HomeMy WebLinkAbout13004 STOCKDALE HWY (5)PHOENIX FIRE
PROTECTION H 2105
PAY FROM THIS INVOICE
210 South Cotta Court
Visalia, CA 93292
TEL: (559) 622 -8969
FAX: (559) 622 -9023
LIC # C16- 779030
Name
Date eryice Time,, A.M.
t .is
Address l `
Annual Semi - Annual
City ( State Zip n
Cash 4
Authorized By:
TankHydro ........................... ...............................
Tank..................................... ...............................
Location of System
Check#
Phone / Cell Fax
Cylinder Size
rr-
Fuse Links 360F
Visa or Mastercard
Email
Other
1
12
Auth #
Description ofAutomatic System
System Description
Date eryice Time,, A.M.
t .is
PullStation ........................... ...............................
Annual Semi - Annual Recharge Install Renovation
Nozzle Location /Appliance Coverage .................
TankHydro ........................... ...............................
Tank..................................... ...............................
Location of System Cylinder Size Slave
r'
Cylinder Size
rr-
Fuse Links 360F Fuse Links 4$OF
Hydrostatic Testing
Other
1
12
Let
0
Failures & Recommendations:
The signature below assures that the above stated services have been rendered accordingly. I have
been given authority to allow and approve payment for such required services by the establishment
which has received this service and hereby authorized payment for all services rendered.
Services performed prior to 30 days of expir tfon.
r
Signature Date
Illood
Size
Payment due upon completion.
Nozzle 4W Links
Hood System Report
System Description
Date eryice Time,, A.M. P.M.
PullStation ........................... ...............................
Annual Semi - Annual Recharge Install Renovation
Nozzle Location /Appliance Coverage .................
TankHydro ........................... ...............................
Tank..................................... ...............................
Location of System Cylinder Size Slave
r'
Cylinder Size
rr-
Fuse Links 360F Fuse Links 4$OF Fuse Links 500F Other
1
12
Fuel Shut -Off Electric Geis Size
1:1
Filter ..................................... ............................... A 1-1
Many acturer Model Number, wets Dry
E]
Make up Air .......................... ............................... M' El
Production Date Hydro Date Last Serviced
Serviced By:
O CD
o o
TYPe APPIt Type APPI '! i ` i Type APPI Type APPI Type APPI Type APPI
Distance Distance Distance Distance Distance Distance
Nozzle Nozzle Nozzle Nozzle Nozzle Nozzle
46
Item Inspected
PullStation ........................... ...............................
Gas Valve / Electrical Cutoff . ...............................
Nozzle Location /Appliance Coverage .................
TankHydro ........................... ...............................
Tank..................................... ...............................
Control Head ....................................................... El Elr9f
Fuse Links - Replaced or Cleaned ....................... 12
Systems Installed to Mfetr's Recommendations.. EV El 1:1
Filter ..................................... ............................... A 1-1 1:1
Fan .......................... ............................... 1:1 E]
Make up Air .......................... ............................... M' El 1:1
300 .................................. ...............................
Filters - Baffle Style ............................................. 1:1 1:1
1 El
Detection Line ...................... ............................... El
System Monitored By: Yes ED No 2 =l
PH #
2 'v El 1:1Hood & Duct ........................ ...............................
Other..................................... ...............................
O CD
o o
TYPe APPIt Type APPI '! i ` i Type APPI Type APPI Type APPI Type APPI
Distance Distance Distance Distance Distance Distance
Nozzle Nozzle Nozzle Nozzle Nozzle Nozzle