HomeMy WebLinkAboutHOOD 1/28/2011Range Hood Systems Report
SERVICE COMPANY DATE OF SERVICE I! TIME r ,
A.M. P.M.
ANNUAL SEMI-ANNUAL RECHARGE INSTALLATION RENOVATION
22. Piping & conduit securely bracketed
4. System installed in accordance w /MFG UL listing 23. Proper separation between fryers & flame
LO {{CATION OF SYSTEM CYLINDERS
7, ' f I ^ / ( d i'.
jL 300
OYES NO
MANUFACTURER MODEL NUMBER WET DRY CHEMICAL
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
SFUSELINK 0' F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER ..
CUSTOMER
Names
9. Check cartridge weight (If applicable) i 28. Manual & remote set/seals in place
Address
FUEL SHUT -OFF ELECTRIC GAS SIZE
1 l
City
t ( State 7` ZIP ?)i'
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
Telephone (j Store No.
MANUFACTURER'S MANUAL REFERENCE
31. Slave system operational
PAGE NUMBER: DRAWING NUMBER: DATE
Owner or Manager
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
1. All appliances properly covered w /correct nozzles
t1
20. Replaced fuse links
2. Duct and plenum covered w /correct nozzles 21. Check travel of cable nuts /S -hooks
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 25. Exhaust fan in operating order
7. If system has been discharged, report same jT 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) i 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 37. Service & Certification tag on system
19. Check fuse links and clean NOTE DISCREPANICES OR DEFICIENCIES BELOW
COMMENTS:
On this date, this range hood 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.
SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM fCUSTOMERS AUTHORIZED AGENT
The above,sefvice technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
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