HomeMy WebLinkAboutHOOD REPORT 12-20-11Pre - Engineered Restaurant Fire Suppression Systems Report
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ZI -O, CA 53307 -C-125
833 -5510 FAX 333 -5512
CUSTOME
Name U 5 / i
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Address 1 ri 7 t J l,l ,n , ,,, A V P
City I ", , K O f s f, 6 trA State ` -1A ZIP 9-13-0-'7
Telephone
Owner or Manager
Store No.
DATE OF SERVICE TIME A.M. P.M.
12 -LV- II 1.440
21. Check travel of cable nuts /S -hooks
1-1
ANNUAL SEMI - ANNUAL RECHARGE INSTALLATION RENOVATION
23. Proper separation between fryers & flame
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5. Hood /duct penetrations sealed w /weld or UL device
LOCATION OF SYSTEM CYLINDERS UL 300
L` 1 4 il• E]YES NO
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MODEL.^NUMBERMANUFACTURER
i 26. All filters in place
DRY CHEMICAL
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WET
CYLINDER SIZE MASTER CYLINDEA SIZE SLAVE CYLINDER SIZE SLAVE
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10. Hydrostatic test date
FUSE LINK 360° F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
30. System operational & seals in place
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FUEL SHUT -OFF ELECTRIC GAS SIZE
32. Clean cylinder & mount
14. Test for proper operation from remote L
SERIAL NUMBER TEST DATE LAST RECHARGE DATET_`HYO
09
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
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21. Check travel of cable nuts /S -hooks
3. Check positioning of all nozzles.
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 i 25. Exhaust fan in operating order
7. If system has been discharged, report same i 26. All filters in place i
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 30. System operational & seals in place
12. Inspect cylinder and mount 31. Slave system operational Ai/ i
13. Operate system from terminal link 32. Clean cylinder & mount
14. Test for proper operation from remote L 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: S /s4
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.
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SERVI E TECHNICIAN PERMIT NO. DATE: TIME: AM PM CUSTOM E '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