
Wet Pipe
Fire Sprinkler System
California Code of Regulations - Title 19
Inspection, Testing, and Maintenance
5 Year
Report
2 of 3
Property Information Contractor or Licensed Owner Information
Building Name Name
Address Job #
City
ANNUAL INSPECTION, TESTING, AND MAINTENANCE
Include ALL Quarterly Inspections (See AES 2.1)
I = Inspection T = Test M = Maintenance
P = Pass F = Fail N/A = Not Applicabl
Item Description
NFPA 25 CA ed.
Reference
Date Comments Only P,F,N/A
1.17 I Small Hose Connections - Hose Valve*
5.1.6, 13.5.2
13.5.5.1
1.18 I PRV – Fire Sprinkler Systems 13.5.1.1
1.19 I Buildings (Freeze Protection) 4.1.1.1 Owner’s Responsibilit
1.20 I Sprinklers 5.2.1
1.21
I Sprinklers - Accessible Concealed Space 5.2.1.1.6
1.22
I Pipe and Fittings 5.2.2
1.23
I Pipe and Fittings - Accessible Concealed Space 5.2.2.3
1.24 I Hangers 5.2.3
1.25 I Hangers - Accessible Concealed Space 5.2.3.3
1.26 I Seismic Braces 5.2.3
1.27 I Seismic Braces - Accessible Concealed Space 5.2.3.3
1.28 I Unsprinklered Areas CFC 901.4 Yes No
2.1 T
Field Service Test Required
Send Report to Fire Code Official
5.3.1
If REQUIRED, Enter 'F' until
results are returned from Lab
2.2 T
Recalled Sprinklers
If not present = Pass; If present = Fail
Title 19
904.1(c)
2.3 T
Water Flow Alarm Devices
90 secs max. Enter time
5.3.3
13.2.6
sec.
2.4 T
Main Drain Test
(Enter data on Page 1 of this form)
13.2.5
13.3.3.4
2.5 T Control Valve - Position 13.3.3.2
2.6 T Control Valve – Operation 13.3.3.1
2.7 T Supervisory Devices 13.3.3.5
2.8 T Backflow Preventer Assemblies 13.6.2
2.9 T
Small Hose Connections*
w/PRV Hose Valves – Partial Flow Test
13.5.2.3
13.5.3.3
2.10 T PRV – Fire Sprinkler Systems 13.5.1.3
2.11 T Pressure Gauges - Calibration 5.3.2
2.12 T
Small Hose Connections
*
13.5.6.2.2
* Small hose connections are hose valves and optional hose supplied by the fire sprinkler system. They do not include Class I, II, or III
standpipe systems.
Form AES 2.
Se
t. 3, 2013