HomeMy WebLinkAbout1109 PACHECO ROAD (4)Pre - Engineered Restaurant Fire Suppression Systems Report
SERVICE COMPANY
A!4A CUALITV SEFVCCMG, INC.
5300 SO. UNION
L. KERSFIELD, CA 93307 -5426
6 r) 833 -5510 FAX 833 -5512
Name e V) I1
Address
city ( ZiTi P C' State _M ZIP233
Telephone 40? 7 -1_20 \ Store No.
Owner or Manager c/P YK (-Ij
DATE OF SERVI E TIME A.M.
RIGHT
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ANNUAL ANNUAL
CYLINDERS
RECHARGE INSTALLATION RENOVATION
LOCATION OF SYSTEM UL 300
NOo' S b J /C/,- c). / /C CJ
4. System installed in accordance w /MFG UL listing
MANUFACTURER MODELNUMBER WET DRY CHEMICAL
I A-107
6. Check if seals intact, evidence of tampering
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25. Exhaust fan in operating order
7. If system has been discharged, report same
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
8. Pressure gauge in proper range (If gauged)
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27. Fuel shut -off in on position
FUSE LINKS 360- F. FUSE LINKS 450° F. FUSE LINKS 500° F OTHER
UEL SHUT-OF ELECTRIC GAS
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SIZE
SERIAL NUMBER LAST HYDROTESTDATE LAST CH GE DATE
30. System operational & seals in place
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12. Inspect cylinder and mount
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
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2. Duct and plenum covered w /correct nozzles
COMMENTS:
On this date, this pre- engineered fire suppression system was inspected and operationally tested in accordanc with the fire
suppression system requirements of NFPA17 or 17A, 96 and the manufacturer's manual with the results indicatod above.
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SERVICE TECHNICIAN' PERMIT NO. DATE: TIME: AM I CUSTOM R'S AUTHORIZED AGENT
The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
AUTHORITY HAVING JURISDICTION
1. All appliances properly covered w /correct nozzles 20. Replaced fuse links
2. Duct and plenum covered w /correct nozzles 21. Check travel of cable nuts /S -hooks 1
3. Check positioning of all nozzles. 22. Piping & conduit securely bracketed
4. System installed in accordance w /MFG UL listing 23. Proper separation between fryers & flame
5. Hood /duct penetrations sealed w /weld or UL device
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24. Proper clearance -flame to filters
6. Check if seals intact, evidence of tampering 25. Exhaust fan in operating order
7. If system has been discharged, report same 26. All filters in place
8. Pressure gauge in proper range (If gauged) LA 27. Fuel shut -off in on position
9. Check cartridge weight (If applicable) 28. Manual & remote set/seals in place
10. Hydrostatic test date 29. Replace systems covers:
11. 6 year maintenance date 30. System operational & seals in place
12. Inspect cylinder and mount 31. Slave system operational
13. Operate system from terminal link 32. Clean cylinder & mount
14. Test for proper operation from remote 33. Fan warning sign on hood
15. Check operation of micro switch 34. Personnel instructed in manual operation of system
16. Check operation of gas valve 35. Proper hand portable extinguishers Z
17. Clean nozzles 36. Portable extinguishers properly serviced
18. Proper nozzle covers in place 37. Service & Certification tag on system
19. Check fuse links and clean NOTE DISCREPANICES OR DEFICIENCIES BELOW
COMMENTS:
On this date, this pre- engineered fire suppression system was inspected and operationally tested in accordanc with the fire
suppression system requirements of NFPA17 or 17A, 96 and the manufacturer's manual with the results indicatod above.
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c;
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SERVICE TECHNICIAN' PERMIT NO. DATE: TIME: AM I CUSTOM R'S AUTHORIZED AGENT
The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
AUTHORITY HAVING JURISDICTION