HomeMy WebLinkAbout1418 BRUNDAGEPre - Engineered Restaurant Fire Suppression Systems Report
COMPANY
4kA QUALM SERVICES, INC.
5600 SO. UNION
3AKERSFIELD, CA 03307 -5426
Ar,si) 8i? -9;9;i 0 FAX 833 -5512
CUSTOMER
Name A ojo xc 5 -0 e-,ye-
Address a A rs r
City k`) Stated - ZIP lcm
Telephone . 7 Z - C oq g Store No.
Owner or Manager 3 IN tA
COOKING APPLIANCE LOCATIONS: 1EFI'TO RIGHT
DATEOF SERVICE TIME
I v ov
A.M. P.M.
ANNUAL SEMI - ANNUAL RECHARGE INSTALLATION RENOVATION
22. Piping & conduit securely bracketed
I
4. System installed in accordance w /MFG UL listing
LOCATION OF SYSTEM CYLINDERS UL300
5. Hood /duct penetrations sealed w /weld or UL device
RIYES E] NO
24. Proper clearance -flame to filters
MODEL NUMBER
6. Check if seals intact, evidence of tampering
DRY CHEMICAL
jMANUFACTURER
WEST
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
A 9 C o%o0
27. Fuel shut -off in on position
FUSE LINKS 360' F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
10. Hydrostatic test date 29. Replace systems covers
FUELSHUT -OFF ELECTRIC GAS SIZE
12. Inspect cylinder and mount 31. Slave system operational
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
Da
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
b 1 G r { 1
20. Replaced fuse links
Fry P r it rr--
2. Duct and plenum covered w /correct nozzles 21. Check travel of cable nuts /S -hooks
1. All appliances properly covered w /correct nozzles v' 20. Replaced fuse links 0
2. Duct and plenum covered w /correct nozzles 21. Check travel of cable nuts /S -hooks
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 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) 27. Fuel shut -off in on position
9. Check cartridge weight (If applicable) l 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
17. Clean nozzles 36. Portable extinguishers properly serviced
18. Proper nozzle covers in place
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37. Service & Certification tag on system
19. Check fuse links and clean Ai NOTE DISCREPANICES OR DEFICIENCIES BELOW
COMMENTS: ' co (n rn P n c- - o orf C 1 E-' cA tj: A,J(
On this date, -this pre- engineered fire suppression system was inspected and operationally tested in accordance with the fire
suppression system requirements of NFPA17 or 17A, 96 and the manufacturer's manual with the results indicated above.
30
SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM P ``-- GUS-T0 ER-S AUTHORIZED AGENT
The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
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