Get Hcd Mp 532

STATE OF CALIFORNIA BUSINESS TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF HOUSING AND COMMUNITY DEVELOPMENT DIVISION OF CODES AND STANDARDS PARK FIRE HYDRANT TEST AND CERTIFICATION REPORT SEE THE REVERSE SIDE FOR INSTRUCTIONS ON COMPLETING THIS FORM ATTACH PARK PLOT PLAN SHOWING HYDRANT LOCATION NUMBERS Part I - Identification Park Name Park ID Park Address Total Number of Hydrants in the Park Number of Lots Water System Check One Public Private Date of Park Construction Part II - Fire Hydrant Operation Test YES NO 1. All hydrant stems threads and caps were inspected for damage and lubrication* 2. All hydrant outlets were fully opened and closed to ensure smooth operation* 3. All hydrant shut off valves were closed and fully reopened to ensure adequate water flow. 4. All hydrants are accessible with outlets 14 inches to 24 inches above grade. 5. All crash posts are in place to prevent vehicular damage. 7. Each hydrant is clearly identified or marked* ITEMS 8 THRU 10 FOR PARK USING PRIVATE SYSTEM AS ADDRESSED IN SECTION 1312 TITLE 25 CHAPTER 2 CCR* 8. Correct nozzles are provided per Section1312 Title 25 CCR* 9. All required gaskets are in good condition* 10. Hose was service tested Date Please explain all No answers on an additional sheet. FOR MORE THAN Hydrant Number REQUIRED EVERY 5 YEARS HYDRANTS IN THE PARK ATTACH ADDITIONAL LIST USING FORMAT BELOW* Barrel Size inches DATE FLOW TEST PERFORMED Flow GPM Pressure PSI PSI - RESIDUAL PRESSURE MEASURED IN POUNDS PER SQUARE INCH. GPM -GALLONS PER MINUTE Part IV CERTIFICATION Certifier Name Address HCD MP 532 New 5/01 Side 1 Contractor s Classification and License Number Telephone Number E-Mail Printed Name Title Signature Date Park Operator Name Phone Number Date Submitted Operator Address to Enforcement agency Park Fire Agency. All hydrant stems threads and caps were inspected for damage and lubrication* 2. All hydrant outlets were fully opened and closed to ensure smooth operation* 3. All hydrant shut off valves were closed and fully reopened to ensure adequate water flow. 4. All hydrants are accessible with outlets 14 inches to 24 inches above grade. All hydrant shut off valves were closed and fully reopened to ensure adequate water flow. 4. All hydrants are accessible with outlets 14 inches to 24 inches above grade. 5. All crash posts are in place to prevent vehicular damage. 7. Each hydrant is clearly identified or marked* ITEMS 8 THRU 10 FOR PARK USING PRIVATE SYSTEM AS ADDRESSED IN SECTION 1312 TITLE 25 CHAPTER 2 CCR* 8. 5. All crash posts are in place to prevent vehicular damage. 7. Each hydrant is clearly identified or marked* ITEMS 8 THRU 10 FOR PARK USING PRIVATE SYSTEM AS ADDRESSED IN SECTION 1312 TITLE 25 CHAPTER 2 CCR* 8. Correct nozzles are provided per Section1312 Title 25 CCR* 9. All required gaskets are in good condition* 10. Correct nozzles are provided per Section1312 Title 25 CCR* 9. All required gaskets are in good condition* 10. Hose was service tested Date Please explain all No answers on an additional sheet. FOR MORE THAN Hydrant Number REQUIRED EVERY 5 YEARS HYDRANTS IN THE PARK ATTACH ADDITIONAL LIST USING FORMAT BELOW* Barrel Size inches DATE FLOW TEST PERFORMED Flow GPM Pressure PSI PSI - RESIDUAL PRESSURE MEASURED IN POUNDS PER SQUARE INCH.