HomeMy WebLinkAbout13004 STOCKDALE HWY (11)PHOENIX FIRE
PROTECTION 2X-27
PAY FROM THIS INVOICE
210 South Cotta Court
Visalia, CA 93292
TEL: (559) 622 -8969
FAX: (559) 622 -9023
LIC # C16- 779030
Name
Date of Se e R
Address
A.M. P.M.
City Stat Zip
k I F Lri Cash
Check#
1:1
Authorized By:
PhoY6 r Ce Fax
Fes. Visa or Mastercard
Email
Location of System Cyli der,Size Slave
Auth #
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 requited services by the establishment
which has received this service and hereby authorized payment,for all services rendered.
Services performed prior to 30 day5.of expiration. I
ZX
Signature Date
Payment due upon completion.
A\ Nozzle 4§0 Links
Hood
Size
Hood System Report
System Description
Date of Se e R Time } A.M. P.M.
Distance
Nozzle 1 Nozzle Nozzle
Annual Semi -Ann 1 Recharge Install Renovation
Location of System Cyli der,Size Slave
Cylinder Size
Nozzle Location/Appliance Coverage .................
Fuse Links 360E i Fuse Links 450F Fuse Links 50OF Other
Fuel Shut -Off Electric Gas \ / Size
Manufacturer Model Number we Dry
Production Date Hydro Date Last Service
Fuse Links - Replaced or Cleaned " ::...:..............
tea
lJp
Serviced By:
Type Appi I Type App] 1. 1 it Type Appl it Type Appl Type Appl Type App]
Distance Distance Distance
Item Inspected
Distance Distance
Nozzle 1 Nozzle Nozzle
Go<<`
PullStation ........................... ...............................
Nozzle
Gas Valve / Electrical Cutoff . ...............................
Nozzle Location/Appliance Coverage ................. a
TankHydro ........................... ............................... 0•
Tank..................................... ............................... ID El
Head........................ ............................... yq- n' El El
Fuse Links - Replaced or Cleaned " ::...:..............
tea
lJp
Systems Installed to Mfctr's Recommendations..
Filter..................................... ...............................
Exhaust Fan .......................... ...............................
Makeup Air .......................... ............................... rrte, i
UL300 .................................. ...............................
Filters - Baffle Style .............. ...............................
K- Class ................................. ...............................
Detection Line ...................... ...............................
System Monitored By: Yes Non'
PH #
Hood & Duct ........................ ............................... 2r
Other..................................... ...............................
Other..................................... ...............................
Type Appi I Type App] 1. 1 it Type Appl it Type Appl Type Appl Type App]
Distance Distance Distance Distance Distance Distance
Nozzle 1 Nozzle Nozzle Nozzle Nozzle Nozzle