No Yes No Yes No Yes No Yes No Yes No Hydraulics Electric Pneumatic Yes No Yes No Yes No Yes No Yes Date Contractor's Material & Test Certificate for Aboveground Piping PROCEDURE Upon completion of work, inspection and tests shall be made by the contractor's representative and wttnessed by an owner's representattve. All defects shall be corrected and system left in service before contractor's personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities. owners. and contractor. It ts understood the owner's representalive's signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving authority's requirements or local ordinances. Property name Property address Accepted by approving authorities (names) Temperature rating Quality Orifice size Years of manufacture Model Maximum time to operate through test connection Seconds Minutes Model Make Serial no. Model Make Serial no. Model Alarm operated properly Time water reached test outlet Trip point air pressure Air pressure Water pressure No Yes Seconds Minutes psi psi Seconds Seconds Yes No Yes No Minutes Maximum time to operate release Does each circuit operate valve release? Does each circuit operate supervision loss alarm? Model Measured from time Inspector's test connectton is opened Make Is there an accessible factlity in each circuit for testing? If no, explain Does valve operate from the manual trip, remote, or both control stations? Detecting media supervtsed Piping supervised Operation If no, explain With Q.O.D Without Q.O.D Minutes Time to trip through test connection Make Q.O.D Dry valve Type Alarm device Make Supplies buildings 3. NFPA 25 2. Care and matntenance instructions 1. System components instructions Have copies of the followtng been left on the premises? Has person in charge of fire equipment been instructed as to location of control valves and care and maintenance of this new equipment? If no, explain? Address Installation conforms to accepted plans Equipment used is approved If no, explain deviations Plans Instructions Location of system Type of fittings Type of pipe Sprinklers Pipe and fittings Alarm valve or flow indicator Dry pipe operating test Deluge and preaction valves 335 Renfrew Drive. Suite 302. Markham. Ontario L3R 9S9 Tel: (905) 477-2270 Fax: (905) 477-3611 E-Mail: [email protected] www.casa-firesprinkler.org
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Contractor's Material & Test Certificate for Aboveground ...€¦ · Contractor's Material & Test Certificate for Aboveground Piping PROCEDURE ... piping Verified by copy of the Underground
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NoYes
NoYes
NoYes
NoYes
NoYes
No
HydraulicsElectricPneumatic
Yes NoYes
NoYes
NoYes
NoYes
Date
Contractor's Material & Test Certificate for Aboveground PipingPROCEDUREUpon completion of work, inspection and tests shall be made by the contractor's representative and wttnessed by an owner's representattve. All defects shall be corrected and system left in service before contractor's personnel finally leave the job.A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities. owners. and contractor. It ts understood the owner's representalive's signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving authority's requirements or local ordinances.
Property name
Property address
Accepted by approving authorities (names)
Temperature ratingQualityOrifice sizeYears of manufactureModel
Maximum time to operate through test connection
SecondsMinutesModelMake
Serial no.ModelMakeSerial no.Model
Alarm operatedproperly
Time waterreached test outlet
Trip pointair pressure
Airpressure
Waterpressure
NoYesSecondsMinutespsipsiSeconds
SecondsYes No Yes No Minutes
Maximum time to operate releaseDoes each circuit operatevalve release?
Does each circuit operatesupervision loss alarm?
Model
Measured from time Inspector's test connectton is opened
Make
Is there an accessible factlity in each circuit for testing?If no, explain
Does valve operate from the manual trip, remote, or both control stations?
Detecting media supervtsedPiping supervised
Operation
If no, explain
With Q.O.D
Without Q.O.D
Minutes
Time to tripthrough test connection
Make
Q.O.DDry valve
Type
Alarm device
Make
Supplies buildings
3. NFPA 25
2. Care and matntenance instructions
1. System components instructions
Have copies of the followtng been left on the premises?
Has person in charge of fire equipment been instructed as to location of control valves and care and maintenance of this new equipment?If no, explain?
Address
Installation conforms to accepted plans Equipment used is approved
psi (bar) for hoursAll piping hydrostatically tested at
Dry piping pneumatically tested
Equipment operates properly
II no, state reason
Do you certify as the sprinkler contractor that additives and corrosive chemicals, sodium silicate or derivatives of sodium silicate, brine, or other corrosive chemicals were not used for testing systems or stopping leaks?
Underground mains and lead in connections to system risers flushed before connection made to sprinkler piping
Verified by copy of the Underground Form flushed by installer of underground sprinkler piping
Other
Explain
If powder-driven fasteners are used in concrete, has representative sample testing be satisfactorily completed?
If no, explain
Number used
Welding pipingIf yes...
Do you certify as the sprinkler contractor that welding procedures comply with the requirements of at least AWS 82. 1?
Do you certify that the welding was performed by welders qualified in compliance with the requirements of at least AWS 82.1?
Do you certify that the welding was earned out in compliance with a documented quality control procedure to ensure that all discs are retrieved, that openings in piping are smooth, that slag and other welding residue are removed, and that the internal diameters of piping are not penetrated?
Do you certify that you have a control feature to ensure that all cutouts (discs) are retrieved?
Nameplate provided
If no. explain
Date left in service with all control valves open
Name of sprinkler contractor
For property owner (signed)
For sprinkler contractor (signed)
Additional explanations and notes
Title
Tests witnessed by
Date
Title & CASA Number Date
Locations Number removed
Draintest
Reading of gauge located near water supply test connection:psi ( bar)
Make and model Setting Static pressure
Inlet (psi)
HYDROSTATIC: Hydrostatic tests shall be made at not less than 200 psi (13.6 bar) for 2 hours or 50 psi (3.4 bar) above static pressure in excess ol 150 psi (10.2 bar) for 2 hours. Differential dry-pipe valve clappers shall be left open during the test to prevent damage. All aboveground piping leakage shall be stopped.PNEUMATIC: Establish 40 psi (2.7 bar) air pressure and measure drop, which shall not exceed 1-1/2 psi (0.1 bar) in 24 hours. Test pressure tanks at normal water level and air pressure and measure air pressure drop, which shall not exceed 1-1/2 psi (0.1 bar) in 24 hours.
Outlet (psi) Inlet (psi) Outlet (psi) Flow (gpm)
Residual pressure (flowing) Flow rate
Residual pressure with valve in test connection open wide:psi ( bar)