604692 1 02/11-P

Device Total: 18

HurtVet Subcontracting LLC 13 Download Date: 07/09/2021

For periodic testing, verify the operation of the notification appliances. (NFPA 72-19 Table 14.4.3.2 (22)(2))

Speaker/Strobe 13 13 0 13 13

Speaker/Strobe 1st Hallway Outside RM A-122 45211489 1 02/11-P

Speaker/Strobe 1st Hallway Outside RM A-108 45211486 1 02/11-P

Speaker/Strobe 1st Main Entrance Outside RM A-101

45211485 1 02/11-P

Speaker/Strobe 1st Corridor B-105 45205887 1 02/11-P

Speaker/Strobe 1st Inside Room A-139 45205883 1 02/11-P

Speaker/Strobe 1st Inside Room A-134 45205879 1 02/11-P

Speaker/Strobe 1st Corridor A-126 45205875 1 02/11-P

Speaker/Strobe 1st Corridor A-131 45205874 1 02/11-P

Speaker/Strobe 1st Corridor A-132 45205873 1 02/11-P

Speaker/Strobe 1st Kitchen A-141 45205832 1 02/11-P

Speaker/Strobe 1st Corridor D-166 45205831 1 02/11-P

Speaker/Strobe 1st Outside Compressor Room 12602988 1 02/11-P

Speaker/Strobe 1st Mechanical Room 12535807 1 02/11-P

Device Total: 13

HurtVet Subcontracting LLC 14 Download Date: 07/09/2021

For periodic testing, verify that each appliance flashes. (NFPA 72-19 Table 14.4.3.2 (22)(3))

Strobe 41 41 0 41 41

Strobe 1st Inside Room A-101 45211494 1 02/11-P

Strobe 1st Women's Bathroom Across From A-113

45211493 1 02/11-P

From A-113

45211492 1 02/11-P

Strobe 1st Men's Bathroom Across From A-111

45211491 1 02/11-P

A-111

45211490 1 02/11-P

Strobe 1st Inside Room A-109 45211487 1 02/11-P

Strobe 1st A-Wing Room A-124 45210893 1 02/11-P

Strobe 1st Inside Room A-133 45210864 1 02/11-P

Strobe 1st Corridor B-128 45205886 1 02/11-P

Strobe 1st Corridor A-132 45205885 1 02/11-P

Strobe 1st Corridor A-129 45205884 1 02/11-P

Strobe 1st Inside Room A-137 45205882 1 02/11-P

Strobe 1st Restroom Near A-137 45205881 1 02/11-P

From A-134

45205878 1 02/11-P

A-134

45205877 1 02/11-P

Strobe 1st Hallway Across From A-134 45205876 1 02/11-P

Strobe 1st Inside Bathroom In Room A-139

45205851 1 02/11-P

Strobe 1st Corridor B-166 12604474 1 02/11-P

Strobe 1st Corridor B-142 12604473 1 02/11-P

Strobe 1st Corridor B-156 12603177 1 02/11-P

Strobe 1st D WING D164 CORRIDOR 12603129 1 02/11-P

Strobe 1st Corridor B-132 12603110 1 02/11-P

Strobe 1st Corridor B-118 12603107 1 02/11-P

Strobe 1st Corridor B-108 12603104 1 02/11-P

Strobe 1st Corridor B-105 12603097 1 02/11-P

Strobe Ground C-Wing Corridor Outside

12604470 1 02/11-P

Strobe Ground C-Wing Corridor by Partition Doors to D-Wing

12604469 1 02/11-P

C-132

12603199 1 02/11-P

C-118

12603195 1 02/11-P

12603192 1 02/11-P

C-105 by Exit

12603187 1 02/11-P

C-156

12603180 1 02/11-P

Strobe Ground D-Wing Reception Exit to Courtyard (Left)

12603165 1 02/11-P

Strobe Ground D-Wing Exit to Courtyard/Right of Reception/Before Entr

12603157 1 02/11-P

Strobe Ground D-Wing Corridor Outside 12603153 1 02/11-P

HurtVet Subcontracting LLC 15 Download Date: 07/09/2021

D-108

Strobe Ground D-Wing Corridor Outside D-118

12603150 1 02/11-P

Strobe Ground D-Wing Corridor Outside

12603146 1 02/11-P

Strobe Ground C-Wing Left of Reception/ By Exit to Courtyard

12603132 1 02/11-P

D-142

12603124 1 02/11-P

D-156

12602974 1 02/11-P

C-165

12602967 1 02/11-P

Device Total: 41

HurtVet Subcontracting LLC 16 Download Date: 07/09/2021

For periodic testing, verify the operation of the notification appliances. (NFPA 72-19 Table 14.4.3.2 (22)(2))

Voice Evacuation 1 1 0 1 1

Voice Evacuation 1st Mechanical Room 12535814 1 02/11-P

HurtVet Subcontracting LLC 17 Download Date: 07/09/2021

EC 02.03.05 EP 05

Annual test of fire alarm equipment for notifying off-site fire responders

Test all system functions and features in accordance with the equipment manufacturer's published instructions for correct operation in conformance with the applicable sections of Chapter 26. Except for DACT, actuate initiating device and verify receipt of the correct initiating device signal at the supervising station within 90 seconds. Upon completion of the test, restore the system to its functional operating condition. (NFPA 72-19 Table 14.4.3.2 (4))

Communicator 1 1 0 1 1

Communicator 1st Mechanical Room 45212984 1 02/11-P 08/18-P 02/09-P

HurtVet Subcontracting LLC 18 Download Date: 07/09/2021

90A-2021

Test duct smoke detectors that use sampling tubes to ensure that they will properly sample the airstream in the duct using a method acceptable to the manufacturer or in accordance with their published instructions. (NFPA 72-19 Table 14.4.3.2 (17)(7)(e))

Duct Detector 15 15 0 15 15

Duct Detector 1st Mechanical Room 45213140 1-56 02/11-P

Duct Detector 1st Room B-136 Shower 45210863 1-2 34 02/11-P

Duct Detector 1st Mechanical Room 45208528 1-57 02/11-P

Duct Detector 1st C WING C136 EMS RM 44230121 3-M 21 02/11-P

Duct Detector 1st Corridor B-116 12602978 1-2-36 02/11-P

Duct Detector Roof BLDG B AHU 2 ROOF 45208529 2-38 02/11-P

Duct Detector Roof Return BLDG D AHU 4 RETURN 12602991 4-37 03/09-P

Duct Detector Ground D WING SHOWER D 136 44230275 1-M4 34 02/11-P

C-160

12602964 1-M4 37 02/11-P

Duct Detector Ground C-Wing Room C-160 12602963 1-3 13 02/11-P

12602770 1-M3 40 02/11-P

12602769 1-M3 -36 02/11-P

D-160

12602972 1-M4 35 02/11-P

D-114

12602970 1-M4 33 02/11-P

Duct Detector Ground B-Wing Corridor Outside B160

12602977 1-M4 35 02/11-P

Device Total: 15

HurtVet Subcontracting LLC 19 Download Date: 07/09/2021

Verify correct receipt of alarm, supervisory and trouble signals (inputs), operation of evacuation signals and auxiliary functions (outputs), circuit supervision including detection of open circuits and ground faults, and power supply supervision for detection of loss of ac power and disconnection of secondary batteries. (NFPA 72-19 Table 14.4.3.2 (2)(1))

Control Panel 1 1 0 1 1

Control Panel 1st Mechanical Room 12535815 1 02/11-P 08/18-P 02/09-P

HurtVet Subcontracting LLC 20 Download Date: 07/09/2021

Verify the correct operation and identification of annunciators. If provided, verify the correct operation of annunciator under a fault condition. (NFPA 72-19 Table 14.4.3.2 (11))

Annunciator 3 3 0 3 3

Annunciator Ground C-Wing Reception Desk C-104

12603185 1 02/11-P 08/18-P 02/09-P

Annunciator Ground D-Wing Reception Desk D-104

12603136 1 02/11-P 08/18-P 02/09-P

Annunciator Ground B-Wing Reception Desk B-3316

12603116 1 02/11-P 08/18-P 02/09-P

HurtVet Subcontracting LLC 21 Download Date: 07/09/2021

With the batteries fully charged and connected to the charger, measure the voltage across the batteries with a voltmeter. Then, with the battery charger disconnected, load test the batteries following the manufacturer's recommendations. (NFPA 72-19 Table 14.4.3.2 (9))

Battery 10 10 0 10 10

Battery 1st Mechanical Room Expander Panel

45205868 1 02/11-P 08/20-P 02/09-P

Battery 1st Mechanical Room Expander Panel

45205867 1 02/11-P 08/20-P 02/09-P

Battery 1st FACP Mechanical Room 44230684 1 02/11-P 08/18-P 02/09-P

Battery 1st FACP Mechanical Room 44230683 1 02/11-P 08/18-P 02/09-P

Battery 1st C Wing 45210415 1 02/11-P 08/18-P 02/09-P

Battery 1st C Wing 45210416 1 02/11-P 08/18-P 02/09-P

Battery 1st D Wing 45210414 1 02/11-P 08/18-P 02/09-P

Battery 1st D Wing 45210413 1 02/11-P 08/18-P 02/09-P

Battery 1st RIGHT RECEPTIONIST Area B Wing

45206286 1 02/11-P 08/18-P 02/09-P

Battery 1st LEFT RECEPTIONIST Area B Wing 45206288 1 02/11-P 08/18-P 02/09-P

Device Total: 10

HurtVet Subcontracting LLC 22 Download Date: 07/09/2021

At a minimum, control equipment shall be tested to verify correct receipt of alarm, supervisory and trouble signals (inputs), operation of evacuation signals and auxiliary functions (outputs), circuit supervision including detection of open circuits and ground faults, and power supply supervision for detection of loss of ac power and disconnection of secondary batteries. (NFPA 72-19 Table 14.4.3.2 (2)(1))

Expander Panel 12 12 0 12 12

Expander Panel 1st D Wing 6 1 02/11-P

Expander Panel 1st Mechanical Room 45212983 1 02/11-P

Expander Panel 1st Mechanical Room 45212982 1 02/11-P

Expander Panel 1st Mechanical Room 45212981 1 02/11-P

Expander Panel 1st Mechanical Room 45212980 1 02/11-P

Expander Panel 1st C Wing 45210417 1 02/11-P

Expander Panel 1st C Wing 45210418 1 02/11-P

Expander Panel 1st C Wing 45210419 1 02/11-P

Expander Panel 1st D Wing 45210411 1 02/11-P

Expander Panel 1st D Wing 45210410 1 02/11-P

Expander Panel 1st D Wing 45210409 1 02/11-P

Expander Panel 1st D Wing 45210412 1 02/11-P

Device Total: 12

HurtVet Subcontracting LLC 23 Download Date: 07/09/2021

Verify correct receipt of alarm, supervisory and trouble signals (inputs), operation of evacuation signals and auxiliary functions (outputs), circuit supervision including detection of open circuits and ground faults, and power supply supervision for detection of loss of ac power and disconnection of secondary batteries. (NFPA 72-19 Table 14.4.3.2 (2)(1))

Power Supply 1 1 0 1 1

Power Supply 1st C Wing 45210420 1 02/11-P 08/18-P 02/09-P

HurtVet Subcontracting LLC 24 Download Date: 07/09/2021

Test interface equipment connections by operating or simulating the equipment being supervised. Verify signals required to be transmitted are received at the control unit. (NFPA 72-19 Table 14.4.3.2 (20))

Special Control 3 3 0 3 3

Special Control 1st Mechanical Room 45205871 1-16 02/11-P

Special Control 1st Mechanical Room 45205870 1-19 02/11-P

Special Control 1st Mechanical Room 45205869 1-18 02/11-P

HurtVet Subcontracting LLC 25 Download Date: 07/09/2021

Service Summary

The Service Summary section provides an overview of the services performed in this report.

Device Type Service Quantity

Passed

Annunciator Tested 3

Battery Tested 10

Communicator Tested 1

Control Panel Tested 1

Duct Detector Tested 15

Expander Panel Tested 12

Heat Detector Tested 1

Power Supply Tested 1

Pull Station Tested 22

Releasing Device Tested 18

Smoke Detector Tested/Cleaned 65

Speaker/Strobe Tested 13

Speaker Tested 18

Special Control Tested/Cleaned 3

Strobe Visually Checked 41

Tamper Switch Tested 6

Voice Evacuation Tested 1

Waterflow Switch Tested 6

Total 237

Grand Total 237

HurtVet Subcontracting LLC 26 Download Date: 07/09/2021

Auxiliary Functions Testing

Building: MP Bldg 331 Control Panel: 1 - SimplexGrinnell 4100

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

Type Location Comment ScanID Simulated

Releasing Device

Ground B-Wing Entry Passed 44230273

Ground B-Wing Entry Passed 44230274

Ground B-Wing Entry Passed 12603102

Ground B-Wing Entry Passed 12603103

Ground B-Wing B136 Passed 12603113

Ground B-Wing B136 Passed 12603114

Ground C-Wing Corridor Outside C-134 Passed 12603202

Ground C-Wing DBL DOOR IN FRONT OF RM C106

Passed 12603189

C106

Passed 12603190

C136

Passed 12603201

Ground C-Wing Entry Passed 12603140

Ground C-Wing Entry Passed 12603141

Ground D-Wing By Room D-106 Passed 12603155

Ground D-Wing By Room D-106 Passed 12603156

Ground D-Wing Partition Doors to A-Wing (A-Wing Side on Floor)

Passed 45212987

Ground D-Wing Partition Doors to A-Wing (D-Wing Side)

Passed 45212986

Ground DBL DOOR ACROSS FROM RM D-134

D WING

Passed 12603143

Ground DBL DOOR ACROSS FROM RM D-134

D WING

Passed 12603144

AHU Shutdown 1st Mechanical Room Passed 45208528

Smoke Compartment Ground B-Wing Corridor Outside B160 Passed 12602977

Smoke Compartment Ground D WING SHOWER D 136 Passed 44230275

Smoke Compartment 1st Mechanical Room Passed 45212979

Building: MP Bldg 331 Control Panel: 2

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

HurtVet Subcontracting LLC 27 Download Date: 07/09/2021

Type Location Comment ScanID Simulated

AHU Shutdown Roof BLDG B AHU 2 ROOF Passed 45208529

HurtVet Subcontracting LLC 28 Download Date: 07/09/2021

Time, Temperature & Level Testing

Building: MP Bldg 331 Control Panel: 1 - SimplexGrinnell

The Time, Temperature, & Level Testing section details the measurements taken from various devices that are designed to respond in a certain amount of time, respond at a certain temperature, or respond within the acceptable range of volume or level. Items are grouped by Passed or Failed/Other.

Type Location Comment Sec Deg Lvl ScanID

Passed Waterflow Switch

Ground floor Behind B Wing Passed 55 n/a n/a 45211320 Ground floor Behind D Wing Passed 60 n/a n/a 45211318 Ground floor Behind D Wing Passed 55 n/a n/a 45211319 Ground floor Electrical room A106 Passed 60 n/a n/a 45211323 Ground floor Electrical room A106 Wing A

Mech room Passed 50 n/a n/a 45211322

Garden Outdoor Inside A Oxygen Storage Room

Passed 55 n/a n/a 45211317

HurtVet Subcontracting LLC 29 Download Date: 07/09/2021

Battery & Power Supply Testing

The Battery & Power Supply Testing section details the readings and measurements of batteries and power supplies used to provide power to the fire alarm and life safety systems. Items are grouped by Passed or Failed/Other.

Battery

Type Location Rated Ah

Rated Volts

Pre Test

Post Test

Min Ah

Tested Ah

Passed Sealed Lead Acid 1st Mechanical Room

Expander Panel 35 12 28

Sealed Lead Acid 1st Mechanical Room Expander Panel

35 12 30

Sealed Lead Acid 1st C Wing 35 12 25

Sealed Lead Acid 1st C Wing 35 12 20

Sealed Lead Acid 1st D Wing 35 12 28

Sealed Lead Acid 1st D Wing 35 12 25

Sealed Lead Acid 1st FACP Mechanical Room 35 12 25

Sealed Lead Acid 1st FACP Mechanical Room 35 12 28

Sealed Lead Acid 1st LEFT RECEPTIONIST Area B Wing

35 12 33

Sealed Lead Acid 1st RIGHT RECEPTIONIST Area B Wing

35 12 30

HurtVet Subcontracting LLC 30 Download Date: 07/09/2021

Inventory & Warranty Report

Building: MP Bldg 331 Control Panel: 1 - SimplexGrinnell 4100

The Inventory & Warranty Report lists each of the devices and items that are included in your Inspection Report. A complete inventory count by device type and category is provided. Items installed within the last 90 days, within the last

Device or Type Category % of Inventory Quantity

Releasing Device Auxiliary 7.59% 18

Tamper Switch Supervisory 2.53% 6

Smoke Detector Initiating 27.43% 65

Pull Station Initiating 9.28% 22

Annunciator Control 1.27% 3

Battery Control 4.22% 10

Duct Detector Initiating 6.33% 15

Expander Panel Control 5.06% 12

Power Supply Control 0.42% 1

Communicator Control 0.42% 1

Control Panel Control 0.42% 1

Heat Detector Initiating 0.42% 1

Speaker Indicating 7.59% 18

Speaker/Strobe Indicating 5.49% 13

Special Control Control 1.27% 3

Voice Evacuation Control 0.42% 1

Waterflow Switch Initiating 2.53% 6

Strobe Indicating 17.30% 41

In Service - 90 Days - 1 Year

Power-Sonic

Battery 1 PS-12350 NB Sealed Lead Acid 08/19/2020

In Service - 1 Year to 2 Years

Power-Sonic

Battery 2 PS-12350 NB Sealed Lead Acid 10/25/2019

In Service - 2 Years to 3 Years

Power-Sonic

Battery 2 PS-12350 NB Sealed Lead Acid 02/13/2019

Battery 4 PS-12350 NB Sealed Lead Acid 01/21/2019

In Service - 3 Years to 5 Years

Power-Sonic

Battery 1 PS-12350 NB Sealed Lead Acid 01/16/2018

Simplex

Annunciator 3 4603-9101 LCD Display 05/19/2017

Duct Detector 3 4098-9701

05/19/2017

Duct Detector 3 4098-9784

HurtVet Subcontracting LLC 31 Download Date: 07/09/2021

Duct Detector 2 4098-9784 Ionization 05/19/2017

Pull Station 6 2099-9138

Pull Station 2 RMS-1T

Releasing Device 18

Smoke Detector 37 4098-9784 Photoelectric 05/19/2017

Smoke Detector 4 4098-9792, 4098-98

Photoelectric 05/19/2017

Speaker 10 4902-9721

Strobe 16 MS-24-VFR

Communicator 1

Con…