HomeMy WebLinkAbout1500 WIBLE ROADPre - Engineered Restaurant Fire Suppression Systems Report
SERVICE COMPANY
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M?."`. .cLD, CA 93307 -5426
C01) €333 -5510 FAX 633 -5512
o Name
Address 14/VeJ - ?3
City . 2,- 12 StateK ZIP 9-93D 4
Telephone ' ?4!L ii /J Store No.
Owner or Manager /d
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
DATE OF SE VICE
2-
TIME /
0
A.M. PM.
2-9
l y 3.PO ''Z
ANNUAL SEMI - ANNUAL
e1
RECHARGE J_____TNSTALLATION
22. Piping & conduit securely bracketed
RENOVATION
LOCATION OF SYSTEM CYLINDERS UL 300
ii
57777/
C- P(YES NO
MANUFACTURER MODEL NUMBER WET DRY CHEMICAL
s/eiSl/G P- /02 41__
9. Check cartridge weight (If applicable)
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
29. Replace systems covers
11. 6 year maintenance date
12. Inspect cylinder and mount
FUSE LINKS 360° F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
32. Clean cylinder & mount
14. Test for proper operation from remote 33. Fan warning sign on hood
FUEL SHUT -OFF ELECTRIC GAS SIZE
35. Proper hand portable extinguishers
17. Clean nozzles
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
37. Service & Certification tag on system
19. Check fuse links and clean
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
The above service technician certifies that the system was personally inspected and found conditions to-be as indicated on this report.
AUVMDR07V HAVO 1G JURISDICTION
1. All appliances properly covered w /correct nozzles
fi?Y i6•' l y 3.PO ''Z
The above service technician certifies that the system was personally inspected and found conditions to-be as indicated on this report.
AUVMDR07V HAVO 1G 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
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
7. If system has been discharged, report same
25: Exhaust fan in operating order
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) 28. Manual &.remote set/seals in place
10. Hydrostatic test date 29. Replace systems covers
11. 6 year maintenance date
12. Inspect cylinder and mount
30. System operational & seals in place
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 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 accordance with the fire
suppression system requirements of NFPA17 or 17A, 96 and the manufacturer's manual with the results indicated above.
T_ 1 2' '3
SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM CUSTOMER'S AUTHORIZED AGENT
The above service technician certifies that the system was personally inspected and found conditions to-be as indicated on this report.
AUVMDR07V HAVO 1G JURISDICTION