Certificate Aboveground Piping

Contractors Material and Test Certificate for Aboveground Piping
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PROCEDURE
Upon completion of work, inspection and tests shall be made by the contractors representative and witnessed by the property owner or their authorized agent. All defects shall be corrected and system left in service before contractors personnel finally leave the job. A certificate shall be filled out and signed by both representatives. Copies shall be prepared for approving authorities, owners, and contractor. It is understood the owners representatives signature in no way prejudices any claim against contractor for faulty material, poor workmanship, or failure to comply with approving authoritys requirements or local ordinances. Property name Property address

Accepted by approving authorities (names) Address
Date
Yes Yes No No
Plans
Installation conforms to accepted plans Equipment used is approved If no, state deviations
Yes No
Has person in charge of fire equipment been instructed as to location of control valves and care and maintenance of this new equipment? If no, explain
Yes Yes Yes No No No
Instructions
Have copies of the following been left on the premises? 1. System components instructions 2. Care and maintenance instructions 3. NFPA 25 4. With whom have the copies been left?
Location of system
Supplies buildings
Make
Model
Year of manufacture
Orifice size
Quantity
Temperature rating
Sprinklers

Alarm device Type Make

Type of pipe Type of fittings
Pipes and fittings
Alarm valve or flow indicator
Maximum time to operate through test connection Model Minutes Seconds
For individual use. No other reproduction or transmission in any form permitted.
1 of 5
2 of 5
Dry valve Make Model Serial No. Make
Q.O.D Model Serial No.
Dry pipe operating test
Time to trip through test connection a,b Minutes Seconds
Water pressure psi Air pressure psi
Trip point air pressure psi
Alarm operated properly Yes No
Time water reached test outlet a,b Minutes Seconds
Without Q.O.D. With Q.O.D. Operation

Pneumatic

Electric

Hydraulics
If no, explain
Piping supervised
Yes
No
Detecting media supervised
Yes Yes
No No
Does valve operate from the manual trip, remote, or both control stations?
Deluge and preaction valves
Is there an accessible facility in each circuit for testing? Yes Make Model No
If no, explain
Does each circuit operate supervision loss alarm? Yes No Does each circuit operate valve release? Yes No Maximum time to operate release Minutes Seconds
Pressurereducing valve test

Location and floor
Make and model
Setting
Flow rate Flow (gpm)
Static pressure Inlet (psi) Outlet (psi)
Residual pressure (flowing) Inlet (psi) Outlet (psi)
Test description
Hydrostatic: Hydrostatic tests shall be made at not less than 200 psi (13.6 bar) for 2 hours or 50 psi (3.4 bar) above static pressure in excess of 150 psi (10.2 bar) for 2 hours. Differential dry pipe valve clappers shall be left open during the test to prevent damage. All aboveground piping leakage shall be stopped. Pneumatic: Establish 40 psi (2.7 bar) air pressure and measure drop, which shall not exceed 1 psi (0.1 bar) in 24 hours. Test pressure tanks at normal water level and air pressure and measure air pressure drop, which shall not exceed 1 psi (0.1 bar) in 24 hours. All piping hydrostatically tested at Dry piping pneumatically tested Equipment operates properly
psi (
Yes Yes
bar) for
No No
hours
If no, state reason
Do you certify as the sprinkler contractor that additives and corrosive chemicals, sodium silicate or derivatives of sodium silicate, brine, or other corrosive chemicals were not used for testing systems or stopping leaks?
Yes No
Tests
Drain test
Reading of gauge located near water supply test connection:
Residual pressure with valve in test connection bar) open wide:
psi(
Other
psi(
Explain
bar)
Underground mains and lead-in connections to system risers flushed before connection made to sprinkler piping Verified by copy of the Contractor's Material and Test Certificate for Underground Piping. Flushed by installer of underground sprinkler piping If powder-driven fasteners are used in concrete, has representative sample testing been satisfactorily completed?
Yes Yes Yes No No No
If no, explain
3 of 5
a b
Measured from time inspectors test connection is opened. NFPA 13 only requires the 60-second limitation in specific sections.
4 of 5
5 of 5

Certificate Aboveground Piping

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Certificate Aboveground Piping

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Contractors Material and Test Certificate for Aboveground Piping

Insert logo here

Contractors Material and Test Certificate for Aboveground Piping

Yes Yes Yes No No No

Pipes and fittings

Alarm valve or flow indicator

Maximum time to operate through test connection Model Minutes Seconds

For individual use. No other reproduction or transmission in any form permitted.

Contractors Material and Test Certificate for Aboveground Piping

For individual use. No other reproduction or transmission in any form permitted.

Contractors Material and Test Certificate for Aboveground Piping

Dry valve Make Model Serial No. Make

Q.O.D Model Serial No.

Dry pipe operating test

Time to trip through test connection a,b Minutes Seconds

Water pressure psi Air pressure psi

Trip point air pressure psi

Alarm operated properly Yes No

Time water reached test outlet a,b Minutes Seconds

Without Q.O.D. With Q.O.D. Operation

Detecting media supervised

Deluge and preaction valves

Pressurereducing valve test

Make and model

Flow rate Flow (gpm)

Static pressure Inlet (psi) Outlet (psi)

Residual pressure (flowing) Inlet (psi) Outlet (psi)

If no, state reason

Reading of gauge located near water supply test connection:

Residual pressure with valve in test connection bar) open wide:

For individual use. No other reproduction or transmission in any form permitted.

Contractors Material and Test Certificate for Aboveground Piping

For individual use. No other reproduction or transmission in any form permitted.

Contractors Material and Test Certificate for Aboveground Piping

For individual use. No other reproduction or transmission in any form permitted.

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