D.6 ATTACHMENT 6 - 2024 SFVA STANDPIPE 5-YEAR BUILDING INSPECTIONS.pdf
PDF 2 MB Posted
- Attached to
- J063--Fire Suppression System Inspection, Testing Maintenance, and Repair Services Federal contract opportunity
- Solicitation number
- 36C26125Q0538
About this file
These documents are a comprehensive set of Standpipe and Hose System Inspection, Testing, and Maintenance reports for multiple buildings located at 4150 Clements St. in San Francisco, CA, performed by Kell Fire Protection Services Inc. on November 4, 2024, as part of a 5-year inspection cycle mandated by the California Code of Regulations, Title 19, and NFPA 25 standards. The inspections cover buildings including Building 2, Building 7, Building 41, Building 200, Building 203, Building 205, Building 208, Building 209, and Building 211, with each report detailing a systematic evaluation of standpipe system components such as control valves, hose connections, pressure gauges, fire department connections, and other critical infrastructure.
The reports reveal multiple deficiencies across different buildings, including missing hose racks, corroded standpipe mains, rusted hangers, non-operational butterfly valves, and missing brass caps. Each report follows a standardized format with four sections: property information, riser information, a comprehensive inspection and testing checklist, and a deficiencies and comments section. The inspections were conducted using a pass/fail/not applicable methodology, with many components receiving a "pass" rating, while others were marked with deficiencies that will require repair or replacement to maintain the fire suppression system's integrity and compliance with safety regulations.
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Other files for this federal contract opportunity
| File | Type | Posted |
|---|---|---|
| 36C26125Q0538 0002 - Updated Price Schedule and Q-As.pdf | ||
| 36C26125Q0538 0002.docx | DOCX document | |
| 36C26125Q0538_2.docx | DOCX document | |
| D.9 ATTACHMENT 9 - PAST PERFORMANCE SURVEY.docx | DOCX document | |
| D.8 ATTACHMENT 8 - VASF TEST AND DEVICE COUNT.pdf | ||
| D.5 ATTACHMENT 5 - STANDARD EP LIST AND FREQUENCY.pdf | ||
| 36C26125Q0538_1.docx | DOCX document | |
| D.7 ATTACHMENT 7 - DOL WAGE DETERMININATION 2015-5637 REV.29, DATED 05-21-2025 - SAN FRANCISCO-SAN MATEO.pdf | ||
| D.4 ATTACHMENT 4 - EXHIBIT D - DAMPER REPORT [2018].pdf | ||
| D.2 ATTACHMENT 2 - EXHIBIT B VASF FA TEST AND DEVICE COUNT.pdf | ||
| D.1 ATTACHMENT 1 - EXHIBIT A TJC LIFE SAFETY EC DOCUMENT LIST REVIEW TOOL.pdf | ||
| RFQ 36C26125Q0538 - Fire Suppression.pdf | ||
| D.3 ATTACHMENT 3 - EXHIBIT C VASF CORRECTED ACTION FORM.pdf |
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Text version
Form AES 3.1 Sept. 3, 2013
Inspection, Testing, and Maintenance Cover Sheet NFPA25 as amended by CCR, Title 19
Property Information:
Name: Building 2 Occupancy/Use: Choose an item.
Address: 4150 Clements St. Construction Type: Choose an item.
City: San Francisco, CA No. Stories:
ZIP: 94121 Year Constructed:
Contact: Christopher Jocson
Telephone: 415-559-9541
Contractor Information: Number of System Risers 1
Copy sent to:
Name: Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth
CA. 95669
916-826-2968
Owner Date:
Address Fire AHJ Date:
City: Contractor Date:
State:
NOTES:
1) For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011 edition as amended by California Code of Regulations, Title 19, §901 to §906.
2) Inspection items may be performed by the owner in accordance with California Code of Regulations, Title 19, §904.1(a)
Telephone:
CA License#: 1103729
Job #:
Performed by:
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
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
*See "Deficiencies and Comments" section at end of each respective form.
Standpipe and Hose System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Property Information
Contractor or Licensed Owner Information
Building Name 4150 Clements St. Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA.
Address San Francisco, CA
94121
City Christopher Jocson License # Contact Person 415-559-9541 SFM Job #
Phone 4150 Clements St. CSLB Misc.
Type of Standpipe System Class of Standpipe System
Manual Wet Automatic Dry Class I Manual Dry Semi-Automatic Dry Class II Automatic Wet Combined Sprinkler/Standpipe Class III
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
This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached
5-Year INSPECTION, TESTING, AND MAINTENANCE Includes ALL Quarterly and Annual Inspections, Tests, and Maintenance Items
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
1.1 I Control Valves – Identification Sign 13.3.1 11-4-24 P
1.2 I Control Valves – Inspection 13.3.2 11-4-24 P
1.3 I Waterflow Alarm Devices 5.2.5 11-4-24 N
1.4 I Supervisory Alarm Devices 5.2.5 11-4-24 N
1.5 I Pressure Gauges
Pass = Normal Pressures
6.2.1 6.2.2
11-4-24 P
1.6 I Water Supply Pressure Below Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 N
1.7 I Water Supply Pressure Above Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 N
1.8 I Pressure at Top of Standpipe Riser 6.2.1
6.2.2, 13.2.7
11-4-24 P
1.9 I Air/Nitrogen Pressure 6.2.1
6.2.2, 13.2.7
11-4-24 N
1.10 I Pressure at Discharge of Fire Pump or Pressure Tank 6.2.1 6.2.2, 13.2.7
11-4-24 N
1.11 I Pressure Readings Acceptable 6.2.2
13.2.7
11-4-24 P
1.12 I Hydraulic Design Information Sign (For
Hydraulically Designed Systems) 6.2.3 11-4-24
P
1.13 I Heat Tape 5.2.7 11-4-24 N
Inspection, Testing, and Maintenance
5-Year Report
Building Name 4150 Clements St.
Kell Fire Protection services Inc.
Name
Address San Francisco, CA Job # City 94121 Misc.
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
1.14 I Standpipe Hose Valves 13.5.6.1 11-4-24 P
1.15 I Pressure Reducing Hose Valves 13.5.2.1 11-4-24 N
1.16 I Pressure Reducing Valves 13.5.1.1 11-4-24 N
1.17 I Fire Department Connections 13.7 11-4-24 P
1.18 I Backflow Preventers 13.6.1 11-4-24 N
1.19 I Buildings (Freeze Protection) 4.1.1.1 11-4-24 Owner’s Responsibility N
1.20 I Pipe and Fittings 6.2.1
Table 6.1.2
11-4-24 P
1.21 I Hangers 6.2.1 11-4-24 P
1.22 I Seismic Braces 6.2.1 11-4-24 P
1.23 I Hose Connection
6.2.1
Table 6.1.2 11-4-24 P
1.24 I Cabinet 6.2.1
Table 6.1.2
11-4-24 N
1.25 I Hose
6.2.1
Table 6.1.2 11-4-24 N
1.26 I Hose Storage Device 6.2.1
Table 6.1.2
11-4-24 N
1.27 I Hose Nozzle 6.2.1
Table 6.1.2
11-4-24 N
2.1 T Control Valve - Position 6.2.1
13.3.3.1
11-4-24 P
2.2 T Control Valve - Operation 6.2.1
13.3.3.2
11-4-24 P
2.3 T Supervisory Devices 13.3.3.5 11-4-24 N
2.4 T Waterflow Alarm Devices 90
sec max. Enter time
5.3.3 13.2.6
11-4-24 sec. N
2.5 T Main Drain Test
(Enter Data on Page 1 of this Form)
13.2.5 13.3.3.4
11-4-24 P
2.6 T Standpipe Flow Test 6.3.1 11-4-24 Provide results in table on 1st page. P
2.7 T Standpipe Hydrostatic Test 6.3.2 11-4-24 P
2.8 T Hose Rack Assembly Flow Test 13.5.3.2 11-4-24 N
2.9 T Backflow Preventer Assemblies 13.6.2 11-4-24 N
2.10 T Pressure Reducing Hose Valves 13.5.2.2 11-4-24 N
2.11 T Pressure Reducing Valves 13.5.3.2 11-4-24 N
2.12 T Pressure Gauges 6.3.4 11-4-24 P
California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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
2.13 T Hose Test 6.2.1 NFPA
11-4-24 N
3.1 M Control Valves 13.3.4 11-4-24 P
3.2 M FDC - Backflush 14.3.2.3
14.3.2.4
11-4-24 P
3.3 M Internal Pipe Inspection: See Deficiencies and
Comments Section for Results 14.2 11-4-24 N
3.4 M
Obstruction Investigation Required. If "Yes", See Deficiencies and Comments Section for Results 14.3 11-4-24 Yes
No N
3.5 M System Returned to Service
4.5.3 15.7
11-4-24 Yes No P
Standpipe and Hose System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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
Check here if additional Deficiencies and Comments are listed on Form AES9.
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 Ty Kell
Signature Ty kell Date 11-4-24
2 ½” PRV OUTLET TEST RESULTS
Annual 5-Year Other DATE: 11-4-24
OUTLET
LOCATION
(STAIR )
RESIDUAL
PRESSURE
Deficiencies/ comments
Stair 1 5th floor . 142
Stair 1 4th floor 144
Stair 1 3rd floor . 146
Stair 1 2nd floor 148
Stair 1 1st floor 150
Stair 2 roof
Stair 2 7th
Stair 2 6th
Stair 2 5th
Stair 2 4th
Stair 2 3rd
Stair 2 2nd
Stair 2 1st
Stair 2 ground
Stair 2 basement
Stair 3 6th
Stair 3 5th
Stair 3 4th
Stair 3 3rd
Stair 3 2nd
Stair 3 1st
Stair 3 ground
NFPA25 as amended by CCR, Title 19
Name: Building 7 Occupancy/Use: Choose an item.
ZIP: 94121 Year Constructed:
Inc.
8850 Randolph Dr.
Plymouth
City: Contractor Date:
State:
NOTES:
1) For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011
§904.1(a)
Telephone:
CA License#: 1103729
Job #:
Performed by:
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
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
Inspection, Testing, and Maintenance
5-Year Report
City Christopher Jocson License #
No. Location Riser
Diameter Main Drain Diameter
Initial Static Pressure
Residual Pressure
Final Static
STAIRWELL CLOSETS
This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached
Reference Date Comments Only P, F, N/A
1.1 I Control Valves – Identification Sign 13.3.1 11-4-24 P
1.2 I Control Valves – Inspection 13.3.2 11-4-24 P
1.3 I Waterflow Alarm Devices 5.2.5 11-4-24 N
1.4 I Supervisory Alarm Devices 5.2.5 11-4-24 N
1.5 I Pressure Gauges
Pass = Normal Pressures
6.2.1 6.2.2
11-4-24 P
1.6 I Water Supply Pressure Below Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.7 I Water Supply Pressure Above Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.8 I Pressure at Top of Standpipe Riser 6.2.1
6.2.2, 13.2.7
11-4-24 psi P
1.9 I Air/Nitrogen Pressure 6.2.1
6.2.2, 13.2.7
11-4-24 psi N
1.10 I Pressure at Discharge of Fire Pump or Pressure Tank 6.2.1 6.2.2, 13.2.7
11-4-24 psi N
1.11 I Pressure Readings Acceptable 6.2.2
13.2.7
11-4-24 P
1.12 I Hydraulic Design Information Sign (For
Hydraulically Designed Systems) 6.2.3 11-4-24
Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
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
1.14 I Standpipe Hose Valves 13.5.6.1 11-4-24 P
1.15 I Pressure Reducing Hose Valves 13.5.2.1 11-4-24 N
1.16 I Pressure Reducing Valves 13.5.1.1 11-4-24 N
1.17 I Fire Department Connections 13.7 11-4-24 P
1.18 I Backflow Preventers 13.6.1 11-4-24 N
1.19 I Buildings (Freeze Protection) 4.1.1.1 11-4-24 Owner’s Responsibility N
1.20 I Pipe and Fittings 6.2.1
Table 6.1.2
11-4-24 P
1.21 I Hangers 6.2.1 11-4-24 P
1.22 I Seismic Braces 6.2.1 11-4-24 P
1.23 I Hose Connection
6.2.1
Table 6.1.2 11-4-24 P
1.24 I Cabinet 6.2.1
Table 6.1.2
11-4-24 F
1.25 I Hose
6.2.1
Table 6.1.2 11-4-24 F
1.26 I Hose Storage Device 6.2.1
Table 6.1.2
11-4-24 F
1.27 I Hose Nozzle 6.2.1
Table 6.1.2
11-4-24 F
2.1 T Control Valve - Position 6.2.1
13.3.3.1
11-4-24 P
2.2 T Control Valve - Operation 6.2.1
13.3.3.2
11-4-24 P
2.3 T Supervisory Devices 13.3.3.5 11-4-24 N
2.4 T Waterflow Alarm Devices 90
sec max. Enter time
5.3.3 13.2.6
11-4-24 sec. N
2.5 T Main Drain Test
(Enter Data on Page 1 of this Form)
13.2.5 13.3.3.4
11-4-24 P
2.6 T Standpipe Flow Test 6.3.1 11-4-24 Provide results in table on 1st page. P
2.7 T Standpipe Hydrostatic Test 6.3.2 11-4-24 P
2.8 T Hose Rack Assembly Flow Test 13.5.3.2 11-4-24 F
2.9 T Backflow Preventer Assemblies 13.6.2 11-4-24 N
2.10 T Pressure Reducing Hose Valves 13.5.2.2 11-4-24 N
California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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
2.13 T Hose Test 6.2.1 NFPA
11-4-24 N
3.1 M Control Valves 13.3.4 11-4-24 P
3.2 M FDC - Backflush 14.3.2.3
14.3.2.4
11-4-24 P
3.3 M Internal Pipe Inspection: See Deficiencies and
Comments Section for Results 14.2 11-4-24 N
3.4 M
Obstruction Investigation Required. If "Yes", See Deficiencies and Comments Section for Results 14.3 11-4-24 Yes
No N
3.5 M System Returned to Service
4.5.3 15.7
11-4-24 Yes No P
Standpipe and Hose System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
11-4-24 X All hose racks are missing rack and hoses
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 Ty kell
(STAIR )
RESIDUAL
PRESSURE
@ GPM
Deficiencies/ comments
OUTLET
LOCATION
(STAIR )
RESIDUAL
PRESSURE
@ GPM
STATIC
PSI @ GPM
G floor Hall to dining
60 2 1/2
2nd fl by elev 60 Missing hose
2nd FL by staircase
60 Missing hose
1st rm 142 60 Missing hose
1 st 110A 60 Missing hose
(STAIR )
RESIDUAL
PRESSURE
@ GPM
STATIC
PSI @ GPM
OUTLET
LOCATION
(STAIR )
RESIDUAL
PRESSURE
@ GPM
STATIC
PSI @ GPM
NFPA25 as amended by CCR, Title 19
Name: Building 41 Occupancy/Use: Choose an item.
ZIP: 94121 Year Constructed:
Inc.
8850 Randolph Dr.
Plymouth
City: Contractor Date:
State:
NOTES:
1) For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011
§904.1(a)
Telephone:
CA License#: 1103729
Job #:
Performed by:
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
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
Inspection, Testing, and Maintenance
5-Year Report
City Christopher Jocson License #
No. Location Riser
Diameter Main Drain Diameter
Initial Static Pressure
Residual Pressure
This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached
Reference Date Comments Only P, F, N/A
1.1 I Control Valves – Identification Sign 13.3.1 11-4-24 P
1.2 I Control Valves – Inspection 13.3.2 11-4-24 P
1.3 I Waterflow Alarm Devices 5.2.5 11-4-24 N
1.4 I Supervisory Alarm Devices 5.2.5 11-4-24 N
1.5 I Pressure Gauges
Pass = Normal Pressures
6.2.1 6.2.2
11-4-24 P
1.6 I Water Supply Pressure Below Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.7 I Water Supply Pressure Above Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.8 I Pressure at Top of Standpipe Riser 6.2.1
6.2.2, 13.2.7
11-4-24 psi P
1.9 I Air/Nitrogen Pressure 6.2.1
6.2.2, 13.2.7
11-4-24 psi N
1.10 I Pressure at Discharge of Fire Pump or Pressure Tank 6.2.1 6.2.2, 13.2.7
11-4-24 psi N
1.11 I Pressure Readings Acceptable 6.2.2
13.2.7
11-4-24 P
1.12 I Hydraulic Design Information Sign (For
Hydraulically Designed Systems) 6.2.3 11-4-24
Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
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
1.14 I Standpipe Hose Valves 13.5.6.1 11-4-24 P
1.15 I Pressure Reducing Hose Valves 13.5.2.1 11-4-24 N
1.16 I Pressure Reducing Valves 13.5.1.1 11-4-24 N
1.17 I Fire Department Connections 13.7 11-4-24 P
1.18 I Backflow Preventers 13.6.1 11-4-24 N
1.19 I Buildings (Freeze Protection) 4.1.1.1 11-4-24 Owner’s Responsibility N
1.20 I Pipe and Fittings 6.2.1
Table 6.1.2
11-4-24 P
1.21 I Hangers 6.2.1 11-4-24 P
1.22 I Seismic Braces 6.2.1 11-4-24 P
1.23 I Hose Connection
6.2.1
Table 6.1.2 11-4-24 P
1.24 I Cabinet 6.2.1
Table 6.1.2
11-4-24 F
1.25 I Hose
6.2.1
Table 6.1.2 11-4-24 F
1.26 I Hose Storage Device 6.2.1
Table 6.1.2
11-4-24 F
1.27 I Hose Nozzle 6.2.1
Table 6.1.2
11-4-24 F
2.1 T Control Valve - Position 6.2.1
13.3.3.1
11-4-24 P
2.2 T Control Valve - Operation 6.2.1
13.3.3.2
11-4-24 P
2.3 T Supervisory Devices 13.3.3.5 11-4-24 N
2.4 T Waterflow Alarm Devices 90
sec max. Enter time
5.3.3 13.2.6
11-4-24 sec. N
2.5 T Main Drain Test
(Enter Data on Page 1 of this Form)
13.2.5 13.3.3.4
11-4-24 P
2.6 T Standpipe Flow Test 6.3.1 11-4-24 Provide results in table on 1st page. P
2.7 T Standpipe Hydrostatic Test 6.3.2 11-4-24 P
2.8 T Hose Rack Assembly Flow Test 13.5.3.2 11-4-24 F
2.9 T Backflow Preventer Assemblies 13.6.2 11-4-24 N
2.10 T Pressure Reducing Hose Valves 13.5.2.2 11-4-24 N
California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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
2.13 T Hose Test 6.2.1 NFPA
11-4-24 N
3.1 M Control Valves 13.3.4 11-4-24 P
3.2 M FDC - Backflush 14.3.2.3
14.3.2.4
11-4-24 P
3.3 M Internal Pipe Inspection: See Deficiencies and
Comments Section for Results 14.2 11-4-24 N
3.4 M
Obstruction Investigation Required. If "Yes", See Deficiencies and Comments Section for Results 14.3 11-4-24 Yes
No N
3.5 M System Returned to Service
4.5.3 15.7
11-4-24 Yes No P
Standpipe and Hose System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
11-4-24 x Roof standpipe starting to rust out
11-4-24 x Missing hoses and hose racks at all locations
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
Signature Date 11-4-24
(STAIR )
2nd floor south hose rack
50 No fire hose
2nd floor stairwell 2 ½ hose valve
2nd hose rack north hall
No fire hose
1st floor south hose rack
52 No fire hose
1st floor stairwell 2 ½ hose valve ground floor hose rack
52 No fire hose
Ground floor south hose rack
52 No fire hose
Ground floor hose rack
52 No fire hose
NFPA25 as amended by CCR, Title 19
Name: Building 41 Occupancy/Use: Choose an item.
ZIP: 94121 Year Constructed:
Inc.
8850 Randolph Dr.
Plymouth
City: Contractor Date:
State:
NOTES:
1) For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011
§904.1(a)
Telephone:
CA License#: 1103729
Job #:
Performed by:
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
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
Inspection, Testing, and Maintenance
5-Year Report
City Christopher Jocson License #
No. Location Riser
Diameter Main Drain Diameter
Initial Static Pressure
Residual Pressure
This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached
Reference Date Comments Only P, F, N/A
1.1 I Control Valves – Identification Sign 13.3.1 11-4-24 P
1.2 I Control Valves – Inspection 13.3.2 11-4-24 P
1.3 I Waterflow Alarm Devices 5.2.5 11-4-24 N
1.4 I Supervisory Alarm Devices 5.2.5 11-4-24 N
1.5 I Pressure Gauges
Pass = Normal Pressures
6.2.1 6.2.2
11-4-24 P
1.6 I Water Supply Pressure Below Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.7 I Water Supply Pressure Above Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.8 I Pressure at Top of Standpipe Riser 6.2.1
6.2.2, 13.2.7
11-4-24 psi P
1.9 I Air/Nitrogen Pressure 6.2.1
6.2.2, 13.2.7
11-4-24 psi N
1.10 I Pressure at Discharge of Fire Pump or Pressure Tank 6.2.1 6.2.2, 13.2.7
11-4-24 psi N
1.11 I Pressure Readings Acceptable 6.2.2
13.2.7
11-4-24 P
1.12 I Hydraulic Design Information Sign (For
Hydraulically Designed Systems) 6.2.3 11-4-24
Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
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
1.14 I Standpipe Hose Valves 13.5.6.1 11-4-24 P
1.15 I Pressure Reducing Hose Valves 13.5.2.1 11-4-24 N
1.16 I Pressure Reducing Valves 13.5.1.1 11-4-24 N
1.17 I Fire Department Connections 13.7 11-4-24 P
1.18 I Backflow Preventers 13.6.1 11-4-24 N
1.19 I Buildings (Freeze Protection) 4.1.1.1 11-4-24 Owner’s Responsibility N
1.20 I Pipe and Fittings 6.2.1
Table 6.1.2
11-4-24 F
1.21 I Hangers 6.2.1 11-4-24 P
1.22 I Seismic Braces 6.2.1 11-4-24 P
1.23 I Hose Connection
6.2.1
Table 6.1.2 11-4-24 P
1.24 I Cabinet 6.2.1
Table 6.1.2
11-4-24 N
1.25 I Hose
6.2.1
Table 6.1.2 11-4-24 N
1.26 I Hose Storage Device 6.2.1
Table 6.1.2
11-4-24 N
1.27 I Hose Nozzle 6.2.1
Table 6.1.2
11-4-24 N
2.1 T Control Valve - Position 6.2.1
13.3.3.1
11-4-24 P
2.2 T Control Valve - Operation 6.2.1
13.3.3.2
11-4-24 P
2.3 T Supervisory Devices 13.3.3.5 11-4-24 N
2.4 T Waterflow Alarm Devices 90
sec max. Enter time
5.3.3 13.2.6
11-4-24 sec. N
2.5 T Main Drain Test
(Enter Data on Page 1 of this Form)
13.2.5 13.3.3.4
11-4-24 P
2.6 T Standpipe Flow Test 6.3.1 11-4-24 Provide results in table on 1st page. P
2.7 T Standpipe Hydrostatic Test 6.3.2 11-4-24 P
2.8 T Hose Rack Assembly Flow Test 13.5.3.2 11-4-24 N
2.9 T Backflow Preventer Assemblies 13.6.2 11-4-24 N
2.10 T Pressure Reducing Hose Valves 13.5.2.2 11-4-24 N
California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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
2.13 T Hose Test 6.2.1 NFPA
11-4-24 N
3.1 M Control Valves 13.3.4 11-4-24 P
3.2 M FDC - Backflush 14.3.2.3
14.3.2.4
11-4-24 P
3.3 M Internal Pipe Inspection: See Deficiencies and
Comments Section for Results 14.2 11-4-24 N
3.4 M
Obstruction Investigation Required. If "Yes", See Deficiencies and Comments Section for Results 14.3 11-4-24 Yes
No N
3.5 M System Returned to Service
4.5.3 15.7
11-4-24 Yes No P
Standpipe and Hose System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
11-4-24 X Roof standpipe starting to rust out
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.
(STAIR )
1st floor 45
2nd floor 40
3rd floor 38
Roof 35
NFPA25 as amended by CCR, Title 19
Name: Building 200 Occupancy/Use: Choose an item.
ZIP: 94121 Year Constructed:
Inc.
8850 Randolph Dr.
Plymouth
City: Contractor Date:
State:
NOTES:
1) For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011
§904.1(a)
Telephone:
CA License#: 1103729
Job #:
Performed by:
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
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
Inspection, Testing, and Maintenance
5-Year Report
City Christopher Jocson License #
No. Location Riser
Diameter Main Drain Diameter
Initial Static Pressure
Residual Pressure
This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached
Reference Date Comments Only P, F, N/A
1.1 I Control Valves – Identification Sign 13.3.1 11-4-24 P
1.2 I Control Valves – Inspection 13.3.2 11-4-24 P
1.3 I Waterflow Alarm Devices 5.2.5 11-4-24 N
1.4 I Supervisory Alarm Devices 5.2.5 11-4-24 N
1.5 I Pressure Gauges
Pass = Normal Pressures
6.2.1 6.2.2
11-4-24 P
1.6 I Water Supply Pressure Below Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.7 I Water Supply Pressure Above Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.8 I Pressure at Top of Standpipe Riser 6.2.1
6.2.2, 13.2.7
11-4-24 psi P
1.9 I Air/Nitrogen Pressure 6.2.1
6.2.2, 13.2.7
11-4-24 psi N
1.10 I Pressure at Discharge of Fire Pump or Pressure Tank 6.2.1 6.2.2, 13.2.7
11-4-24 psi N
1.11 I Pressure Readings Acceptable 6.2.2
13.2.7
11-4-24 P
1.12 I Hydraulic Design Information Sign (For
Hydraulically Designed Systems) 6.2.3 11-4-24
Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
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
1.14 I Standpipe Hose Valves 13.5.6.1 11-4-24 P
1.15 I Pressure Reducing Hose Valves 13.5.2.1 11-4-24 N
1.16 I Pressure Reducing Valves 13.5.1.1 11-4-24 N
1.17 I Fire Department Connections 13.7 11-4-24 P
1.18 I Backflow Preventers 13.6.1 11-4-24 N
1.19 I Buildings (Freeze Protection) 4.1.1.1 11-4-24 Owner’s Responsibility N
1.20 I Pipe and Fittings 6.2.1
Table 6.1.2
11-4-24 P
1.21 I Hangers 6.2.1 11-4-24 P
1.22 I Seismic Braces 6.2.1 11-4-24 P
1.23 I Hose Connection
6.2.1
Table 6.1.2 11-4-24 P
1.24 I Cabinet 6.2.1
Table 6.1.2
11-4-24 N
1.25 I Hose
6.2.1
Table 6.1.2 11-4-24 N
1.26 I Hose Storage Device 6.2.1
Table 6.1.2
11-4-24 N
1.27 I Hose Nozzle 6.2.1
Table 6.1.2
11-4-24 N
2.1 T Control Valve - Position 6.2.1
13.3.3.1
11-4-24 P
2.2 T Control Valve - Operation 6.2.1
13.3.3.2
11-4-24 P
2.3 T Supervisory Devices 13.3.3.5 11-4-24 N
2.4 T Waterflow Alarm Devices 90
sec max. Enter time
5.3.3 13.2.6
11-4-24 sec. N
2.5 T Main Drain Test
(Enter Data on Page 1 of this Form)
13.2.5 13.3.3.4
11-4-24 P
2.6 T Standpipe Flow Test 6.3.1 11-4-24 Provide results in table on 1st page. P
2.7 T Standpipe Hydrostatic Test 6.3.2 11-4-24 P
2.8 T Hose Rack Assembly Flow Test 13.5.3.2 11-4-24 N
2.9 T Backflow Preventer Assemblies 13.6.2 11-4-24 N
2.10 T Pressure Reducing Hose Valves 13.5.2.2 11-4-24 N
California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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
2.13 T Hose Test 6.2.1 NFPA
11-4-24 N
3.1 M Control Valves 13.3.4 11-4-24 P
3.2 M FDC - Backflush 14.3.2.3
14.3.2.4
11-4-24 P
3.3 M Internal Pipe Inspection: See Deficiencies and
Comments Section for Results 14.2 11-4-24 N
3.4 M
Obstruction Investigation Required. If "Yes", See Deficiencies and Comments Section for Results 14.3 11-4-24 Yes
No N
3.5 M System Returned to Service
4.5.3 15.7
11-4-24 Yes No P
Standpipe and Hose System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
11-4-24 X Handle broken off 2 ½ hose valve needs to be replaced
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
Signature Date 11-4-24
(STAIR )
Stair 1 Roof stair 1 FL 3
Stair 1 floor 2
Stair 1 floor 1
Stair 1 floor G
Stair 1 Basemeant
Stair 2 roof stair 2 3rd stair 2 2nd stair 2 1st
Stair 2 G
Stair 3 3rd stair 3 2nd stair 3 1st stair 3 G
NFPA25 as amended by CCR, Title 19
Name: Building 203 Occupancy/Use: Choose an item.
ZIP: 94121 Year Constructed:
Inc.
8850 Randolph Dr.
Plymouth
City: Contractor Date:
State:
NOTES:
1) For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011
§904.1(a)
Telephone:
CA License#: 1103729
Job #:
Performed by:
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
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
Inspection, Testing, and Maintenance
5-Year Report
City Christopher Jocson License #
No. Location Riser
Diameter Main Drain Diameter
Initial Static Pressure
Residual Pressure
This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached
Reference Date Comments Only P, F, N/A
1.1 I Control Valves – Identification Sign 13.3.1 11-4-24 P
1.2 I Control Valves – Inspection 13.3.2 11-4-24 P
1.3 I Waterflow Alarm Devices 5.2.5 11-4-24 N
1.4 I Supervisory Alarm Devices 5.2.5 11-4-24 N
1.5 I Pressure Gauges
Pass = Normal Pressures
6.2.1 6.2.2
11-4-24 P
1.6 I Water Supply Pressure Below Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.7 I Water Supply Pressure Above Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.8 I Pressure at Top of Standpipe Riser 6.2.1
6.2.2, 13.2.7
11-4-24 psi P
1.9 I Air/Nitrogen Pressure 6.2.1
6.2.2, 13.2.7
11-4-24 psi N
1.10 I Pressure at Discharge of Fire Pump or Pressure Tank 6.2.1 6.2.2, 13.2.7
11-4-24 psi N
1.11 I Pressure Readings Acceptable 6.2.2
13.2.7
11-4-24 P
1.12 I Hydraulic Design Information Sign (For
Hydraulically Designed Systems) 6.2.3 11-4-24
Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
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
1.14 I Standpipe Hose Valves 13.5.6.1 11-4-24 P
1.15 I Pressure Reducing Hose Valves 13.5.2.1 11-4-24 N
1.16 I Pressure Reducing Valves 13.5.1.1 11-4-24 N
1.17 I Fire Department Connections 13.7 11-4-24 P
1.18 I Backflow Preventers 13.6.1 11-4-24 N
1.19 I Buildings (Freeze Protection) 4.1.1.1 11-4-24 Owner’s Responsibility N
1.20 I Pipe and Fittings 6.2.1
Table 6.1.2
11-4-24 P
1.21 I Hangers 6.2.1 11-4-24 P
1.22 I Seismic Braces 6.2.1 11-4-24 P
1.23 I Hose Connection
6.2.1
Table 6.1.2 11-4-24 N
1.24 I Cabinet 6.2.1
Table 6.1.2
11-4-24 N
1.25 I Hose
6.2.1
Table 6.1.2 11-4-24 N
1.26 I Hose Storage Device 6.2.1
Table 6.1.2
11-4-24 N
1.27 I Hose Nozzle 6.2.1
Table 6.1.2
11-4-24 N
2.1 T Control Valve - Position 6.2.1
13.3.3.1
11-4-24 P
2.2 T Control Valve - Operation 6.2.1
13.3.3.2
11-4-24 P
2.3 T Supervisory Devices 13.3.3.5 11-4-24 N
2.4 T Waterflow Alarm Devices 90
sec max. Enter time
5.3.3 13.2.6
11-4-24 sec. N
2.5 T Main Drain Test
(Enter Data on Page 1 of this Form)
13.2.5 13.3.3.4
11-4-24 P
2.6 T Standpipe Flow Test 6.3.1 11-4-24 Provide results in table on 1st page. P
2.7 T Standpipe Hydrostatic Test 6.3.2 11-4-24 P
2.8 T Hose Rack Assembly Flow Test 13.5.3.2 11-4-24 N
2.9 T Backflow Preventer Assemblies 13.6.2 11-4-24 N
2.10 T Pressure Reducing Hose Valves 13.5.2.2 11-4-24 N
California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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
2.13 T Hose Test 6.2.1 NFPA
11-4-24 N
3.1 M Control Valves 13.3.4 11-4-24 P
3.2 M FDC - Backflush 14.3.2.3
14.3.2.4
11-4-24 P
3.3 M Internal Pipe Inspection: See Deficiencies and
Comments Section for Results 14.2 11-4-24 N
3.4 M
Obstruction Investigation Required. If "Yes", See Deficiencies and Comments Section for Results 14.3 11-4-24 Yes
No N
3.5 M System Returned to Service
4.5.3 15.7
11-4-24 Yes No P
Standpipe and Hose System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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 Ty kell
(STAIR )
RESIDUAL
PRESSURE
@ GPM
Deficiencies/ comments
Stair 1 Roof stair 1 FL 3
Stair 1 floor 2
Stair 1 floor 1
Stair 1 floor G
Stair 1
Stair 2 roof stair 2 3rd stair 2 2nd stair 2 1st
Stair 2 G
Stair 2 basement stair 3 roof stair 3 3rd stair 3 2nd stair 3 1st stair 3 G stair 3
NFPA25 as amended by CCR, Title 19
Name: Building 205 Occupancy/Use: Choose an item.
ZIP: 94121 Year Constructed:
Inc.
8850 Randolph Dr.
Plymouth
City: Contractor Date:
State:
NOTES:
1) For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011
§904.1(a)
Telephone:
CA License#: 1103729
Job #:
Performed by:
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
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
Inspection, Testing, and Maintenance
5-Year Report
City Christopher Jocson License #
No. Location Riser
Diameter Main Drain Diameter
Initial Static Pressure
Residual Pressure
This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached
Reference Date Comments Only P, F, N/A
1.1 I Control Valves – Identification Sign 13.3.1 11-4-24 P
1.2 I Control Valves – Inspection 13.3.2 11-4-24 P
1.3 I Waterflow Alarm Devices 5.2.5 11-4-24 N
1.4 I Supervisory Alarm Devices 5.2.5 11-4-24 N
1.5 I Pressure Gauges
Pass = Normal Pressures
6.2.1 6.2.2
11-4-24 P
1.6 I Water Supply Pressure Below Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.7 I Water Supply Pressure Above Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.8 I Pressure at Top of Standpipe Riser 6.2.1
6.2.2, 13.2.7
11-4-24 psi P
1.9 I Air/Nitrogen Pressure 6.2.1
6.2.2, 13.2.7
11-4-24 psi N
1.10 I Pressure at Discharge of Fire Pump or Pressure Tank 6.2.1 6.2.2, 13.2.7
11-4-24 psi N
1.11 I Pressure Readings Acceptable 6.2.2
13.2.7
11-4-24 P
1.12 I Hydraulic Design Information Sign (For
Hydraulically Designed Systems) 6.2.3 11-4-24
Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
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
1.14 I Standpipe Hose Valves 13.5.6.1 11-4-24 P
1.15 I Pressure Reducing Hose Valves 13.5.2.1 11-4-24 N
1.16 I Pressure Reducing Valves 13.5.1.1 11-4-24 N
1.17 I Fire Department Connections 13.7 11-4-24 P
1.18 I Backflow Preventers 13.6.1 11-4-24 N
1.19 I Buildings (Freeze Protection) 4.1.1.1 11-4-24 Owner’s Responsibility N
1.20 I Pipe and Fittings 6.2.1
Table 6.1.2
11-4-24 P
1.21 I Hangers 6.2.1 11-4-24 P
1.22 I Seismic Braces 6.2.1 11-4-24 P
1.23 I Hose Connection
6.2.1
Table 6.1.2 11-4-24 P
1.24 I Cabinet 6.2.1
Table 6.1.2
11-4-24 F
1.25 I Hose
6.2.1
Table 6.1.2 11-4-24 F
1.26 I Hose Storage Device 6.2.1
Table 6.1.2
11-4-24 F
1.27 I Hose Nozzle 6.2.1
Table 6.1.2
11-4-24 F
2.1 T Control Valve - Position 6.2.1
13.3.3.1
11-4-24 P
2.2 T Control Valve - Operation 6.2.1
13.3.3.2
11-4-24 P
2.3 T Supervisory Devices 13.3.3.5 11-4-24 N
2.4 T Waterflow Alarm Devices 90
sec max. Enter time
5.3.3 13.2.6
11-4-24 sec. N
2.5 T Main Drain Test
(Enter Data on Page 1 of this Form)
13.2.5 13.3.3.4
11-4-24 P
2.6 T Standpipe Flow Test 6.3.1 11-4-24 Provide results in table on 1st page. P
2.7 T Standpipe Hydrostatic Test 6.3.2 11-4-24 P
2.8 T Hose Rack Assembly Flow Test 13.5.3.2 11-4-24 F
2.9 T Backflow Preventer Assemblies 13.6.2 11-4-24 N
2.10 T Pressure Reducing Hose Valves 13.5.2.2 11-4-24 N
California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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
2.13 T Hose Test 6.2.1 NFPA
11-4-24 F
3.1 M Control Valves 13.3.4 11-4-24 P
3.2 M FDC - Backflush 14.3.2.3
14.3.2.4
11-4-24 P
3.3 M Internal Pipe Inspection: See Deficiencies and
Comments Section for Results 14.2 11-4-24 N
3.4 M
Obstruction Investigation Required. If "Yes", See Deficiencies and Comments Section for Results 14.3 11-4-24 Yes
No N
3.5 M System Returned to Service
4.5.3 15.7
11-4-24 Yes No P
Standpipe and Hose System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
11-4-24 X 3 Hose racks in building they are missing hose and rack. These need to be reinstalled per code
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.
(STAIR )
RESIDUAL
PRESSURE
@ GPM
Deficiencies/ comments
OUTLET
LOCATION
(STAIR )
RESIDUAL
PRESSURE
@ GPM
STATIC
PSI @ GPM
1st south floor hose Missing hose and rack
1st north floor hose
2nd Floor center hose
NFPA25 as amended by CCR, Title 19
Name: Building 208 Occupancy/Use: Choose an item.
ZIP: 94121 Year Constructed:
Inc.
8850 Randolph Dr.
Plymouth
City: Contractor Date:
State:
NOTES:
1) For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011
§904.1(a)
Telephone:
CA License#: 1103729
Job #:
Performed by:
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
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
Inspection, Testing, and Maintenance
5-Year Report
City Christopher Jocson License #
No. Location Riser
Diameter Main Drain Diameter
Initial Static Pressure
Residual Pressure
This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached
Reference Date Comments Only P, F, N/A
1.1 I Control Valves – Identification Sign 13.3.1 11-4-24 P
1.2 I Control Valves – Inspection 13.3.2 11-4-24 P
1.3 I Waterflow Alarm Devices 5.2.5 11-4-24 N
1.4 I Supervisory Alarm Devices 5.2.5 11-4-24 N
1.5 I Pressure Gauges
Pass = Normal Pressures
6.2.1 6.2.2
11-4-24 P
1.6 I Water Supply Pressure Below Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.7 I Water Supply Pressure Above Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.8 I Pressure at Top of Standpipe Riser 6.2.1
6.2.2, 13.2.7
11-4-24 psi P
1.9 I Air/Nitrogen Pressure 6.2.1
6.2.2, 13.2.7
11-4-24 psi N
1.10 I Pressure at Discharge of Fire Pump or Pressure Tank 6.2.1 6.2.2, 13.2.7
11-4-24 psi N
1.11 I Pressure Readings Acceptable 6.2.2
13.2.7
11-4-24 P
1.12 I Hydraulic Design Information Sign (For
Hydraulically Designed Systems) 6.2.3 11-4-24
Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
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
1.14 I Standpipe Hose Valves 13.5.6.1 11-4-24 P
1.15 I Pressure Reducing Hose Valves 13.5.2.1 11-4-24 N
1.16 I Pressure Reducing Valves 13.5.1.1 11-4-24 N
1.17 I Fire Department Connections 13.7 11-4-24 P
1.18 I Backflow Preventers 13.6.1 11-4-24 N
1.19 I Buildings (Freeze Protection) 4.1.1.1 11-4-24 Owner’s Responsibility N
1.20 I Pipe and Fittings 6.2.1
Table 6.1.2
11-4-24 P
1.21 I Hangers 6.2.1 11-4-24 P
1.22 I Seismic Braces 6.2.1 11-4-24 N
1.23 I Hose Connection
6.2.1
Table 6.1.2 11-4-24 P
1.24 I Cabinet 6.2.1
Table 6.1.2
11-4-24 N
1.25 I Hose
6.2.1
Table 6.1.2 11-4-24 N
1.26 I Hose Storage Device 6.2.1
Table 6.1.2
11-4-24 N
1.27 I Hose Nozzle 6.2.1
Table 6.1.2
11-4-24 N
2.1 T Control Valve - Position 6.2.1
13.3.3.1
11-4-24 P
2.2 T Control Valve - Operation 6.2.1
13.3.3.2
11-4-24 P
2.3 T Supervisory Devices 13.3.3.5 11-4-24 N
2.4 T Waterflow Alarm Devices 90
sec max. Enter time
5.3.3 13.2.6
11-4-24 sec. N
2.5 T Main Drain Test
(Enter Data on Page 1 of this Form)
13.2.5 13.3.3.4
11-4-24 P
2.6 T Standpipe Flow Test 6.3.1 11-4-24 Provide results in table on 1st page. P
2.7 T Standpipe Hydrostatic Test 6.3.2 11-4-24 P
2.8 T Hose Rack Assembly Flow Test 13.5.3.2 11-4-24 N
2.9 T Backflow Preventer Assemblies 13.6.2 11-4-24 N
2.10 T Pressure Reducing Hose Valves 13.5.2.2 11-4-24 N
California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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
2.13 T Hose Test 6.2.1 NFPA
11-4-24 N
3.1 M Control Valves 13.3.4 11-4-24 P
3.2 M FDC - Backflush 14.3.2.3
14.3.2.4
11-4-24 P
3.3 M Internal Pipe Inspection: See Deficiencies and
Comments Section for Results 14.2 11-4-24 N
3.4 M
Obstruction Investigation Required. If "Yes", See Deficiencies and Comments Section for Results 14.3 11-4-24 Yes
No N
3.5 M System Returned to Service
4.5.3 15.7
11-4-24 Yes No P
Standpipe and Hose System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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.
(STAIR )
RESIDUAL
PRESSURE
@ GPM
Deficiencies/ comments
Stair 1 1st floor 55
Stair 1 2nd 45
Stair 2 basement
Stair 2 1st
Stair 2 2nd
Stair 2 3rd
Stair 3 2nd 50
Stair 3 1st 60
Stair 2 1st
Stair 2 basement
NFPA25 as amended by CCR, Title 19
Name: Building 211 Occupancy/Use: Choose an item.
ZIP: 94121 Year Constructed:
Inc.
8850 Randolph Dr.
Plymouth
City: Contractor Date:
State:
NOTES:
1) For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011
§904.1(a)
Telephone:
CA License#: 1103729
Job #:
Performed by:
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
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
Inspection, Testing, and Maintenance
5-Year Report
City Christopher Jocson License #
No. Location Riser
Diameter Main Drain Diameter
Initial Static Pressure
Residual Pressure
This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached
Reference Date Comments Only P, F, N/A
1.1 I Control Valves – Identification Sign 13.3.1 11-4-24 P
1.2 I Control Valves – Inspection 13.3.2 11-4-24 P
1.3 I Waterflow Alarm Devices 5.2.5 11-4-24 N
1.4 I Supervisory Alarm Devices 5.2.5 11-4-24 N
1.5 I Pressure Gauges
Pass = Normal Pressures
6.2.1 6.2.2
11-4-24 P
1.6 I Water Supply Pressure Below Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.7 I Water Supply Pressure Above Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.8 I Pressure at Top of Standpipe Riser 6.2.1
6.2.2, 13.2.7
11-4-24 psi P
1.9 I Air/Nitrogen Pressure 6.2.1
6.2.2, 13.2.7
11-4-24 psi N
1.10 I Pressure at Discharge of Fire Pump or Pressure Tank 6.2.1 6.2.2, 13.2.7
11-4-24 psi N
1.11 I Pressure Readings Acceptable 6.2.2
13.2.7
11-4-24 P
1.12 I Hydraulic Design Information Sign (For
Hydraulically Designed Systems) 6.2.3 11-4-24
Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
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
1.14 I Standpipe Hose Valves 13.5.6.1 11-4-24 P
1.15 I Pressure Reducing Hose Valves 13.5.2.1 11-4-24 N
1.16 I Pressure Reducing Valves 13.5.1.1 11-4-24 N
1.17 I Fire Department Connections 13.7 11-4-24 P
1.18 I Backflow Preventers 13.6.1 11-4-24 N
1.19 I Buildings (Freeze Protection) 4.1.1.1 11-4-24 Owner’s Responsibility N
1.20 I Pipe and Fittings 6.2.1
Table 6.1.2
11-4-24 F
1.21 I Hangers 6.2.1 11-4-24 P
1.22 I Seismic Braces 6.2.1 11-4-24 P
1.23 I Hose Connection
6.2.1
Table 6.1.2 11-4-24 N
1.24 I Cabinet 6.2.1
Table 6.1.2
11-4-24 N
1.25 I Hose
6.2.1
Table 6.1.2 11-4-24 N
1.26 I Hose Storage Device 6.2.1
Table 6.1.2
11-4-24 N
1.27 I Hose Nozzle 6.2.1
Table 6.1.2
11-4-24 N
2.1 T Control Valve - Position 6.2.1
13.3.3.1
11-4-24 P
2.2 T Control Valve - Operation 6.2.1
13.3.3.2
11-4-24 P
2.3 T Supervisory Devices 13.3.3.5 11-4-24 N
2.4 T Waterflow Alarm Devices 90
sec max. Enter time
5.3.3 13.2.6
11-4-24 sec. N
2.5 T Main Drain Test
(Enter Data on Page 1 of this Form)
13.2.5 13.3.3.4
11-4-24 P
2.6 T Standpipe Flow Test 6.3.1 11-4-24 Provide results in table on 1st page. P
2.7 T Standpipe Hydrostatic Test 6.3.2 11-4-24 P
2.8 T Hose Rack Assembly Flow Test 13.5.3.2 11-4-24 N
2.9 T Backflow Preventer Assemblies 13.6.2 11-4-24 N
2.10 T Pressure Reducing Hose Valves 13.5.2.2 11-4-24 N
California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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
2.13 T Hose Test 6.2.1 NFPA
11-4-24 N
3.1 M Control Valves 13.3.4 11-4-24 P
3.2 M FDC - Backflush 14.3.2.3
14.3.2.4
11-4-24 P
3.3 M Internal Pipe Inspection: See Deficiencies and
Comments Section for Results 14.2 11-4-24 N
3.4 M
Obstruction Investigation Required. If "Yes", See Deficiencies and Comments Section for Results 14.3 11-4-24 Yes
No N
3.5 M System Returned to Service
4.5.3
15.7 11-4-24
Yes No P
Standpipe and Hose System California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
11-4-24 X Standpipe mains next to stairwell are heavily corroded and will start leaking in the future
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.
(STAIR )
RESIDUAL
PRESSURE
@ GPM
Deficiencies/ comments
Stair 1 5th floor . 142
Stair 1 4th floor 144
Stair 1 3rd floor . 146
Stair 1 2nd floor 148
Stair 1 1st floor 150
Stair 2 roof
Stair 2 7th
Stair 2 6th
Stair 2 5th
Stair 2 4th
Stair 2 3rd
Stair 2 2nd
Stair 2 1st
Stair 2 ground
Stair 2 basement
Stair 3 6th
Stair 3 5th
Stair 3 4th
Stair 3 3rd
Stair 3 2nd
Stair 3 1st
Stair 3 ground
NFPA25 as amended by CCR, Title 19
Name: Building 209 Occupancy/Use: Choose an item.
ZIP: 94121 Year Constructed:
Inc.
8850 Randolph Dr.
Plymouth
City: Contractor Date:
State:
NOTES:
1) For specific inspection, testing, and maintenance requirements and information, see NFPA 25, 2011
§904.1(a)
Telephone:
CA License#: 1103729
Job #:
Performed by:
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
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
Inspection, Testing, and Maintenance
5-Year Report
City Christopher Jocson License #
No. Location Riser
Diameter Main Drain Diameter
Initial Static Pressure
Residual Pressure
This building has more than 5 risers. See additional AES 2.9 form attached. Number of AES 2.9 forms attached
Reference Date Comments Only P, F, N/A
1.1 I Control Valves – Identification Sign 13.3.1 11-4-24 P
1.2 I Control Valves – Inspection 13.3.2 11-4-24 F
1.3 I Waterflow Alarm Devices 5.2.5 11-4-24 N
1.4 I Supervisory Alarm Devices 5.2.5 11-4-24 N
1.5 I Pressure Gauges
Pass = Normal Pressures
6.2.1 6.2.2
11-4-24 P
1.6 I Water Supply Pressure Below Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.7 I Water Supply Pressure Above Dry Pipe or Preaction
Valve
6.2.1 6.2.2
11-4-24 psi N
1.8 I Pressure at Top of Standpipe Riser 6.2.1
6.2.2, 13.2.7
11-4-24 psi P
1.9 I Air/Nitrogen Pressure 6.2.1
6.2.2, 13.2.7
11-4-24 psi N
1.10 I Pressure at Discharge of Fire Pump or Pressure Tank 6.2.1 6.2.2, 13.2.7
11-4-24 psi N
1.11 I Pressure Readings Acceptable 6.2.2
13.2.7
11-4-24 P
1.12 I Hydraulic Design Information Sign (For
Hydraulically Designed Systems) 6.2.3 11-4-24
Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
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
1.14 I Standpipe Hose Valves 13.5.6.1 11-4-24 P
1.15 I Pressure Reducing Hose Valves 13.5.2.1 11-4-24 N
1.16 I Pressure Reducing Valves 13.5.1.1 11-4-24 N
1.17 I Fire Department Connections 13.7 11-4-24 P
1.18 I Backflow Preventers 13.6.1 11-4-24 N
1.19 I Buildings (Freeze Protection) 4.1.1.1 11-4-24 Owner’s Responsibility N
1.20 I Pipe and Fittings 6.2.1
Table 6.1.2
11-4-24 F
1.21 I Hangers 6.2.1 11-4-24 F
1.22 I Seismic Braces 6.2.1 11-4-24 P
1.23 I Hose Connection
6.2.1
Table 6.1.2 11-4-24 N
1.24 I Cabinet 6.2.1
Table 6.1.2
11-4-24 N
1.25 I Hose
6.2.1
Table 6.1.2 11-4-24 N
1.26 I Hose Storage Device 6.2.1
Table 6.1.2
11-4-24 N
1.27 I Hose Nozzle 6.2.1
Table 6.1.2
11-4-24 N
2.1 T Control Valve - Position 6.2.1
13.3.3.1
11-4-24 P
2.2 T Control Valve - Operation 6.2.1
13.3.3.2
11-4-24 F
2.3 T Supervisory Devices 13.3.3.5 11-4-24 N
2.4 T Waterflow Alarm Devices 90
sec max. Enter time
5.3.3 13.2.6
11-4-24 sec. N
2.5 T Main Drain Test
(Enter Data on Page 1 of this Form)
13.2.5 13.3.3.4
11-4-24 P
2.6 T Standpipe Flow Test 6.3.1 11-4-24 Provide results in table on 1st page. P
2.7 T Standpipe Hydrostatic Test 6.3.2 11-4-24 P
2.8 T Hose Rack Assembly Flow Test 13.5.3.2 11-4-24 N
2.9 T Backflow Preventer Assemblies 13.6.2 11-4-24 N
2.10 T Pressure Reducing Hose Valves 13.5.2.2 11-4-24 N
California Code of Regulations - Title 19 Inspection, Testing, and Maintenance
5-Year Report
Kell Fire Protection services Inc.
8850 Randolph Dr.
Plymouth, CA
Name
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
2.13 T Hose Test 6.2.1 NFPA
11-4-24 N
3.1 M Control Valves 13.3.4 11-4-24 F
3.2 M FDC - Backflush 14.3.2.3
14.3.2.4
11-4-24 P
3.3 M Internal Pipe Inspection: See…
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