Ocfa Water Availability Form
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1OCFA WATER AVAILABILITY FORM
SECTION A: To be completed by customer
Project Name: ____________________________________
OCFA SR #: _____________________
ASSIGNED UPON PLAN SUBMITTAL
Project Address: ___________________________________
City: ____________________________
Applicant Phone #: (______)__________________________
Fax #: (______) ___________________
2
Area of largest building ___________ ft
;
Construction type?
IA
IB IIA IIB IIIA IIIB IV
VA VB
(check one):
Is this building sprinklered throughout?
N
Y
(check one)
SECTION B: To be completed by local water department/district
Customer to provide results to OCFA
Water Department/District: ______________________________________________________________
Test location
: __________________________________
(indicate address or cross-streets & provide reference map)
Hydrant number(s)
: ___________________________________________________________
(if applicable)
Elevation of test hydrant: _______________________________________________ feet above sea level
1
1
Date of Test
: _____________________________
Time of test
: _____________________
am
pm
1
Test to be performed as close as possible to the time that the lowest flows and pressures are expected (e.g., M-F, 6:00 – 9:00 am and 5:00 - 9:00 pm)
FLOW TEST RESULTS
TEST INFORMATION IS VALID FOR 6 MONTHS FROM DATE TEST IS PERFORMED
Static pressure:
psi
Residual pressure:
psi
Flow calc’d at 20 psi:
Observed flow:
gpm
gpm
Check the box if the test information above was obtained in a manner other than an actual flow test (i.e. by computer modeling).
Based on fluctuations known to exist at the site of the test, provide estimated values for the following:
Maximum static pressure
psi
Minimum static pressure
psi
Minimum residual pressure
psi
Minimum residual flow
gpm
I have witnessed and/or reviewed this water flow information and by personal knowledge and/or on-site
observation certify that the above information is correct.
Name: _____________________________________
Company/Agency: _________________________
Signature: __________________________________
Title: ___________________________________
Date: ______________________________________
Revised 1/7/16 ese
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Parent category: Legal