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7110 210TH ST SWIIII��IiI Z I64 T S1 s LJ FIRE PREVENTION SNOHOIIISH Cb Serving Brier, Edmonas, ana 12425 Meridian Ave S INSPECTION REPORT �;. FIRE Mountlake Terrace Everett, WA 98208 ❑ EDMONDS ❑ BRIER ``� DIST � Phone 425 551-1200 � ) ❑ MOUNTLAKE TERRACE ❑ UNINCORPORATED www.FireDistrictl.org Fax (425) 551-1272 F�1EQUEfyCY ST SHIFT LOCATION: 7110 210 th Street SW 98026 Annual ��� Edmonds Public Works (Office and Garage) 4257710235 SCHEDULED Jul 2017 BUSINESS NAME: PHONE: DATE DUE MAILING 7110 210th Street SW, Edmonds, WA 98026 UFIR ADDRESS: / BUSINESS OWiV�OVti l l/�I�Q V�. HOME PHONE: EMERGENCY. • Ste irn 4257603334 x HOME PHONE: 16 CURRENT YES( ` NO KEY ACCESS-2: HOME PHONE: CITY EMA 'u )ig4 .*�j I U� 4 i0 ed' Vn 0hdS LI.tQ'50 1 BUSINESS ❑ ❑ LICENSE PERSON CONTACTED: INTIAI, Ita�SPCCTiQN DATE 11 �L l► NAME OF INSPECTOR: Oe !n. A QC rlKt JTJ I tIVIJ: A.p.tfflb HA b/1b FIf-4/1b 11:UU:UU AM Date Last Serviced: 1 llty V%--)` SNOHOMISH'( FIR,] DIS7 FIRE PREVENTION :'Serving Brier, Edmonds, and 12425' Meridian Ave S INSPECTION REPORT Mountlak❑BRIERe Terrace Everett, WA 98208 ❑ S BRIER Phone (425) 551-1200 ❑ MOUNTLAKE TERRACE www.FireDistrictl.org Fax (425) 551-1272 ❑ UNINCORPORATED FREQUENCY STATION & SHIFT LOCATION: 7110 210 th Street SW 98026 An lual BUSINESS NAME: PHONE: SCHEDULED � Edmonds Public Works (Office and Garage) 4257710235 DATE DUE 1-12016 MAILING UFIR / ADDRESS: 509 7110 21 Oth Street SW, Edmonds, WA 98026 BUSINESS OWNER: HOME PHONE: Miller, Noel EMERGENCY-1: HOME PHONE: CURRENT KEY ACCESS-2: Stevens, Jim HOME PHONE: 4257603334 CITY YES NO EMAIL: BUSINESS El LICENSE PERSON CONTACTED: INITIAL INSPECTION DATE NAME OF INSPECTOR: N 4 4 Q— 1 Q— FIRE SYSTEMS:. AS 955 FA 4/14 FE 4/15 FDI /Lk Box O)atedna cbcAnONS / COMMUNICATIONS 2 2 3 3 4 4 5 6 6 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1 st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: EXTENSION GRANTED TO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: INSPECTOR: ' •��Ct;r v" ��SI'�'" INSPECTOR: INSPECTOR: Z DATE: Ll ' Z � - I jd DATE: DATE: 3 �//V�IOLATIONS 1 _2" M 2 3 15 6 VIOLATIONS 1 5 LETTEPRE-CR SENT LETTER SENT CITATION ISSUED NUMBER: 4 2 6 DATE: CODE SECTION: _ 6 ...._.�...... 7 3 7 RETURN RECEIPT RECEIVED 6 LETTER NEEDED ❑ YES ❑ NO 4 18 DATE: DISPOSITION: 7 LETTER NEEDED ❑ YES ❑ NO 6 j. .. .... ..'�, wl;r•_.i.. n1_n� ... _ ..�• �1,; „y:, rat, ... r,j ..^,"...i `.,.J .,.. 11r,_•_l..i - __S•.C,. :�:... :c.. } Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY 3434 First Ave. So., Seattle, WA 98134, 206.622.4656 WA.: VI-KI-NA-S373NTLEVEL m 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report Page: 10 2 REPORT TO: rm'Y1 An) ID-s ?ta10:4e C ��1lr�%('� JOB NO. 1A) I 60'M DATE: STREET: �� .Ld•P..� rt� �� ] BLDG. / LOCATION: CITY / STATE : !FD1vVs1V®5 INSPECTOR: 1.GENERAL a. Is the building occupied ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b. Is occupancy the same as previous inspection ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Are all systems in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . - - - - - - . _ - _ - _ _ _ _ - . _ _ - d. Are all fire protection systems the same as last Inspection ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e. Is the building completely sprinklered ?. _ _ . . . . . . . . _ . . . . . . . . . . . . . . . . . . . . I. Are all new additions and building changes properly protected ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Is all stock or storage properly below sprinkler piping ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ h• Was property free of fires since last Inspection ? (Explain any fire on Page 2) . _ _ _ . . . . . . . . . . . . . . . . . I. In areas protected by wet systems, is building property heated, Le.: blind attics, perimeter areas, and are all exterior openings protected against the. cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ _ _ _ _ _ _ _ _ . . _ b. Are all other control valves In proper position ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Are all control valves In good condition and sealed or supervised ? . . . . . . . . . . . . . . . . . . . . . . . . . 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ... _ _ _ _ _ _ _ _ 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevolrs and pressure tanks In good condition and properly maintained 7 _ _ _ . - _ _ b. Are Fire Department Connections In satisfactory condition, couplings free, caps In place and check valves tight®_ 5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Have antifreeze systems been tested and left In satisfactory condition ? Temp. ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Are alarm valves, water flow indicators and retard chambers in satisfactory condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 6, DRY SYSTEMS (See Section 14) a. Are dry valve(s) In service and in good condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are pressure and priming water levels normal ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c: Is air compressor in good condition ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. Were low points drained during fall and winter Inspections ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ e. Are Quick- opening devices in service ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I. Has piping been checked for stoppage within the past ten (10) years ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Has piping been checked for proper pitch within the past five (5) years ? . . _ _ . . . . _ _ . . . . . . . . . . . . . . h. Have dry valves been trip tested satisfactorily as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I. Are dry valves adequately protected from freezing ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ J. Are valve house and heater conditions satisfactory ? _ . _ _ _ _ _ _ _ _ • _ _ . . _ . _ . . . . _ 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - . - _ _ _ _ _ _ . - - _ _ _ b, Were all heat -responsive systems tested and were the results satisfactory ? . . . . . . . . . . . . . . . . . . . . . . . . c. Were supervisory features tested and were the results satisfactory ? - _ _ _ _ . . _ _ _ --- _ _ _ _ _ _ _ _ _ _ _ _ 8. ALARMS a. Is the water motor and gong test satisfactory ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Is the electric alarm test satisfactory ? _ _ _ . . _ _ _ f�cp,,ti _ ... _ _ _ _ _ _ _ _ _ _ . . . _ _ _ c. Is the supervisory alarm service test satisfactory ? Monitoring Co.hfe,1 f -F g Ph. 2-96 Code: 523 31 S 9. SPRINKLERS PIPING a. Are all sprinkler heads in good condition, not obstructed and free from corrosion or loading ?----- _ _ - _ _ _ _ _ _ _ _ ®/ _ b. Are all sprinkler heads less than fifty (50) years old ? Head Manufacturer : I k' j?A AQ Date of head : 4 WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY e`: - ,,. -+.i .. a .t � .' . .Vlb^ .1 C r - ..trv,....-,j- ... •!t^.5.-�: �': '+,. .ry - R _ -�-.. •, . •. :•,, {... �' _ , Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY 3434 FliBtAvten $0., WA 98134, ZI'16. 622.4656 WA.: V1-K/-NAS3MNT LEVEL I// 602 QWWnfa Why, L&IgWet% WA 98632, 360. 425. 700 Fire Sprinkler Inspection Report Page: 2of 2 9. SPRINKLER / PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? •: _ _ . , . _ _ _ _ _ _ _ _ _ � d. Is condition of piping, drain valves, check valves,, hangers, pressure• open sprinklers, and strainers sadfactory ? 11+C° 0- e. Are all sprinklers of proper temperature rating? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I. Are portable fire extinguishers In good condition ?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - g. Is hand hose on sprinkler systems satisfactory ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Date Dry System Piping last checked for stoppage.. . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1� 11. Date Dry System Piping last checked for proper pitch . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .� 12. Date Dry Pipe Valve last trap tested.. . . . . . . . . . . . . . . . . . . . . _ . _ . _ . . . . . . 13. Wet systems: Number. Make /Model /Year. 14. Dry Systems: Number: Make / Model / Year: 15. Accelerator: Make / Model / Year: 16. Special Systems: Number: Type: Make / Model / Year: Condition 17. CONTROL VALVES n a: City Connection Control Valves Zsak,.��P_ b.Tank Control Valves- - - - . - - - - c. Pump Control Valves- - . - - - - d. Sectional Control Valves - - - - - - - a.. System Control Valves- - . . . . . I& WATER FLOW TEST a. Water Pressure Source : OCIty, 13Tank, O Fire Pump , Water Flow Test taken ? �� 1f not, reason: t Test Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After 19. Explanation of any "No" answers: 20. Recent changes In building occupancy.or fire protection equipment: Adjustments or corrections made: 22. Desirable Improvements: 23. Has building owner / representative been notified of any deficiency to the fire protection system? ❑ Yes ❑ No, Person notified: If answer Is "No",explain: 24. Inspector's Signature: Witness (property owner / lessee) and date: WHITE: VIKING COPY YELLOW' INVOICE COPY PINK- FIRE DEPARTMENT COPY GOLD' BUILDING COPY f +•.>.,• • : u,r' t. . - , ..w-r`' ..f''a,, i 4, ...i 4 w .i. t ram. _ r Sy l�,e� r,7i.,�-r .. : ,.L'- Lj� , ." Sfl•.• ....v'•. ,-_'►" "" "a •�a ur'' ?�" �'�,.�o...1iR,. •v.1�Sr a.; a�'•».r S�-�1.•=r' ,; '�v::.t. ;+,.� 'Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY 3434 First Ave: So:; Seattle, WA 98,134, 206.622.4656 WA.: V1;KI-NA-S373NT LEVEL 111 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report Page:1 of 2 REPORT TO : 9"_A-)m,e AA)) D5 JOB NO. AA 2. 51 47,9 -4 *DATE : 1 ' /2 -/(y STREET: BLDG. / LOCATION CITY / STATE: p DryyiAOS /.iJ G INSPECTOR: �J I I f '6 J-RJo►1t Y�%Z /'�CG % �i Sfc+Q 1.GENERAL a. Is the building occupied ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . - . _ _ . . . _ _ _ - _ . _ b. Is occupancy the same as previous Inspection ?. . . . . . . . . . . . . . . . . . . . . . . .. . _ _ . . . _ . . C. Are all systems In service 1 _ _ _ _ _ _ _ _ . _ . . . _ - _ . . _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Are. all fire protection systems the same as last inspection ?. . _ _ . . . _ _ _ _ _ . _ _ . _ _ . . . . _ . . . . e. Is the building completely sprinklered ? _ _ _ - _ - - - _ _ . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I. Are all new additions and building changes properly protected ? .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - g. Is all stock or storage properly below sprinkler piping ? . . . . . . . . . . . . . . . . . . . . . . . . ... . h• Was property free of fires since last inspection ? (Explain any fire on Page 2) . . . . . . . . . . . . . . . . . . . . _ . I. In areas protected by wet systems, Is building properly heated, I.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) -a. Are all sprinkler system main control valves open ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are all other control valves In proper position ? _ _ . . . . . ... . . . . . . . . . . . . . . . . _ . . c. Are all control valves in good condition and sealed or supervised ? . . . . . . . . . . . . . . . . . . _ 3- WATER SUPPLIES (See Section 18) .y .. a. Was a water flow test preformed and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ ... _ _ _ _ _ _ _ _ _ _ _ _ _ 4. TANKS, PUMPS. & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks In good condition and properly maintained Z . _ . _ _ _ . b. Are Fire Department Connections in satisfactory condition, couplings free, caps In place and check valves tight 5.'WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . _ . . . _ . . . b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. 7 . _ _ _ _ _ _ _ c. Are alarm valves, water flow Indicators and retard chambers In satisfactory condition ? _ _ _ _ _ _ _ _ _ _ _ _ 6, DRY SYSTEMS (See Section 14) a. Are dry valve(s) in service and in good condition ? . - _ . . . _ . _ _ . . . . . . . . . . . . : . . . . . . . b. Are pressure and priming water levels normal ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . . . . . . _ C.. Is air compressor In good condition ? _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - _ _ - . d. Were low points drained during fall and winter inspections ? ... _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ e. Are Oulck- opening devices in service ? . . . ... . . . . . . . . . . . ... . . . . . . . _ _ _ - _ _ - - _ _ I. Has piping been checked for stoppage within the past ten (10) years ? _ . _ _ _ _ _ _ _ _ _ _ _ _ ;/ Iu�t�+N . . . g. Has piping been checked for proper pitch within the past five (5) years ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ VAX 4�f7?*sfU _ h. Have dry valves been trip tested satisfactorily as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - 1. Are dry valves adequately protected from freezing ? . . . . . . . . . . . . . . . . . . . . . . . . . _ _ _ . j. Are valve house and heater conditions satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ... _ . . . . _ . . . _ 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? - - _ _ - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b, Were all heat -responsive systems tested and were the results satisfactory ? . . . . . . . . . . . . . . . . _ . . _ _ . . c. Were supervisory features tested and were the results satisfactory ? _ _ - _ _ _ _ - _ _ _ _ _ _ . . . . . _ _ . . 8. ALARMS a. Is the water motor and gong test satisfactory ?- _ _ _ _ - _ - - _ _ _ - - - - - - - - _ _ - _ - - - - - - - - b. Is the electric alarm test satisfactory ? - _ _ _ - - _ _ _ - _ c.. is the supervisory alarm service test satisfactory ? Monitoring Co. g L Q1,'.t 4_ Ph.: -Qn'J - 9 Code: Q 3 ' 31 S 9. SPRINKLERS.- PIPING a. Are all sprinkler heads in good condition, not obstructed and free from corrosion or loading _ _ _ _ _ _ _ �j _ _ _ b. Are all sprinkler heads less than fifty (50) years old? Head Manufacturer : V tyil /yt' Date of, head WHITE: VIKING COPY YELLOW: INVOICE COPY PINK; FIRE DEPARTMENT COPY • ; .GOLD; BUILDING COPY 11 r .1: � . 'a. ..; ..iY. �-•.�'.Y p` 'W:.. f' .... .. ...-t� , -Il,.� •i-.i�.l.e1 rlf.l, l: .`tl�l"11.1 •: `ht..4"w �r.�• � 1...�'`rj .l • mot... t,.ti '-1'�Jlr .. r .... `. .. .� Fire Protection Contractors since 1930 We VIKING AUTOMATIC SPRINKLER COMPANY 3434 RistAm So., Seaft WA 98134, 206. 622. 4656 ' WA.: VWIWA�SMNT LEVEL 111 602 Ca ank WW, LAn[pi6w,, WA 9�Gi2, 360. 425. 7620 Fire Sprinkler Inspection Report Page: 2of 2 9. SPRINKLER / PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? - - - - - - - - - _ - - - - - - - - - - - - - - - - - - - - - - - - d. Is condition of piping, drain valves, check valves, hangers, pressure, open sprinklers, and strainers satMictory ? e. Are all sprinklers of proper temperature rating? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - f. Are portable fire extinguishers In good condition ?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - g. Is hand hose on sprinkler systems satisfactory ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Date Dry System Piping last checked for stoppage- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ! JA3kl1i./ii 11. Date Dry System Piping last checked for proper pitch. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . UGL1lYndJU 12. Date Dry Pipe Valve last trip tested. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 13. Wet systems: Number. Make / Model / Year. 14. Dry Systems: Number: ,!1 Make / Model / Year. , 1 F?i AIM) rV_W f2 11 / 996 15. Accelerator: Make / Model / Year: 16. Special Systems: Number: Type: Make / Model / Year: Condition 17. CONTROL VALVES a. City Connection Control Valves'`-`'-' b.Tank Control Valves- - - - - - - - c. Pump Control Valves- - - - - - - d. Sectional Control Valves - - - - - - - e. System Control Valves - - - - - - - - Number Type Yes penNo YeSecur No Closed Yes NoYesSignNo Condition 1 "1 i t>• LI I✓ /, f� ex L) 16, WATER FLOW TEST a. Water Pressure Source : licity, O Tank, O Fire Pump , Water Flow Test taken ? I � If not, reason: Test Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After 7- 1 "iced 916 19. Explanation of any "No" answers: 20. Recent changes In building occupancy or fire protection equipment: 21. Adjustments or corrections made: 22. Desirable Improvements: 23. Has building owner / representative been notified of any deficiency to the fire protection system? ❑Yes ❑ No, Person notified: If answer is "No",explain: 24. Inspector's Sig --'o✓/�"" ' Witness (property owner /, lessee) and date: WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY �M 4 Fire Protection Cdntractors since 1930 $, VIKING AUTOMAIC SPRI�KLER COMPANY ' , 3434 FinstAve. So.; Seattle, WA 98134, 206. 1i72.4656 s' WA.:. VI-KI-NA-S373NT LEVEL Ill 602 Calikn►lia Way, Longview, WA 981S32, 360.425.762D r : COMPANY: aw 7 M.I,A MD ° t'l l� /,� r a..�G irr Se, JOB NO.:14) -51 6m 7 el 3 DATE: 1 STREET: �� i c��� _S•�. PROPERTY NAME / LOCATION: CITY / STATE : _1� 1' 1 �i+11I�+a' INSPECTOR: DRY PIPE VALVE TEST 1 • Valve description a. Size b. Make c. Model d. Year of Mfg. 2. Control Sprinklers in 3. Pressure (Lb) before tests: a. Air b. Water 4. Control Valve a. Wide open b. No (No.of turns to open) 5. Operated at: a. Air pressure (Lb) -M,tD b. Time (Min.,Sec.) 6. Operation Indicated: a. Satisfactory b. Partially satisfactory c. Failed 7. 'Reason for: ' a. failure b. partially satisfactory 8. Valve reset dry? (yes/no) 9..Condition: a. Interior of body b. Water for test pipe c. Moving parts d. Seats e. Rubber facing 10.Alarms operated? (yes/no) 11.Inspector.'s Test trip time (Sec.) .12.Quick Opening Devices: a. Make b. Model c. Year 13.Operation Indictated: a. Satisfactory b. Failed to shut off 14• List of repairs made: DRY PIPE VALVES No.4.2- No.2 No.3 joL SAP c� v �e se G �+ QUICK OPENING DEVICES / Title of person performing test Witness (owner / lessee of property ) and date signed. � . ,..ttg1'» .-r .. ai..--. ...J,..'1..,,:....; •;i:.-..�-- -r '�- . .a.-...'�;.-...1 � .. �i.. •.rv'.r.�'• _ r!`. — ,.. .. ". `� i Fire Protection Contractors since 1930 VIKING' AUTOMATIC SPRINKLER COMPANY 3434 First Ave., So., Seattle, WA,,,98�134, 206.622.4656 WA.: VI-KI-NA-S373NT LEVEL I11 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report Page: 10 2 REPORT TO : �,C ,I_%NV'A' JOB NO. 405—r Gov 7 4� -3 DATE: p�® /� le, STREET: .� �N .S'T�a i BLDG. / LOCATION: lilt .�- J./8C ,✓ CITY / STATE : n : ►�0 to -0f) ; U.,A INSPECTOR: 1- )t (?Ly"t t -R 1. GENERAL YES N.A. NO a. Is the building occupied ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b. Is occupancy the same as previous Inspection ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . c• Are all systems in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ d. Are all fire protection systems the same as last inspection ?. . . . . . . . . . . . . . . . . . . . . . . . . . ... . / e. Is the building completely sprinklered ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f. Are all new additions and building changes properly protected ? _ _ . - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Is all stock or storage properly below sprinkler piping ? _ _ .. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ h. Was property free of fires since last Inspection ? (Explain any fire on Page 2) . . . . . . . . . . . . . . . . . . . . . . I. In areas protected by wet systems, is building properly heated, Le.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ? . . . . . . . . . . . . . . . . . . . . b. Are all other control valves In proper position ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - _ _ _ _ _ _ - _ _ _ _ c. Are all control valves in good condition and sealed or supervised ? . . . . . . . . . . . . . . . . . . . . . . . . . . 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? _ - - - - - - _ _ _ _ - _ 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks In good condition and properly maintained ? _ _ _ _ _ _ _ _ _ _ _ b. Are Fire Department Connections in satisfactory condition, couplings free, caps In place and check valves tight ? _2g'l/ 5. WET SYSTEMS (See Section 13) / a. Are cold weather valves open or closed as necessary ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ^� b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. ? _ _ _ _ - - - - _ _ _ _ _ _ - _ c. Are alarm valves, water flow Indicators and retard chambers In satisfactory condition ? _ _ _ _ _ _ - _ _ _ _ _ _ _ _ _ _ _ , 6, DRY SYSTEMS (See Section 14) a. Are dry valve(s) in service and In good condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ... _ _ _ _ _ _ _ - b. Are pressure and priming water levels normal ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ... _ c. Is air compressor In good condition ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - d. Were low points drained during fall and winter Inspections ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ e. Are Quick- opening devices In service ? _ _ _ _ _ _ _ _ _ _ ... _ _ _ _ _ _ _ _ _ _ ... _ _ _ _ _ _ _ _ _ _ _ I. Has piping been checked for stoppage within the past ten (10) years ? _ . . . _ _ _ . . . . _ _ _ - lot) _ g. Has piping been checked for proper pitch within the past five (5) years ? . . - _ - . . - _ - . . . _ - 1440(114✓nw h. Have dry valves been trip tested satisfactorily as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ / I. Are dry valves adequately protected from freezing ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . - . . . _ _ d J. Are valve house and heater conditions satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ... _ _ 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - . . . . _ _ . . . _ . �+ b• Were all heat -responsive systems tested and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ' c. Were supervisory features tested and were the results satisfactory ? . . . . . . . . . . . . . . . . . . . . . . . . . . 8. ALARMS a. Is the water motor and gong test satisfactory ?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b. Is the electric alarm test satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ - - ✓ c. Is the supervisory alarm service test satisfactory ? Monitoring Co. WWnZ Ph.: AX-J'' 2--3 G Code: 9. SPRINKLERS - PIPING a. Are all sprinkler heads in "good condition, not obstructed and free from corrosion or loading ? _ - . _ - - - - _ _ _ _ _ b. Are all sprinkler heads less than fifty (50) years old? Head Manufacturer : )/t �ti �>��- ✓P' 120I Date of head WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY 4rt Fire Protection, Contractors since 1930 VIVJ96 AUT15MA3k SPRINKLER COMPANY ;!Smft;WA 98134,206. 622.4656 WA: VWJ-M-S3731VT'LEVEL /I/ Longv*w WA 360. 425. 7620 Fire Sprinkler Inspection Report Page: W2 9. SPRINKLER I PIPING (Continued) YES N.A.- NO c. Are extra sprinkler heads readily available - - - - - - - - - --- - - - - - - --- - - - - - .?..J� d. Is condition of piping, drain valves, check valves, hangera�i, pros UFO ga�, open sprinklers, and strainers sallfactory ? 4�ICU.J - A-44 9. Are all sprinklers of proper temperature rating? - - - - - - - - - - - - - - - - - - - - - - - - - - - - I. Are portable fire extinguishers In good condition ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - g. Is hand hose on sprinkler systems satisfactory ? . . . . . . .. . . . . . . . . . . . . . . . . . 6 - - - - - - - - 10. Date Dry System Piping last checked for stoppage.. . . . . . . . .. . . . nn . . . . . . . . . - - --- - - - - - - - - If. Date Dry System Piping last checked for proper pRch ---- - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - - 12. Date Dry Pipe Valve last trip tested. . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . 13. Wet systems: Number. Make Model / Year. 14. Dry Systems: Number: Make Model I Year: A 15. Accelerator: Make / Model Year: 16. Special Systems: Number: Type: Make / Model / Year: Condition: 17.' CONTROL VALVES :2 a. City Connection Control Valves b. Tank Control Valves- . . . . . . . . c. Pump Control Valves- - - - - - - - - d. Sectional Control Valves - - - - - - - - - a. System Control Valves - ; - - - - - - - Number Type Open yes No Secured Yes No Closed Yes No s Ign YesNo Condition UZI) 7- J--- 1& WATER FLOW TEST a. Water Pressure Source : 112C111y, 07ank, 0 Fire Pump, Water Flow Test taken ? If not, mason: Test Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After "75 45. Z5 19. Explanation of any "No" answers: 20. Recent changes In building occupancy or fire protection equipment: 21. Adjustments or corrections made: 22. Desirable Improvements: 23. Has building owner I representative been notified of any deficiency to the fire protection system? 0 Yes 0 No, Person notified: It answer Is "No",explain: 24. Inspector's Signature: Witness (property owner / lessee) and date: WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY 0 ING AUTOMATIC'SPRINKILER COMPANY W VI-OVA-S37.3NT LEVEL M Fire Protection Contractors since 1930 3434 Rat Ave. So., Seatda, WA 98134, 205. 622. 4656 602 Qdifwnia Way, LongvLsw, WA 98M, 360. 425. 7aW COMPANY: -JOB NO.: 7 4) DATE: STREET: 7//19 PROPERTY NAME/ LOCATION:dPe- vo CITY / STATE: �7Dyvrrui* INSPECTOR: DRY NPE VALVE TEST DRY PIPE VALVES 9. Valve description a. Size b. Make c. Model d. Year of Mfg. 2. Control Sprinklers in 3. Pressure (Lb) before tests a. Air b. Water 4. Control Valve a. Wide open b. No (Ho.of turns to open) 5. Operated at: a. Air pressure (Lb) -rRii?r'w#9 b. Time (Min.,Sec.) 6. Operation Indicated: a. Satisfactory b.'Partially satisfactory c. Failed Rea .7. son for: a. failure b. partially satisfactory 8. Valve reset dry'? (yes/no) 9. Condition: a. Interior of, body b. Water for test pipe C. Moving parts d. Seats e. Rubber facing 10.AIarms operated? (yes/no) 11. Inspector.'s Test trip time (Sec.) 12.Quick Opening Devices: a. Make Model c. Year 13.Operation Indictated: a. Satisfactory b. Failed t® shut off 14. List of repairs made: , No.1 No.2 No.3 2- AJ& 9 -Y Al 14 QUICK OPENING DEVICES Title of person performingtAt Witness (owner / lessee of property ) and date signed. ,,,�:. - ...:..,..., �, •�.�..•r�".r.-..,.i.-Nan:i"i.".^""r�"a"'-;..-•1'✓.�,1.'�n/••�-•^ J �.1 .:�.�.:..%� Wvv.r •T ,�,-.. ..,. ,I � ` , .. � ti �' _ Ly. ...r..,u••• ^ �, vyo-�-^'••r Y�.., ' i�r ,. �... ..... �•,.,�;,..; . .�;.�,y........... ... yn...r., r,. i ��r r e� a :Fire P,rotectlon Contractors=since 1930 W VIKING AUTOMATIC SPRINKLER COMPANY 3434 Firs eAve.''SO., Seattle, WA`98134, 206.622.4656 WA: VI;KI-NA-S373NT LEVEL 111 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report Page: 1 of 2 .k REPORT TO : 1�8N�(t1 i�Sy7rt..�.A i'l l a�<e�l JOB NO. 6i51��}�'� o�DATE: STREET : Yl1,l /� W � < 7 KJ l BLDG. / LOCATION: �70 e-e CITY/ STATE : 1,�V�il�D `c I d 3 INSPECTOR: ►7, t'^9I I '6""f.Ubq.%0--C ., I.GENERAL r YES a. 18. 06 building occupied ? _ _ ... _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Is occupancy the same as previous Inspection ?. . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . c. Are all systems In service ? _ _ . _ _ _ _ . - _ . . . . . . . . . . . . . . . . _ _ _ _ _ d. Are all fire protection systems the same as last Inspection ?. . . . . . . . . . . ... . . . . . . . _ e. Is the building completely sprinklered ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ _ _ . _ _ . _ . _ . . _ f: Are ail new additions and building changes properly protected ? _ _ . _ _ _ _ _ _ _ g. Is all stock or storage properly below sprinkler piping ? _ _ _ _ _ _ _ _ _ _ - - - - - - - - _ _ _ _ _ _ _ _ _ - h• Was property free of fires since last Inspection ? (Explain any fire on Page 2) . . . _ . _ . . . .... _ _ _ I. In areas protected by wet systems, Is'building properly heated, Le.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open,? . . . . . . . . . . . . . . . . . . . . : . . . . . . . _ . . b. Are all other control valves In proper position ? _ _ _ _ _ _ _ - - - _ _ _ _ 7 . . . . _ _ . ..... _ e..Are all control valves In good condition and sealed or supervised ? . . . . . . . . . . . . . . . . . . . . . ... . 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? . . . . . . . . . . . . . . . . . . . . . _ . . 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevolrs and pressure tanks In good condition and properly maintained 7 _ . . . . _ _ _ ' b. Are Fire Department Connections In satisfactory condition, couplings free, caps In place and check valves tight ?_7!E', _.5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. ? ' _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Are alarm valves, water flow indicators and retard chambers in satisfactory condition.? _ _ _ _ _ _ _ _ - 6• DRY SYSTEMS (See Section 14) I a. Are dry valve(s) In service and in good condition ? _ _ _ _ _ _ _ _ _ _ _ - - - _ _ ,y b. Are pressure and priming water levels normal ? . . . . . . _ _ . . . . . . . . . . . . . _ . _ . . _ _ . . c. Is air compressor In good condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . _ _ _ . _ _ / d. Were low points drained during fall and winter Inspections ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ,p e. Are Ouick- opening devices in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - - _ I. Has piping been checked for stoppage within the past ten (10) years ? _ _ - - _ _ _ _ - - _ _ _ _ _ _ _ - _ _ _ g. Has piping been checked for proper pitch within the past five (5) years ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ h. Have dry valves been trip tested satisfactorily as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I. Are dry valves adequately protected from freezing ? _ _ . . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . _ . . _ ). Are valve house and heater conditions satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ _ - _ - - _ _ _ - _ 7. SPECIAL SYSTEMS (See Section 16) a; Were valves tested as required ? _ . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ... . _ _ _ . . _ . b• Were all heat -responsive systems tested and were the, results satisfactory ? . _ _ . _ . _ _ . . . . _ _ _ c. Were supervisory features tested and were the results satisfactory ? _ _ . . _ _ . . _ . . : . _ - - . _ _ _ _ _ 8. ALARMS a. Is the water motor and gong test satisfactory ?_ _ ... _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ A. J - . b. Is the electric alarm test satisfactory ? _ - _ _ t� _ _ _ _ _ ._ c. Is the supervisory alarm service test satisfactory ? Monitoring Co. �mY+1 r 9•lg Ph : �if * ..38 Code: 9. SPRINKLERS - PIPING a. Are all sprinkler heads in good condition, not obstructed and free from corrosion or loading ? _ _ _ _ _ _ _ _ - ... _ _ _ 4 b. Are all sprinkler heads less than fifty (50) years old ? Head Manufacturer : /i WrOr- e 'Ai_-rt241 - Date of head WHITE VIKING COPY YFI I OW- INVOICF COPY PINK- FIRE nFPARTMFNT COPY - GOI n. RI III IIING COPY r +. 9 • t � dam:;-...� 5: .� �� ...�aR .-� � w:.;.�..:'�' ` .7,3.\•}�'iy ... _.�t.-�:. 1� • r"'r` ,.,i.. , ,. . � „ :. ,.f i .n Jet Fire Protection Contracti G AUTOMATIC SPRINKLER COMPANY ` 3434 RW Awl --S& WA.: VI-KML4S373KT LEVEL 111 602 CaUb►Ifa Nay :,'Fire Sprinkler Inspection Report Seatdtr, WA 981, LoMJvl1W WA 96 s since 1930 , 206. 622. 4656 2,360,425.7620 Page: 20 2 9. SPRINKLER / PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? .-.. . _ . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Is condition of piping, drain valves, check vahres, hangers ressure gauges, open sprinklers, and strainers satlfactory ? f4d_ �: _ _ e. Are all sprinklers of proper temperature rating? . . . _ _ _ - - _ - - _ - - -. - - - - - - - - - - - - - - f. Are portable fire extinguishers in good condition ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . g. Is hand hose on sprinkler systems satisfactory ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10. Date Dry System Piping last checked for stoppage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .)p 11. Date Dry System Piping last checked for proper pitch . . . . . . . . . . . ... . . . . . . . _ . . . . . . _ . . . . . 111 12. Date Dry Pipe Valve last trip tested.,_' . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . )A 13. ,_r' Wet systems: Number. � Make / Model / Year. 9 rr F -a .4995 14. Dry Systems: Number: Make / Model / Year. 15. Accelerator: Make / Model / Year: 16. Special Systems: Number: Type: Make / Model / Year: Condition: 17. CONTROL VALVES a. City Connection Control Valves - -ki5le— . b.Tank Control Valves- - - - - - - - - c. Pump Control Valves- - - - - - - - - d. Sectional Control valves - - - - - - - - - e. System Control Valves- - - - - - - 18. WATER FLOW TEST a. Water Pressure Source :4! City, O Tank, O Fire Pump, Water Flow Test taken? I%!�!i If not, reason: Test Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After Az W-fed 19. Explanation of any "No" answers: 20. Recent changes In building occupancy or fire protection equ 21. Adjustments or corrections made: 22. Desirable Improvements: '11,23. Has building owner / representative been notified of any deflclency to the fire protection system? ❑Yes ❑ No,Person notified: If answer Is "No",explain: 24. Inspector's Signature: 0�vnr�""" i Witness (property owner./ lessee) and date: WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY ` Serving Brier; Edmonds, and. 12425 Meridian Ave S Mountlake Terrace Everett, WA 98208 ,::FIRE PREVENTION INSPECTION REPORT ❑ EDMONDS,” ❑ BRIER / Phone (425) 551-1200 ❑ MOUNTE TERRACE ❑ UNINCORPORATED 171rwwFireDistrictl.org LOCATION: 7110 210 th' Street SW 98026 BUSINESS NAME: Edmonds Public Works (Office and Garage) MAILING ADDRESS:MAILING 7110 210th Street SW, Edmonds, WA 98026 Miller Noel FRErQu ET STATION & SHIFT Annual ' 16-B PHONE: 4257710235 SCHEDULEDJul2015 DATE DUE 509 UFIR II, r BUSINESS OWNER: HOME PHONE: I I EMERGENCY-1: Stevens, Jim HOME PHONE: 4257603334 CURRENT KEY ACCESS-2: 1 HOME PHONE: CITY YES/ NO EMAIL: BUSINESS LICENSE PERSON CONTACTED: INITIAL INSPECTION DATE ' NAME OF INSPECTOR: FIRE SYSTEMS: AS q/14 FA 4/14 FF/Fria Fn I k RnY bW[Il$aS4tg&pjoCATIONS / COMMUNICATIONS 3 3 4 0 4 5 5 6 6 7 7 1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE. EXTENSION GRANTED TO' FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED. PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: 1 INSPECTOR: INSPECTOR: INSPECTOR: 2 r DATE: ` - DATE: DATE: 3 VIOLATIONS 1 VIOLATIONS 1 5 PRE -CITATION LETTER SENT' CITATION ISSUED NUMBER: a 2 UL 2 F) DATE: CODE SECTION: 5 3 7 3 7 RETURN RECEIPT RECEIVED 6 4 8 4 8 DATE: DISPOSITION: 7 LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO 8 � FIRE DEPARTMENT COPY a Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY 3434 First Ave. So.,, Seattle, WA 98134, 206.622.4656 WA.: VI-KI-NA-S373NT LEVEL III 6. 602 California "Way, 'Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report /Pa e: 1 of 2 REPORT TO: -� �L%7/�A C LsL>� �� JOB NO. DATE: STREET: 2ZA9 PO D BLDG. / LOCATION: �� ��' ` /sG/�� �L✓ CITY/STATE: &aJA ---INSPECTOR: 1. GENERAL a. Is the building occupied ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1. b. Is occupancy the same as previous Inspection ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c, Are all systems in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ _ _ _ _ _ d. Are all fire protection systems the same as last inspection ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ _ . . _ _ . e. Is the building completely sprinklered ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - _ _ - - _ _ _ I. Are all new additions and building changes properly protected ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Is all stock or storage properly below sprinkler piping ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ - _ h• Was property free of fires since last inspection ? (Explain any fire on Page 2) _ _ _ _ _ _ - _ _ _ _ _ _ _ - _ _ _ - _ _ _ _ 1. In areas protected by wet systems, is building properly heated, i.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ b. Are all other control valves in proper position ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Are all control valves in good condition and sealed or supervised ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ : _ - _ _ 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - _ _ - _ _ _ 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks in good condition and properly maintained T_ _ b. Are Fire Department Connections in satisfactory condition, couplings free, caps In place and check valves tight ?_A-VL 5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ _ _ - _ _ _ b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Are alarm valves, water flow Indicators and retard chambers In satisfactory condition ? _ - - _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ 6• DRY SYSTEMS (See Section 14) a. Are dry valve(s) in service and in good condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ _ - - _ - _ b. Are pressure and priming water levels normal ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Is air compressor In good condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ d. Were low points drained during fall and winter inspections ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ e. Are Quick- opening devices in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - _ _ _ _ _ _ _ _ _ I. Has piping been checked for stoppage within the past ten (10) years ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Has piping been checked for proper pitch within the past five (5) years ? _ _ _ _ _ - - - - _ _ _ _ _ _ _ _ _ - - h. Have dry valves been trip tested satisfactorily as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1. Are dry valves adequately protected from freezing ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - - - - - j. Are valve house and heater conditions satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as, required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ _ _ - _ b, Were all heat -responsive systems tested and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Were supervisory. features tested and were the results satisfactory ? _ _ _ _ _ _ _ - _ _ _ _ _ _ _ _ _ _ _ - _ _ _ _ 8. ALARMS a. Is the water motor and gong test satisfactory ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ _ _ _ . _ _ _ b. Is the electric alarm test satisfactory ? . _ _ _ - - - _ _ _ � - c. Is the supervisory alarm service test satisfactory ? Monitoring Co. 14A1 W "4; Ph.: � Ilk-C. Code: 9. SPRINKLERS - PIPING'"f1} ' a. Are all sprinkler heads in good condition, not obstructed and free from corrosion. loading ? /tee _ _ _ _ _ _ - _ _ t _ b. Are all sprinkler heads less than fifty (50) years old ? Head Manufacturer Date of head ` WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE EPARTMENT`COPY.'4- GOLD DING COPY ;%�/�7 Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY 3434 F6stAve. Six, Secede, WA 90134, 206. 622. 4656 WA.: VJLK/-NAS373NT LEVEL M 6172 CaWanie W W, L aVvieN, WA AIM, JIM. 425. MO Fire Sprinkler Inspection Report ` Page: W 2 9. SPRINKLER / PIPING (Continued) . YES NA. NO c. Are extra sprinkler heads ready available ?_ _ d. Is condition of piping, drain valves, check valves, hangers, ure gaulp ss)open sprinklers, and strelnere satifacfory ? e. Are all sprinklers of proper temperature rating? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ r _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ,,?C f. Are portable fire extinguishers in good condition ?. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Is hand hose' on sprinkler systems satisfactory ? _ . . . . . . . . . . . . . . . . . . - -. - - - - - - - - 10. Date Dry System Piping last chocked for stoppage. . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . 11. Date Dry System Piping last checked for proper pitch- - - - - - - - - - - - - - - - - - - - - I � - - - - - - - - - . - 12. Date Dry Pipe Valve last tri tested.. _ _ - _ - - _ _ _ _ _ _ _ 7- _ _ _ _ _ _ 13. Wet systems: Number. Make / Model / Year. j✓I �1i� Z IMS . 14. Dry Systems: Number : Make ! Model / Year: 15. Accelerator: Make / Model / Year., 16. Speclal Systems: Number:, -Type: Make / Model / Year : Condition 17. CONTROL VALVES a. City Connection Control Valves `-^- Ze b.Tank Control Valves- - - - - - - - - c. Pump Control Valves- - - . . . . . - d. Sectional Control Valves . . . .. . . . . e. System Control Valves. . - - - - - IF 16. WATER FLOW TEST a. Water Pressure Source :;d City, OTank, O Fire Pump, Water Flow Test taken ?90_� If not, reason: Test Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After 2" 75 2, 19. Explanation of any "No" answers: 20. Recent changes in building occupancy or fire protection equipment: 21. Adjustments or corrections made: 22. Desirable Improvements: 23. Has building owner / representative been notified of any deficiency to the fire protection system? O Yes ❑ No, Person notified: If answer is "No",explain: i 24. Inspector's Signature: ` Witness, (property own�r / lessee) and date: ITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT, COPY,;: GOLDi$UILDING COPY taNcIr Fire Protection' Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY 3434 First Ave. So., Seattle, WA 98134, 206.622 ' 4656 ' WA.: VI-KI-NA-S373NT LEVEL III `° 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report Page: 1 of 2 REPORT TO STREET CITY / STA 1.GENERAL JOB NO. +'J DATE:r� �( BLDG. / LOCATION: / 7^' ea ✓+�'/ "� ° INSPECTOR: r a. Is the building occupied ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Is occupancy the same as previous Inspection ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ - - _ _ _ . c. Are all systems in service ? . . . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Are all fire protection systems the same as last Inspection ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ e. Is the building completely sprinklered ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . f. Are all new additions and building changes properly protected ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ - _ _ _ g. Is all stock or storage properly below sprinkler piping ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . _ . _ . - _ _ - _ _ _ h. Was property free of fires since last Inspection ? (Explain any fire on Page 2) . . . . . . . . . . . . . . . . . . . . . . 1. In areas protected by wet systems, is building properly heated, i.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are all other control valves.in proper position ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Are all control valves In good condition and sealed or supervised ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - . _ _ 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ' _ - _ _ 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks in good condition and properly maintained ? b. Are Fire Department Connections in satisfactory condition, couplings free, caps in place and check valves tight ?_ 5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. ? - - _ _ _ _ - _ - _ _ _ _ - c. Are alarm valves, water flow indicators and retard chambers In satisfactory condition ? - _ _ _ - - - _ _ - _ _ _ _ - _ _ _ 6, DRY SYSTEMS (See Section 14) a. Are dry valve(s) In service and in good condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ... _ _ _ _ _ _ _ _ _ _ b. Are pressure and priming water levels normal ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Is air compressor In good condition ? _ _ - _ _ _ - _ _ _ _ _ - _ _ _ _ _ _ __ _ _ _ _ _ d. Were low points drained during fall and winter Inspections ? _ - _ _ _ _ _ _ _ '�� _ _ _ - _ - - - - e. Are Quick- opening devices in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - _ _ _ _ - _ - _ _ f. Has piping been checked for stoppage within the past ten (10) years ? . . . . . . . . . . . . I. . . _ _ _ _ . - _ _ - g. Has piping been checked for proper pitch within the past five (5) years ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I _ _ _ _ _ _ _ _ _ _ h. Have dry valves been trip tested satisfactorily as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - _ _ . I. Are dry valves adequately protected from freezing ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - j. Are valve house and heater conditions satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ - _ _ _ 7..SPECIAL SYSTEMS (See Section 16) a.. Were valves tested as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - _ - - - _ _ _ _ b, Were all heat -responsive systems tested and were the results satisfactory ? _ - _ _ _ - _ , _ _ - _ _ _ _ _ _ _ _ _ _ c. Were supervisory features tested and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ S. ALARMS a. Is the water motor and gong test satisfactory ?_ _ _ _ _ _ _ _ ... _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Is the electric alarm test satisfactory ? _ - _ _ _ _ _ _ c. Is the supervisory alarm service test satisfactory ? Monitoring Co./ Ph.: Code: 9. SPRINKLERS - PIPING' a. Are all sprinkler heads in good condition, not obstructed and free from corrosion or oaiding ? _ b. Are all sprinkler heads less than fifty (50) years old ? Head Manufacturer.: --"+y °"� "� Date of head ` WHITE ' VIKING COPY YELLOW INVOICE COPY PINK. FIRE DEPARTMENT,COPK:; GOLD, BOIL4ING:COPY . .. d:i=4:;'n .•7 Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKL R COMPANY 3434 Flirt Aw— Sa , Seems WA 98134, 206. 622. 4656 WA.: VI-XLNA- 373NT LEVEL 111 6Q2 CaWolrn 8 Way, Longview WA 9�►?2, 360. 425. 71520 'Fire Sprinkler Inspection Report Page: 20f 2 9. SPRINKLER / PIPING (Continued) c. Are extra sprinkler heads readily available ? _ _ . . . . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Is condition of piping, drain valves, check valves, hangers ressure gau , open sprinklers, and strainers sadfactory ? _ � ! �� e. Are all sprinklers of proper temperature rating? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ f. Are portable fire extinguishers in good condition ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Is hand hose on sprinkler systems satisfactory ? _ . . . . . . . . . . . . . . . . . . . _ _ . _ . . . . . 10. Date Dry System Piping last checked for stoppage._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 11. Date Dry System Piping last checked for proper pitch. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ' 12. Date Dry Pipe Valve last trip tested._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ _ _ - _ _ _ _ _ _ 13. Wet systems: Number. Make / Model / Year. F III! 14. Dry Systems: Number: Make / Model / Year. Jd " 15. Accelerator: Make / Model / Year: 16. Special Systems: Number: Type: Make / Model / Year: Condition: 17. CONTROL VALVES a. City Connection Control Valves /..6s�,�uY� b.Tank Control Valves- - - - - - - c. Pump Control Valves- - _ - - - - d. Sectional Control Valves - - - - - - - e. System Control Valves. - - - - - - 18. WATER.FLOW TEST a. Water Pressure Source : §rCity, 0 Tank, O Fire Pump , Water Flow Test taken ? �&� If not, reason: Test Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After T Xz 19: Explanation of any "No" answers: 20. Recent changes in building occupancy or fire protection equipment: 21. Adjustments or corrections made: 22. Desirable Improvements: 23. Has building owner / representative been notified of any deficiency to the fire protection system? ❑ Yes ❑ No, Person notified: If answer is "No",explain: 24. Inspector's Signature: " WHITE VI <ING COPY Witness (property owner /lessee) and date: INVOICE COPY PINK- FIRE DEPARTMENT CORY 3, GOLD: _BUILDING COPY t VIKING AUTOMATIC SPRINKLER COMPANY" WA.: VI-KI-NA-S373NT LEVEL N Fite Protection Contractors since 1930 3434 First Ave. So., SeafgLp, WA 98134, 20s. 622. 4656 602 Cdhbmia Way, Lot , WA 98M, 360. 426. 7620 COMPANY: JOB NO.: G DATE STREET: X/& -.5 CITY/STATE: DRY NNE VALVE TEST description a. Size b. Make c. Model d. Year of Mfg. 2. Control Sprinklers, in 3., Pressure (Lb) before tests: a. Air b. Water 4. Control Valve a. Wide open b. No (Ho.of turns to open) 5. Operated at: a-'Ajr. pre S'sure (Lb) b.' Yuma (Min.,Sec.) 6. Operation, Indicated: a. Satisfactory b. Partially satisfactory c. Failed 7. Reason- for: a. failure b. parUally satisfactory 8. Valve reset.dry? (yes/no) 9. Condition: a. Interior of body b. Water for test pipe c.' Moving parts d. Seats. a. Rubber facing 10.Alarms operated? (yes/no) 11. Inspector's Test trip time (Sec.) 12.Quick Opening Devices: a. Make b. Model C. Year 13.Operation Indictated: a. satisfactory b. Failed to shut off 14.List of repairs made: Signature / Title of in. perf071 hig test Witness (owner lessee of property) and date signed. y'la? Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY, 3434 First Ave. So., Seattle, WA 98134, 206.622.4656 WA.: VI-KI-NA-S373NT LEVEL III`4 602 California Way, Longview, WA 98632,.360.425.7620 Fire Sprinkler Inspection Report Page: 1 of 2 REPORTTO:96m� Ah& JOB NO. f1:1 Y DATE: '57 0 � STREET: �7"e BLDG. / LOCATION: � � � � � 4'�J,'�! CITY / STATE : d"✓�� INSPECTOR : 1.GENERAL a. Is the building occupied ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Is occupancy the some as previous inspection ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. Are all systems in service ? . . _ _ _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . _ d. Are all fire protection systems the same as last Inspection ?_ . . . . . . _ . . . . . _ e. Is the building completely sprinklered ?. . . . . . . . . . . . . . . . . . . _ . . - ./�. f. Are all new additions and building changes properly protected ? - - - - - - - - - - - - - - - � - - - - - _ - _ /- g. Is all stock or storage properly below sprinkler piping ? . . . . . . . . . . . . ... . . . _ // . . . . _ . . . _ . _ h• Was property free of fires since last Inspection ? (Explain any fire on Page 2) . . . . . . . . . . . . . . . . . . . . . . . . I. In areas protected by wet systems, is building properly heated, I.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Are all other control valves in proper position ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Are all control valves in good condition and sealed or supervised ? . . . . . . . . . . . . . . . . . . . . . . . . . . 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? . . . . - - - - - - . _ . . . . . . . . . . . . . 4. TANKS, PUMPS, &FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevolrs and pressure tanks In good condition and properly maintained ?- . . b. Are Fire Department Connections in satisfactory condition, couplings free, caps In place and check valves tight ?. .v .¢.d 5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. ? ..- - - - - - - - - - - - - - - - - c. Are alarm valves, water flow Indicators and retard chambers In satisfactory condition ? - - - - - - - - - - - - - - - - - - - - - 6, DRY SYSTEMS (See Section 14) a. Are dry valve(s) in service and in good condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - - - - - - . - - . . . - _ - b. Are pressure and priming water levels normal ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Is air compressor In good condition ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . - - - _ _ _ _ _ d. Were low points drained during fall and winter Inspections ? - - - - - - - - - - - - - - - - - - _ _ _ _ _ _ - _ . _ e. Are Oulck- opening devices In service ? . . . - . . . . _ - - _ _ - - - - - - - - - - - - - - - - I. Has piping been checked for stoppage within the past ten (10) years ? - - - - - - - - - - - - - - - _ - . - _ _ _ _ _ _ g. Has piping been checked for proper pitch within the past five (5) years ? - . - - - - - - - - - - - : - _ _ . _ _ _ _ - h. Have dry valves been trip tested satisfactorily as required ? - - - - - - - - - - - - - - - - - - _ _ - _ _ _ _ _ _ . 1. Are dry valves adequately protected from freezing ? - - - - - - - - - - - - - - - - - _ _ ... . _ _ _ _ _ _ _ _ ). Are valve house and heater conditions satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . . . _ . . _ . . . _ 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . ... . . _ . . b, Were all heat -responsive systems tested and were the results satisfactory ? . . . . . . . . . . . . . . . . . . . . . . . c. Were supervisory features tested and were the results satisfactory ? . . . . . . . . . . . . . . . . . _ . . _ _ . S. ALARMS a. Is the water motor and gong test satisfactory ?_ - - - . - _ - - . _ - _ - - _ - - _ _ - - - - - b. Is the electric alarm test satisfactory ? - . _ - - - - _ - _ _ _ - _ _ _ _ _ _ c. Is the supervisory alarm service test satisfactory ? Monitoring Co.�r>s�° - �'`�✓� Ph.: ��o-� Code:_- 2 - - 9. SPRINKLERS - PIPING a. Are all sprinkler heads in good condition, not obstructed and free from corrosion or loading ? b. Are all sprinkler heads less than fifty (50) years old ? Head Manufacturer : !y ®� I wD Date of head : ��- WHFrE: MKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT. COPY , , GOLD: BUILDING COPY 77 VIKING AuTOMATICSPRINKLER COMPANY.ir. WA.: VI-KML4tiS37MT LEVEL' l%i „g ��y..d�.a:,b,�YN,lk,�'...v-'4t•,L,,.... ,. ',f. ., ,:..il^'•.'I""' _-.Jl •'��'` '1 Fire Protection Contractors since 1930 . , 3434. RistAva Sm, Sew WA 98134, 206. 622. 4656 602 C&Wmn s Wr/, La WWow, WA 99632, 350. 425. 7520 Fire Sprinkler Ins' pection Report Page: 20 2 9. SPRINKLER / PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? _ _ _ _ _ - - - - . - - - - - - - - - - - _ - . , d. Is condition of piping, drain valves, check valves, hangers, ure gauges open sprinklers, and strainers. satlfactory ? _ _ _ ,ram+ e. Are all sprinklers of proper temperature rating?,_ - -_ - f. Are portable fire extinguishers in good condition ?- - _ - _ _ _ _ _ g. Is hand hose on sprinkler systems satisfactory ? _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . /.. 10. Date Dry System Piping last checked for stoppage.. - - - - - - - - - - - - - - - - - - - - - - - _ - _ 11. Date Dry System Piping last checked for proper pitch. - - - - - - - - - - - - - - - - - - - - - 12. Date Dry Pipe Valve last trip tested.. . . . ... _ _ . . . _ . . . . . . . +�+ 13. Wet systems: Number: Make / Model / Year: 14. Dry Systems: Number: Make / Model / Year. 15. Accelerator: Make / Model / Year: 16. Special Systems: Number:Type: Make / Model / Year: Condition: 17. CONTROL VALVES a. City Connection Control Valves . - - - - b.Tank Control Valves- - - - - - - - c. Pump Control Valves- - - - d. Sectional Control Valves - - - - - - - - e. System Control Valves - - - - - - - - A WATER FLOW TEST a. Water Pressure Source W..City, UTank, 0 Fire Pump, Water Flow Test taken ? ti not, reason: Test Pipe Location Size Test Pipe Pressure Before . Flow Pressure Pressure After 40 19. Explanation of any "No" answers: 20. Recent changes in building occupancy or fire protection equipment: 21. Adjustments or corrections made: 22. Desirable Improvements: 23. Has building owner / representative been notified of any deficiency to the fire protection system? []Yes ❑ No, Person notified: If answer is "No",explain: 24. Inspector's Signature: Witness (property owner / lessee) and.date: WHrrE: VIKING CO YELLOW' INVOICE COPY PINK- FIRE DEPARTMENT COP,X, . "GOLD''bIJ1 ING COPY _ .. _ _ .. _ ..-5�. „r...-.... ,. - .5. . _ L't H ry .......� .isr•.M:.'.:.-.,;,",,.,.�-J"1-).,ryu.:Y•. yi-1+^t,.-,l•vir-•. u' Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY" R 3434 First Ave. So., Seattle, WA 98134, 206.622.4656 WA.: VI-KI-NA-S373NT LEVEL III 602 California Way, Longview, WA 90632, 360.425.7620 Fire Sprinkler Inspection Deport Page:1 of 2 REPORT TO : Ave oelw<. JOB NO. � � DATE : STREET : o 2/C V4- <Z✓ 2p"g / _5 BLDG. / LOCATION : CITY / STATE: dX / -• INSPECTOR: 1.GENERAL a. Is the building occupied ? _ . . _ . . . ... . . . . . . . . . . . . . . . _ , b. Is occupancy the same as previous Inspection ?. . . . . _ . . . . . . . . . . . . . . . . . . . . . . . . . c, Are all systems In service ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . ... . d. Are all fire protection systems the same as last Inspection ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e. Is the building completely sprinklered ? - - - - - . . . . . . . . . . . . . . . . . . . f. Are all new additions and building changes properly protected ? _ _ _ _ _ _ _ _ , g, Is all stock or storage properly below sprinkler piping ? _ . _ _ _ _ . . . _ _ _ _ _ _ _ _ , , , , , . , , , , h. Was property free of fires since last Inspection ? (Explain any fire on Page 2) . . . . . . . . . . . . . . . . . . . . . 1. In areas protected by wet systems, is building property heated, i.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ?. . . . . . . . . . . . . . . . . . . . . , , . . . , _ , b. Are all other control valves in proper position ? _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Are all control valves in good condition and sealed or supervised ? . . . . . . . . . . . . . . . . . . . . . . 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? _ . _ _ _ . _ .. _ _ _ _ _ ... _ _ _ _ _ _ _ _ _ _ , 4. TANKS, PUMPS: &"F.IRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks in good condition and properly maintained 7 . . _ b. Are Fire Department Connections In satisfactory condition, couplings free, cap* In place and check valves tight ?. r,4 5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Have antifreeze systems been tested and left In satisfactory condition ? Temp. ? _ _ _ , _ _ . . _ , . _ _ , , , , , , c. Are alarm valves, water flow Indicators and retard chambers in satisfactory condition ? _ _ . . _ , , , , , , , , , , , , , 6, DRY SYSTEMS (See Section 14) a. Are dry valve(s) In service and In good condition ? , _ . _ . , b. Are pressure and priming water levels normal ? . . . . . . . . . . . . . . . . . . . . . . . . . . c. Is air compressor In good condition ? . . . ..... _ . . . . _ . . _ . . d. Were low points drained during fall and winter Inspections ? _ _ _ _ _ , _ , , - r e. Are Oulck- opening devices In service ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f. Has piping been checked for stoppage within the past ten (10) years ? . . . . . . . . . . . _ _ . . . . . . _ . g. Has piping been checked for proper pitch within the past five (5) years ? _ _ _ _ _ _ _ ... _ _ _ _ , , , _ , , . _ , , h. Have dry valves been trip tested satisfactorily as required ? . . . . . . . . . . . . . . . _ . . . . . . . . . . . I. Are dry valves adequately protected from freezing ? _ _ _ - _ _ _ , - - , _ , . _ _ _ �. Are valve house and heater conditions satisfactory,? . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . _ b, Were all heat -responsive systems tested and were the results satisfactory ? . , _ . . . . _ . . . . . c. Were supervisory features tested and were the results satisfactory ? . . . . . . . . . . . . . . . . . . _ . . _ . . 8. ALARMS a. Is the water motor and gong test satisfactory ?, , , , , , , , , , , , , , , , , , , , , , , , , , , , _ _ . b. Is, the electric alarm test satisfactory? _ _ _ _ . _ _ , _ 1 c. Is the supervisory alarm service test satisfactory ? Monitoring Co. ° ' . �� � PhAz— 4hicode: 9. SPRINKLERS - PIPING a. Are all sprinkler heads In good condition, not obstructed and free from corrosion pr I ading T , , , _ , C _ b. Are all sprinkler heads less than fifty (50) years old ? Head Manufacturer : o . ""r/%� Date of head WHFFE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRED PARTMENT.COPY, ;:.,GO,LD:rB1.1I4DING COPY ilk Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLERtOMPANY 3434 RWAta So., Seatdlry WA 98134, 206. 622. 46W WA.: Vf4G4MS373NT LEVEL 111 602 WW, L.ongviW WA 91911M, 360. 4Z5. MO Fire Sprinkler Inspection Report Page: 20 2 9. SPRINKLER / PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? - - - _ - - �. . . . . . . . . . . . . . . . . . . d. Is condition of piping, drain valves, check valves, hangers, ure gau , open sprinklers, and strainers setifectory ? . _ _ _ e. Are all sprinklers of proper temperature rating? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ f. Are portable fire extinguishers In good condition ?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - g. Is hand hose on sprinkler systems satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 10. Date Dry System Piping last checked for stoppage .. . . . . . . . . . . . . . . . . . . . . _ . . - - - - - - d` 11. Date Dry System Piping last checked for proper pitch. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - "' �� .12. Date Dry Pipe Valve last trip tested. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d ' %f 13. Wet systems: Number. Make / Model / Year. — 14. Dry Systems: Number: , Make / Model / Year. 7,46 2 1,F 1 15. Accelerator: Make / Model / Year: 16. Special Systems: Number: Type: Make / Model / Year: Condition: 17. CONTROL VALVES a. City Connection Control Valves - - - - b. Tank Control Valves- - - - - - - - - c. Pump Control Valves- - - - - - - - - d. Sectional Control Valves - - - - - - - - - e. System Control Valves - - - - - - - - 18. WATER FLOW TEST a. Water Pressure Source :JjCCIty, DTank, O Fire Pump, Water Flow Test taken ? �<If not, reason: TesOlpe Location Size Test Pipe Pressure Before Flow Pressure Pressure After Ole 19. Explanation of any "No" answers: 20. Recent changes in building occupancy or fire protection equipment: 21. Adjustments or corrections made: 22. Desirable Improvements: 23. Has building owner / representative been notified of any deficiency to the fire protection system? ❑ Yes ❑ No, Person notified: If answer Is "No",explain: 24. Inspector's Signature: Witness (property owner / lessee) and date: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT,COPY :GOLDf"BUILDING COPY Fire Protection Contractors since 1930 VIKING AUTOAAanc SPRIRIKLER COMPAWY 34M Fist Ave. Sb., Seaft, WA 98134, 208. 522. 4656 WA.: dNal-NlA-s373Nr LEVEL 111 < 602 Cadiibmia flay, Longue-/, WA 98632, 360. 425. MO COMPANY' LZA2aaF Oxl 110P h J JOS NO.: ���Y �� DATE : ���'C�'�✓�i�� STREET : A#0 n PROPERTY NAME / LOCATION : /; o e C_ ¢ A") CITY / STATE : /r t�eai' � O✓� �i ✓ . fJ ®tom (�i —INSPECTOR: DRY MPE VALVE TEST �. Valve description cal. Size b. Make C. Model dl. Year of Mfg. a. Control Sprinklers 6n 3. Pressure (Lb) before tests: a. Air b. Water 4. Control Valve a. Wide ®Pen b. No (Ho.®ff turns 4® open) 5. Operated at: a. Air pressure (Lb) b. Time (Min.,Sec.) 6. Operation Indicated: a. satisfactory b. Partially satisfactory c. Faile� 7. Reason for: a. failure b. partially satisfactory S. Valve reset dry? (yes/no) 9. Condition: a. Interior of body b. Water for test pipe cc. Moving Pains dl. Suits a. Rubber facing 10.Alarms operated? (yes/no) 11. Inspector's Test trip time (Sec.) 92..Quic z Opening Devices: a. Make b. Model c. Year. 13.Operatu®n Indictatedl: a. Satisfactory b. Failed to shut off 14. Lust of repairs made: DRY PIPE VALVES ®.� H0.2 No.3 O a121 . a C� QUICK ®PENIN DEVICES Signature / Title of person Witness. (owner / lessee of property ) and date signed. d 1 Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY , 3434 First Ave. $O., Seattle, WA 98134, 206.622.4656 WA.: VI-KI-NA-S373NT LEVEL 1// 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report Page: 1 of 2 REPORT TO : - STREET : ,/& /r CITY / STATE: 16AI Ahlli( .,.,_ PO� JOB NO. DATE: 5 7 �� —4 / BLDG. / LOCATION: INSPECTOR: .71 A® 4W, F46&�V 1.GENERAL a. Is the building occupied ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . . b. Is occupancy the same as previous inspection ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . C. Are all systems In service ? . . . . . . . . . . . . . . . . . . . .. . . . . . _ :. - - d. Are all fire protection systems the same as last Inspection ?. . . . . . . . . . . . . .. 1 /. . . . . . . . . . . e. Is the building completely sprinklered ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f. Are all new additions and building changes properly protected ? . . . . . . . . . . . . . . . . . . . . . . g. Is all stock or storage properly below sprinkler piping ? . . . . . . . . . . . . . . . . . . . . . . . . . . . h. Was property free of fires since last Inspection ? (Explain any fire on Page 2) . . . . . . . . . . . . . . . . . . . . . . . . I. In areas protected by wet systems, is building property heated, i.e.: blind aides, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ? . . . . . . . . . . . . . . . . . . . . . . . b. Are all other control valves in proper position ? . 7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Are all control valves in good condition and sealed or supervised ? . . . . . . . . . . . . . . . . . . . . . . . . 3. WATER SUPPLIES (See Section 18) . a. Was a water flow test preformed and were the results satisfactory ? . . . _ _ . _ _ _ . . . . . . . . . . . . . . . . . 4. TANKS, PUMPS. WFIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks In good condition and properly maintained ? . . .''' b. Are Fire Department Connections In satisfactory condition, couplings free, caps In place and check valves tight I. 6i� 5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Have antifreeze systems been tested and left In satisfactory condition ? Temp. ? . . . _ ... _ _ . _ . - . c. Are alarm valves, water flow Indicators and retard chambers in satisfactory condition ? . . . . . . . . . . . . . . _ _ . . - 6, DRY SYSTEMS (See Section 14) a. Are dry valve(s) In service and In good condition ? _ _ _ . . . _ . _ _ _ . . . . . _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are pressure and priming water levels normal ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Is air compressor In good condition ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. Were low points drained during fall and winter Inspections ? _ _ . _ . _ . . . _ _ _ . _ . _ _ . _ _ . . _ _ . . e. Are Quick- opening devices In service ? . . . . . . . . . . . . . . . . . . . . . . . . . _ _ . . _ . . . . . f. Has piping been checked for stoppage within the past ten (10) years ? . . . . . . . . . . . . . . . . . . . . . . . . . . g. Has piping been checked for,proper pitch within the past five (5) years ? . . . . . . . . . . . . . . . . . . . . . . . . h. Have dry valves been trip tested satisfactorily as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ... _ _ _ _ _ _ _ _ _ _ I. Are dry valves adequately protected from freezing ? . . . . . . . . . . . . . . . _ . _ . _ . _ _ _ . _ ). Are valve house and heater conditions satisfactory ? . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? . . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b, Were all heat -responsive systems tested and were the results satisfactory ? . . _ _ . . _ . _ _ . _ _ . _ _ _ _ _ . c. Were supervisory features tested and were the results satisfactory ? . . . . . . . . . . . . . . . . . . . . . . . . ... S. ALARMS a. Is the water motor and gong test satisfactory ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . _ . . _ b. Is the electric alarm test satisfactory ? _ _ _ _ . _ _ . - _ . _ _ . _ _ _ _ _ _ . _ _ c. Is the supervisory alarm service test satisfactory ? Monitoring Co. 11d,,"1 �* ®' Ph. � "Code: S21 - �J ' 9. SPRINKLERS - PIPING a. Are all sprinkler heads In good condition, not obstructed and free from corrosion or loa In . _ _ . . . _ . . . b. Are all sprinkler heads less than fifty (50) years old? Head Manufacturer : / ��' Date of head WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTME, COPY GOLD: BUILDING COPY iA w , , ...t. .. lc...r - .: r"a".r�;` 4.�I�",J �b -�:Y .yh-y,•.... S.. ,nl:.. � ..,. ,, �. .. •: ...•4. r r4, �.. n. e. - - AUTOMATIC SPRINKLER COM WA.: VI-K1-NA S373NT LEVEL 111 Fire Sprinkler +! Fire Protection Contractors since 1930 „ 3434 RtW Am. So., Sefettle, WA 98134, 206. 622. 4656 6W Ca@bn* Wi9tjy, LofVview, WA 982, 360. 425. 7= ;pection Report Page: 20 2 9. SPRINKLER / PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? _ _ _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ �- _ d. Is condition of piping, drain valves, check valves, hangers, ure gauges open sprinklers, and strainers sadfactory ? - _ - _ _ _ e. Are all sprinklers of proper temperature rating? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ f. Are portable fire extinguishers in good condition ?. . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . g. Is hand hose on sprinkler systems satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 10. Date Dry System Piping last checked for stoppage. _ _ _ _ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �� 11. Date Dry System Piping last checked for proper pitch. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . . . . . . _ _ . . . . . 4/+0,F;P - 12. Date Dry Pipe Valve last trip tested.. _ . . . . _ _ . . . - _ - _ _ _ . . . . . . r� .� 13. Wet systems: Number. Make / Model / Year. %r 14. Dry Systems: Number: Make ! Model / Year. 15. Accelerator: Make / Model / Year: 16. Special Systems: Number: Type: Make / Model / Year: Condition: 17. CONTROL VALVES a. City Connection Control Valves - - - - b. Tank Control Valves- - - - - - c. Pump Control Valves- - - - - - - - d. Sectional Control Valves - - - - - - - - e. System Control Valves - - - - - - - - I& WATER FLOW TEST a. Water Pressure Source :J3CIty, p Tank, O Fire Pump, Water Flow Test taken ? lie-eIf not, reason: Test�Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After, , 6f 19. Explanation of any "No" answers: 20. Recent changes In" building occupancy or fire protection equipment: 21. Adjustments or corrections made: 22. Desirable Improvements: 23. Has building owner / representative been notified of any deficiency to the fire protection system? 0 Yes ❑ No, Person notified: If answer is "No",explain: 24. Inspector's Signature: / XE Witness (property owner / lessee) and date:WIN PV YELLOW INVOICE COPY PINK FIRE DEPARTMENT -COPY .,ty GOLD BQILDING;COPY b . •'i t. Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY, 3434 First Ave. So., Seattle, WA 98134, 206.622.4656 WA.: w-Ki-Na-s373Nr LEVEL. ai 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler -inspection Report Page: 1of 2 REPORT TO: ff�3i� s9 f� Aiki_ ��elxr JOB NO. (dJ `� DATE: STREET: 7,116 016 /I �1�,°�f%% l�f® BLDG. / LOCATION : " Ate2l A01 A CITY / STATE: �✓�' t/fJla + �,..[ INSPECTOR: I.GENERAL a. Is the building occupied ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ _ _ . b. Is occupancy the same as previous inspection ?. . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . . . . c. Are all systems In service ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. Are all fire protection systems the same as last Inspection ?. . . . . . . . . . . . . . . . . . . . . . t . . . . T . e. Is the building completely sprinklered ?. . . . . . . . . . . . . . . . . . . . . • . _ , • . . - f. Are all new additions and building changes properly protected ? . - . . • _ - _ _ . _ . _ - _ _ _ : _ _ _ • - g. Is all stock or storage properly below sprinkler piping ? . . . _ _ _ _ . _ _ . • _ • • . _ _ _ _ _ . _ _ _ _ _ _ _ h. Was property free of fires since last Inspection ? (Explain any fire on Page 2) . . . . . . . . . . . . . . . . . . . . . . . I. In areas protected by wet systems, Is building properly heated, I.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ?. . . . . . . . . . . . . . . . . . . . • _ _ • _ • _ • • _ _ _ . b. Are all other control valves In proper position ? . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . c. Are all control valves In good condition and sealed or supervised ? . . . . . . . . . . . . . . . . . . . . _ . . . 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? . - . - _ _ _ . . _ . _ _ _ • _ _ _ _ • _ _ 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks in good condition and properly maintained ? . . b. Are Fire Department Connections In satisfactory condition, couplings free, caps In place and check valves tight S. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? . _ _ _ . _ . . . . _ . . . . . . . . . . . . . b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. ? . . . . . . : . . . ... . _ - c. Are alarm valves, water flow Indicators and retard chambers in satisfactory condition ? . _ _ _ • _ • _ . _ _ _ _ _ _ _ • - - 6, DRY SYSTEMS (See Section 14) a. Are, dry valve(s) In service and in good condition ? _ _ _ _ . . _ . . . _ • . . _ - _ • . _ . • • _ _ . - - b. Are pressure and priming water levels normal ? . . . . . . . . . . . . . . . . . . . • . . . . . . . _ . . . . c. Is air compressor In good condition ? . . . . . . . . . . . . . . . . . . . . . . r dGm a+o/ d. Were low points drained during fall and winter Inspections ? _ . _ _ _ _ � _ _ _ _ _ • _ _ . • . _ • . . e. Are Quick- opening devices in service ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . _ . . . . I. Has piping been checked for stoppage within the past ten (10) years ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Has piping been checked for proper pitch within the past five (5) years ? . . . . _ _ _ _ _ _ _ _ . _ • _ _ . _ • _ h. Have dry valves been trip tested satisfactorily as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ • - _ _ _ . . . . 1. Are dry valves adequately protected from freezing ? _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ _ - 1. Are valve house and heater conditions satisfactory ? _ _ . . _ _ . _ _ . . . ... . . . _ . _ . . . . . . _ . . . 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . . . . _ _ b, Were all heat -responsive systems tested and were the results satisfactory ? . . . _ _ _ _ _ _ - c. Were supervisory features tested and were the results satisfactory ? . . . . . . . . . . . . . . . . . . . . . . . . . . . 8. ALARMS a. Is the water motor and gong test satisfactory ?. . . _ _ _ _ _ • _ • _ _ _ • . _ _ . • _ • . . . . • _ . _ . _ _ b. Is the electric alarm test satisfactory ? . _ . _ _ _ _ _ _ / _ _ _ _ _ _ _ . . _ _ . - c. Is the supervisory alarm service test satisfactory ? Monitoring Co. A&O P" flf Ph.: % es Code: S_ /-K 9. SPRINKLERS - PIPING a. Are all sprinkler heads In good condition, not obstructed and free from corrosion or loa ng ? .- - _ / b. Are all sprinkler heads less than fifty (50) years old ? Head Manufacturer : Date of head WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT,CO D:'BUILDING COPY .• "„. . Esc ;,. _ ... , ,. . •.: .. „ �Qi+i :+ Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER,COMPANY 3434 First Ate Sa. , SeRM WA 98134, 206. 622. 4656 WA.: VA4a NA-S373NT LEVEL N 6W Cafta & W, La/Kjv"% WA 9%W, 3W . 425. MO Fire Sprinkler Inspection Report Page: 2of 2 9. SPRINKLER / PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? _ . . _ . d. Is condition of piping, drain valves, check valves, hangers, _ _ . . . . . . . . . . . . . . . . . . _ ure gau , open sprinklers, and strainers satlfactory ? . X e. Are all sprinklers of proper temperature rating? _ _ _ _ _ ._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ox f. Are portable fire extinguishers in good condition ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Is hand hose on sprinkler systems satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 10. Date Dry System Piping last checked for stoppage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11. Date Dry System Piping last checked for proper pitch. _ _ _ _ _ _ _ _ _ _ _ 12. Date Dry Pipe Valve last trip tested. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 13. Wet systems: Number. Make / Model / Year. 14. Dry Systems: Number: Make / Model / Year. 70 "&/� d7�9 o 15. Accelerator: Make / Model / Year: 16. Special Systems: Number: Type: Make / Model / Year: Condition 17. CONTROL VALVES a. City Connection Control Valves - - - - b.Tank Control Valves- - - - _ - - - c. Pump Control Valves- - - - - - - A. Sectional Control Valves - - - ® - e. System Control Valves - - - - - - - I& WATER FLOW TEST a. Water Pressure Source City, OTank, O Fire Pump , Water Flow Test taken ? H not, reason: 0 Test'Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After r Rlirze 19. Explanation of any "No" answers: 20. Recent changes In building occupancy or fire protection equipment: 21. Adjustments or corrections made: 22. Desirable Improvements, 23. Has building owner / representative been notified of any deficiency to the fire protection system? O Yes ❑ No, Person notified: If answer is "No",explain: i 24. Inspector's Signature: Witness (property owner / lessee) and date: WH : VIKING C44POOY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY , . GOLD:,BUILDING, COPY Fire Protection Contractors since 1930 VIKING AUTOMATICS SPRIMKLER COMP, NY 3� Filst AVe. So., Siamla, WA 98934, 2d8. 622. 4656 Wig.: VI-KI-MA-S373NT LEVEL III i. 602,'Wtamia Way, Lam, WA MM, 360. 425. 7620 COMPANY: �� � JOB NO.: DATE �� STREET:. W/0 � A- i PROPERTY NAME / LOCATION : CITY / STATE : �/ �' C/s✓'4? 1 & �(/� INSPECTOR: 71 DRY MPE VALVE TEST DRY POPE VALVES �. Valve description a. Size b. Make C. Model dl. Year of Mfg. 2. Control Sprinklers in 3. Pressure (Lb) before tests: a. Air b. Water 4. Control Valve a. Wide ®Pen b. No (No-ol turns t® ®Pen) 5. Operated at: 0 a. Air pressure (Lb) b. Time. :(Min., Sec.) 6. Operation Indicated: a. Si sffact®rrb b. Partially satisfactory c. Failed 7- Reason for: a. failure b. Partially satisfactory 3. Valve reset dry? (yes/no) ° 9. Condition: a. Interior of body b. Water for test pipe cc. Moving Pars dl. Seats e. Rubber facing 1 QD. Alarms operated? (yes/no) 91.Inspector's Test trip time (Sec.) 92.Quich Opening Devices: a. Make b. Model c. Year 13.Operatu®n Indictatedl: a. Satisfactory b. Bailed to shut off 14. Lust of repairs made: Signature / Title of pF#Fson perfor 'ing test Witness (owner / losses of property) and data signed. �e Serving Brier, Edmonds Mountlake Terrace,and ' T the Town of Woodway www.FireDistrictl.org LOCATION: 7110 210th Street BUSINESS NAME: Edmonds Public Works MAILING ADDRESS: 7110 210th St SW Edmonds BUSINESS OWNER: Facility MaintJCOE EMERGENCY-1: Stevens, KEY ACCESS-2: Jim PERSON CONTACTED: C OD Y NAME OF INSPECTOR: 0 V f L_ I AJ FIRE AS 712 FA M0 FD ILk@x SYSTEMS: -1/ 1 Z 2 /l 5 (0 IL. Stiff 12425 Meridian Ave S Everett, WA 98208 Phone (425) 551-1200 Fax (425) 551-1272 PHONE: 4257710235 90026 HOMEPHONE: 4257752525 HOMEPHONE: 4257603334 HOME PHONE: FIRE PREVENTION INSPECTION REPORT ❑ EDMONDS ❑ BRIER ❑ WOODWAY ❑ MOUNTLAKE TERRACE ❑ UNINCORPORATED FREQUENCY I STATION & SHIFT 366 16 D SCHEDULED DATE DUE ► 71 1113 UFIR ► 509 7207 ACTIVE CURRENT CITY YES NO BUSINESS LICENSE INITIAL INSPECTION DATE Z013 FE 3 1� ANNUAL HAZARDS FOUND AND L CATIONS / COMMUNICATIONS 1 1 2 2 3 :;. 3 4 4 5 5 6 6 If 7/ 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: EXTENSION GRANTED TO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: DATE: 3 VIOLATIONS 1 ',. 5 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 2', 6 2 6 DATE: CODE SECTION: 5 3 7 3 7 RETURN RECEIPT RECEIVED 5 4 $ 14 18 DATE: DISPOSITION: LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO 8 FIRE DEPARTMENT COPY _ �.- , v....�..-...,.. J„ :,�,.., �.,,,`...y .•. �r,�.r'4'-tr hiv ,- ,..1 ..\.. .'•l' .. ...!'., r•�'v.� _ r�Jyr - � � .-.�.. ..... �'ry. .''-Fire Protection Contractors since 1930 NW VIKING AUTOMATIC SPRINKLER COMPANY ' 3434 First Ave. So., Seattle, WA 98134, 206.622.4656 WA.: VI-KI-NA-S373NT LEVEL III 602 California Way, Longview, WA 98632, 360:425.7620 Fire Sprinkler 'Inspection Report Page: 1 of 2 REPORT TO: y4^➢ A5'�' r + I i� is ' i O r /.�C � r f JOB NO. IAJ!r .- 7414 ✓ DATE: F '22I Z6Z 73 STREET : 114 BLDG. / LOCATION: 7— CITY/STATE: Z M d ,4U` S INSPECTOR: 1.GENERAL a. Is the building occupied ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Is occupancy the same as previous inspection ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c, Are all systems in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Are all fire protection systems the same as last inspection ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ,:a; Is the building completely sprinklered ? _«_ :.. f. Are all new additions and bullding'changes properly protected ? - _ _ _ _ _ _ - _ _ _ *_ _ _ _ '_ _ _ _ _ _ _ _ _ _ g. Is all stock or storage properly below sprinkler piping ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ h. Was property free of fires since last Inspection ? (Explain any fire on Page 2) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1. In areas protected by wet systems, is building properly heated, I.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are all other control valves in proper position ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Are all control valves In good condition and sealed or supervised ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks in good condition and properly maintained 2 _ _ _ _ b. Are Fire Department Connections in satisfactory condition, couplings free, caps In place and check valves tight ?_ 5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Are, alarm valves, water flow indicators and retard chambers In satisfactory condition ? _ _ _ - _ _ _ _ - _ - _ _ _ _ _ _ _ 6, DRY SYSTEMS (See Section 14) a. Are dry valve(s) in service and in good condition ? _ _ _ _ _ _ _ - - _ - _ _ _ _ _ , _ - _ - _ - _ b: Are pressure and priming water levels normal ? . _ _ _ _ _ _ _ _ _ _ _ _ _ t ; _ _ _ _ _ _ c. Is air compressor in goo d,conditil ?' -'- - _ _ _ _ �- ' d. Were low points drained during fall and winter Inspections ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ e. Are Ouick- opening devices.in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ f. Has piping been checked for stoppage within the past ten (10) years ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Has piping been checked for proper pitch within the past five (5) years ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ h. Have dry valves been trip tested satisfactorily as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1. Are dry valves adequately protected from freezing ? _ _ _ - _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ). Are valve house and heater conditions satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b• Were all heat -responsive systems tested and were the results satisfactory ? - _ _ _ _ _ _ _ _ _ _ _ - _ _ _ _ _ - _ _ _ c. Were supervisory features tested and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ 8. ALARMS a. Is the water motor and gong test satisfactory ?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b. Is the electric alarm test satisfactory ? _ _ _ _ _ _ _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ C. Is the supervisory alarm service test satisfactory ? Monitoring Co. ✓�' Q om / Ph.: ROV'2-28— 9124 Code: ' 9. SPRINKLERS - PIPING a. Are all sprinkler heads in good condition, not obstructed and free from corrosion 9r loading ? }p % _ _ _ _ _ _ - i- - - b. Are all sprinkler heads less than fifty (50) years old ? Head Manufacturer, : (i Pig 1�D 4"w'rrrTd6 / Date of head : / 919V WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY err-, .... _ << _ . �.,. ,. tl _- _.Y . -!'�: ,! i..�.'��y c Yf'tl k x,�'�`_',^ -fz �.,.FA �:.'. ;J tG may° -..- 1 -i �• ' ( r �; r.; r #N Ln�tPY,f1 t. +`¢ryFl hT ujaa�r. ` i- �� �*✓:a" F' Fire Protection Contractors since 1930 . VIKING AUTOMATIC SPRINKLER COMPANY 34M RWAve Sa, Sea[tie, WA.98134; 206. 622. 4656 WA.: VI-XLM-S473NT LEVEL 111 : ` 6Q2 Caiikada W W, Longview, WA 9 1M, 360. 425. 7620 Fire Sprinkler Ipspection Report Page: W. 2 9. SPRINKLER / PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? _ _ . . _ . _ _ _ _ _ - _ _ _ _ _ _ .. - - d. Is condition of piping, drain valves, check valves, hangers, pressure gauges, --open sprinklers, and strainers sadfactory ? _ - - . - - - - , 4 � e. Are all sprinklers of proper temperature rating? _ _ _ _ , _ _ _ _ _ _ _ _ _ _ . _ _ _ _ _ _ _ _ _ _ _ _ _ I. Are portable fire extinguishers in'good condition ?_ _ _ _ : _ _ _ _ _ _ _ _ - _ _ _, _ _ - _ - _ _ g. Is hand hose on sprinkler systems satisfactory ? _ _ _ _ _ . _ _ _ . . - - - - _ - - _ - - •g & Ar7_ 10. Date Dry System Piping last checked for stoppage. _. _ _ _ _ _ _ _ _ . - _ - - - �i _ _ _ _ _ - _ 11. Date Dry System Piping last checked forproper pitch. _ _ _ _ _. _ _ _ _ _ _ _ 12. Date Dry Pipe Valve last trip tested. _ _ . . . . _ . J . 13. Wet systes:, Number: Make / Model / Yea mr. 14. Dry Systems: Number: Make / Model / Year: 15... Accelerator: Make / Model / Year: 16. Special Systems: Number' Type: Make / Model / Year: Condition 17. CONTROL VALVES a. City Connection Control Valves - - - - - b.Tank Control Valves- - - - - - - - c. Pump Control Valves- - - - - - - - d. Sectional Control Valves - - - - - - - - e. System Control Valves- - - - - - - Number Type Open Yes No Secured Yes No Closed Sign Yes No Condition !` yIX IX 16. WATER FLOW TEST a. Water Pressure Source ' City, OTank, Cl Fire Pump, Water Flow Test taken ? W If not, reason: Test Pipe Location Size Test Pipe Pressure Before Flow Pressure Orb.ssure After 7A Ile, 19. :Explanation of any "No" answers: k 21: Adjustments or corrections made: 22. , Desirable Improvements: 23. Has building owner / representative been notified of any deficiency to the fire protection system?.OYes ❑ No, Person notified:_ If answer Is "No",explain: 24. Inspector's Signature: � 4itness(property owner / lessee) and date: WHI : VIKING COP YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY : GOLD: BUILDING COPY ;fir-., ......., ..� „--,. .. .. -: ,-, a .., _.... .,,. .. . .-,- _.:; ..... ,�..',1s_•,f�^, ; .. ., - , ,. .. , '�iv.a , ..v . ..., -.- ... .. Fire Protection Contractors since 1930 -`VIKING AUTOMATIC SPRINKLER COMPANY a 3434 First Ave. So., Seattle, WA 98134, 206.622.4656 • WA.: VI-KI-NA-S373NT LEVEL III { 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report Page: 1 of 2 REPORT TO: �• ®/!t" �I/� Z�t I L ` ' C„ JOB NO, t.1.� �s' / DATE : 57+ 27^ AeV STREET: Y�.6 �+wv-� BLDG. / LOCATION: �✓ r �� CITY / STATE : � � ` � �� INSPECTOR : % ✓ � �✓ � '� W.�C/ / 1.GENERAL a. Is the building occupied 7 _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Is occupancy the same as previous Inspection ?- - - - - - - - - - - - - - - - - - - - - - - - _ _ - - _ _ _ _ _ C. Are all systems In service ? _ _ _ _ - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Are all fire protection systems the same as last inspection ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ e. Is the building completely sprinklered ? _ _ _ _ _ _ _ - f. Are all new additions and building changes properly protected ? _ _ _ _ _ _ _ _ - . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Is all stock or storage properly below sprinkler piping ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ h. Was property free of fires since last inspection ? (Explain any fire on Page 2) _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I. In areas protected by wet systems, is building properly heated, I.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are all other control valves in proper position ? - _ - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - c. Are all control valves In good condition and sealed or supervised ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks in good condition and properly maintained 'L . . . _ b. Are Fire Department Connections In satisfactory condition, couplings free, caps In place and check valves tight ?_ _ ° :� �� :*f_Z _ 5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. A alehn valves, water flow Indicators and retard chambers in satisfactory condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 6, DRY SYSTEMS (See Section 14)' a. Are dry valve(s) In service and in good condition ? _ _ _ _ _ _ _ _ _ _ - _ _ _ _ _ _ _ _ _ - b. Are pressure and priming water levels normal ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ ' _ _ _ _ _ _ _ { _ _ _ _ _ _ _ _ _ - - I c. Is air compressor In good coriditiop ?, _: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Were low points drained during fall and winter inspections ? - - - - - - - - Q_ _ _ _ _ _ e. Are Quick= opening devices in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I. Has piping been checked for stoppage within the past ten (10) years ? _ _ _ _ _ _ _��� _ _ _ _ _ _ _ _ _ _ _ g. Has piping been checked for proper pitch within the past five (5) years ? . . . . . . . . . . . . . . . . . . . . . . . . h. Have dry valves been trip tested satisfactorily as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1. Are dry valves adequately protected from freezing ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ). Are valve house and heater conditions satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b, Were all heat -responsive systems tested and were the results satisfactory ? _ . _ . . . . _ _ _ _ _ _ _ _ _ _ _ _ c. Were supervisory features tested and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 8. ALARMS a. Is the water motor and gong test satisfactory ?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b. Is the electric alarm test satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ c. Is the supervisory alarm service test satisfactory ? Monitoring Co. X-4 �°^ �Q `� � 1311 a 3,�- �� F Coder �' S 9. SPRINKLERS - PIPING a. Are all sprinkler heads in good condition, not obstructed and free from corrosion/ or loading ?/ _ / _ - _ - _ _ _ - - _ / _ - b. Are all sprinkler heads less than fifty (50) years old? Head Manufacturer: PJl?1 .-I, Date of head WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY .. .. .. .. . •t..-• .�- , .•i ,. . ,.,.r.AF,.✓,,y�- `LAY, i�r. e, •5}.,'l'.,i-. ,i1- .,.. .P .. - car Fire J �.✓) Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY ' 3434 RrW Ave. Sa, SiBeft, WA 98134, 206. 622. 46M WA.: VI-KJ-NA-S473NT LEVEL N ? : 6Q2 Ce/i bmia NY, Longview, WA SO=, 360.425: 7620, Fire Sprinkler Inspection Report Page: 20 2 9. SPRINKLER / PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? _ _ _ _ - - - - - - - - - - - - - - - - - - - - - - - - - - - d. Is condition of piping, drain valves, check valves, hangers, pressure gauges, open sprinklers, and strainers satifactory e. Are all sprinklers of proper temperature rating? _ - - - - _ _ - - - - - - . . - - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ I. Are portable fire extinguishers In good condition ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ - - - _ - g. Is hand hose on sprinkler systems satisfactory ? _ . . . _ . . _ _ . . . , - - - - - - - - - - - - - - - - 10. Date Dry System Piping last checked for stoppage._ _ _ _ _ _ _ _ _ _ _ _ _ - .Y , _ - - - - _ - - - - 11. Date Dry System Piping last checked for proper pitch. _ - _ _ _ _ - _ _ _ - - - - - v - - - - - - - - - - - - - _22 12. Date D Pi Valve last trip tested- - _ - - - - - _ - - _ _ _ - - _ _ _ _ - - - _ _ _ � �%� Pe P - - ry - - _ 13. Wet systems: Number: Make /Model / Year: 14. Dry Systems: Number: Make / Model / Year.`, .15. Accelerator: Make./,Mode( / Year: 16. Special Systems: Number: -Type: Make / Model / Year: Condition 17. CONTROL VALVES a. City Connection Control Valves - - - - - b.Tank Control Valves-' - - - - - c. Pump Control Valves- - - - - - - - I d. Sectional Control Valves - - - - - - e. System Control Valves - - - - - - 18. WATER FLOW TEST a. Water Pressure Source : jBrCkv, OTank, O Fire Pump, Water Flow Test taken ? 4LIi If not, reason: Test Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After 7 Ali JZ z 19. Explanation of 'any "No" answers: w a 4 20. Recent changes in building occupancy or fire protection equipment: 21. Adjustments or corrections made: 22. Desirable Improvements: 23. Has building owner / representative been notified of any deficiency to the fIre, protection system? OYes O No,Person notified: If answer is "No",explain: 24. Inspector's Signature: Witness (property owner / lessee) and date: WHITE/ IKING COP YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY. GOLD: BUILpING.COPY Iry VIKING AUTOMATIC SPRINKLER COMI WA.: VI-KI-NA-S373NT LEVEL M Fire Protection Contractors since 1830' IY 3434 Fist Ave. So. , Seattle, WA 98134, 206. 622.4656 602 Calitomis Way, Longview, WA 96632, 360. 425. 7620 COMPANY: 2*11M6.4A Abl i.f IJbl'4S Al /!_L JOB NO.: t� / � T 1 � DATE: _ F- 22 - 3 STREET:. o �1^ -V one z PROPERTY NAME / LOCATION: CITY / STATE : 04 --5 %yu �� INSPECTOR: � DRY PIPE VALVE TEST 1• Valve description. a. Size b. Make C. Model d. Year of Mfg. 2. Control Sprinklers in 3.._.Pressure (LW-.before.tes.ts:.._:. a. Air b. Water 4. Control Valve a. Wide open b. No (No.of turns to open) 5. Operated, at: a. Air pressure (Cb) b. Time (Min.,Sec.) 6. Operation Indicated: a. Satisfactory b. Partially satisfactory c. Failed, 7. Reason for: a. failure b. partially satisfactory 8. VaJve reset dry? (yes/no) 9.: .C.ondition: a. Interior of body b. Water for test pipe c. Moving parts, d. Seats e. Rubber facing. 10.Alarms operated:? (yes/no) 11.Inspector's Test trip time (Sec.) �12.Quick Opening Devices: a. Make b. Model c. Year 13.Operation Indictated: a. Satisfactory b. Failed to shut off 14. List of repairs made: DRY PIPE VALVES No.1 No.2 N,o.3 `1 9" ell, �" O 72 NU Old �rr'� ell QUICK OPEN NG DEVICES Signature / Title of per on per for ng test Witness (owner / lessee of property ) and date signed. r . Fire Protect/on Contractors since 1930 j VIKING AUTOMATIC SPRINKLER COMPANY; 3434 First Ave. So., Seattle, WA 98134, 206.622.4656 WA.: VI-KI-NA-S373NT LEVEL UI 602 California Way, Longview, WA 98632, 360.425.7620 i Fire Sprinkler Inspection Report Page: 1 of 2 REPORT TO : al�,l , Od 5 "y" li(At2t= JOB NO. 4!2:5�r .3 W/ DATE: 9 - 22+240'-3 STREET:, Y I6 7/ BLDG. / LOCATION : CITY STATE: - Mo-,+ls IWOK -INSPECTOR: AW � ��� ���'r �� ✓ 1. GENERAL YES N.A. NO a. Is the building occupied ? - - - - - - - - - - - - - - - - - - - - - - - - - _ _ _ _ ... _ . _ _ _ _ b. is occupancy the same as previous Inspection ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Are all systems in service ? _ . . _ . . .._ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Are all fire protection systems the same as lest Inspection Z_ . _ _ . . . _ . . . . . . . . . _ . . . . _ _ _ e. Is the building completely sprinklered ?_ _ _. _ _ , _ _ } _ _ _ _ _ v •' _ _ _ _ _ _ _ A. Are alPnew,additions and'b I ding cha'ngesproperly protected ? - _ _ - - _ - - �_ `_ - _ - - - - g, . Is all stock or storage properly below sprinkler piping ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ' h• Was property free of fires since last Inspection ? (Explain any fire on Page 2) - - - - - - - - - - - - - - - - ... - - - - - 1. In areas protected by wet systems, is building properly heated, i.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section.17) a. Are all sprinkler system main control valves open ?- - - - - - - - - - - - - - - - - - - - - - - - - - - - . b. Are all other control valves in proper position ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - c. Are all control valves In good condition and sealed or supervised ? - - - - - - - - - - - - - - - - - - - - - - - - IX 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks in good condition and properly maintained ? - - - ti. Are Fire Department Connections in satisfactory condition, couplings free, caps In place and check valves tight ?_ - _ 5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - X b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. ? - - - - - - - - - - - - - - - - -IXI c. Are alarm valves, water flow'Indicators and retard chambers in satisfactory condition ? - - - - - - - - - - - - - - - 6, DRY SYSTEMS (See Section 14) a. Are dry valve(s) In service and in good condition ? - - - - . _ . _ _ . . . _ , _ _ . . . . _ . . b. Are pressure and priming water levels normal ? _ _ _ _ _ _ _ _ _ _ _ _ ' W' C c. Is air compressor in good condition _., _ - - - - - - . _ _ _ _ _ - - - .y d. Were low points drained during fall and winter inspections ? - - - - - - - - - - - - - - - - - - - - - - - - - - - e. Are. Quick- opening devices in service ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ - _ _ f. Has piping been checked for stoppage within the past ten (10) years ? - - - - - - - - - - - - - - - - - - - - - - - - g. Has piping been checked for proper pitch within the past five (5) years ? - - - - - - - - - - - - - - - - - - - - - - - h. Have dry valves been trip tested satisfactorily as required ? - - - - - - - - - - - - - - - - - _ - - - - - - - - - - 1. Are dry valves adequately protected from freezing ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - J. Are valve house and heater conditions satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ b, Were all heat -responsive systems tested and were the results satisfactory ? - _ - - - - - - - - - - - - - - _ _ - - - - c. Were supervisory features tested and were the results satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - 8. ALARMS a. Is the water motor and gong test satisfactory ?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b. Is the electric alarm test satisfactory ? - - - _ - - - - _ _ _ _ _ _ _ _ _ _ _ _ c. Is the supervisory alarm service test satisfactory ? Monitoring Co. a %+%, �`'�r.•7,�s Ph.:1?4V - M-7�26 Code: 52 7- .7/ 1 9. SPRINKLERS - PIPING a. Are all sprinkler heads in good condition, not obstructed and free from corrosion or loading ? - - - - - . - . _ - - _ - Ix b. Are all sprinkler heads less than fifty (50) years old? Head Manufacturer:- I Date of head : +� 917) WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT &PY GOLD: BUILDING COPY M' 10 -�4 Ige Fire Protection Contractors since 1430­ mKING AUTOAN NIMIC SPRINKLER COMPANY 3434 First Ave. Sa, Seatift WA 98134, 206. 622. 4656 ' WA.: VPK1-NA-W73NT LEVEL 111 bat Cafe" Ma Way, Longview, WA SIRM, 360. 425. 760 Fire Sprinkler Inplection Report Page: 202 9. SPRINKLER I PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? - - - - - - - - - - -- - - - - - - - - - - - - - --- - - ---- - - - - d. Is condition of piping, drain valves, check valves, hangers, pressure gauges, open sprinklers' and strainers astllfactory ? - - - - - - X a. Are all sprinklers of proper temperature rating? - - - - - - - - - - - - - - - - - - - - - - - - - - f. Are portable fire extinguishers In good condition ? - - - - - - - --- - - - - - - ---- - - - --- - I - - - - - - - - -- - - - W . l�, - t g. Is hand hose on sprinkler systems satisfactory? - - -- - - - - - - - - - I k- - - - - - - - - - -- - - 10. Date Dry System Piping last checked,for stoppage. - --- - - - - - - --- - - - - - - - - - - - - - --- --- - Ale 7- 11. Date Dry System Piping last checked for proper pitch. . . . . . ... 12. Date Dry Plpe,Valve last test ed. ted.- A4C7 14X - - - - - - - - - - - - - - - - - - - --- - - - - - - - 13. Wet, systems: -Number: Make Model Year. 14. Dry Systems: Number: Make Model /.Year: 15. Accelerator: Make Model Year: 16.. Special Systems: Number: type,: Make Model Year: Condition 4 17. CONTROL VALVES,, a. City Connection Control Valves b. Tank ControlVilves C. Pump Contfol Valves- 7 - - - - - - - d.. Sectional Control Valves - . . . . . . . a. , System Control Valves - r I , N 1& WATER FLOW TEST a. Water Pressure Source ;WCity, E3 Tank, - E3 Fire Pump , Water Flow Test taken ? M not, reason:'_ 'Test Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After -:.19. Explanation of any "No" answers: 21, Adjustments or corrections made: 22. Desirable improvements: 23. Has building owner / representative been notified of any deficiency to the fire protection system? Oyes 0 N6,Person notified:- If answer Is "No",explain: 24. Inspector's Signature: Witness (property owner and date: WHITE: VIKING C(O<< YELLOW: INVOICE COPY.,.r,,'[PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY P Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY 3434 First Ave. $o., Seattle, WA 98134, 206.622.4656 WA: VI-KI-NA-S373NT LEVEL M 602 California Way, Longview, WA 98632,360,425.7620 Fire Sprinkler Inspection Report Page: lof2 A bi REPORT TO: JA d 6'1 JOB NO. DATE: STREET: . 7116 216-11- <41 - BLDG. / LOCATION :#2 Allw�i,, CITY / STATE: —INSPECTOR: M-12 I.GENERAL a. Is the building occupied ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b. Is occupancy the same as previous Inspection ? - - - - - - - - - - - - --- - - - ---- - - - - - - - - - - - - - - - C. Are all systems In service ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - d. Are all fire protection systems the same as last Inspection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . a. Is the building completely'sprinklered ? - - — - - - --- - - - - - - - - - - - - - - f. :Are ill new additions and building changes Properly Protected ? - - --- - - - - - - - - •- - -- 7 ... . . . . . . . . g. Is all stock or storage properly below sprinkler piping ? - - - - - - - - - - - - - -- - - - - - - - --- - - - - - - - - h. Was property free of fires since last Inspection ? (Explain any fire on Page 2) . . . . . . . . . . . . . . . . . . . . . . . . 1. In areas protected by wet systems, Is building properly heated, I.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVE (See Section 17) a. Are all sprinkler system main control valves open ?_ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b. Are all other control valves In proper position ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - c. Are all control valves In good condition and sealed or supervised ? - - - - - - - - - - - - - - - - - - - - - - - - - - - 3. WATER SUPPLIES `(See Section 18) a. Was a water flow test preformed and were the results satisfactory ? - - - - - - - - - - - - - - - - - - - - - 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks In good condition and properly maintained ? - - - --- - - - - 0/1 - - - - - b. Are Fire Department Connections In satisfactory condition, couplings free, caps In place and check valves tight t -5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? - - - - - - - - - - - - - - - - - - - --- - - - --- - - - - - 'b. Have antifreeze systems been tested and left In satisfactory condition ? Temp. ? — - - - - - - - - - - - - - - - - — c. Are.,alarin valves, water flow Indicators and retard chambers In satisfactory condition ? . . . . - - - - - - - - - - - - - - - - 6. DRY SYSTEM (See Section 14) a. Are dry valve(s) In service and In good condition ? - - - - - - - - - - - - - - - - - - - - - --- - - - b. Are pressure and priming water levels normal ? - - - - - - - - - - - - --- c. is air compressor In good conditi 0.1 - - 7 - - - - - - - - - - - - - - - - - - - - - --- ? d. Were.low polnt.6.drained during fall and winter Inspections ? - - - - - - - - - - - - - - - - - - - - - ­ - - - - - a. Are Oulck- opening devices In service ? - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - - - - - - - I. Has piping been checked for stoppage within the past ten (10) years ? - - -- - - - - - - - - - --- - - - - - - - g. Has piping been checked for proper pitch within the past five (5) years ? - - - - - - - - - - - - - - - - - - - - - - - - - h. Have dry valves been trip tested satisfactorily as required ? - - - - - - - - - - - - - - - - - - - - - - - - - - - --- - 1. Are dry valves adequately protected from freezing ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - J. Are valve house and heater conditions satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b. Were all heat -responsive systems tested and were the results satisfactory ? - - - - - - - - - - - - -- - - - - - - - - - - - c. Were supervisory features tested and were the results satisfactory ? - - - - --- - - - - - - - - - - - - - - - - - - S. ALARMS a. Is the water motor and gong test satisfactory ? - - - - - - - - - - - - - - - - - - - - --- - - - - - - - - - - - - b. Is the electric alarm test satisfactory ? - - - - - - - - - - - - - - - - - - - - - - 14'4� Ph.: 4 J;6"— �Iii Code: M- 7 c. Is the supervisory alarm service test satisfactory? MonitoringCo. YK 9. SPRINKLERS - PIPING a. Are all sprinkler heads In good condition, not obstructed and free from corrosion or loadiqg ? - - - - - - - - - - - - - - - - - - b. Are all sprinkler heads less than fifty (50) years old TDate of head, Head Manufacturer: WHITE: VIKING COPY YELLOW,.' INVOICE COPY PINK:,FIRE DEPARTMENT COPY GOLD: BUILDING COPY .. ,. . -.. L � ��,.. i . .:,^( vy . a h C� f P .4 � d'1- t ',Y.i<'• ' f'„ ._ r _r , 't-.....•r" . � �: ' 1lo ���� . �� Fire'Protection Contractors since 1930 . • VIKING AUTOMA C SPRINKLER OMPANY' 3434 FirstAtne. SO:, Seattle, WA 98134, 206. 622.4656 WA.: VPK/-NA-S373NT LEVEL N 602 ChWom n W, Langvliew, WA 91511i32, 360. 425. 7620 Fire Sprinkler Inspection Report Page: 2of 2 9. SPRINKLER / PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ , d. Is condition of piping, drain valves, check valves, hangers, pressure gauges, open sprinklers, and strainers sadfactory ? e. Are all sprinklers of proper temperature rating? _ - - . _ _ _ _ - - _ - _ _ _ _ _ f. Are portable fire extinguishers in good condition ?_ _ _ _ _ _ - - _ _ ._ _ _ - _ _ _ _ . be g. Is hand hose on sprinkler systems satisfactory ? s- _ _ '- - _ _ _ _ _ 10. Date Dry System Piping last checked for stoppage. . . . . . . . . . . . . . . . r '` 11. Date Dry System Piping last checked for proper pitch. _ _ _ _ _ - _ - _ _ _ _ _ - - _ A -22�'� 12. Date Dry Pipe Valve last trip tested. _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - _ _ _ _ _ _ . _ _ _ _ _ _ _ _ 13. Wet systems: Number: Make / Model '/ Year: � �g 14. Dry Systems- Number: Make / Model / Year: 15. Accelerator: Make/Model /,Year: 16. , Special Systems: Number:. Type: 'Make / Model / Year : Condition r 17. CONTROL VALVES a. City Connection Control Valves - - . b.Tank Control Valves- - - ... - - c. Pump Control Valves- - - - - I- - d. Sectional Control Valves . . . . . . . e. System Control,Valves'- - - - - - I& WATER FLOW TEST a. Water Pressure Source : P,Clty, :OTank, O Fire Pump , Water Flow Test taken ? If not, reason: Test Pipe Location Size Test,Pipe Pressure Before Flow Pressure Pressure After 7 /did ,'' /. GrJ 3 '21. Adjustments or corrections made: 22. Desirable improvements: 23. Has building owner / representative been notified of any deficiency to the fire protection system? ❑ Yes ,❑ No, Person notified: If answer is "No",explain: ,y 24. Inspector's Signature: " Witness (property owner / lessee) and date: WHITE;. IKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY— 7 S9`^.i.,,. sue•'-• . _•. -. /'�i°. 'r', . ,. "�1.. _ I �::1; l.A�-°�r:�. •Fjn '.f•, Fire Protection Contractors since 1930 �. VIKING AUTOMATIC SPRINKLER COMPANY WA.: VI-KI-NA-S373NT LEVEL X �1 3434 Fist Ave. So., Seattle, WA 98134 , 206. 622.4656 602 Calikvnia Way, Longview, WA 99M, 360. 425. 7620 COMPANY: Z222i:ij� l -4C. JOB NO.: F J G��/ DATE : +� 6 V.Y STREET:. 7/ail /1) 5� ? lit JPROPERTY NAME / LOCATION: k APIA— CITY 62' INSPECTOR � �"' � �`m / DRY PIPE VALVE TEST 1 • Valve description a. Size b. Make c. Model d. Year of Mfg. 2. Control Sprinklers in .3.. Pressure: (Lb).'. before tests: a.. Air b. Water 4. Control Valve a. Wide open b. No (No.of turns,to open) 5. Operated at: a. Air pressure (Lb) b. Time (Min.,Sec.) 6. Operation Indicated: a. Satisfactory b. Partially satisfactory c. Failed 7. Reason for: a. failure b. partially satisfactory 8. Valve reset dry? (yes/no) 9. Condition: a. Interior of body b. Water for test- pipe c. Moving parts d. Seats e. Rubber facing 10. Alarms operated,? (yes/no) 11.Inspector's Test trip time (Sec.) 12.Quick Opening Devices: a. Make b. Model c. Year 13.Operation Indictated: a. Satisfactory b. Failed to shut off 14. List of repairs made: DRY PIPE VALVES No.1 No.2 No.3 lJ N/ "Al QUICK OPENING DEVICES Signature / Title test Witness (owner / lessee of property ) and date signed. -rA r X. 5 CA LIE Nc� �7 . !o� Pflo� L;1-4 C/L., t� S 3 APPROVED piRE DBP R� TMENT El L CITY OF EDMONDS BUILDING DEPARTMENT WORK ADORES OWNER APPROVED DATE BURG OFFICIAL PERMIT NUMBER EC I E OCT 16 2012 DEVELOPMENT SERVICES CTfI. CITY. OF Et,Mo'i IDS CITY COPY 0 SNO110MISII CO. Serving Brier, EdmondsMountlake krrace,and FIREthe Town of Woodway DISTRIVIT www.FireDi.vtrictl.org LOCATION: 7110 210th Street BUSINESS NAME: Edmonds Public Works MAILING 7110 210th St SW ADDRESS: Edmonds BUSINESS OWNER: Facility MaintaCOE EMERGENCY-1: Stevens, Jim KEY ACCESS-2: PERSON CONTACTED: 14,A fZ tom- A\ NAME OF INSPECTOR: Ii�) D V V L ) FIRE AS 6/11 FA 1110 FD LkBx SW 12425 Meridian Ave S Everett, WA 98208 Phone (425) 551-1200 Fax (425) 551-1272 PHONE: 4257710235 90026 HOME PHONE: 4257752525 HOME PHONE: 4257603334 HOME PHONE: FIRE PREVENTION INSPECTION REPORT ❑ EDMONDS ❑BRIER ❑ WOODWAY ❑ MOUNTLAKE TERRACE ❑ UNINCORPORATED FR OUE CY I STATIQ6 & ZHIFT 366 SCHEDULED 07!01I12 DATE DUE ► UFIR ► 509 7207 ACTIVE CURRENT CITY YES NO BUSINESS LICENSE INITIAL INSPECTION DATE 9-2-J- Z6/Z. SYSTEMS: '� ! L � �)'� o �L- ANNUAL HAZARDS FOUND AND LOCATIONS I COMMUNICATIONS 1 1 T v-1I r21 v b i I' P< G II -A 'T U 12-_- - - 3 3 4 - 4. . ? s_.- _ _ .. _ - _ -- — s - i -z- 2- -ram- - - -- - I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X In our continuing effort to promote fire safety and prevention within the community, your fire department conducts regularly scheduled "Fire Safety Survey Inspections" of all businesses and multi -family occupancies in the Cities covered by Snohomish County Fire District 1. You are to be congratulated on the relative good condition of your occupancy in regards to fire safety. Above you will find the item(s) that were noted during our inspection which require attention to bring them into compliance with the minimum standards adopted by the above jurisdictions. Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions or violation. If you require additional information or to schedule a re -inspection for Edmonds or the Town of Woodway, call (425) 775-7720; for Mountlake Terrace or Brier, call (425) 754-0434. BUSINESS COPY Fire Protection Contractors since 1930 �� VIKING AUTOMATIC SPRINKLER COMPANY 3434 First Ave. So., Seattle WA 98134 206.622.4656 WA.: VI-KI-NA-S373NT LEVEL OI 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report Page:1 of 2 REPORT TO : Y) tW () A, 45 IotA ib of I'JOCA O iEAl .t - JOB NO. t4A Z 15 V DATE: -7 A 0 STREET: ITh - I C) ,;LL `i % • �� BLDG. / LOCATION: S(4 % V1$95 CITY / STATE : F O M o Ai 5 W A • '7f 0 7 INSPECTOR: /01 I t i;i it tdl 1.GENERAL a. Is the building occupied ? - - _ - _ - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - . - _ - - b. Is occupancy the same as previous Inspection ?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - C. Are all systems in service ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. Are all fire protection systems the same as last Inspection ?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - e. Is the building completely sprinklered ? _ _ . . . . . . . . I. . . . . . . . . . . . . . . . . . . . . _ f. Are all new additions and building changes properly protected ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - g. Is all stock or storage properly below sprinkler piping ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . h. Was property free of fires since last Inspection ? (Explain any fire on Page 2) - - - - - - - - - - - - - - - - - - - - - - - - I. In areas protected by wet systems, Is building properly heated, Le.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b. Are all other control valves in proper position ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Are all control valves In good condition and sealed ► supervised - - - - - - - - - - - - - - - - - - - - - - - - - - - 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - - 4. TANKS, PUMPS. & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks In good condition and properly maintained ? - - - - - - - _ -i - - free, in tight ?.#_ b. Are Fire Department Connections in satisfactory condition, couplings caps place and check valves 5. WET SYSTEMS (See Section 13) ' a. Are cold weather valves open or closed as necessary ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. ? - - _ - - - - - - - - - - - - - - c."Are alarm valves, water flow Indicators and retard chambers In satisfactory condition ? _ _ _ _ _ . _ . _ . _ _ _ _ _ _ . 6, DRY SYSTEMS (See Section 14) a. Are dry valve(s) In service and in good condition ? _ _ . _ . _ . _ _ . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are pressure and priming water levels normal ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - c. Is air compressor In good condition ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. Were low points drained during fall and winter inspections ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ e. Are Quick- opening devices in service ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . f. Has piping been checked for stoppage within the past ten (10) years ? . . . . . . . . . . . . . . . . . . . . . ;W_ rz. g. Has piping been checked for proper pitch within the past five (5) years ? . . . . . . . . . . . . . . . . . . . . . . . . . h. Have dry valves been trip tested satisfactorily as required ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I. Are dry valves adequately protected from freezing ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ). Are valve house and heater conditions satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - b, Were all heat -responsive systems tested and were the results satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - c. Were supervisory features tested and were the. results satisfactory ? _ - _ - - - - - - - - - - - - - - - - - - - - S. ALARMS a. Is the water motor and gong test satisfactory ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Is the electric alarm test satisfactory ? _ . _ _ . . . . _ _ _ _ _ _ . . . . . . . c. Is the supervisory alarm service test satisfactory ? Monitoring Co. �'��? GTI"yA� I. ph,;�iVU� T��-4i/7.d_Code:T23 -3/5- 9. SPRINKLERS - PIPING a. Are all sprinkler heads In good condition, not obstructed and free from corrosion or loads g ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are all sprinkler heads less than fifty (50) years old ? Head Manufacturer : Ll A4 e-41< 7_X',4 -- Date of head : 1"214/ WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY .r Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY 3434 First Ave. So., Seattle, WA 96134, 206. 622. 4656 WA.: VI-KI-NA-S373NT LEVEL 1// 602 Calilomia Way, Longview, WA 96632, 360. 425. 76M Fire Sprinkler Inspection Report - Page: 2of 2 9. SPRINKLER / PIPING (Continued) YES N.A. NO c. Are extra sprinkler heads readily available ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. is condition of piping, drain valves, check valves, hangers, pressure gauges, open sprinklers, and strainers satifactory ? _ _ _ _ _ - _ _ _ e. Are all sprinklers of proper temperature rating? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I. Are portable fire extinguishers in good condition ?- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - g. Is hand hose on sprinkler systems satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 10. Date Dry System Piping last checked for stoppage. _ 40�'L _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 11. Date Dry System Piping last checked for proper pitch. -U AAl(A,.,0L LAJ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 12. Date Dry Pipe Valve last trip tested. _ _ _ _!!in<� _Itp ?/ _ _ _ - _ - _ - t_ - - _ _ _ - _ _ _ _ _ 13. Wet systems: Number: Make / Model / Year: u I N G !4 e X4 V o 14. Dry Systems: Number: Make / Model / Year: a no ?� 15. Accelerator: Make / Model / Year: 16. Special Systems: Number: -Type: Make / Model / Year: Condition 17. CONTROL VALVES a. City Connection Control Valves - - - b.Tank Control Valves- - 7 - - - - - c. Pump Control Valves- - - - - - - - d. Sectional Control Valves - - - - - - - - e. System Control Valves- - - - - - - - 18. WATER FLOW TEST Number Type Open Yes No Secured Yes No Closed Yes No Sign Yes No Condition 69 6y !� !/ ✓ Ue a. Water Pressure Source : pity, 0Tank, O Fire Pump , Water Flow Test taken ? 7/L, If not, reason: Test Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After 19. Explanation of any "No" answers: 20. Recent changes in building occupancy or fire protection equipment: 21. Adjustments or corrections made: EDI& E M U v y c ooz K 22. Desirable improvements: 71 23. Has building owner / representative been notified of any deficiency -to the fire protection system? ❑ Yes ❑ No, Person notified: If answer is "No",explain: 24. Inspector's Signatures Witness (property owner / lessee) and date: FIRE DEPARTMENT COPY Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY 3434 FitstAve. So., Seattle, WA 96134,206. 622.4656 WA.: VI-KI-NA-S373A&,,L"EL IN 602 California Way, La View, WA 99=, 360. 425. 700 COMPANY- b 171w JOB NO.: L.") 'r, DATE :--2 17& STREET: PROPERTY NAME LOCATION: CITY / STATE INSPECTOR: P414 M-n-4A DRY PIPE VALVE TEST 1. Valve description a. Size b. Make c. Model d. Year of Mfg. 2. Control Sprinklers in. 3. Pressure (Lb) before tests: a. Air b. Water 4. Control V61ve a. Wide open b�-No,(No.of turns to open) 5. Operated at: a. Air pressure (Lb) b. Time (Min.,Sec.) 6. Operation Indicated: a., Satisfactory b. Partially satisfactory c. Failed 7. Reason for: w. faiture b.-partially satisfactory -8.- Valve reset dry? (yes/no) 9. Condition: a. Interior of body b. Water for test pipe c. Moving parts d. Seats e. Rubber facing 1.0.Alarms operated? (yes/no) 11. Inspector's Test trip time (Sec.) 12.Quick Opening Devices: a. Make b. Model c. Year 13.Operation Indictated: a. Satisfactory b. Failed to shut off 14. List of repairs made: DRY PIPE VALVES No.1 No.2 No.3 si I Wei G AAIP QUICK OPENING DEVICES AM Signature Title of person performing test Witness (owner lessee of property) and date signed. APPLICATION FOR PERMIT FOR MATERIALS OR PROCESSES January 3, 2012 Please verify and correct the following information: Name of Company (DBA): COE Edmonds Public Works Edmonds Location : 7110 210th Street SW In conformity with the terms of the International Fire Code, application is Storage and use of Class I, II, and III hereby made to store, use flammable/combustible liquids and hazardous or maintain the following materials. activity, storage or pro- cesses: c/o City Of Edmonds Mailing Address: Director of Public Works Edmonds, WA 98026 EFD UFIR #: (for office use) 59100007Z207 Your Signature Your Name (print) Your Title _ Please make corrections, attach $40 payable to the City of Edmonds and mail to: Fire Marshal Department of Fire Prevention 121-5th Avenue North Edmonds, WA 98020 FOR OFFICE USE ONLY Rec'd Check# CITY OF EDMONDS DEPARTMENT OF FIRE PREVENTION PERMIT -w K�- January 1, 2011 591-000-07Z-207 December 31, 2011 Date of Issue UFIR Number Date of Expiration This PERMIT is issued to: I COE Edmonds Public Works located at: 17110 210th Street SW I Edmonds, WA To engage in the business, occupation or process of: And shall constitute permission to maintain, store, use or handle materials or to conduct process which produce conditions hazardous to life or property or to install equipment used in connection with such activities as follows: Storage and use of Class I, II, and III flammable/combustible liquids and hazardous materials. Allowed Occupant Load: I -- Pursuant to the provisions of the International Fire Code, any violation of the Code may be grounds for the revocation of this PERMIT. This permit does not take the place of any license required by law and is not transferable. Any change in the use or occupancy of premises shall require a new permit. This Permit Must Be Posted At All Times in The Premises Identified Above City of Edmonds Community Development Code 19.25.020 �"t� �Y'r i�-y Y"".. '-: a.a.arv� ..:''"}.,,. ... i e^ `Iw✓u✓s�s-ai^•.f `..MMtiPr-�•,.k,-,� „vim"•'-'..� ..}.:... _; 1 :•1�[,: na-n�^ - _ t e. y,..- c-.^3Yr v'+/`J ,-. r r� ..-,M.,ar�.t`-, ,.r,;a •r .�Z"'•,�..ii•ry �..� ...ro�r<�-v� � ro'l'`..t� ;r .jc`L_Y+',ti..+w✓�+Y,...�W -: +� `,,,Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER COMPANY. 3434 First Ave. So., Seattle, WA 98134, 206.622.4656 WA.: VI-KI-NA-S373NT LEVEL III 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report Page: 1 of 2 REPORT TO: " JJ7W-4 pt, �J J C-. L.t..l�//r7 S G� r F /!� L JOB NO. !.1 I `y -r Z DATE: t10 _ 41 / ! STREET: 1 IU 21& J/ i''.t i JL►+i i° BLDG. / LOCATION �bdd CITY / STATE : ; 6M 6'La.+' INSPECTOR: 1.GENERAL a. Is the building occupied ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - _ - - - - b. Is occupancy the some as previous inspection ?_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . . . . . . . . . _ _ _ _ c. Are all systems in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Are all fire protection systems the same as last Inspection ?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . e. Is the building completely sprinklered ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ f. Are all new additions and building changes properly protected ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - g. Is all stock or storage properly below sprinkler piping ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - h. Was property free of fires since last Inspection ? (Explain any fire on Page 2) . . . . . . . _ . . . . . . . . . . . . . . 1. In areas protected by wet systems, Is building properly heated, i.e.: blind attics, perimeter areas, and are all exterior openings protected against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ? - - - - - - - - - - - - - - - - - - - - - ... - - - - - - - - b. Are all other control valves in proper position ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... c. Are all control valves in good condition and sealed or supervised ? . . . _ . . . . . . . . . . . . . . . . . . . . . . 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoirs and pressure tanks In good condition and properly maintained ? . . . . . . . . . . . . . . b. Are Fire Department Connections in satisfactory condition, couplings free, caps in place and check valves tight ?- - - _ - - - . - - - - 5. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . b. Have antifreeze systems been tested and left in satisfactory condition ? Temp. ? _ . . . . _ _ _ _ . . _ _ . . . c. Are alarm valves, water flow Indicators and retard chambers In satisfactory condition ? - - - - - - - - - - - - - - - - - - - - 6, DRY SYSTEMS (See Section 14) a. Are dry valve(s) in service and in good condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - b. Are pressure and priming water levels normal ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . c. Is air compressor In good condition ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . d. Were low points drained during fall and winter inspections ? - - - - - - - - - - - - - - - - - - - - _ - - _ _ _ _ _ _ _ e. Are Quick- opening devices in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ f. Has piping been checked for stoppage within the past ten (10) years ? . . . . . . . . . . . . . . . . . . . . . . . . . . g. Has piping been checked for proper pitch within the past five (5) years ? - - - - - - - - - - - - - - . - . - - - - . - - _ _ h. Have dry valves been trip tested satisfactorily as required ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Are dry valves adequately protected from freezing ? - - - - - - - - - - - - - - - - - - - - - - - _ _ _ _ _ _ _ ). Are valve house and heater conditions satisfactory ? - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b• Were all heat -responsive systems tested and were the results satisfactory ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . _ _ . c. Were supervisory features tested and were the results satisfactory ? . . . . . . . . . . . . . . . . . . . . _ . . . 8. ALARMS a. Is the water motor and gong test satisfactory ?- - - - - _ - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Is the electric alarm test satisfactory ? . - - - _ - -_ c. Is the supervisory alarm service test satisfactory ? Monitoring Co. p0ii�lt f i a . ors Ph: 9" �! Code 9. SPRINKLERS - PIPING a. Are all sprinkler heads in good condition, not obstructed and free from corrosion or/loading ? _ - - - - - - _ _ - _ b. Are all sprinkler heads less than fifty (50) years old? Head Manufacturer : V ! Date of head WHITE: VIKING COPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY r � ..� � U•� !^` l�='#mow Fire Protection Contractors since 1930 VIKING AUTOMATIC SPRINKLER' COM 71. 3434 Riat Ate Sa, , Seeft WA 98134, 206. 622. 4656 WA.: WKML4.S373NT LEVEL ddd602QeMMI19 Nay, Longview WA 96632, 3 SO.425.7620 Fire Sprinkler Inspection Report Page: 2of 2 9. SPRINKLER / PIPING (Continued)' ,. YES N.A. NO c. Are extra sprinkler heads readily available ? . . . . . . . . . . . . . . . . . . . . _ . . . . . . . . %X d. Is condition of piping, drain valves, check valves, hangers, pressure gauges, open sprinklers, and strainers satllaciory ? . . . . . . . . . .X e. Are all sprinklers of proper temperature rating? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ . . . I. Are portable fire extinguishers In good condition ?_ - - _ - - - _ _ _ . . . . . - . . . . . . . . . . . . . . it g. Is hand hose on sprinkler systems satisfactory ? . . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . /✓ %/�� 10. Date Dry System Piping last checked for stoppage. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ! Y: 11: Date Dry System Piping last checked for proper pitch. . . . _ . ... . . . . . . . . . . . . . . . . . . . .! 12. Date Dry Pipe Valve last trip tested.. . . . . . . . _ / . . . _ ` - - . - - - _ . . . - 13. Wet systems: Number. 1 Make! Model / Year. r r J/ �LLd 1 °'� 14. Dry Systems: Number: Make / Modal / Year 15. Accelerator:. Make / Model / Year: 16. Special Systems: Number: Type: Make / Model / Year: Condition: m CONTROL VALVES a. City Connection Control Valves . . _ . - b.Tank Control Valves. . . . . . . - c. Pump Control Valves- - - - - - - - d. Sectional Control Valves - - - - - - - e. System Control Valves. - . . . . _ - Number Type Ysa Open Yes fed Cloasds No Yes Sign No Condition 12 Il Pam" x X ?� ,, X CJ 18. WATER FLOW TEST a. Water Pressure Source :O City, 0 Tank, 0 Fire Pump, Water Flow Teet taken ?0.1 If not, reason: Test Pipe Location Size Test Pipe Pressure Before Flow Pressure Pressure After T /'P/ A� T 19. Explanation of any "No" answers: 20. Recent changes In building occupancy or fire protection equipment: 21. Adjustments or corrections made: 22. Desirable Improvements: d it-IU/ YV O IJAS L'+ Gjo&f &Ar,/JI L P%Vdf 6n 1546 WL 6.0q '111-4 / _ Z.G6N►d1 r.G. of 23. Has building owner / representative been notified of any deficiency to the fire protection system? 0 Yes ❑ No, Person notified: If answer is "No",explain: 24. Inspector's Signature: Witness (property owner / lessee) and date: WHITE: VIKING OPY YELLOW: INVOICE COPY PINK: FIRE DEPARTMENT COPY GOLD: BUILDING COPY I CITY OF EDMONDS 121 5'4'AVENUE N. • EDMONDS, WASHINGTON 98020 (425) 771-0215 FIRE DEPARTMENT �St. 189� LOCATION: 7110 210th Street SAY BUSINESS NAME: Edmonds Public Works MAILING Ir 7110 210th St SW FIRE PREVENTION SAFETY SURVEY PHONE: 4257710235 ADDRESS: Edmonds 98026 BUSINESS OWNER: Facility MaintJCO E HOME PHONE: 4257752525 ACTIVE EMERGENCY-1: 5 7 s HOME PHONE: 286V2 �� V.1° - 3 6,14 KEY ACCESS-2: HOME PHONE: r FREQUENCY STATION 1£ SHIFT 366 16 A I SCHDATEEDUEE ► 07/01/10 UFIR ► 509 7207 PERSON CONTACTED: C 1�7L INITIAL INSP CTION DATE NAME OF INSPECTOR: �/( v FIRE AS 6f10 FA 1108 FD LkBx FE SYSTEMS: ANNUAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS ENTER CODE ONLY ONCE ► VIOLATION CODE 2 L G % �% T e LT Al 1� G2 5'i�j(� .�� T ?i 2 3 S�iL 1^- 3 4 / _ 4 5 5 6 6 7 7 8 8 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: 1 EXTENSION GRANTED TO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: \i PERSON CONTACTED: PERSON CONTACTED: 1 INSPECTOR: Uyy6 INSPECTOR: INSPECTOR: 2 DATE: r-? C/ DATE: DATE: 3 VIOLATIONS 1 VlL 5 VIOLATIONS 1 5 PRE -CITATION LETTER SENT CITATION ISSUED NUMBER: 4 r 2\R/ 6 2 6 DATE: CODE SECTION: 5 3 7 3 7 RETURN RECEIPT RECEIVED 6 7 4 O 8 4 8 DATE: DISPOSITION: g LETTER NEEDED ❑ YES ❑ NO LETTER NEEDED ❑ YES ❑ NO FIRE DEPARTMENT COPY APPLICATION FOR PERMIT FOR MATERIALS OR PROCESSES November 20, 2009 Please verify and correct the following information: Name of Company; DBA COE Edmonds Public Works Edmonds Location 7110 210th Street In conformity with the terms of Storage and use of Class I, II, and III flammable/combustible the International Fire Code, liquids and hazardous materials. application is hereby made to store, use or maintain the following activity, storage or processes: Mailing Address: City Of Edmonds Director of Public Works Edmonds WA 98026 EFD UFIR #: 59100007Z207 (for office use) Your Signature Your Name (print) owl F �1; III✓ Your Title Di"cFor Please make corrections, , and mail to: Fire Marshal City of Edmonds 121-5th Avenue North Edmonds, WA 98020 n "-•T'"r^r'!"S` y i'a�Va, .r'? r.: ':r"*.^—.s,. •1` 1 n . 1 �> KIN& Fire Protection Contractors since 1.430 VIKING AUTOMATIC SPRINKLER COMPANY 3434 First Ave. So., Seattle, WA 98i34, 206.622.4656 WA: i- Kl-niA-s3r3wr LEVEL 111 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report. Page:1 of 2 REPORTTO: !t ,l( Ythk, O&IX i (TG`/1.��'1t— J09.NO. GIJStOz b1y1I/R DArE: 7-10 STREET: 7/hQ 5'/ w BLDG. / LOCATION CITY / STATE : O INSPECTOR : e; 1. GENERAL a. Is the building occupied ? . . . . . .. . . . _ . _ _ . . _ . ... - - - - - - - - - - b. Is occupancy the:some as previous Inspection ?. _ _ _ - - - - - - - - - - - - - - - - - - - - - - c. Are all systems In service ? . . . . . . . . . . . . . . _ ... _ . . . _ . . . _ _ . _ _ _ _ _ _ . . d. Are all fire protection systems the same as last Inspection ?_ . . . . _ - . _ _ _ _ _ _ - _ _ _ _ . _. _ _ . e. Is the building completely sprinklered 7 _ . _ _ _ - - - - _ - - _ I. Are all new additions and building changes properly protected ?. _. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Is all stock.or storage properly below sprinkler piping? - - _ _ . _ - _ - _ - - _ - .. _ _ _ _ _ _ _ _ - _ - h. Was property iree.of Brea since last inspection ? (Explain any fire an Page 2) . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I. In areas protected by wet systems, Is building property heated, Le.: blind attics, perimeter areas, and are all exterior openings protected against the cold ?. 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ? . _ _ . . . _ _ _ _ _ _ _ _ _ _ w _ - _ _ _ _ _ ,. b. Are all other control valves In proper position ? _. . . . . . . . . . . . . . . . . . . . _ - _ - - - - _ _ - _ c. Are all control valves In good condition and sealed or supervised ? . . _ _ . _ ._ . . . _ . . . . _ _ . _ . _ . _ . 3. WATER SUPPLIES (See Section 18j a. Was a water Row test,preformed and were the results satisfactory ? . . . . . . _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4. TANKS, PUMPS, & FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks,,resevolre,and pressure.tanks to good condition and properly maintained ?.- b. Are Fire Department Connections In satisfactory conditian; couplings free, caps In place and check valves tight ?_ _ _ _ _ . _ . ... S. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? _ _ _ _ _ . _ - _ _ - _ - _ _ - - _ - _ - _ - - b: Have antifreeze systems been tested and left In satisfactory condition'? Temp. ? c. Are alarm valves, Water flow indicators and retard chambers In satisfactory condition ? _ _ _ - _ - - - - . _ _ _ - - 5. DRY SYSTEMS (See Section 14) a. Are dry valve(s) In service and In good condition? - - - - - - - - - - - - - - - - - - - - - - _ ... _ _ . b. Are pressure and priming water levels normal ? . c. Is air compressor In good condition? _ - - .. _ - - _ - _ - - - _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Were low points drained during fail and w.Intei Inspections-? - - _ - - _ _ _ - _ _ - _ _ - - _ _ - - e. Are Quick- opening devices in service ? _ _ _ _ _ _ _ _ _ _ _ _ _ - - _ - - _ f. Has piping been checked for stoppage within the past ten (10) years ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Has piping been checked Tor proper pitch within :the past five (5) years 7 . , - - - . _ , - _ _ _ - - _ _ _ _ _ _ - _ h. Have dry valves been trip tested satisfactorily as required ? _ _, , _ _ _ . . - _ - - _ _ - - - - _ _ _ _ - _ _ 1. Are dry valves adequately protected from freezing ? _ _ . _ . . . . . . . . . . . . . . . . . . . . . . . . . . . 1. Are valve house and heater conditions satisfactory ? .. . _ . . . . . . _ _ _ . _ _ . . . . _ _ _ . 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? . . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b, Were all heat -responsive aystems ,tested and were the, results satisfactory ? _ - - - - - - - _ _ _ _ _ . _ _ . . . . c., Were supervisory features tested and were the results satisfactory ? _ _ _ _ _ _ _ _ , _ _ _ _ _ _ _ B. ALARMS a. Is the water motor and gong tesLoatisfactory ?_ _ . . . _ - - - - - - - - - - - - - b. Is the electric alarm test satisfactory ? - - - - - - _ _ _ _. _ _. _ _ _ _ _ _ _ _ _ _ _ _ _ _ c, la the supervisory alarm servico test_satisfactory? Monitoring Co. P/o �� /i s.-• a �_ ph :'90 — ?7Ft^ 9/7G Cade: <27— 9. SPRINKLERS - PIPING a. Are all sprinkler heads in good condition, not obstructed and tree. from corroslon or loadip ? _ _ - - - - _ _ _ _ - - - - - _ b. Are,all.spdnkler heads less than fifty (50),years old? Head Manufacturer : 0 / i t" Date of head - .._.�... ....___�. ..._.. r.. _.w..����w• www•_w�rw-rw •A/.M. n/V .a MafV.M M'MwI 77 Fire Protection Contractors since 1930 s•• VilUNG AUTOMA C SPRINKLER COMPANY 3434 FhstAw- So., Seaft WA 98134, 206. 622. 4656 WA.: VFKI-NAS373fVr LEVEL)1111 602 Cat kmis Bey, Lwgykig WA SM2, 36O. 425. MO Fire Sprinkler. Inspection Report Page:.2of 2 9. SPRINKLER / PIPING,(Cootinued) YES N_.A- NO a Are'extra sprinkler fieada.readlly.'evallable r , a ia' eluo� ot. i l�' :also;.valves, ei�ecls vetvoa; i nl r6 uro euges; opel'sprinlilh►e;,and strainers aatHactory? L` ' �✓: _�'�. /�_� jG - e. Are ell sprinkler¢ of proper temperature rating?.` - i _ _ - - ` - _ f. Ace"portable fire exllnj"iiirs,In good'coridltlon 7:''- - - - - - - - - - - - - - - - _ _ _ _ _ _ _ _ _ _ _ _ _ - - ' jC g:'Is hand hose on sprinkler systems satisfactory 4 - - - - - - - - - - - - - - - - - - - - - - - - - - - - . .. 1 10. Date Dry System PtpIhg last checked for stoppage- - - - - - - - - - - - - - - - - - - - - - - - - - - L1Yw . �95v 11. Date Dry System Piping last checked for proper pitch. - - - - - - - - - - - - - - - - - - - - - - - - - - - - /-N-rt,) . l4 fo 12. Date Dry Pipe Valve last tri tested- - - - - - - - _ L _ - _ f _ - _ _ - - - _ _ 41-y-10 13. Wet systems: Number: Make I Model / Year., r n r o %r/D 1�U 14. DrySystems: Number: Make/Model/Year: 21' D - 5 15. Accelerator. Make / Model / Year. 16. Speelal Syatems:..- Number: . __ TYPe ... _ ..— v .- . - • - ... - Make / Model / Year: Condition: 17. CONTROL VALVES a. City Connection Control Valves - - - - b.Tank Control Valves. - - - - - - Number Type Open Yes No Secured Yea o Closed Slgn Yes No Condition b 5/ o� .� lJ Pl- c. Pump Control Valves- - - - - - I d. Sectional Control Valves- - - - - - - - e. System Control Valves- - - - - - - - ;j 14 WATEit MOW JEST Water PressureSource gCity,: OTank, l7 Flre Pump Water.Flow Teat taken•? 'zCLL if not, lesson: - t. - - - , .';Test PIpe:Locatlon ' :Size Test Pressure Before '. Flow Pressure ''" Pressure After,.•`: 1f / A /s�i �" g� a �a 10. Explanation of any -"No" answers: 20. Recent changes In building occupancy or fire protection equipment: 21. Adjustments or corrections made: FCnl ALii " G✓t T n/; tl.� y 5�1r�! r4 ;22: Dealrable'jiri.polram,@ate_: �s 7"ti 1 23. Has building owner / representative been notified of any deficiency to the fire protection system? OYes O No, Person notified: If answer Is "No",explain: 24. Inspector's Signature: L 1 5� Witness (property owner / lessee) and date: wurrc. %JW*J s raw VM 1 r". "~.r raw p w- mar rv:mRTmrmT (YV,V rin n• RI a mr; rr vv a iG. VIKING AUTOMATIC. SPRINKLER COMPANY Fire Protection 3434 First. Avenue South 602 California Way Suite #1 Since 1930 Seattle, WA 98134 Longview, WA 98632 (206) 6224656 (360) 426-7620 FOREMAN'S REPORT WEEK ENDING:' &�- / -7 -/0 (Sundays Dam( Employee Name: Mon Tue Wed Thur Fri 'Sat. Date 2 Vz Job Name:. Job Address: Building Area: Foreman's S VIKING JOB #: 4J (prlrt name - one prawn Parking $ Fe $ Travel Expense ( Miles) # Subsistence (Days) # Miscellaneous Expense $ Customer POtk Hours on Job: Travel Time: Provide a brief description of work or services performediQ/,,,,i,•i� /,�,�`y,-,,,a• T� ! . Z" <r.' i Comment on status of the job (future work'to be completed, parts needed, desirable improvements): /1/, �/,,�/ Is job complete? Yes No ( ) Was sprinkler system shut-off by others? Yes ( ) No (X) Was sprinkler system restored by Viking? Valve Seal Yes {,,j- No ( ) Are all shut-off valves open? Yes (,<) No ( ) Is system to be restored by others? If yes, by whom Yes ( ) No (� is system connected to central signal service? Yes ) No ( ) If yes, Monitor'.Co: U Lx, ci Monitor Phone # and Code: UGv vu� Viking Employee Report of Safety (must be completed) Work area inspected for,safety prior to starting work 'Yes 1-1 No [ ] # of Viking Employee's on Job: \ Number of Viking Employee's in. attendance: I Issues Found: GJ 1,41 k-, Al" %J,{ C_ Suggestions Offered: AUTHORIZATION TO -PERFORM WORK AND ACKNOWLEDGEMENT OF SERVICE r Signature of Owner or Representative: h .� NAG— -�� Date: / C / O Print Name and Tide: rev 12-08 White - V17ang Copy Pink - Safety (rerum to oflfce) Yellow- Customer Copy Page 1 Page 2 Page 3 VIKING AUTOMATIC SPRINKLER. COMPANY FIRE. PROTECTION CONTRACTORS SINCE 1930 3245 N.W. invoice -- . .,:FRONT AVENUE, PORTLAN Q, OREGON 97210 CITY OF EDMONDS 7110 21 OTH ST SW EDMONDS, `WA 98206 2.1 Invoke:m 40590 Jnvoke Date: Customer Contract: WS10417 EDMONDS FRANCIS ANPERSOM4 EDMONDS FRANCIS ANDERSON Ifikina6momerO 1.b1B Charges, Through: 6113/2010 ANNUAL TEST AND INSPECTION OFAUTOA4ATICFIRE SPRINKLER SYSTEM. COPY OF INSPECTION REPORT ENCLOSED. INSPECTION FEE MATERIAL FIELIXILA.1136IR 699 FOREMAN BARGE Sub -Total SALES TAX. Cbrr6nt Due: 66.00 45.20 45.20, - 295,00 295.00. 390.20 300.26 '37.07 'VIE, ACCEPT VISA Nilfste4drid TERMS. NET 30 DAY_ , llnte.rest.of 1 % permonth (Annual Rate of 12%) will. be -charged on al . l,past due accounts: To pay by Visa/ Mastercard4all (503).227-1171 Total MATERIAL 2.50 HRS @ 118.00, Total FIELD LABOR invoice Sub -Total 306J0 @, 0.,6606i/. r Fire Protection Contractors since 1990 VIKING AUTOMATIC SPRINKLER COMPANY 3434 First Ave. So., Seattle, WA 98134, 206.622.4656 WA: vl « /-NA-W73fur LEVE M 602 California Way, Longview, WA 98632, 360.425.7620 Fire Sprinkler Inspection Report Page! 1 of 2 REPORTTO: f1111 4 P.A/r't_ �i),'/`f < JOB NO. (J5-rO y/S� WE: STREET: 7I /D 711) f 1- 52. <Z BLDG. / LOCATION : D FF CITY / STATE : fi//i31/i.�/� G � Oj�)%[5 INSPECTOR :7-1l-,-:) I.GENERAL a. Is the building occupied ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ , _ - _ - _ _ _ _ _ _ _ _ _ _ _ _ - b. Is occupancy the some as previous Inspection ?- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c, Are all systems In service ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Are all fire protection systems the same as last Inspection 7. . . _ _ _ _ _ - _ , _ _ _ _ _ _ _ _ _ _ _ _ _ _ e. Is the building completely sprinklered 7. . . . _ _ . . . . 6- _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - - I. Are all new additions and building changes properly protected ? _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ g. Is all stock or storage properly below sprinkler piping ? _ _ _ _ _ _ _ _ _ _ _ _ - _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ h. Was property tree of fires since last Inspection ? (Explain any fire on Page 2) _ , _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 1. In areas protected by wet systems, is building properly heated. I e_: blind allics, perimeter areas, and are off exterior openings protracted against the cold ? 2. CONTROL VALVES (See Section 17) a. Are all sprinkler system main control valves open ? _ - _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are all other control valves in proper position ? _ _ _ _ _ - - _ _ _ _ - _ - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Are all control valves In good condition and sealed or supervised ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 3. WATER SUPPLIES (See Section 18) a. Was a water flow test preformed and were the results satisfactory? . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 4. TANKS, PUMPS. If FIRE DEPARTMENT CONNECTIONS a. Are fire pumps, gravity tanks, resevoira and pressure tanks In good condition and properly maintained Z _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are Fire Department Connections In satisfactory condition, couplings free, caps in place and check valves tight S. WET SYSTEMS (See Section 13) a. Are cold weather valves open or closed as necessary ? _ _ _ _ - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Have antifreeze systems been tested and left in satisfactory condlUon ? Temp. ? - _ - _ _ _ - _ - _ _ . _ _ _ _ _ - c. Are alarm valves, water flow Indicators and retard chambers in satisfactory condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ 8, DRY SYSTEMS (See Section 14) a. Are dry valve(s) In service and in good condition ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are pressure and priming water levels normal ? _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. Is air compressor in good condition ? - _ _ _ _ - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ d. Were low points drained during fall and winter Inspections ? _ _ _ _ _ _ - _ _ _ - _ _ _ _ _ _ _ _ _ _ _ _ _ .e, Are dulck- opening devices in service ? - - - - - - - - - - - - -. _ _ _ _ _ _ _ _ . . . _ _ _ _ _ _ _ _ _ I. Has piping been checked for stoppage within the past ten (10) years ?. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ / ! -r Uj g..Has piping been checked for proper pitch within the past five (5) years ? _ _ _ _ _ _ _ _ _ _ _ _ _ �� �✓_ _ �yy? _ h. Have dry valves been trip tested satisfactorily as required ? _ _ _ _ _ _ _ ,_ - - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ I. Are dry valves adequately protected from freezing ? _ . _ . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ i. Are valve house and heater conditions satisfactory ? . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . 7. SPECIAL SYSTEMS (See Section 16) a. Were valves tested as required ? - _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ - _ _ _ - _ - _ - _ _ - b, Were all heat -responsive systems tested and were the results satisfactory ? _ _ _ _ ._ - _ _ - - _ _ _ _ _ - _ _ _ _ c. Were supervisory features tested and were the results satisfactoryT,, 8. ALARMS a. la the water motor and gong test satisfactory ?_ _ _ . _ _ _ _. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ b. Is the electric alarm test satisfactory ? _ - _ - _ - . _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ c. is the supervisory alarm service test satisfactory ? Man].toring Co. Pkr �i ��ii �. �c Pn R/10— 7?St - 9/Iti Ada; 527 T/C 9. SPRINKLERS - PIPING a. Are all sprinkler heads In good condition, not obstructed and free from corrosion or loading ? _ _ _ _ _ _ _ _ _ _ _ _ _ b. Are all sprinkler heads less.than fifty (50) years old ? Head Manufacturer: V / A / / ' Date of head.: Fire Protection Contractors since:.1930'''' KIN; AUTOMATIC .S0Ft1NkI_ER C01"N'Y" .3434 FhW Ai&k So., SMU4 WA 98134,206.. 622. 4656 I&A.: VHa-NAS373NT LEVEL Iff 6021ChftvidWw.LofWv*%%WA M. M. 76d17 "Fire Sprinkler Inspection Report -Page: 2of 2 b, . SPRINKLER I PIPING (Continued) YES N.A. NO c. Ar•ditiu'sprinithir heads readily A_li condition at plping,&a!6.iafves, dp p",jamf strainers r nklem:of,p 6fii6n, Iri im , portable v�od con Tr. pt g. Is hand. h6se on sprinkler systems satisfactory ? - - - - - - - - - - Date Dry System Piping last chocked for stoppage.' . . . . . . . . . . It. Date Dry System Piping Wet chocked for . or proper pitch. . . . . . . . . . . . . . . . 12. Data Dry. Pipe Valve last trip tested..- - - - - - - - - - - - - - - - - - - -- - - - - - - rl- 4 13. Wet systems, Number.. Me / Model /Year y/!;4-- .14. Dry Systems: Number:. 'Make jModel jYear . QdTi,, 71,7,o 15. Accelerator. Make I Model / Year - 16. Special Systems: Number: Type: ;altlon:�w�� 17. CONTROL VALVES a. City Connection Control Valves - b.Tank Control Valves- - . . . . . . . c.pump Control Valves- - -- - - - - - - A. Sectional Control Valves - - - - i.Syltem Control Valves- = - - - - - - IMMMMMM MIND"NAM I _4 1lL..:WATER FLOW TEST Walgr1 reS6urEg:XC!y,37ank Pump F4w.7eitik'en ? r t'not.,reason: ' Test Pipe' 6o Aon 'Plo Test .Pipe phiisu'r-e* Beford- Flow .Proasun3. 7 9 10- Explana . tlon,of any "No" answers: 20. Recent changes In buildirig accupanaj or fi!e.pr6tectldn equipment: 21. AdjUstmdnts or ci)rrectlon,d made-.-' J�;Je < U. - Di 'Im q ProjemArq! q 23.. Has building owner I representative been notified of any deficiency to the fire Protection systemTO Yes ONo.Personnotified: It answer Is "No'%expl.ain: ij 24. Inspector's Signature: Witness (property owner! lessee) and date: Mbli Pt%av vC, 4 rum. DA~= Pruw 9)Wlet MCC rWM9rMWW rrWY r4v n. Pi ri rimr rrwy t�. VIKING AUTOMATIC SPRINKLER COMPANY Fire Protection 3434 First Avenue South 602 California Way Suite #1 Since 1930 Seattle, WA 98134 • : Longview, WA 98632 (206) 622-4656 (360) 425-7620 FOREMAN'S REPORT WEEK ENDING: G-I - 16) VIKING JOB #., G J 5-2-6 y/1 (Sundays Date) Employee Name: / (print name ;mm person per time slip) Mon Tue Wed Thur Fri Sat Sun Date Reg OT DT Shift Job, Name: Job Address: Building Area: ' Pull;, 00,X s 7/ /U Z/O / "- S/. 5' c J Fore rian's Parking $ Fe $ Travel Expense (Miles)' # Subsistence (Days) # Miscellaneous Expense $ Customer PO#: Hours on Job: Travel Time: Provide a brief description of work or service performed: m/�NHi-G% ��� Fd�•-,w �•< 1 t 2vrSp. O� / l0� 7-i & � 4-Plttr t, be desirable improvements):. Nr flps Com ent on status of the job ((pture'work to completed, pails needed, v//d 4-;7 C,,/A n1ell. axIye_ z" FOL Is job complete? Yes (t) No ( ) Was'sprinkler:system shut-off. by others? �. Yes () No (,x) Was sprinkler system restored by Viking? Valve Seal # TG y--.5w, �e L< Yes No ( ) Are all shut-off valves open? Yes) No ( ) Is system to be restored by others? If yes, by whom Yes ( ) No-(e ) Is system connected to central signal service? Yes (X} No ( ) If yes, Monitor Co: O L� lGZ Monitor Phone # and Code: 040J,"i Viking Employee Report of Safety (must be compieted) Work area inspected for safety prior to startingl work Yeses) No (j # of Viking Employee's on Job: / Number of Viking Employee's in attendance: 1 Issues Found: Suggestions, Offered: AUTHORIZATION TO PERFORM WORK` AND ACKNOWLEDGEMENT OF SERVICE Signature of Owner or Representative:._ �ir�' Date: /U f Print Name and Title: rev 12-08 While - Viking Copy Pink - Safety (retum to office) Yellow- Customer Copy Page 1 Page 2 Page 3 ` i -77 APPLICATION ROUTING FORM FILE: ADB-2000-60 AND CHECKLIST FROM: PLANNING ROUTED TO:RETURNED Engineering 5/22/00 'Pi re 5T/y2@'/j001A Public Works 5/22/00 Parks & Rec. 5/22/00 Engineering_ Fire Public Works Parks & Rec. Staff Comments: 'P`-'6✓'166 R�� Ftk-& 6-*K1'1•jr-,isH�'-:::2' *PER WHAT SECTION OF THE CODE? vie 1007Z *COMMENTS WITHOUT CITATIONS WILL NOT BE CONSIDERED *Additional Information Required for Complete Application *Additional Studies Required to Complete Review, • Owner Citv of Edmonds Public Works • Property Address 7110 21011 St. SW • Date of Application 5/18/00 • Type Construct outdoor, equipment building and canopy • Meeting Required: Yes X No Date of Meeting • Planning Contact Steve Bullock X Application Fee APO List Critical Areas Determination Vicinity Map Colored Renderings Elevations Petition (Official Street Map) Site Plan for Short Subdivision (8.5 x 11) X Site Plan Legals (Existing & Proposed) Environmental Assessment Title Report Proof of 6-month Occupancy (ADU) Declarations (Variance) SEPA Checklist MATERIAL SAFETY DATA SHEET 9I Q 'f- 4 '�?- C FFECTIVE NNE 2001 Suburban Propane, L.P. P.O. Box 206 Whippany, NJ 07981-0206 TRANSPORTATION EMERGENCY GENERAL ADDITIONAL INFORMATION: RESPONSE: CHEMTREC (800) 424-9300 SAFETY SERVICES (973) 887-5300 I SECTION 1- PRODUCT IDENTIFICATION Product Name: Commercial Odorized Propane Chemical Name: Propane Chemical Family: Petroleum Hydrocarbon Common Names: Liquefied Petroleum Gas, LP -Gas, LPG, Bottle Gas I SECTION 2 - PHYSICAL AND CHEMICAL CHARACTERISTICS I BOILING POINT: - 44° F FLASH POINT: -156° F BULK DENSITY: 4.20 lbs. /gal. SPECIFIC GRAVITY: LIQUID: 0.504 VAPOR: 1.50 - GAS VOLUME @ ATM. PRESSURE & 60° F (Cu. Ft. gas/gal. Liquid): 36.38 VAPOR PRESSURE: 208 prig @ 100° F (ASTM) SPECIFIC HEAT of LIQUID: .630 BTU/LB. & 60° F FLAMMABILITY LIMITS (% BY VOLUME IN AIR): L.E.L.: 2.1 U.E.L.: 9.5 EXPANSION RATIO OF LIQUID TO GAS @ 14.7psia : 1 to 270 LIQUID BOIL -OFF TO PROPANE VAPOR ABOVE - 44 F°: 100% COMPONENTS PROPANE PROPYLENE BUTANES SULPHUR RESIDUAL MATTER ODORANT(S) CAS NO. * * 2.5 % 185 ppmw with no discoloration of Lead Acetate paper** 0.05 ml after boil off of 100 ml liquid sample ** Odor concentration detectable in air of not over one -fifth of the lower limit of flammability per NFPA 58. CORROSIVES Not to exceed #1 grade copper strip test** PROPANE IS COLORLESS AND ODORLESS. PROPANE IS VERY STABLE. POLYMERIZATION WILL NOT OCCUR. AN ADDED ODORANT GIVES PROPANE A STRONG UNPLEASANT SMELL. Information regarding the effectiveness or intensity of odorants, is set forth in Section 3 below. 74-98-6 115-07-1 106-97-8 7704-34-9 Various * Combined constituents comprise a minimum 97.45 % of the total weight under Gas Processors Association (GPA) Standard 2140-97 ** Based on American Society of Testing and Materials (ASTM) Standard D1835-91, NFPA CLASSES: 4 - Severe 3 - Serious 2 - Moderate 1- Slight 0 - Minimal SECTION 3 - PHYSICAL HAZARD DATA Health Hazard Fire Hazard 4 Reactivity PROPANE IS FLAMMABLE. PROPANE IS A SIMPLE ASPHYXIANT. Flammable Gas under pressure - Keep away from sources of ignition such as heat, sparks or flame. Vapor is heavier than air and may collect in low-lying areas. ITEM NO. 1519278 SAF 5152 The intercity of odorants may fade over time due to chemical oxidation (in the presence of rust, air or moisture), adsorption or absorption. Underground leaks passing through certain soils may reduce odorant level. If odorant level appears weak, notify propane supplier at once. The ability of people to detect odors can vary greatly. Individuals with nasal perception problems may have a reduced sensitivity to odorants. This condition can be initiated or aggravated by the use of alcohol, tobacco or drugs. These odorants may not impart the warning of the presence of propane in every instance. - SECTION 4 — HEALTH HAZARD DATA I Propane is a simple asphyxiant and care must be taken to provide adequate ventilation. Vapors can displace available oxygen for breathing in confined spaces. Odor may not provide adequate warning of potentially hazardous concentrations. Propane is heavier than air and may collect in low-lying areas in the absence of wind or ventilation. Liquid propane can cause freeze burns when brought into direct contact with body parts. SECTION 5 — PRIMARY ROUTES OF ENTRY I Eye: Although propane vapor is generally non -irritating, pressurized gas may inflict mechanical injury to the eye. Direct contact with liquid propane can cause freeze burns and resultant swelling of the eye. Skin: Contact with liquid propane can cause freeze burns similar to frostbite. Ingestion: Deemed unlikely. Inhalation: Simple asphyxiant. Extreme over exposure may cause dizziness, headache, disorientation, excitability, fatigue, coughing, vomiting, anesthesia, unconsciousness and death. SECTION 6 — EXPOSURE LIMITS COMPONENT THRESHOLD LIMIT VALUE PERMISSABLE EXPORSURE LIMIT (TLV) (PEL) PROPANE NE 1000 ppm PROPYLENE NE NE BUTANES NE 800 ppm PROPANE CAN DISPLACE OXYGEN REQUIRED FOR NORMAL RESPIRATION AND CARE SHOULD BE TAKEN TO PROVIDE ADEQUATE VENTILATION, ESPECIALLY IN CONFINED SPACES AND IN THE ABSENCE OF WIND. I SECTION 7 — TOXICOLOGICAL INFORMATION Propane is not listed in the latest edition of the National Toxicology Program Annual Report on Carcinogens, has not been found to be a potential carcinogen in the latest edition of the International Agency for Research on Cancer Monographs, and has not been identified as a carcinogen by OSHA Propane does not contain any Class 1 or Class 2 ozone -depleting chemicals. Propane is not a listed marine pollutant. The Food and Drug Administration (FDA) has said propane is GRAS (generally recognized as safe) as a direct human food ingredient when used as a propellant, aerating agent and gas. Normal combustion products of propane are carbon dioxide, nitrogen and water vapor. Incomplete combustion of propane can produce carbon monoxide (CO), a toxic gas, and various aldehydes; an eye and nose irritant. These can be produced both by gas appliances and internal combustion engines. SECTION 8 — SAFE HANDLING AND USE Propane systems must be tested and proven leak free prior to use. Refer to National Fire Protection Association (NFPA) 54 National Fuel Gas Code for further instructions. 2 Keep away from all sources of ignition, including heat, sparks and open flames. Never check for leaks with a lit match or flame. Use an approved leak detector solution or electronic leak detector. All piping and equipment used for the handling, storage and use of propane must be specifically designed for that purpose. Refer to NFPA 54 National Fuel Gas Code and NFPA 58 Liquefied Petroleum Gas Code. OSHA 29 CFR 1910.110, DOT 49 CFR 172.700 and NFPA 58 all require that persons handling LP gases be specially trained in proper handling and operating procedures, which must be documented by the employer. Only qualified persons should transport, operate, service and/or install propane systems and containers. Propane vapor is heavier than air and can collect in low-lying areas, especially in the absence of wind or ventilation. Propane is a simple asphyxiant. Liquid propane can cause freeze burns, and appropriate personal protective equipment should be used whenever handling this product. Propane cylinders should always be stored in an approved location with relief valves in direct communication with the vapor space, and with service valves closed and plugged when not in use. Refer to NFPA 58 for. details of specific storage requirements. Empty propane containers retain residue and should be treated as if M. Never drop or damage containers. Damaged or corroded and leaking containers should not be utilized Contact your local Suburban Propane supplier immediately to report any problems. If container service valve fails to operate properly, discontinue use. Never insert any object into the pressure relief valve. Return unused propane to supplier for proper disposal. SECTION 9 — EXPOSURE CONTROLS Propane is Odorized: In its natural state, propane is odorless. An odorant has been added as a warning agent to detect its presence. This smell is characterized as "skunk -like" or having a `rotten egg" smell. It is important to recognize the smell of propane. If you are unsure about the smell of odorized propane, contact your local Suburban Propane Customer Service Center for a sample. Detection of Odors: The faint odor of propane may occasionally be present, due to a pilot light outage, or a burner left partially open. Information regarding the effectiveness or intensity of odorants, is set forth in Section 3 above. If, after checking these items, a smell persists, contact your local Suburban Propane immediately. Engineering Controls: Provide ventilation in enclosed areas where accumulation of vapors may provide a flammable mixture. Where flammable mixtures may be present, specially designed electrical systems must be used in accordance with NFPA 70 National Electric Code. Respiratory Protection: For general use no protection is required Under emergency conditions, concentrations may be high enough to warrant supplied -air or self-contained breathing apparatus. Under these conditions, a flammable atmosphere is likely and precautions should be taken to avoid ignition. Eye Protection: Approved safety glasses should be used whenever filling and handling propane containers. Protective Clothing: To avoid skin contact with liquid propane, approved gloves that are impervious to propane should be worn along with clothing that will provide protection from liquid propane for the expected duration of exposure. Other Protective Equipment: Safety shoes are recommended when handling cylinders. Use non -sparking tools when performing maintenance or repairs on or near propane systems. SECTION 10 — EMERGENCY AND FIRST AID PROCEDURES Contact with Liquid propane can cause freeze burns similar to frostbite. Remove saturated clothing, shoes and jewelry immediately. Affected body parts should be gently flashed with or immersed in lukewarm water for 15 minutes. Seek medical attention. If respiratory symptoms occur, get victim away from source and into fresh air. If breathing difficulties develop, qualified personnel may administer oxygen. If breathing or heartbeat cease, artificial respiration or cardiopulmonary resuscitation should be started immediately. Contact emergency medical responders at once. If you smell the strong odor of propane indoors: Immediately evacuate and get away from the building. Turn off the gas supply at the tank or shutoff valve at the meter or where gas enters the building. Call your nearest Suburban Propane Customer Service Center from a neighbor's house, or other phone away from immediate area. Do not use ANY electrical devices, including light switches and telephones. Do not light matches or use any open flame. Tampering: Never tamper with any gas appliances, their controls, or any related equipment. Never force an appliance control valve. All gas appliances and related equipment must be serviced by a qualified service technician. Connecting and disconnecting tanks and cylinders to or from your main gas service should only be performed by a qualified LP -Gas technician it If you run out of gas: If you are a customer, and you suspect you have run out of gas, contact your nearest Suburban Propane Customer Service Center immediately. By running out of gas, a potential safety hazard may exist, which requires us to perform a Leak Test before your system can be returned to service. Know how to shut off the gas in event of an emergency: It is important to know the location of the tank or cylinder and shutoff valve(s), if present, in your system. The service valve can be turned off by turning the knob clockwise. In the event of an accidental release or spill out of doors, these actions should be taken: Evacuate immediate area. Eliminate all possible sources of ignition including heat, sparks and open flame. Provide maximum ventilation and shut off source(s) of leak if possible to do so safely. If cylinder or container is leaking, contact the nearest Suburban Propane supplier or local fire department. Never enter a vapor (white) cloud Release without fire: Use a "fogging" hose stream of water to break up and dissipate propane into the atmosphere. Stay uphill and upwind of release at all times. Release with fire: Apply a direct stream of water to container.in order to prevent overheating. Do not attempt to extinguish flame until source of leak is shut off. Water spray or "fog" should be used for adjacent areas and to dissipate liquid propane to atmosphere. Extinguishing Media: Class B fire -extinguishing media such as Halon, CO21 or dry chemical can be used. Water spray or fog is appropriate for surrounding areas. Do not extinguish flame until source of gas is shut off. Only those with specialized training should attempt fire fighting. For further information, refer to NPGA "Propane Emergencies" Text #7220. I SECTION 11 — OTHER INFORMATION This Material Safety Data Sheet, issued June 2001, was prepared by Safety Services of Suburban Propane and supercedes April 1999. I SECTION 12 — CONTACT INFORMATION I For further information write to: SUBURBAN PROPANE, L.P. Safety Services 240 Route 10 West P.O. Box 206 Whippany, NJ 07981-0206 Or call: (973) 887 — 5300 DISCLAIMER: The information contained in this document is believed to be correct at the time of writing. NO WARRANTY OF MERCHANTABILITY, SUITABILITY FOR ANY SPECIFIC PURPOSE, OR ANY ASPECT REGARDING ITS INTENDED USE OR THE EXPECTED RESULTS TO BE OBTAINED ARE EXPRESSED OR IMPLIED. This information and the product furnished is done so on condition that the person(s) receiving them shall make their own determination as to the suitability of the product for any specific purpose, .and that they assume any and all risks associated with that use. 4 1 Date: To: From: MEMORANDUM September 5, 1996 Ron Holland, Water Supervisor John Westfall, Fire Inspector Subject: Fire Alarm Control Identification Fire crews spent a bit of time in locating the fire alarm control panel at Public Works Building. Fire Department requests that both doors leading to the alarm panel be identified as such. "FIRE ALARM CONTROL" would be appropriate verbage to guide us in case of emergencies. Call me if you have questions or concerns. cc: Lt.Oftedahl Fire Marshal McComas City of Edmonds * Office of Fire Prevention Date: AUGUST 2, `96 To: JOHN WESTFALL From: D. OFTEDAHL Subject: PUBLIC WORKS BUILDING WE HAD AN A.F.A. AT THE NEW PUBLIC WORKS BLDG. TODAY. WE HAD A LITTLE TROUBLE FINDING THE MECHANICAL ROOM WHERE THE ALARM PANELS ARE LOCATED. THEY ARE LOCATED IN THE MECHANICAL ROOM WHICH IS BEHIND THE WATER DEPT. STORAGE ROOM ON THE TOP FLOOR. THE PROBLEM IS, NEITHER DOOR IS DESIGNATED AS THE LOCATION OF ALARM PANELS OR MECHANICAL ROOM. I WOULD LIKE TO SUGGEST THAT SIGNS BE MADE TO IDENTIFY THESE DOORS AS "MECHANICAL ROOM", "FIRE ALARM PANEL". THIS SIGNAGE WOULD SPEED UP IDENTIFICATION OF THE ALARM PANEL DURING FUTURE CALLS. ► M• ('.ity of F.dmnndc MEMORANDUM DATE % /g_ N, REPORTED BY L-A„—A-6— Cl?---. I.D. OF C k n F -C, L- %-1- ,tom Nt SUBJECT y� ADDRESS: 7II 0 Z � (� Q CONCERNS/ 6L— 560— FL -/SN V& v6 INs HAZARDS: SIGNED FOLLOW-UP: vUlj � To L,+Cv� V/�x-✓`— (Z / ,&t4 o r,.j pro 1 /4i So Q I �t �3 e-►-� F� C (/3L1c-) JOrM-� � �T' C t L I s T �Az, v� 8t• v✓, e-rf- A�2� /Ay"& -1?�3t rc _ �Qc�� v NT 12 Av"`o c s raj roc, vC� SIGNED City of Edmonds * Office of Fire Prevention J --nam— C�0 8 g 0_ 19 CITY OF EDMONDS CIVIC CENTER . EDMONDS, WA 98020 • (206) 771-0215 - FAX (206) 771-0208 FIRE DEPARTMENT EDMONDS FIRE DEPARTMENT LOCK BOX AUTHORIZATION LETTER Lawrence Cretin' �' t �' This is to authorize for the: Edmonds Public Works Buildings at 7110 210th St SW (Building Name) (Building Address) LAURA M. HALL MAYOR to purchase a Lock Box for Fire Department use for emergency access. 1. Assigned key # 2. Location of Supra Box Give a brief description of where the Lock Box will be mounted in relation to the main entrance. The Fire Depart- ment recommends that the box be located just to the right of the main door, if possible. 3. Key(s) identification/access to: Identify each key with a brief description of what the key will unlock. Keep a minimal number of keys in the box. The Fire Department should have easy access to: Main Entrance Electrical Room Mechanical Room Sprinkler Room Alarm Panel Fire Apartment Autho 'zed Signature NOTE: A copy of this authorization, noting the assigned' key number, must be returned to the Edmonds Fire Department. 08/05/93 • Incorporated August 11, 1890 0 Sister Cities International — Hekinan, Japan Public Works Inventory 11/94 �© Common Storage Requirements: 2(61-* 97%�4 HMIS HMMP (ESCA) MSDS readily available on -site. Visible hazard i.d. signs (UFC Standard 79-3) shall -be placed at entrances to locations where materials are stored, dispensed, used or handled in permittable quantities; or HMMP waived (FM). Container markings (as shipped). Smoking prohibited < 25'. Incompatible materials separated from other material's containment systems(see chart below). Secondary containment shall be designed to retain the spill from largest container. Utilize visual monitoring method for product leakage. Cabinets conspicuously labeled "Hazardous -Keep Fire Away." Cabinet shall be listed for appropriate hazardous product storage. Operations & Maintenance building alarm pull stations shall be used for emergency situations involving hazardous materials. Post protection if storage is neXt to vehicular traffic areas. Inventory Compatibility Chart: Tri I AP A Tri Y N Y AP N Y N A Y N Y Individual Storage Requirements: Triethanolamine 85 -Other Health Hazard -Combustible liquid 1116 Exempt amounts Ref: UFC Table 80.315-A 55 gallon inventory within exempt limits for unprotected, non sprinklered. Exterior storage conditions Ref: UFC 80.315(b). Secondary containment required per 80.301(I) 4 20' to buildings, public -ways, streets and property lines, or; 2 hr FIR separation (30" extension). Hazmat permit not rqrd for either hazard class per UFC Table 4.108-C. "Natural" venting acceptable for this material. Ammonium Persulfate -Class 1 Oxidizer, solid Exempt amounts Ref: UFC Table 80.306-A 1.200 lb. inventory within exempt limits for unprotected, non-sprinklered. Exterior storage conditions Ref: UFC 80.306(b) & Table 80.306-C & E. No storage limits for detached storage. Secondary containment rqrd per 80.301(1)4. Hazmat permit rqrd for Class 1 Oxidizing Solid per UFC Table 4.108-C. Mechanical ventilation not rqrd. Smoke and heat venting. Acrylamide -Toxic material -Flammable solid Exempt amounts Ref: UFC Table 80.312-A 1250 lbs. (1/2 inventory) under exempt amount for sprinklered bldg within cabinet. Exterior storage conditions Ref: UFC 80.312(b). Secondary containment required per 80.301(1) 4. 20' to buildings, public -ways, streets and property lines, or; 2 hr FR separation (30" extension). Fire Resistive containers rqrd or protected by auto fire extinguishing system. Hazmat permit rqrd for "Toxic and Flammable Solid" per UFC Table 4.108-C. Check with Air quality authority regarding air processing/ventilation. K PW HMIS Inventory Control for Public Works Hazardous Material Statement 11/94 Quantity: I Quantity: I Criterion Criterion Criterion Product CAS No. Ibs gallons 1 2 3 Classification Basis & Notes TRIETHANOLAMINE 85 55 Health 2* React 1* Flam 1* .MSDS / NFPA 325M / UFC APP VI-A2(b)4B -Triethanolamine 85% 102-71-6 liquid (Other health (Comb "Immediate Health" per SARA sec 311 012 -Diethanolamine 15% 111-42-2 hazard)** 11113) Ammoniacal odor. Colorless liquid. Incompatible w/ strong oxidizer, strong acids. Seasonal: April thru November Heated above 140F releases N oxides: corrosive to aluminum and reacting to create H gas. Combustible Liquid Class IIIB. LD50 (skin) > 2000 mg/kg. LD50 (oral) > 4000 mg/kg. (felt to be target organ toxin: liver, kidneys) AMMONIUM PERSULFATE 1200 Oxidizer Health 1* React 1* MSDS / UFC APP VI-A2(a)5C CLASS 1 -Diammonium Peroxydisulfate 99% 7727-54-0 solid, crystalline (Class 1 solid)** Strong oxidizer. Polymerization initiator. Incompatible w/ acids, alkalis, halides Annual supply (fluorides, chlorides, bromides), combustible materials. (Sulfuric) Acidic mist upon thermal decomp. Moisture presence accelerates decomp. Avoid heat, moisture, reducing agents. ACRYLAMIDE 79-06-1 2500 Health 3* Flam 2* React 2* MSDS / UFC APP VI-A2(b)1 B SOLIDS -also called 2-Propenamide; solid, powder (Toxic material)** NFPA 49 Acrylic Amide. (1250) (Flam solid)** Highly toxic & combustible solid. Polymerizes excessively @ melting pt: 184F. Seasonal: April thru November Releases ammonia & H gases. Store in cool, dry, well ventilated area away from heat, sunlight, acids, alkalines. Products utilized in formation of grout for sanitary sewer connections. *NFPA 704 classification: 4=Extreme 3=High 2=Moderate 1=Slight 0=Insignificant. **UFC Art 80 category Ar' e- Yh 5 S S H�Cs g� P S-i�Y �J � i�►- -�-- -6L.c '�'r e-{�, Rr+c� 1 o tiw; � � 5 � A�yv►dw riP� 5o lr,4�1It ► -Tr-I E nL CA'w 5 z AM^D,.Jl%JM PE2.svi- FATE we r"rf�q q 3 µgoto 3e®V 03cc 1106 RECEI.N.ED 00-1 0'v 11994 (Qq C40'OkL AA15A 8-6.01-OAAN", EDMONDS FIRE DEPL, .Material Safety Data Sheet. U.S. Department of Labor May be used to comply with Occupational Safety and Health Administration OSHA's Hazard Communication Standard. (Non -Mandatory Form) / 29 CFR 1910.1200. Standard must be Form Approved consulted for specific requirements. OMB No. 1218-0072 IDENTITY (As Used on Label and List) AV-100 C}il✓MICAI. GROUT' Note: Blank spaces are not permitted. if any item is not applicable, or no information is available, the space must be marked to lnd/ca!e that. Section I Manulacturer's Name Emergency Telephone Number Avanti International CHEMTREC 800.424-9300 Address (Number. Street. City, State, and 21P Code) Telephone Number for Information 16920 Texas Ave. Ste. C-7 713-554-7541 Webster, TX 77598 Date Prepared JULY 1989 Signature of Preparer (optional) Section II — Hazardous Ingredients/Identity Information Hazardous Components (Specific Chemical Identity; Common Name(s)) OSHA PEL ACGIH TLV Other Limits Recom ended % (optional) Acr lamide .03m Specific Chemical Identity - Acrvlamide nr -Prnn nllmiciP Common Name - Acrylamide, Crystalline CAS # 79-06-1 'yN Zp Section III — Physical/Chemical Characteristics Boiling Point N/R Specific Gravity (H2O.- 1) Vapor Pressure (mm Hg.) Meltin Point 0.03 TORR g 0 Vapor Densay (AIR = 1) Evaporation Rate 2.45 Solubility in Water (Butyl Acetate - 1) 215.5 9/100 g water (30- C) Appearance and Odor White, Crystalline powder, odorless Section IV — Fire and Explosion Hazard Data Flash Point (Method Used) N/A cxunguisning Media Flammable Limits .122 g/cm-' -0- 84.50 C N/A LEL I UEL I;1 Water s ra carbon dioxide c Special Fire Fighting Procedures ii Avoid skin contamination and inhalation by wearing full protective clothing and Pn•^•i ive pressure respirator. Unusual Fire and Explosion Hazards carbon monoxide and ammonia Section V — Reactivity Data Stability Unstable Conditions to Avoid Stable X None Known !ncompalibility (Materials to Avoid) Acids, alkalis, peroxides, oxidizing and reducing agents, carbon steel. or rust Hazardous Decomposition or Byproducts TV, I A--n,,,n n-i ti t'i nn may Or+T1PYrl I'n r'nvl r c nz i nr'"I Itrli nr r nrhnn mnnn-vi dr` Hazardous Polymerization May Occur x Conditions to Avoid anc ammonia Store below 40°C with no ex osurc to direct sunlight and avoid Will Not Occur contamination to the incompatible materials shown above. Section VI — Health Hazard Data Roule(s) of Entry: Inhalation? Skin? Ingestion? Yes Yes Yes Health Hazards (Acute and Chronic) Skin contact causes peeling and redness of the skin. Repeated contac inhalation results in troubles with nervous system. Neurotoxin. Carcinogenicity. NTP? IARC Monographs? OSHA Regulated? Potential occupational carcinogen Yes Signs and Symptoms of Exposure Skin troubles such as peeling and redness. Repeated exposure causes nervous system troubles such as sweating, numbness, unsteady gait and decreased reflex. Medical Conditions Generally Aggravated by Exposure Emergency and First Aid Procedures Eye contact: Flush with water for 15 minutes. Skin contact: wash throupltly. Ingestion: Induce vomiting with water. Inhalation: Remove to fresh air.. _ Section Vll — Precautions for Safe Handling and Use Steps to Be Taken in Case Material Is Released or Spilled Collect into a covered container and dispose of in accordance with governmental. regulations Waste Disposal Method --Incinerate or treat at a sewerage plant in accordance with governmental regularions_ Precautions to Be Taken in Handling and Storing Take measures not to raise dust mist and vnp or and provide good vnnrilnrinn_ Wear protective clothing, gloves, boots, goggles and respirators -Store below 40°C with Other Precautions 110 exposure to direct sunlight. Do not leave open to the atmosphere. Store at Clean up the working area if contaminated. Wash thoroughly in case of skin or eye contac Section VIII — Control Measures Respiratory Protection (Specify Type) 1 Respirator I Ventilation Local Exhaust Fan ! Special N/A Mechanical (General) Fan Other N/A Protective Gloves Eyo Protection Yes goggles Other Protective Clothing or Equipment N/A WorWHygienic Practices Shower at the end of each workday and wash work clothes before re -use. Pago 2 ou.s. Gov.-m.nt Pnnnnc 0111«3 1187-1191•504v44342 UN #2074 REPORT NUMBER: 703 MSDS i �O : DZ87719 EFFECTIVE DATE: 01/1.4/93 RODUCT: TRIETI-ANOL.AMINE 8 VAN WATERS & ROGE:.RS INC. PAGE: 00:1 MATERIAL SAFETY DATA SHEET' VERSION: 002 ORDER NO i 31.0907 PROD NO : 370311 rib eA (A CITY OF E.DMONDS 200 DAYTON ST . Gyp WATER & SEWER DEPT, E: DMON DS , WA 9aO20 ,c VAN WATERS & ROGERS INC, , SUBSIDIARY OF UN I� � �. c ._. c JAIL (:..()fi}f3c3J .340U 61.00 C:ARl:I_LO►`: POINT" KIRKLAND � t ' WA Jt3U:3;3 EMERGENCY ASSISTANCE ............................... FOR EMERGENCY ASSISTANCE INVOLVING,CHEMICALS CALL - CHEMTREC' (800) 424--9300 --------------------- FOR PRODUCT AND SALES INFORMATION CONTACT YOUR LOCAL VAN WATERS n ROGI: RS.'3 BRANCH OFFICE AT VW&R KENT 206_ 87 --5000 KENT , WA PRODUCT NAME: TRIETHANOL_AMINE 83 MSDS alp : OZ87719 I. IN(.7RL--DIENTS: (% w/w, unless> otherwise noted) Tri.e'thanolami.nea Die'thanolamine CASO 000:102--71.--6 CAS* 000111.•-42--2 This document is prepared pursuant to the OSHA Hazard Communication Standard (29 CFR 1910,1200). In addition, other substances not 'Hazardous' per this OSHA Standard may be listed. Where Proprietary ingredient shows, the identity may be made available as provided in this standard. 2. PHYSICAL DATA: BOILING POINT: 325C; 617F- VAP PRESS: < 0.1. mmHg @ 20C VAP DENSITY: Not determined, SOI_. IN WATER: Completely miscible SP. GRAVITY: 1.1. 0 25/4C APPEARANCE: Colorless liquid, ODOR: Slight ammoniaca.l odor. FREEZE POINT: 63F , 17C . . ^ REPORT NUMBER: 703 MSDS NO: DZ87719 EFFECTIVE DATQ 01/14/93 ,RODUCT: TRIETHANOLAMINE 85 VAN WATERS & ROGERS INC. MATERIAL SAFETY DATA SHEET 3. FIRE AND EXPLOSION HAZARD DATA: FLASH POINT: 354F, 179C METHOD USED: PMCC FLAMMABLE LIMITS LFL: Not determined. OFL: Not determined. PAGE: 002 VERSION: 002 ORDER NO: 310907 PROD NO / 370311 EXTINGUISHING MEDIA; Water fog' alcohol foam, CO2' dry chemical. FIRE & EXPLOSION HAZARDSi Not available. FIRE -FIGHTING EQUIPMENT: Wear positive -pressure, self-contained breathing apparatus. ^ REACTIVITY DATA: STABILITY: (CONDITIONS TO AVOID) Stable under normal storage conditions. BILITY: (SPECIFIC MATERIALS TO AVOID) Strong oxidizers, acids. HAZARDOUS DECOMPOSITION PRODUCTS: Pos gen oxides. This product should not be heated ab tun the presence of aluminum due to excessive corrosion apotential chemical reaction releasing flammable hydrogen gas. HAZARDOUS POLYMERIZATION: Will not occur. 5. ENVIRONMENTAL AND DISPOSAL INFORMATION: ACTION TO TAKE FOR SPILLS/LEAKS/ Soak up with absorbent material or sand. Scoop into waste container. DISPOSAL METHOD: Burn in approved incinerator. state, and federal requirements for disposal. 6. HEALTH HAZARD DATA: Follow all local, EYE: May cause moderate irritation with corneal injury. SKIN CONTACT: Prolonged or repeated expysure may cause skin irritation, even a burn. SKIN ABSORPTION: A single Prolonged exposure is not likely to REPORT NUMBER: 703 MSDS NO: DZ87719 EFFECTIVE DATEi 01/14/93 ODUCT/ TRIETHANOLAMINE 85 VAN WATERS & ROGERS INC. MATERIAL SAFETY DATA SHEET PAGE: 00,3 VERSION/ 002 ORDER NO: 310907 PROD NO : 370311 result in the material being absorbed through skin in harmful amounts. The L050 for skin absorption in rabbits is /2000 mg/kg. INGESTION: Single dose oral toxicity is lou. The oral L050 for rats is >4000 mg/kg. Small amounts swallowed incidental to normal handling operations are not likely to cause injury; swallowing larger amounts may cause injury. INHALATION/ At room temperature, exposures to vapors are unlikely due to physical properties; higher temperatures may generate vapor levels sufficient to cause irritation and other effects. SYSTEMIC & OTHER EFFECTS: Observations in animals include liver and kidney effects. Results from repeated exposure tests on diethanolamine in laboratory animals include anemia (rats) and effects on kidney (rats and mice) and liver (mice). Heart and nervous system effects were also observed in these animals given exaggerated doses. Changes in other organs, causes of which are nonspecific, were judged secondary to the poor health of the animals due to the extremely high doses of diethanolamine given. CANCER INFORMATION: Triethanolamine did not cause cancer in long— term animal studies. MUTAGENICITY (EFFECTS ON GENETIC MATERIAL): Results of in vitro (test tube) mutagenicity tests have been negative on components. 7. FIRST AID: EYES: Irrigate with flowing uater immediately and continuously for 15 minutes. Consult medical personnel. - . SKIN: Wash off in flowing water or shower. Remove contaminated clothing immediately and wash before reuse. Remove and destroy contaminated leather articles' such as shoes' belts' and watch --- bands. INGESTION: Induce vomiting if large amounts are ingested Consult medical personnel. ' INHALATION: Remove to fresh air if effects occur. Consult medical. NOTE TO PHYSICIAN: If burn is present, treat as any thermal burn after decontamination. No specific antidote. Supportive care ' Treatment based on judgment of the physician in response to ' reactions of the patient. REPORT NUMBER: 703 MSDS NO: DZ87719 EFFECTIVE DATE: 01/14/93 .dDDUCT: TRIETHANOLAMINE 85 8. HANDLING PRECAUTIONS: VAN WATERS & ROGERS INC. MATERIAL SAFETY DATA SHEET PAGE: 004 VERSION: 002 ORDER NO: 310907 PROD NO : 370311 EXPOSURE GUIDELINE(S): OSHA PEL and ACGIH TLV are 3 ppm for Diethanolamine. None established for Triethanolamine. VENTILATION: Good general ventilation should be sufficient for most conditions. Local exhaust ventilation may be necessary for some operations. RESPIRATORY PROTECTION: If respiratory irritation is experienced, use an approved air —purifying respirator. SKIN PROTECTION: Use protective clothing impervious to this material. Selection of specific items such as gloves, boots, apron, or full —body suit will depend on operation. EYE PROTECTION: Use chemical 3oggles. 9. ADDITIONAL INFORMATION: SPECIAL PRECAUTIONS TO BE TAKEN IN HANDLING AND STORAGQ Avoid skin and eye contact. Avoid breathing vapors if generated. Do not use sodium nitrite or other nitrosating agents in formulations containing this product. Suspected cancer —causing nitrosamines could be formed. MSDS STATUS: Revised sections 6, 8 and 9. REGULATORY INFORMATION: (Not meant to be all —inclusive --selected regulations represented). NOTICE: The information herein is presented in good faith and ' believed to be accurate as of the effective date shown above. However, no warranty, express or implied, is given. Regulatory requirements are subject to change and may differ from one location to another; it is the buyer's responsibility to ensure that its activities comply with federal, state or provincial, and local laws. The following specific information is made for the Purpose of complying with numerous federal, state or provincial, and local laws and regulations. See MSD Sheet for health and safety information. U.S. REGULATIONS ================= noRA 313 INFORMATION: This product contains the following substances subject to the reporting requirements of Section 313 of Title III of the Superfund Amendments and Reauthorization Act of 1986 and 40 CFR Part 372: REPORT NUMBER/ 703 MSDS NO: DZ87719 EFFECTIVE DATE: 01/14/93 RODUCT: TRIETHANOLAMINE 85 VAN WATERS & ROGERS INC. MATERIAL SAFETY DATA SHEET PAGE: 005 VERSION: 002 ORDER NO: 310907 PROD NO : 370311 CHEMICAL NAME CAS NUMBER CONCENTRATION DIETHANOLAMINE ---------- ------------------ 000111-42-2 15 % SARAHAZARD CATEGORY: This product .as been reviewed according to the EPA "Hazard Categories" promulgated under Sections 311 and 312 of the th Superfund Amendment and Reauthorization Act of 1986 (SARA TitleIII) zstconsidered' under applicable definitions' to meet the following and An immediate health hazard A delayed health hazard NADIAN REGULATIONS The Workplace Hazardous Materials Information System �W H M I S > Classification for this product is: / ' ' ' ' ' D28 The Transportation of Dangerous Goods Act (T.D.G'A')znzs Product is: classification fo r Not regulated REPORT- NUMBER: 703 MSDS NO: D1_87719 EFFECTIVE DATE: 01/1.4/93 'RODUCT: TRIE:THANOLAMINE 85 VAN WATERS & R(: GE=RS INC. MATERIAL SAFETY DATA SHEET PAGE: 006 VERSION: 002 ORDER NO: 310907 PROD NO : 370311 ._.._.._______.____.-__.____- _. _._. __.__._._ FOR ADDITIONAL INFORMATION ........................... CONTACT: MSDS COORDINATOR VW&R KENT DURING BUSINESS HOURS, PACIFIC TIME (206)L3T39- 3400 O4/06/93 0g:07 PRODUCT: 37031.1. CUST NO: 1015og ORDER NO: 31.0907 _._. _._._._____..________.-____...._..._.._.._.._.__.._...._--_..__._._...._ *---------------------------------------------------------------------------------- * VAN WATERS & ROGERS INC. ("VW&R") EXPRESSLY DISCLAIMS AL..L.. EXPRESS OR ---------------------------------------------------------------------------------- IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE:, WITH RESPECT TO THE: PRODUCT OR INFORMATION PROVIDED HERE']:' tiff -------------------------- ALL INFORMATION -APPEARING HEREIN IS BASED UPON DATA OBTAINED FROM THE MANUFACTURER AND/OR RECOGNIZED TECHNICAL SOURCES. WHILE THE: INFORMATION IS BELIEVED TO BE ACCURATE, VW&R MAKES NO REPRESENTATIONS AS TO ITS ACCURACY OR SUFFICIENCY. CONDITIONS OF USE ARE BEYOND VW&RS CONTROL_ AND THEREFORE USERS ARE: RESPONSIBLE TO VERIFY THIS DATA UNDER THEIR OWN OPERATING CONDITIONS TO DETERMINE WHETHER THE PRODUCT IS SUITABLE FOR 'THEIR PARTICULAR PURPOSES AND THEY ASSUME ALL. RISKS OF THEIR USE, HANDLING, AND DISPOSAL OF THE: PRODUCT, OR FROM THE PUBLICATION OR USE OF, OR RE:.L_IANCE UPON THIS INFORMATION RELATES T"ES ONLY TO THE PRODUCT DESIGNATED THEREIN ,ON AND DDOES}~NO T RELATE r0 ITS USE IN COMBINATION WITH ANY OTHER MATERIAL_ OR IN ANY OTHER PROCESS. �` E N D O F M S D S ** I,. ^ u ` REPORT NUMBERi 703 MSDS NO: P1055VS F"FECTIVE DATE: 02/26/93 TODUCT: AMMONIUM PERSULFATE CITY OF EDMONDS 200 DAYTON ST. WATER & SEWER DEPT. VAN WATERS & ROGERS INC. MATERIAL SAFETY DATA SHEET EDMONDS ,WA 98O20 VAN WATERS & ROGERS INC. , SUBSIDIARY OF UNIVAR 6100 CARILLON POINT ' KIRKLAND PAGQ 001. VERSIONt 001 ORDER NO: 310907 PROD NO : 500406 u (206)889-3400 , WA 980313 ---------------- ------------- EMERGENCY ASSISTANCE ----------------------------- FOR EMERGENCY ASSISTANCE INVOLVING CHEMICALS CALL — CHEMTREC (800)424-9300 --------------------- FOR PRODUCT AND SALES INFORMATION ---------------------- CONTACT YOUR LOCAL VAN WATERS & ROGERS BRANCH OFFICE AT VW&R KENT 206-872-5000 KENT , WA PRODUCT IDENTIFICATION ***+**************+*********************************************************** PRODUCT NAME: AMMONIUM PERSULFATE MSDS #: P1055VS DATE ISSUED: 03/09/90 ISSUED BYi 008418 AMMONIUM PERSULFATE NFPA Designation 704 HrALTH (BLUE) 1 \MMABILITY (RED) O 'ACTIVITY (YELLOW) 1 ^pECIAL HAZARD OXY MANUFACTURER'S MSDS DEGREE OF HAZARD 4 = EXTREME 3 = HIGH 2 = MODERATE 1 = SLIGHT 0 = INSIGNIFICANT REPORT NUMBER: :() i EPF E C T•:I: VL' DATE: 02/ 6/9 3 eRODUCT : AMMONIUM i PE:RSUL..F ATr: VAN WATERS & ROGE::RS INC. MATERIAL SAF"1:::•T•Y DATA SHEET EMERGENCY TELEPHONE NOS: C:HEM•T•REC (800) 42 4-•• 9 300 MEDICAL (30:3) 593---9048 CALL- COLLECT* REVISION: 03 EFFECTIVE: 0:.3/09/90 PAGE::: 002 VERSION: O 001 ORDER NO: 310907 PROD NO : 500406 h A• •A• •A• A• •k yr •k •k •k •:c r'.• �r dr •k & A .,: k A• k A• •h• •k •A• •k •k •k h k A• !c •h• sl• •A• ,h •k •k �• ,t• dr A• A• •!r A• •A• •h ,l• •A• 3r A di• �• �r h dr % •k �r �: �.• h• h• h •k it h• % A• •h :d• fi• +'c :tc �%• :s• �c /r PRODUCT INFORMATION �- k i:• �• A• A• � �r A• h k �• f• �r :d• �e it dr {�• �• h �r �r A• A A• �r � A• dr �• �• �r A• it �• it �• �t dl• al• �• ie dr •h• h �• h h �• �c �• d4 �• �: f• � �• �• h• •!e •h• •k �• •k �• fi: •A• �r it •A• •A- l.• f do �%• h• A• SYNONYMS: AMMONIUM PE::ROXYDISULF•ATE SHIPPING NAME:: --- DOT: AMMONIUM PEERSULFA•T•E: OXIDIZER IATA: AMMONIUM PERSUL..PHATE OXIDIZER :I:MDG: AMMONIUM PE:RSUL.PHATE:: OXIDIZ.E:R FORMULA: (NH0 ?S:20B CHEMICAL FAMILY: PEROXYGE:N (DUCT USES: AMMONIUM PERSULFA-T•E: IS USED AS A POL..YMERI:ZATION INITIATOR BY THE POLYMER INDUSTRY, IT HAS ALSO BEEN WIDELY ACCEPTED BY THE ELECTRONICS INDUSTRY AS AN EFFICIENT E:TCHAN•T• AND CLEANER IN THE MANUFACTURE:: OF PRINTED CIRCUIT BOARDS. IN ADDITION, IT IS USED AS A BOOSTER IN HAIR BLEACHING FORMULATIONS BY THE COSMETIC: ]INDUSTRY. A• A• k �c ti%• �• k yl• k h •k �h yl• �r it �r •k is �r it %%% 3e is �• A• do �e •A• �• h $c �r �i• ii• •k• it �r �• �c �r �c• �• �e �r •A• al• 3r �r �c dh �r dr it �• it % •A• �• �r �r � A• r%• �e �: �.• �!• it t: h k �•.• A• h• •A• PRECAUTIONARY INFORMATION A• A• h• •h• 4e h �r �r •A• �• % ar h �c �.• 7%• it �: !r �• k it •k it •k � it �r •A• �r h A• �r A• •k it •6. �• �r �• k �• dr h �• it yi• % �• dr �r 3t �r do it �r f• d!• :k A• yl• � � ie K1• it �• � it �• •k �• h: �- ar it h• *• PRECAUTIONARY STATEMENT: (PLEASE USE THIS STATEMENT TO SATISFY THE:: IN —PLANT LABELING REQUIREMENTS OF THE OSHA HAZARD COMMUNICATIONS STANDARD 29CFR 1910.1200) HEALTH: AIRBORNE DUST MAY BE: IRRITATING TO EYES, NOSE, THROAT AND SKIN UPON CONTACT. CONTINUOUS CONTACT MAY PRODUCE SKIN DERMATITIS. INHALATION OF AIRBORNE:. DUST AT HIGH LEVELS MAY PRODUCE SHORTNESS OF BREATH IN ALLERGIC PERSONS. PHYSICAL.: DECOMPOSES IN STORAGE UNDER CONDITIONS IONS OF EXCESSIVE HEAT AND OR MOISTURE-. (WATER, WATER VAPOR) CAUSING RELEASES OF OXIDES OF SULPHUR. DENSE MIST OF SULPHURIC ACID AND OXYGEN WHICH SUPPORTS COMBUSTION. REACTS WITH ACIDS, ALKALIS, HALIDES, COMBUSTIBLES AND HEAVY METALS TO RELEASE OXYGEN. A• •�• •k k •h• •h• h •k k k it �r �c k �r it it dr •A• k •k �• k A• •A• •h• •h A• h• �. h il• •A• •A• •k �• h �• A •k •k •k A. yh ni..k •A• •k •k tih k �r A �l• A y% �1 �r A• � �r :d• �r A• A 3c :4 :d• tit• •k •A• :d• :d• �r •A• •!r •k •k INGREDIENTS ...r �• •A• •k �r •k $r A• •A• k it dr �• �r �• :d• 3r 7l• •k A• �• lr h A• A •k h h �• �c yk �. A• •A• al• •A• yh •k A •k A h �- il• A• •k •k •A• it h �r �r A• k k A •A• •A• st• k :4 dl• A• •A• •h• �F dr A• •k •A• •k irk •!c -k :d• •A- CAS* AND COMPONENT MATERIAL/COMPONENT: DIAMMONIUM PE:ROXYDISUL.F•A-T•I=: PERCENT: 99% REPORT NUMBER: 703 MSDS NO: P1035VS E PF•ECT:I: VE DATE::: O.T./ 6/9 3 RODUCT: AMMONIUM PERSI.JLFATI: VAN WATERS & RU(: ERS INC. MA•T•E::RIAL.. SAFETY DATA SHEET CAS 0: 7727•-54--0 HAZARD CLASS: OXIDIZER CANADIAN PRODUCT IDENTIFICATION NUMBER: 1.444 PAGE: 00:3 VERSION: 00:1. ORDER NO: 3:1.0907 PROD NO , 500406 •h % h •A• A• •h A k •A• •h •!c k k k• A• •A• •k �• A• •k A• A• �c h tih k-h •h •k �h •A• •A• •h dl• •h tii• •h tit• •h •h •A• k •k dr yt• tit •h •h A• A •k tit• �c �r •k •k •h •A• •A• k :tc k �• •h •h• •!r x x •h •h •A• x is •A• •k •% �c 7t• PHYSICAL.. DATA •h h •h k k •A• tit• 3c •k A h h x �c •tc �� •k A is yt •A• k � dl• tit• it• •h �e >� it• •k it• •h •k •h � tit � �• *l• k h A �• •k al• •h •k •h tit• � 3c tit• A• tit• •k •A• A •A• �• ie tit• A• A• �• :4 �• •k •h �c �e 7h .k vl• �c k tit• •k MELTING/FREEZING POINT: BOILING POINT: VAPOR PRESSURE: VAPOR DENSITY (AIR :_ 1) : ROOM TEMPERATURE: APPEARANCE AND STATE: ODOR: SPECIFIC GRAVITY (H2 0 = 1) : �- ' UBIL ITY IN H2O X BY WT: VOL_AT:ILES BY VOLUME: JAPORATI.ON RATE (BUTYL ACETATE = 1) : PH (AS IS) : PH (1.% SOLUTION): ODOR THRESHOLD: DENSITY (GMS3/MI-.) : COE:FF, WATER/OIL DIST: DECOMPOSES NOT APPLICABLE NONE: NOT APPLICABLE: ABL.E: WHITE CRYSTALS NONE:: I198 1 % @ 25*C NOT APPLICABLE NOT APPLICABLE: NOT APPLICABLE TYPICALLY 4-6 NOT AVAILABLE NOT AVAILABLE: NOT AVAILABLE •h• � •h til• oi• -h k h A• tit % dc• �c �• �• tit k til• A• �• A• tit• tit• � A til• tit• do A• 3c h v1• % ti4 tit ti4 tit• til� •h •h •k �i• �• � •h tit• •h •A• •h •k do �c A sl •k A• yl• dh A• � •A• %%% �• •A• % �• st• -k •h :4• n• :k •h •!e •A• •h FIRE, EXPLOSION AND REACTIVITY DATA •h A �• �c �• k k tit• •h � � 3c do �c dc• � * yl• A �• 7L• al• h �l• is til• tiF tit• �F dh h �e y1• A• •h A •A• til• •A• •k tit• •A• h it •h •A• •h •k •A• dl• �• �• do til• •A• •A• h k �F k A• til• •h % :+c lc 3r tit• •h •A• •A• :+r �e •k •h �c k A• FLASH POINT: AUTO:IGN:ITION TEMPERATURE: FLAMMABLE LIMITS UPPER: (AIR) LOWER: EXTINGUISHING MEDIA: SPECIAL FIREFIGHTING: PROCEDURES DEGREE: OF FIRE AND: EXPLOSION HAZARD ABILITY: NZARDOUS POLYMERIZATION: _ JNDIT.T.ONS TO AVOID: MAJOR CONTAMINANTS THAT: CONTRIBUTE TO INSTABILITY NONCOMBUSTIBLE: NONCOMBUSTIBLE NOT APPLICABLE: NOT APPLICABLE DELUGE WITH WATER NONCOMBUSTIBLE: --- CONSIDER MATERIAL. AS A STRONG OXIDIZER WITH ACIDIC: MIST ALSO BEING PRESENT. 00 NOT USE CARBON DIOXIDE OR OTHER GAS —FILLED FIRE EXTINGUISHERS, THEY WILL HAVE NO EFFECT ON DECOMPOSING PERSULFATE. DECOMPOSES WITH THE: LIBERATION OF OXYGEN, PRESENCE OF MOISTURE ACCELERATES DECOMPOSITION. UNSTABLE; DECOMPOSES WITH EXOTHERMIC REACTION WILL NOT OCCUR HEAT. MOISTURE. REDUCING AGENTS, HEAVY METALS, REDUCING AGENTS, MOISTURE. REPORT NUMBER: 70:3 ....,-FE:C•T•:I:VE: DATE: 02/26/93 PRODUCT: AMMONIUM PERSULFATE VAN WATERS & ROGE::RS INC. MATERIAL.. SAFETY DATA SHEET PAGE::: 004 VERSION: 001 ORDER NO: 31.0907 PROD NO . 500406 c-INCO1111") :I:F3:LL-:ETYACIDS, ALKALIS, HALIDES (FLUORIDES,£ F•LORIDES, E3ROMIDES), COMBUSTIBLE: MATERIALS, HEAVY METALS, HAZARDOUS DECOMPOSITION: PRODUCTS SENSITIVITY IMPACT SENSITIVITY DISCHARGE TO MECH: TO STATIC: £.1)`.EGI7A13L.0 MF'�TE:.R.EAI.0. FUMES OF SULFURIC ACID MISTS OXYGEN WHICH SUPPORTS COMBUSTION AND OXIDES OF SULFUR AND NITROGEN. NOT AVAII.-ABLI--: NOT AVAILABLE: �.• A• A• k �• �r �r di• �:• A• �c 1: 7:• �• •h �• �t {r �k h• k• �r •k de �• �r � it �r k h h• �.• �• �r A• !r �r h A• /r �• h is A• �r it dr �• A �• �• 3c �• �• � �• �r �.• h �r ik �: �: L• ;t• f• :Q• :4 �• •h •1•::+: •f: �� �1• it �r ROUTES OF EXPOSURE :fir A• A• /r it �• A h yE• �r �r �.• f• �e �r �c h h •k ai• •k �r yl• �: �r :4 A• h •k �• * � � �• f• 3c f• 3r �r •ir k• �• A dt tik :A• �• h :h A• ii• � �• �• �• •h � �• it �l• �• �• it �r k �• � �• •A• h h yl• �r �% � ak• AA• EYE CONTACT: SOURCE" I:lATE-: POWDER IS MINIMALLY IRRITATING UNWASHED EYES; PRACTICALLY ,..N-••IRRITATING TO WASHED EYE','-) (RABBIT). RE1= .:E£37--9h£3 FMC 1988 SKIN CONTACT: POWDER IS NON --IRRITATING (RABBIT) MAY BE SENSITIZER TO ALLERGIC PERSONS, REF.I£37--9£30 FMC 19£38 SKIN ABSORPTION: NO SIGNIFICANT HAZARD. L.D50 ABOVE 1.0G/KG (RABBIT) FMC 1979 REF. ICG/T . 79 . 02 5 INHALATION: NO SIGNIFICANT HAZARD ACGIH 1.985-6 PROPOSED TI_V 5MG/M:3 AS S20H FMC: 1988 FOR 8 HRS. TWA 4 HR . L-C a0 > 2 . 9 MG/L. (RAT) MAXIMUM ATTAINABLE DUST CONCENTRATION. REF.I£37-969 INGESTION: SLIGHTLY HAZARDOUS FMC 1979 L_050 =_600 MG/KG ( RAT) '''P F . I CG/T . 79 . 025 30 -- NOT AVAILABLE •!c •M •!r �• k• h •k k �• �• 6 it �: � f• h k• h• k �• �• fi• k• •!r k A• �r �• h �• d• k• �• •h �• �• k �r �e �• h �• h •A• h �r �'r �• al• �• % �r �r �r �: do it h• is k �r �r �r it f.• �• •k •!r 3r �• �• fi• h 3: it •k /c ac EXPOSURE: LIMITS A• h• A• A• A �r �r �h 3r do %• �r �• � �r �c �i• dr �c �l• k is �r �k• h h :h i:• � � •k �r 3r �• •h 4c k fi• �r A• �• !c �r �• •A• �h f• � �• �• dr � � �• :k �• dl• �c �• dk• k �• $r y1• % •h � 3r •A• �r dr y1• h •k •A• •k A •6. REPORT NUMBER: 703 MSDS NO: P1055VS FE FE::CT IVE DATE : 0 '/ 6/93 RODUC T : AMMONIUM PE:RSULFATE: VAN WATERS & ROGE RS INC. MATERIAL SAFETY DATA SHEET PAGE: 005 VERSION: 00:1. ORDER NO : 310907 PROD NO : 500406 SOURCE: DATE PROPOSED TLV 5 MGfM3 AS ACG:I:H 1.985-6 S 08 FOR 8 HRS. DOTE:: IN :1986--87 ACG:I:H LISTED PERf:31JLFATES IN APPENDIX F (C:HEMI:C.'AL. SUBSTANCES AND OTHER ISSUES UNDER STUDY) AND DI:U NOT RECOMMEND A TLV. A• A• A• h• �• A• A• A �• �• •ir •k it k k �r �r �• �l• �r �• f. �r �t :k• k �r •k �• fi: �• �• di• �r �• h• �: �• fi• �!• k• it k f• fi• •h �• �• � •h k ar �r k k �l• is $r �t �r :r �r �c dr �s'.�.• � h• �• •ir � it •h •�::+r •AA� •,k EFFECTS OF OVEREXPOSURE h• h• �• tr �:• �• •k �• :�::+r �• h A• !r •A• �r f• *• �• fi• �r :d• fi• �• A• A• �r �• �: it �!• �• it �• � �• �: *• �: 3r •M. til• � k �r h• fi• �• k A• •k �• � •h• is �• * �• h � �: �: �: •h• f• •tr f: f• *• �• �!• fi: �:• h• A• it it it ACUTE: EXPOSURE.: CHRONIC EXPOSURE: •-'FELTS CONSIDERED <CLUDE: SENSITIVITIES, •,vARCINOGENICI:TY , T'ERAT•OGENICITY, .MUTAGE:NIC:IT•Y, SYNERGISTIC PRODUCTS, AND ANY MEDICAL CONDITIONS GENERALLY RECOGNIZED AS BEING AGGRAVATED BY EXPOSURE.) DUST MAY BE HARMFUL. AND IRRITATING, MAY BE:: HARMFUL. IF SWALLOWED. . ALLERGIC PERSONS MAY DEVELOP DERMATITIS AND ASTHMA. REF. RESPIRATION 38: 144 (1979) . CARCINOGENICITY, TERATOGENICITY, MUTAGENI:C ITY, SYNERGISTIC PRODUCTS, REPRODUCTIVE TOXICITY. AND ANY MEDICAL CONDITIONS GENERALLY RECOGNIZED ZE D AS BEING AGGRAVATED BY EXPOSURE WERE EXAMINED AND NO INFORMATION WAS FOUND OR IS AVAILABLE. •A• ,1• A• •h• A A h• h k •A �• 3c 3r al• do � h A •A dl• k il• •A• �� A •A• •h yl• h si A• al• it �r �• •A •k A• •A• A• ,1• nL• h �c •k •k •k •k •k •k •A• A• •h •A• •A• dr fi• •k A yt• A• A yl• :b: �r :4 �r yl• •k •k •A• :$ at• •k -!c :4 h• •k EMERGENCY AND FIRST AID PROCEDURES •h• A• •k A •k �r •A •A �• de it % it 3c •A 71 k• :+r al• �• •h• •h• A• it A• yl• it• �• A• A •A JI •A• y% �� �r �c A• •k al• •k 7l. •A •A• A• •h• •k •h• h k •h• !r •!r •A• yh � �• yl• A A• •A % A •k •k k �r :k k •A• •A• :k :4 % •k /r •k •h EYES: WASH THOROUGHLY WITH WATER. IF IRRITATION OCCURS AND PERSISTS, SEE A14 OPHTHALMOLOGIST, SKIN: WASH THOROUGHLY WITH WATER, IF IRRITATION OCCURS AND PERSISTS, OBTAIN MED:I:CAL.. ATTENTION, INHALATION: REMOVE SUBJECT TO FRESH AIR, IF DISCOMFORT OCCURS AND PERSISTS OBTAIN MEDICAL ATTENTION, TNGESTION: DRINK PLENTY OF WATER. CALL PHYSICIAN, CONTAMINATION PROCEDURC: WASH THOROUGHLY WITH SOAP AND WATER. NOTES TO PHYSICIAN: ASIDE FROM ALLERGIC REACTIONS SUCH AS DERMATITIS AND ASTHMA REPORTED IN ONE CASE ONLY. EXPOSURE PROBLEMS ARE RELATED TO THE REPORT NUMBERi 703 MSDS NO: P1055VS -rFECTIVE DATE: 02/26/93 PRODUCT: AMMONIUM PERSULFATE VAN WATERS & ROGERS INC. MATERIAL SAFETY DATA SHEET PAGE: 006 VERSION: 001 ORDER NO: 310907 PROD NO : 500406 OXIDIZING PROPERTIES AND RESEMBLED AND ARE TREATED LIKED THOSE CAUSED BY STRONG ACIDS. HOWEVER, ATTEMPTS TO NEUTRALIZE WITH BASIC OR HALIDE -CONTAINING MATERIALS SHOULD BE AVOIDED BECAUSE OF POSSIBLE EXOTHERMIC REACTION, FLOODING OF EXPOSURE AREAS WITH WATER IS SUGGESTED, BUT GASTRIC LAVAGE OR EMESIS INDUCTION FOR INGESTIONS MUST CONSIDER THE POSSIBLE AGGRAVATION OF ESOPHAGEAL INJURY AND THE EXPECTED ABSENCE OF SYSTEM EFFECTS, DEMULCENTS MAY BE HELPFUL, TREATMENT OTHERWISE IS SUPPORTIVE AND SYMPTOMATIC. *+**************************************************************************** SPECIAL PROTECTION *************************************************+**************************** VENTILATION REQUIREMENTS: USE ONLY IN WELL VENTILATED AREA. CONTROL DUST IN WORK PLACE AREA AT OR BELOW PROPOSED TLV (5MG/M3 AS 5208 FOR 8 HRS.) RECOMMENDED PERSONAL PROTECTIVE EQUIPMENT SPIRATORY: WHEN EXPOSURE ABOVE THE ESTABLISHED STANDARD IS LIKELY, A A-SPIRATORY PROTECTION PROGRAM WHICH COMPLIES WITH OSHA GENERAL INDUSTRY STANDARD 1910.134(E) AND RESPIRATORY EQUIPMENT, SUCH AS A DUST MASK APPROVED BY NIOSH/MESA SHOULD BE IMPLEMENTED. EYES: EYE PROTECTION, SUCH AS CHEMICAL TYPE GOGGLES AND FACE MASK, SHOULD BE WORN WHENEVER SPLASHING, SPRAYING, OR OTHER EYE CONTACT IS LIKELY. GLOVES; GENERAL PURPOSE RUBBER OR NEOPRENE GLOVES. SPECIAL CLOTHING AND EQUIPMENT: USE NORMAL WORK CLOTHES WITH GOOD PERSONAL HYGIENE. FOOTWEAR: GENERAL PURPOSE RUBBER OR NEOPRENE FOOTWEAR. *********+************************************+********************+********** STORAGE AND HANDLING *******************************+**+**************+**************************** (PLEASE USE THIS STATEMENT STORE (UNOPENED) IN A COOL, CLEAN, DRY PLACE TO SATISFY THE IN -PLANT AND AWAY FROM POINT SOURCE HEAT I.E. RADIANT LABELING REQUIREMENTS HEATERS OR STEAM PIPES. USE FIRST IN FIRST OUT OF THE OSHA HAZARD STORAGE SYSTEM, AVOID CONTAMINATION OF OPENED COMMUNICATIONS STANDARD PRODUCT, AVOID PROLONGED OR REPEATED SKIN CON- 29CFR 1910.1200) TACT. USE GOOD PERSONAL HYGIENE, WEAR SUITABLE PROTECTIVE CLOTHING, IN CASE OF FIRE OR DECOMPOSITION CONDITIONS (SMOKING) USE SELF-CONTAINED BREATHING APPARATUS WITH FULL FACE PIECE, ACID RESISTANT CLOTHING AND DELUGE WITH PLENTY OF WATER TO CONTROL DECOMPOSITION. FOR STORAGE REQUIREMENTS, REFER TO THE NFPA REPORT NUMBER: 703 T: "PEC:TIVE DATE: 2/26/9 3 RODUCT : AMMONIUM PERSULFATE VAN WATERS & ROGERS INC MATER.I.AL. SAFETY DATA SHEET PAGE: 007 VERSION: 001. ORDER NO: 310907 PROD NO i 500406 BULLETIN 4:3A ON THE STORAGE OF LIQUID AND SOL 113 OXIDIZING MATERIALS, NFPA HAZARD CLASS 1 OXIDIZER, IMCD HAZARD CLASS +,1 OXIDIZER, •A•kk•kkk•6:k•h•kk•hkitkkkiekkkkkkki!•iel:•h•kl:kkkkkkkkiett•khkkk•p:k•h-kicirkkk�•kl:ich•irat•h-kkkkiekkki:•kkie�k�: DISPOSAL., SPILL OR LEAK PROCEDURES kA•kk•hh•lrki.•irk•h•k•kkkkkietit•kkkkkkir�.•kk�:kkkkkkktit•k•lrkl.•A•kiskitkA•icirkiekk�•irkkktit•k�.•k>k•kkkkkstkkk•kicir PROCEDURE FOR RELEASE OR SPILL..: MATERIAL. SHOULD BE:. PUT INTO AN APPROVED DOT CONTAINER THEN DILUTED WITH LARGE QUANTITY OF WATER AND DISPOSED OF ACCORDING TO •T•1-E METHODS OUTLINED BELOW FOR WASTE DISPOSAL., WASTE:. DISPOSAL METHOD: AN ACCEPTABLE METHOD OF DISPOSAL IS TO DISSOLVE IN WATER AND DISPOSE VIA A TREATMENT SYSTEM IN ACCORDANCE WITH ALL LOCAL, STATE AND FEDERAL_ ENVIRONMENTAL_ LAWS, RULES, REGULATIONS, STANDARDS AND OTHER REQUIREMENTS, BECAUSE ACCEPTABLE METHODS OF DISPOSAL. MAY VARY BY LOCATIONS AND BECAUSE REGULATORY REQUIREMENTS MAY CHANGE, •T•1'E APPROPRIATE REGULATORY INCIES SHOULD BE CONTACTED PRIOR TO DISPOSAL..., .n.k•k•A••kkkkA•kkkkk{�•ktit•Akil•kic•,t-A•tit•til•kkA•dt•kkktit•kk•A•kAk•kkkA•A•kA••h•h•,t••h•A•A•at•k kkirtit•kkkkkkkkk•k•kkicie•k•Akk•A• TRANSPORTATION DATA k k •A• •h •A• •A• •h• irk •k k k k k k k k k A• k• k k •/l k •A• A• A• k A• k •A• til• k it •k k is tit• k tit• h k k •h k •A• •k •h •k tit• k k A• A• k k •A• k tit-!r k k ot• it •A• tit :+c k A• •A• •k k is �t• •k -k •lr i<• DOT PROPER SHIPPING NAME: DOT CLASSIFICATION: : DOT LABELS: DOT MARKING: DOT PLACARD: UN NUMBER: HAZARDOUS SUBSTANCE/RQ : 49 STCC: NUMBER: EMERGENCY ACCIDENT PRECAUTIONS AND PROCEDURE: PRECAUTIONS TO BE TAKEN: IN TRANSPORTATION TYPE PACKAGES: OTHER SHIPPING IDS: AMMONIUM PERSULFATE OXIDIZER OXIDIZER AMMONIUM PERSUI._FA TE UN 1444 OXIDIZER 1444 NO RCS LISTED 4918733 WASH AREA WITH LARGE" AMOUNTS OF WATER, KEEP MATERIAL COOL_ AND DRY. 225 LE3, FIBER DRUM DOT 21C250 W/ POL.YLINE:R 55 LB. POLY BAG DOT 441:1 :1.000-2200 LB. IBC DOT EXEMPTION E841:9 kA..A•kkA••A•iciclrkirkirk�:kirkicyl•icie•A•icirkirkirk•h•kkkkktit•kiricirkicA•!.•kicickkkickkiririri!•irkkkirkkk•h•til•ickkai•kkick•k ADDITIONAL_ REGULATORY INFORMATION .l••.kielr.hirk•A•A.•dcickkkkkickkirh: irA•ieA•kh•ickhklrkki.•drh•irlckirirh•kA•ie•kA•kA•kh•kirkkieirkiciFkkirkickir•kkktil•�.-ic�l•kicx' )T•ERIAL_ IS REPORTED IN EPA TSC:A INVENTORY LIST? YES MATERIAL IS LISTED AS A CARCINOGEN/POTENTIAL REPORT NUMBER: 703 MSDS NO: P1055VS "FECT:I:VI:E DATE; 02/26/93 PRODUCT: AMMONIUM P E:RSUL.FATE:: CARCINOGEN IN FOLLOWING NTP ANNUAL. REPORT? IARC GROUP I OR II? OSHA ::9CFR PART I.910 SUBPART Z? ACG I:H APPENDIX A DOES PRODUCT CONTAIN A TOXIC CHEMICAL(S) SUBJECT TO SARA TITLE III SECTION 313 REPORTING C:HEMICAL..(S) : SARA TITLE III SECTION :311/312 CLASSIFICATION: VAN WATERS & ROf:;ERS INC. MATERIAL SAFETY DATA SHEET NO N C) NO NO PAGE:: OOE3 VERSION: 00I. ORDER NO: 310907 PR0D NO : 500.406 NO THIS PRODUCT DOES NOT CONTAIN ANY TOXIC: CHEMICALS IN QUANTITIES SUBJECT TO TINE:: REPORTING REQUIREMENTS OF SECTION 313 OF TITLE:: III OF THE SUPERFUND AMENDMENTS AND REAUTHORIZATION ACT OF 1986 (SARA) AND 40 CFR PART :372. IMMEDIATE (ACUTE) HEALTH HAZARD, FIRE:: HAZARD. PROPOSITION 65 •-• CALIFORNIA SAFE: DRINKING WATER AND TOXICS ENFORCEMENT ACT OF 1986 (PROPOSITION 65) CALIFORNIA, THIS ACT REQUIRES THAT THE. GOVERNMENT OF CALIFORNIA DEVELOP A I...IST TJF• CARCINOGENS AND REPRODUCTIVE: TOXINS AND THAT NO PERSONS DOING BUSINESS SHALL KNOWINGLY EXPOSE ANY INDIVIDUAL_ TO A CHEMICAL KNOWN TO THE STATE TO CAUSE: CANCER OR REPRODUCTIVE TOXICITY WITHOUT FIRST GIVING CLEAR AND REASONABLE WARNING TO SUCH AN ]INDIVIDUAL_. FMC WOULD LIKE: YOU TO KNOW THAT OUR AMMONIUM PERSULFATE CONTAINS THE INDICATED CONCENTRATION(S) OF CHEMICALS WHICH ARE LISTED BY CALIFORNIA AS CHEMICALS KNOW TO CAUSE CANCER(A) , RE:PRODUCTIVE TOX.T.CI:TY(E3) OR BOTH OF THESE: EF••FECTS(C) . CHEMICAL.. CONCENTRATION (PPM, PPB, Y ETC) ARSENIC EQUAL. TO/LESS THAN 1 PPM CHROMIUM EQUAL TO/LESS THAN 0,05 PPM LEAD EQUAL TO/LESS THAN I. PPM LISTED A S : (A), (B), (C) (A) (A) (0) A• A• h� 1c •k •k •k k !e •k k �r %• •k �r dr x1• di• ak yi• •k it• A � •k A A• A• h dl• vk- yl• ,t• y1 A• •te •k �L• •k •k •k •k •k �• k A• •k yh A� k tik � �c � •fi �l• •k A• k• •!e •k •A• •A• :4 •k :4 �• �t• •A• •h v1• i1• •k •k k �{ �h •k ADDITIONAL INFORMATION !r � h• •k •A• •k h A• % •k �• �k �1• A..A..k �l• •A• �• •k �• •A• k •h yl• •k �• •k h •h sc •A- �• •h A• A• h• •k h A• �% A• •k •k •k •k tih A• de � y1• A •A• A• �e 7t• h• A• •A• �- •A• h• �• de �c A A• •k �r �• •k •!e k :d• A AQUATIC: TOXICITY CLASSIFICA•T'I.ON -- NIOSH RTECS NO, 79--100 EFFECTS OF LOW CONCENTRATION ON AQUATIC LIFE NOT DETERMINED, , REPORT NUMBER: 70:3 MSDS N O : P:I.055VS EFFECTIVE DATE: 02/ _6/9 3 ]DUCT: AMMONIUM PERSUL..FATE VAN WATERS & ROGrERS INC. MATERIAL.. SAFETY DATA SHEET - PAGE : 009 VERSION: 001. ORDER NO: 310907 PR0D NO , 500406 h k !h 9i �c •k it h• k •h •k :k 3r !i- k• x- �• i,: �- A• •!c A h �c � �l• A Jl• •A• yl• �• �• � � � �: !c al• ak � A• �- y1 � �• yl• •k •A• •k �. A• h al- •A• •A- •,1 :+r � al• ti\ h yl• :4• :rt :k � •A• A• !t it !c A A 4c •k •k �l- k ADDITIONAL- TECHNICAL.- DATA A A �• A• •k k % •h k •k k !�• �• �. � �c •k -h �l- r': �• �• h h k •h h yh il• •k � � •k yl• •k �. •k it •k •Jl• k dl• al• il• •A• •k •k •Ic •k �c �c Sr •k •k •A- yi •k A- h �• til• � i�• �• �c al• A• �r yl•d• •A• •k •A is •tc �• •A• k SUGGESTED USES: AMMONIUM PERSULF•ATE IS USED AS A P0LYMEERI.ZATION INITIATOR BY THE POLYMER INDUSTRY. IT HAS ALSO BEEN WIDELY ACCEPTED BY THE ELECTRONICS INDUSTRY AS AN EFFICIENT ET•C:HANT AND -CLEANER IN THE MANUFACTURE OF PRINTED CIRCUIT BOARDS, IN (-DDITIONS IT IS USED AS A BOOSTER IN HAIR BLEACHING FORMULATIONS BY THE COSMETIC INDUSTRY, TYPICAL.- ANALYSIS: CRYSTAL DE:.NSITY, G/CC 1.98 L.00SEE BULK DENSITY, G/CC .95 SOLUBILITY, G/:1.00ML @ 20*C 62.1. SOLUBILITY, G/100ML C 50*C 78. ACTIVE OXYGEN, X 6.94 SPECIFICATIONS: % PRODUCT PASSING U.S. 8 MESH 100 .DDITIONAL- INFORMATION: T.`.I..EAN PLASTIC OR STAINLESS STEEL_ SCOOPS, SHOVELS, ETC. ARE SUITABLE FOR RE:.MOVAL. OF THE PRODUCT FROM THE SHIPPING CONTAINER. METALS OTHER THAN STAINLESS STCEEEL. ARE APT TO CAUSE DECOMPOSITION OF PE:RSULF•ATE SOLUTIONS AND CARE SHOULD BE TAKEN SO THAT CONTAMINANTS ARE NOT INTRODUCED TO THE PERSULFATES STORAGE CONTAINER. FURTHER INFORMATION ON AMMONIUM PERSUL-FATE AND THE OTHER FMC PERSULFA•T•ES (POTASSIUM AND SODIUM) MAY BE FOUND IN THE FOLLOWING BULLETINS: -"PERSULFATE:S IN (=EMULSION POLYMERIZATION", TECHNICAL. BULLETIN 445 -"SAFE HANDLING OF PIE:RSULFAT•E--BASED EET•CHANTS & CLEANING SOLUTIONS", TECHNICAL BULLETIN *110 --"GLEANING COPPER WITH SODIUM PERSULFATE", TECHNICAL BULLETIN 0115 "PE::RSUL-FATES TECHNICAL BULLETIN; AMMONIUM, POTASSIUM AND SODIUM SALTS", 0144. / REPORT NUMBERi 703 MSDS NO: P1055VS E,7ECTIVE DATQ 02/26/93 RODUCT: AMMONIUM PERSULFATE VAN WATERS & ROGERS INC. MATERIAL SAFETY DATA SHEET PAGE: 010 VERSION: 001 ORDER NO; 310907 PROD NO / 500406 -------------------------- FOR ADDITIONAL INFORMATION ------------------------- CONTACT; MSDS COORDINATOR VW&R KENT DURING BUSINESS HOURS, PACIFIC TIME (206)889-3400 04/06/93 09:07 PRODUCT: 500406 CUST NO: 101509 ORDER NO: 310907 ------------------------------------ NOTICE ----------------------------------- - ** VAN WATERS & ROGERS INC. ("VW&R") EXPRESSLY DISCLAIMS ALL EXPRESS OR --------------------------------------------------------------------------------- IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, -------------------------------------------------------------------------------- WITH RESPECT TO THE PRODUCT OR INFORMATION PROVIDED HEREIN. ** '----------------------------------------------------------------------------- ALL INFORMATION APPEARING HEREIN IS BASED UPON DATA OBTAINED FROM THE MANUFACTURER AND/OR RECOGNIZED TECHNICAL SOURCES, WHILE THE INFORMATION IS BELIEVED TO BE ACCURATE, VW&R PAKES NO REPRESENTATIONS AS TO ITS ACCURACY OR SUFFICIENCY, CONDITIONS OF USE ARE BEYOND VW&RS CONTROL AND THEREFORE USERS ARE RESPONSIBLE TO VERIFY THIS DATA UNDER THEIR OWN OPERATING CONDITIONS TO DETERMINE WHETHER THE PRODUCT IS SUITABLE FOR THEIR PARTICULAR PURPOSES AND THEY ASSUME ALL RISKS OF THEIR USE, HANDLING, AND DISPOSAL OF THE PRODUCT, OR FROM THE PUBLICATION OR USE OF, OR RELIANCE UPON , INFORMATION CONTAINED HEREIN, THIS INFORMATION RELATES ONLY TO THE PRODUCT DESIGNATED HEREIN, AND DOES NOT RELATE TO ITS USE IN COMBINATION WITH ANY OTHER MATERIAL OR IN ANY OTHER PROCESS. *** END OF MSDS *** r P rrE,l c; . rn1 Tod n i^fs- A � P .. AEG f-rE _ s S . �G.9 �' implex S1roplex Time Recorder Co. Gardner, MA 01441-0001 U.S.A. FIRE ALARM TEST/INSTALLATION ACKNOWLEDGEMENT CONTINUATION SHEET _ BOOK It CALL p PG OF PERIPHERAL FUNCTION TEST DEVICE DEVICE LOCATION ANE TYPE AR M S�TELEPHONE T NOTE NO. ANNUN.ZONE OR ZONE ALARMZO SIGNAL ZONE DEVICE TYPE DEVICE LOCATION AR M Ta o . �� E Sl T NOTE NO. ANNUN.ZONE OR TELEPHONE ZONE AtARMZONE OR SIGNAL ZONE u �� G..iYL[,/ LLLJJJ }f jr or _ .1 -S- eLA`D LA $� oJill ALN - J ! ` t PSD = Photoelectric Smk Det 'PS = Manua?Pull Station B = Bell Only TS = Tamper Switch ISO = Ionization Smk Det CPS = Coded Pull Station H = Horn Only WF = Water Flow Sw POD ,= Photo. Duct Smk Det RR = Rate of Rise Ht Det C =Chime OnlyDH =Door Holder IDD = Ion. Duct Smk Del HT = Fixed Temp Heat Del S = Spkr Only FP = Fire Phone DHS = Door Hldr & Smk Del MD = Mercoid Heat Del A/V = Audio Visual PJ = Phone Jack SSD = Sgl Station Smk Det FD = Flame Del V = Visual Only NCS = Nurse Call Sta. BD =Beam Del - - t p �tt�� Ay ) FAILURES AND SYSTEM DEVIATIONS FROM NFPA STANDARDS: None As Follows (describe fully) ADV-0352 1-93 AUTHORITY HAVING JURI$DICTIQO . J;.simpiexINSTALLATION SERVICE ACKNOWLEDGEMENT Simplex Time Recorder Co. CLOSE DATE Gardner, MA 01441-0001-1j:8.A. PAGE OF gTT�OF) - ADDRESS [;ITYtr D S jQTj€ TR ARRIVAL DA BILL. I NO -B L. ZIP -MIN I TRACT BOOK # S CALL # Poll -REG I LABOR -OT I LABOR -DT I MILES TRAVEL -IREG TRAVEL i OT TRAVEL i DT I ` INV TO BR LIST PARTS INSP. MONTH PAID AMOUNT Simpl& chnical Installer Support (TIS), which is provided during normal Simplex Business hours, requires five (5) business days' advance notice for scheduling. Before requesting additional TIS services, please insure that any Installer / Customer'Action items that were identified on previous installation calls are completed. ITEM PRODUUCT I.D. SERIAL # / DESCRIPTION OTY. INV. LOC./SEO. NC USG. UNIT PRICE Z J, Y 2 3 4 5 _ Problem Corrective SERV COMPL. Code Action Project No. JOBSITE INFORMATION Installer: Contact: Phone-#; 7 ' � � i Estimated project completion date Start warranty on listed equip. ent Purpose of Visit/Points Discussed: Ak i r ? j` Foe u - 1 ,v � % -iz r TL Simplex Action Items: - r Installer/Customer Action ltems: ECG Print Customer Name PrinMS'fffiplex Retrev ative Na" a nd Number Customer Signature Simple ep sentative.Signature Adv-1182 White - Customer Yellow - Project Folder Pink - Project Eng./Sales Rep Gold - Book -A ;� t, _. ;y I.D. DATE I0 / tr(? 4 CITY OF EDMONDS FIRE PREVENTION FILE MEMO/HAZARD FORM REPORTED BY & ✓/NI S OF 96�- 70?0 6f i:15 I 774-L/Gs1 Yz�gs(rE SUBJECT ADDRESS: CONCERNS/ � � nib_ /L(� t4 , HAZARDS: FOLLOW-UP: t SIGNED SIGNED I -"%j1MMi 90 19� NOTICE TO PERMITTEE AND/OR OWNER KPARTIAL APPROVAL II VIOLATION L] CORRECTIONS REQUIRED Permit Number g3o7ex/ Owner Ci" c 7-: Job Address 21 I o6- ­7 Z - A-V .,j NO PERMIT -STOP WORK -REMOVE CONSTRUCTION OR OBTAIN PERMIT AND MAKE WORK COMPLY WITH ALL APPLICABLE CITY CODES. CONSTRUCTION IS NOT IN ACCORDANCE WITH APPROVED PLANS AND PERMIT - STOP WORK. MAKE WORK COMPLY WITH APPROVED PLANS AND PERMIT OR REMOVE. STOP WORK - UNTIL AUTHORIZED TO CONTINUE BY CITY INSPECTOR. CORRECTIONS LISTED BELOW MUST BE MADE: BEFORE WORK CAN BE APPROVED AND/OR THE NEXT PHASE IS STARTED; TO AVOID POSTING OF A STOP WORK ORDER, ORDER TO CORRECT, OR ABATEMENT PROCESS. JOB CARD MUST BE POSTED ON SITE AND BE VISIBLE FROM STREET. APPROVED PLANS MUST BE AVAILABLE TO INSPECTOR ON SITE. WORK DESCRIBED BELOW HAS BEEN INSPECTED AND IS APPROVED. CONTACT INSPECTOR AND ARRANGE FOR APPOINTMENT. RECALL FOR INSPECTION. THE ACTIONS OR CORRECTIONS INDICATED ABOVE ARE REQUIRED WITHIN DAYS OR PENALTIES MAY BE APPLIED. FOR INSPECTIONS CALL 771-0220. LjBuilding Division 0Planning Department Engineering Department ` d Fire Department DMONDS Inspector s/S (q � Date CITY OF EDMONDS FIRE PREVENTION / FILE MEMO/HAZARD FORM DATE S/mil REPORTED BY OF SUBJECT �-}-t,� 2-11 OS 72 `� /�-►/ �-L,, ADDRESS: i I Sls CONCERNS/ LA.)ITM�SSc'� HAZARDS FOLLOW-UP PA-6�SS146 ' T15-5 1 QA l 1/ ) hs Fe4, : 3 o SIGNED SIGNED - f-4�4(= CITY OF EDMONDS FIRE PREVENTION FILE MEMO/HAZARD�?FORM DATE ` / Z ` 1 REPORTED BY OF SUBJECT ADDRESS: 7 / 1 o CONCERNS t, HAZARDS] �•';- SIGNED FOLLOW-UP C 1 d.v �� ��v�✓ r`1t ^ram,-'-S' `TC� �- 71-1 (1�iS [ �/ C o u�`'� ti _" Kv q-"4 4.�l,` (moo `J c� c c�d 110z ��-�d 3uo �pl C't4 , 7_ 2 SIGNED Merritt+Pardini Architecture Urban Design Space Planning Interior Design April 13, 1994 Noel Miller 1110 2 t 6'Pt,-- Superintendent of Public Works R E C E I V E City.of Edmonds APR 15 1994 250 5th Avenue N. Edmonds, WA 98020 ED119GpV1 FIRE DES Dear Noel: Re: Operations and Maintenance Center - 91024 Paint Storage Room The purpose of this letter is to inform you of the maximum paint quantities that can be stored in the Paint Storage Room #029 before additional containment measures must be employed. The Paint Storage Room #029 will be considered part of the "Control • Area" which also encompasses the street and water shop bays. The control area will be bounded by a one -hour fire -resistive occupancy separation from the Sign Storage Room and the offices above. If the quantity of paint/flammable material stored in this room does not exceed the amounts listed below, no further spill containment or fire treatment will be required. (From Table 9-A, UBC) Material Class Maximum Gallons Traffic Paint I -A 60 Total Union station Thinner, Epoxy Resin, Historic District P Y 1701 Commerce and Hardener I-C 120 Total Tacoma, Washington 98402-3207 753.0087 The totals shown are double the amounts listed in Table 9-A based on Olympia 206 Tacoma 2063-footnote number 6 which allows a 100% increase for sprinklered buildings. 087 206383-8728 (Fax) (See Attached UBC Table 9-A and related footnotes.) These quantities Members of should be posted in the room. The American Institute of Architects Q ` 2-0- Noel Miller April 13, 1994 Page Two Based on our recent conversation, I understand that the City will receive bulk quantities of paint materials during the summer months only, at which time the paint will be stored and mixed at a separate containment area outside of the building. Any future changes in the type or quantity of paint/flammable material being stored in Room #029 should be verified through the Fire Department to determine if any additional containment measures will be necessary. Please contact me if you have any questions regarding this matter. Sincerely, Randal J. Cook, Project Architect Enclosures cc:GaryMRcComas,E�d`mondsFireI�ept. Jennine Graf, Edmonds Bldg. Dept. db.97-2-36.91024 �; TABLE NO.9-A—EXEMPT AMOUNTS OF HAZARDOUS MATERIALS, LIOUIDS Ibs:: Ta T)'P+�AND CHEMICALS PRESENTING A PHYSICAL HAZARD (410 41.t.oN BASIC QUANTITIES PER CONTROL AREAS ; When two units are given, values within parentheses are In cubic feet (Cu. Ft.) or pounds (Lbs.) t " CONDITION STORAGE' USES —CLOSED SYSTEMS USEZ—OPEN SYSTEMS Solid Lba? Llquld Gellona° Gas Solid Lbs. Llquld Gallons Gas Solid Lbs. Llquld Gellona MATERIAL CLASS (Cu. Ft.) (Lbs.) Cu. Ft. (Cu. Ft.) (Lbs.) Cu. FL (Cu. Ft.) (Lbs.) 1.1 Combustible liquid4,5, ,8,9,10 li N.A. 1207 N.A. N.A. 120 N.A. N.A., 30 III -A N.A. 3307 N.A. N.A. 330 N.A. N.A. 80 III-B N.A. 13,2007,11 N.A. N.A. 13,20011 -' N.A. N.A.". 3,3001' 1.2 Combustible dust Ibs./1000 cu,,ft.12 1 N.A. N.A. 1 N.A. N.A. 1 -N.A. 1.3 Combustible fiber (loose) (100) N.A. N.A. (100) N.A. N.A. (20) N.A., (baled) (1,000) N.A. N.A. (1,000) N.A. N.A. (200).. N.A. 1.4 Cryogenic, Flammable or 45 N.A. N.A. 45 N.A. N.A. 10 oxidizing 2.1 Explosives13 17.14 (1)7,14 N.A. 1/4 0/4) N.A. I/4 (I/4) 3.1 Flammable solid 1256•7 N.A. N.A. 256 N.A. N.A. 256 N.A. 3.2 Flammable gas (gaseous) N.A. N.A. 7506.7 N.A. N.A. 7506.7 N.A: ; N.A.":. (liquefied) N.A. 157 N.A. N.A. 156,7 N.A. N.A. N.A.-. °. 3.3 Flammable Iiquid4,5,649,10 I -A N.A. 307 N.A. N.A. 30 N.A. N.A.'- 10 ". I-B , N.A. - 607 N.A. N.A. 60 N.A. N.A.�;. 151 ;. I-C N.A. 907 N.A. N.A. 90 N..A N.A.- • 20-•' , Combination I -A, I-B, I-C N.A. 1207 N.A. I N.A. 120 N.A- N.A..-- 30 - - -- (Conrinuedi � ,_F,,.;Gr! tr,���i �!•. unu,,d.,. fa r.,,,,t'.: ,I :ai-.".., vi � ;.:;.i,:- r r. ,;i, ,.;,"... ..,; i L:<C, .� ;;:,!:: 2The:aggregate quantity -in -use and storage,shall not exceed the quantity listed for storage. E•.' I' ' ; +' ?The aggregate quantity of nonflammable solid and nonflammable or noncombustible liquid hazardous materials within a single control area of Group B, Division 2 Occupancies used for retail sales may exceed the exempt amounts when such areas are in compliance with the Fire Code. i 411te quantities of alcoholic beverages in retail -sales uses are unlimited provided the liquids are packaged in individual containers not Exceeding four '--liters.. �..._.-..._.._ .� __.� .;_ i ••,,.:.:., .. _ 1 .! _ '- ._- •__.. ._..:_ ! �_ The quantities of medicines, foodstuffs and cosmetics containing not more than .50 percent of volume of 'water -miscible liquids and with the. ! . • remainder of the solutions not beipg flammable in retail sales or storage occupancies are unlimited when packaged in individual containers not I=' exceeding four liters. j ..._.. .. - I j _ _.! I Vor aerosols, see the Fire Code... ; 6Quantities may be increased 100 percent in sprinklered buildings, When Footnote,No. 7 also applies; the increase for both footnotes may be,applied. Quantities -may be increased 100 percent when stored in approved storage cabinets, gas cabinets, fume hoods, exhaust enclosures or safety cans as specified in the Fire Code. When Footnote No: 6 also applies; the increase for both footnotes may be applied.':,. Vor,storage, and use of flammable and combustible liquids in Groups A, B, E, I, M and R Occupancies, see Sections 608. 708, 808, 1008,1104 and . 9For wholesale and retail sales usei also see the Fire Code. ''- -- -- ._j j_ roSpray:application of any quantity of flammable, or combustible liquids shall be conducted as set forth in the Fire Code. j 11The quantities permitted in a sprinklered building are not limited. „; ! j 1 I?A dust.explosion potential is considered to exist if I pound or more of combustible dust per 1,000 cubic feet of volume is normally in suspension or could -be Out into suspension, in all or's portion of•an enclosure or inside pieces,af equipment. This;also-includes combustible.'dust which 1-•-•accumulates on horizontal surfaces -inside buildings or;equipment and which could be put ir)to suspension by an accident, sudden force or small. j explosion. ; .. 14perriiitted in spnnklered buildings only. None is allowed in unsprinklered buildings. 1 One pound of black sporting powder and-20 pounds of smokeless powder are permitted in sprinklered or unspnnklered buildings 1 15Containingpot more than the exempt amounts of Class l tA, Class I B or Class I-C.flammable liquids. _ .` . ' ` ' 16A maximum quantity of 200 pounds of solid or 20 gallons of liquid Class 3 oxidizers may be permitted in Groups I, M and R Occupancies when. �- such materials are necessary for maintenance purposes or operation of equipment as set forth in the Fire Code: 9.108 1991 UNIFORM FIRE CODE I FLAMMABLE LIQUID is a liquid having a flash point below 100°F. and having a vapor pressure not exceeding 40 psia at 1000R Class I liquids include those having flash points below 100°F. and are subdivided as follows: Class I -A liquids include those having a flash point below 73°F. and having a boiling point below 100°F Class I-B liquids include those having a flash point below 73°F. and having a boiling point at or above 1000F = Class I-C liquids include those having a flash point at or above 73°F. and below 100°F FLAMMABLE MATERIAL is (a) a material that will readily ignite from common sources of heat and (b) a material that will ignite at a temperature of 600°F. or less._ . FLAMMABLE SOLID is a solid substance, other than one which is defined as a blasting agent or explosive, that is liable to cause fire through friction or as a result of retained heat from manufacture, which has an ignition temperature below 2120F., or which burns so vigorously or persistently when ignited that it creates a serious hazard. Flammable solids include finely divided solid materials which when dispersed in air as a cloud may be ignited and cause an explosion. - FLASH POINT is the minimum temperature at which a liquid gives off vapors. in sufficient concentrations to form an ignitable mixture with airnear the surface of the liquid within the vessel as specified by"appropriate. test procedures• and apparatus as follows: The flash point of a liquid having a viscosity less than 5.82 centistokes at 100'F. and a flash point below 200°F is determined in accordance with U.F.C. Standard No. 9-1. The flash point of a liquid having a viscosity of 5.82 centistokes or more at 100°F. or a flash point of 200°F. or higher is determined in accordance with U.F.C. Standard No. 9-2. As an alternate, U.F.C. Standard No. 9-3 may be used for testing aviation turbine fuels within the scope of this procedure. As an alternate,. U.F.C. Standard No. 9-4 may be used for paints, enamels, lacquers, varnishes and related products and their components having flash points between 32°F. and 230°F. and having a viscosity less than 1.5 centistokes at 77°F. FLEXIBLE CORD is multiconductorflexible sheathedcable which is used for extension cords, as the connection means for appliances, and for permanent use by connecting pieces of equipment or devices to each other or to the premises wiring system where flexibility or portability is required: B FLOOR AREA is the area included within the surrounding exterior walls of a building or portion thereof, exclusive of vent shafts and coons. The floor area of a building, or portion thereof, not provided with surrounding exterior walls shall be B the usable area under the horizontal projection of the roof or floor above.- - = FLUIDIZED BED is a. container holding powder coating.material which is aerated from below so as to form an air -supported expanded cloud of such material through which the preheated object to be coated is immersed and transported.; . 38 71 1991 UNIFORM FIRE CODE 9.108-9.110 e - _= r <FOLDING AND TELESCOPING SEATING is a structure that is used for tiered seating of persons and which overall shape and size may be reduced, without B being dismantled, for purposes of moving or storing. FOOTBOARDS are that part of a raised seating facility other than an aisle or cross aisle upon which the occupant walks to reach a seat. FUEL BREAK is a strip or block of land on which the vegetation has been permanently modified so that fines burning into it will not propagate across it. FUEL OIL is kerosene or any hydrocarbon oil conformingto nationally - recognized standards and having a flash point not less than 100°F FUMIGANT is a substance which, by itself or in combination with other substances, emits or liberates a gas, fume or vapor used for the destruction or t, control of insects, fungi, vermin, germs, rodents or other pests. Fumigants are .. distinguished from insecticides and disinfectants. FUMIGATION is a process using a fumigant. G _ . • - r jh, B t % Sec. 9.109. GARAGE is a building or portion thereof in which a motor vehicle containing flammable or combustible liquids or gas. in its tank is stored, repaired _ B + or kept.. _ GARAGE, PRIVATE, is a building or a portion of a building not more than ' 1,000 square feet in area in which only motor vehicles used by the tenants of the B building or. buildings on the premises are stored or kept. See Uniform_ Building ' Code Section 1101. ... B I T GARAGE, PUBLIC, is any garage other than a private garage. - GENERAL-PURPOSE WAREHOUSE is a detached building or a. separate a portion of a building used for storage or warehousing operations involving mixed x3 ` commodities. GRANDSTANDS are tiered or stepped seating facilities wherein an area of f ;,r more than 3 square feet is provided for each person. GROUND PIECE is a pyrotechnic device that functions on the ground. Ground pieces include fountains, roman candles, wheels and set pieces. : GUEST is any person hiring or occupying a room for living or sleeping B purposes. GUNPOWDER is any of various powders used in firearms and small arms ammunition as propelling charges. H Sec. 9.110. HANDLING. is the deliberate transport of material by any means # to a point of storage or use. :... HAZARDOUS CHEMICAL REACTION is a'reaction.whichl'generates g- pressure or, byproducts which may cause injury, illness or harm to humans, }' domestic animals, livestock or wildlife HAZARDOUS FIRE AREA is land which is covered with grass, grain brush ! or forest; mhether privately or publicly owned, which is so situated or is of such I,. 39 International Conference of Building Officials i. REGIONAL OFFICE: 2122-112th AVENUE, N.E., SUITE B-300 • BELLEVUE, WASHINGTON 98004 • (206) 451-9541 r�1i / , BOARD OF DIRECTORS /.go OFFICES OF v JERRY J. BARBERA, P.E. CHAIRMAN REGIONAL MANAGER PHIL M. HERRINGTON, C.B.O. DIRECTOR.BUILDING ANDS SAFETY July 30, 1993 RUE REGIONAL ENGINEER RK CHANG, S.E. RENO,NEVADA JAMES E. PERSING, S.E. FIRST VICE-CHAIRMAN Plan Check: 6807 REGIONAL ENGINEER BOB FOWLER, P.E., AIA, C.B.O. DIRECTOR OF BUILDING INSPECTION Project: Public Works Building CHARLES J. WILLIAMS, S.E. ABILENE. TEXAS g REGIONAL ENGINEER SECOND VICE-CHAIRMAN Address: 7110 210th St. SW JAN P. GASTERLAND, C.B.U. 1991 Uniform Building Code BUILDING CODE OFFICER A ST. PAUL, MINNESOTA Occupancy: B2-B1-A3/H4 IMMEDIATE PAST CHAIRMAN Type of Construction: V-N Sprinklered JAMES L MANSON, C.B.O. DIRECTOR, Stories: 2/1 OEPCO THE OFOSPOKANEGS Floor Area: 21520/pi7 500 SPOKANE, WASHINGTON Valuation: $1,402,000 RON F BULLOCK, BUILDING OFFICIAL Occupant Load: 380/40 CHIEF BUILDING OFFICIAL SANDY, UTAH Seismic Zone: 3 PAUL T. ILDWind Speed: 80 mph MANAGER, BUILDINGING AND CODE ND ENFORCEMENT Wind Exposure: B VANCOUVER, WASHINGTON ROBERT J. EPPSTEN, C.B.O. DIRECTOR, BUILDING AND SAFETY Jeannine Graf FREMONT, CALIFORNIA Acting Building Official KENNETH G. LARSEN, C.B.O. DIRECTOR OF BUILDING AND HOUSING 250 5th Ave N CHULA VISTA, CALIFORNIA [�� Edmonds, WA 98020 GORDON W. MURDOCH, P.E., C.B.O. BUILDING OFFICIAL DANA POINT, CALIFORNIA Dear Ms. Graf: ALAN P.OLSON, R.A., C.B.O. ASSISTANT DEVELOPMENT SERVICES DIRECTOR PHOENIX, ARIZONA We have reviewed the plans and associated data for the project mentioned RON PERKEREWICZ, C.B.O. above to see if it conforms to the Uniform Building Code as well as parts of DIRECTOR OF COMMUNITY DEVELOPMENT the Uniform Mechanical Code. We have not reviewed them for requirements COUNTY OF KITSAP PORT ORCHARD, WASHINGTON of federal, or other state and local regulatory agencies. In most cases, the LARRY W. RICHARDS, C.B.O. designer should modify the plans and/or specifications to satisfy these DIRECTOR OF BUILDING SAFETY GLENDALE, ARIZONA comments. THOMAS R. THOMPSON, C.B.O.BUILDING OFFICIAL BROOMFIIELD COLORADO 7�� GENERAL RON K. WATTS, C.B.O. CHIEF OF BUILDING INSPECTIONS BUILDING SAFETY DIVISION 1. We have not reviewed this plan for items which are building code ANCHORAGE. ALASKA related, but are regulated by other departments in your jurisdiction such as ROBERT O. WEBER, P.E., C.B.O. DIRECTOR, DEPARTMENT OF BUILDING zoning, grading etc. COUNTY OF CLARK LAS VEGAS, NEVADA ALLEN O. ZEPPER, C.B.O. 2. Your fire department should approve: BUILDING OFFICIAL STILLWATER. MINNESOTA a. The sprinkler system. , PRESIDENT JAMES E. BIHR, P.E. b. Location of fire hydrants and portable fire extinguishers. FAX NUMBERS Order Department (310) 692-3853 Plan Review (310) 692-3425 ICBO ES, Inc. (310) 695-4694 Administration (310) 699-8031 Northern California (510) 463-3295 Indiana (317) 879-0966 Missouri (816) 741-9475 Texas (512) 343-9116 Washington (206) 637-8939 Main Office: 5360 South Workman Mill Road 0 Whittier, California 90601 0 (310) 699-0541 _ Plan Check 6807 Jeannine Graf, City of Edmonds July 30, 1993 Page 2 3. The fuel pumps should be installed in accordance with Article 79.901 of the UFC. Your fire department should approve the installation. 4. The plans as submitted are not complete. Additional comments may be forthcoming when the completed plans are submitted. OCCUPANCY AND TYPE OF CONSTRUCTION 1. A one hour occupancy separation is required between the Bl occupancy (rooms 025 and 026) and the remainder of building 1. The exact location of the occupancy separation should be indicated on the drawings. 2. The office areas (rooms 028 and 023) could be considered part of the B-1 occupancy if the total area does not exceed 25% of the Bl occupancy. However, the wall between the offices and the remainder of the building should be of one hour construction. 3. The remaining portion of the area adjacent to the B-1 should be separated with a one hour occupancy separation. The following doors should be one hour listed assemblies: 022, 021, 027A, 026A and 027. 4. The floor/ceiling assembly above areas 028, 023, and 024 should be of one -hour fire resistive construction. The plans should clearly indicate the extent of the one hour construction. It would probably be best to provide the one hour floor/ceiling assembly over the entire area between C1/El- C2/E2 and C4/E4-05/E5. 5. Beams, columns, walls and other members supporting the one hour occupancy separation should also be of one hour construction. 6. The columns at D1, El, D2, E2, C2, C4, D4, E4, C5, D5 and E5 should be protected as required for one hour construction. See the attached detail. 7. The corridor wall construction should be wrapped around the columns at lines A2, A7, B7, B3, B4 and B5. Detail should be provided. 8. The exact amount of paint stored in room 029 should be specified. The actual amounts should be less than that shown in Table 9A including provisions of footnotes 6 and 7. 9. Doors 030B, 113 and the double doors into room 113 should be listed 20 minute assemblies and should be included in the door schedule. 10. All glazing in the corridor walls should be listed 3/4 hour assemblies, including the frames. 11. All glazing within a 24" arc of either side of all doors should be safety glazing. The location of all safety glazing should be shown on the plans. Plan Check 6807 Jeannine Graf, City of Edmonds July 30, 1993 Page 3 12. The glazing within 18" of the floor at room 101 and 117 (exterior wall) should be safety glazing. 13. The floors of the bathrooms should be of a smooth, hard, non -absorbent material such as ceramic tile. The walls should be of a similar material for a height of 48". Section 510. 14. Details of the guardrails at the stairs and the cross over bridge should be provided. Section 1711. 15. The brick veneer should be provided with metal ties supported no more than 2 sq ft of veneer (12" o.c. horizontally). The ties should be attached to a #9 gauge wire horizontal joint reinforcement. Section 3006(d). 16. Exit signs should be provided at all doors in the multi -use room (005) and at all exit doors in building #2. Section 3314. - 17. Panic hardware should be provided on doors 001, 103A, 005, 005A, 005B, and 103B. Section 3317(d). 18., The maximum occupant load of room 005 should be posted. Section.3302(b). 19. A hardware schedule for all the doors should be provided. Section 3304. 20. Details of the stairways including rise/run, handrail sizes and location etc. should be provided on the plans. Section 3306. 21. Emergency exit illumination should be provided for the exit system. The location of the illumination devices should be shown. Section 3313. 22. Details should be provided for the through penetration fire stops at the occupancy separation walls and the corridor walls. Section 4304(e). 23. The details should be clarified that the corridor walls are to extend to the underside of the floor sheathing at the first floor and to the underside of the metal deck at the second floor. 24. Details should be provided for protecting the penetrations of the corridor walls by the roof and floor beams and for sealing between the door frames and corridor walls. 25. Complete details should be provided on the plans for lateral bracing of the suspended ceiling system. The prescriptive requirements in the 1988 UBC Standards could be used or the system designed in accordance with Table 23-P footnote 6. 26. All duct penetrations of the corridor walls should be provided with combination smoke/fire dampers. The location of the smoke detector used to control the smoke damper should be shown on the plans. Plan Check 6807 Jeannine Graf, City of Edmonds July 30, 1993 Page 4 27. All duct penetrations of the occupancy separations should be provided with fire dampers. The locations should be shown. 28. Duct penetrations of the ceiling membrane of the one hour floor/ceiling assembly should be protected with ceiling fire dampers. 29. Areas 025 and 026 should be provided mechanical ventilation with OSA at the rate of 1.5 cfm/ft2. See Table 3-4, WSVIAQC. 30. Building #2 (H-4) should be provided with OSA at 1 cfm/ft2 plus exhaust pipe extension and exhaust fan of 300 cfm each repair bay. STATE CODES 1. Insulation: a. The U-value for the walls and ceiling should be adjusted to reflect the use of metal framing members. See Section 502.1.1 WSEC. b. Slab insulation is required and should either extend down between the slab and the foundation wall and be at least 2' long or should extend outside of the foundation across from the slab to the top of the footing or to the frost line (6" minimum). Section 502.1.4.8. C. A vapor retarder is required on the walls and roof ceiling. Section 502.1.6.1. 2. Outdoor air is required for this building. Washington State Ventilation and Indoor Air Quality code. The amount should be justified for the occupancy used so that compliance with Table 3-4 can be verified. 3. Mechanical systems: a. The size of the HVAC system should be justified to be within 150% of the heat loss, infiltration and ventilation requirements of the building. Section 503.2.2. b. An economizer cycle may be required. Section 503.7. C. The ductwork should be insulated per Table 5-11. Section 503.10. d. The piping should be insulated per Table 5-12. Section 503.11. e. The water heater should be labeled to show that it complies with 1987 National Appliance Energy Conservation Act and should have automatic temperature controls. Section 504.2.1. Plan Check 6807 Jeannine Graf, City of Edmonds July 30, 1993 Page 5 f. The shower heads should be equipped with a flow constriction device of 3 gallons per minute or less. Section 504.8.1. 4. Lighting. a. Each full height partitioned space less than 400 sf, rooms should have individual lighting controls. Section 505.2(c). b. All the rooms over 400 sf should have dual level switches. Section 505.2(d). C. The rooms which have natural lighting should have switches to control the luminaries near the window wall. d. All exterior lighting except for signs and security lights should be on automatic controls to reduce or turn them off during daylight hours and period of nonuse of the building. Section 505.2(g). ,, e. The building lighting should be justified. The fixture count, watts/fixture and allowable watts should be provided on the plans. Section 505.3.1 and Table 5-13. The actual wattage used should be calculated to show it is below this amount. MECHANICAL 1. The plans submitted are not complete. Additional comments may be forthcoming when the complete plans are submitted. 2. Locations of all required fire dampers should be shown on the plans. 3. Details of fire dampers consistent with the Sheet Metal and Air Conditioning Contractors' National Association's (SMACNA) Fire Damper and Heat Stop Guide for Air Handling Systems should be shown on the plans. 4. Fire dampers should be equipped with access doors, with a label reading "FIRE DAMPER," as required by Section 1006. 5. Condensate drain from air-conditioning equipment should be shown to drain to an approved location as required by Section 510. 6. Size of condensate drain should be indicated on the plans to ensure compliance with the sizing requirement of Section 510. 7. Overflow drains from air-conditioning units should discharge to conspicuous locations as required by Section 1205. Plan Check 6807 Jeannine Graf, City of Edmonds July 30, 1993 Page 6 8. It should be noted on the plans that each piece of heating, ventilating and air-conditioning equipment shall be labeled to the space served as required by Section 504. 9. Smoke detectors located in the main return -air ducts, ahead of outside -air inlets, serving systems exceeding 2,000 cubic feet per minute should be provided. In addition, smoke detectors should be provided for these systems, in the supply ducts, downstream' of the filters, in compliance with the provisions of Section 1009. Cross -sectional details should be shown on the plans. ACCESSIBILITY, WASHINGTON STATE REGULATIONS 1. Site Accessibility: a. One 8' wide accessible parking spaces should be provided. They should have an adjacent 60" access aisle which may be shared with the other spaces. Section 3107(b)2 and Table #31-F b. A maximum slope of 1:48 should be shown in the HC spaces and among the accessible routes of travel from the HC parking and public sidewalks to the primary entrance(s) to the buildings. Section 3107(b)4 C. The side slopes of the ramp appear to exceed a 1:10 ratio and should be modified. Section 3106(d)8C d. The curb along the edge of the accessible route of travel exceeds 2" above grade and requires a 34" high guard rail with a midrail. Section 3106(d)6 e. Each HC space should be shown as having a ground sign centered between 3 and 5 feet above the parking surface at the head of the space and bearing the words, "State Disabled Parking Permit Required". Section 3107(c) f. Signs should be shown at every parking lot at the major junctions leading to accessible route of travel and accessible building entrances, displaying the International Symbol of Access and indicating the direction of travel. Section 3103(b)4 2. Accessible toilet room facilities: a. A 60" minimum diameter unobstructed floor space should be provided within the toilet rooms (with 12" maximum door encroachment). Section 3106(k)2 b. The details of grab bars such as diameter, clearance, etc. to be provided at the front and sides of the toilet should be shown. Section 3106(k)5C C. Lever -type faucet handles should be provided no more than 17" from the front of the lavatory. Drain pipes and hot water pipes should be shown recessed and insulated or guarded to prevent contact. Section 3106(k)7D Plan Check 6807 Jeannine Graf, City of Edmonds July 30, 1993 Page 7 3. General requirements: - a. Accessible openings should have a 32" minimum clear width. Section 31066)2. (Note: 2'-8" doors may not achieve this.) b. All doors in the building which have a latch set or lock set should have lever -type operating hardware, except doors to mechanical, electrical, janitor and similar rooms which should have knurled operating hardware. Section 3106(q)2 C. Raised "bump" -type of detectable warning surfaces should be provided at the stairs. Sections 3106(d)5 and 3106(q) d. Stairways should have at least one handrail which extends 23" beyond the bottom and 12" beyond the top risers of each stair run. Section 3306(i) e. The open risers at the stairs are not allowed. Section 3106(i)2 f. Stairways should have rounded non -slip nosings which project less than M". Section 3106(i)3. The pre -fabricated ones do not comply. g. The international symbol of access should be displayed at half the public building entrances, accessible public toilet rooms and all areas of evacuation assistance. Section 3103(b)3,4 h. Signs for the visually impaired should be provided to identify public toilet and reception rooms, stairs, elevators and all hazardous rooms such as mechanical, electrical and storage. Section 3106(p,q). Note that the details are quite specific and should be defined completely on the plans. 4. Specific requirements: J a. The type of non -slip floor finishes should be specified in the toilet rooms, shower rooms, shower rooms, and along the accessible route of travel. Section 3106(g) b. The manual fire alarm should be mounted no more than 54" above the floor. Section 3106(o)3 C. Structural supports and/or grab bars should be dimensionally located on the plans. Section 3106(k)11. Note that two grab bars are required at the water closet. Section 3106(k)9,10 Plan Check 6807 Jeannine Graf, City of Edmonds July 30, 1993 Page 8 STRUCTURAL 1. Special inspection should be provided for the following. a. During placement of all reinforced concrete. b. During placement of the concrete anchor bolts. C. During all on -site structural welding. d. During installation of all high -strength bolts. e. During installation of the concrete piles. 2. I cannot review any of the building structure until the plans are submitted from the metal building manufacturer. 3. The concrete piles should comply with all of the requirements of Section 2625(e) for a length of 120% of the flexural length of the pile. Section 2910(e) 4. The concrete anchor bolts at the moment frames should be designed in accordance with Section 2624. The length of embedment should be specified on the plans. 5. Footings on Building #2 that are subjected to uplift forces should be proivded with reinforcement at the top and bottom. 6. If the owner wants to get a separate foundation permit, then the attached form should be completed and kept as part of your records. 7. The loads to the footings should include the weight of the drifted snow at the canopy areas. 8. Design calculations and details should be submitted for the support of the access bridges on Building 1. 9. The maximum height of the CMU veneer should be indicated on the plans and associated details. Our headquarters accounting department in Whittier, California will send you an invoice for this plan reviewing service based on a valuation of $1,502,000. Plan Check 6807 Jeannine Graf, City of Edmonds July 30, 1993 Page 9 I am retaining all data and plans in anticipation of telephone calls from the designer and also that I will be doing the recheck. I am taking the liberty of sending a copy of this plan checking list directly to them. Please instruct him to indicate on a separate sheet on which sheet or detail the corrections may be found. Please feel free to contact us if there are any questions. Very truly yours, Charles J. Williams, S.E. Senior Regional Engineer spm Enclosure