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Home My WebLink About1705 17 STREET (2)Pre - Engineered Restaurant Fire Suppression Systems Report SERVICE COMPANY AfrA CUl rl 3 tl It -d".": _ -1g .. v. E120 tea. W: 'j l btrr ni. Lt7 CA C'3•70-7 -C-425 661)€333 -5513 FAX KS -5512 C-,k/ CUSTOMER r- Name -C p Il YC Address LSD Z City I c r^, r1 f t c' _ i r' i State ZIP Telephon6,612 32 %f Store No. Owner or Manager DATE OF SERVICE TIME f A.M. P.M. I ANNUAL SEMI- ANNUAL RECHARGE INSTALLATION RENOVATION LOCATION OF SYSTEM CYLINDERS UL 300 W/ i'ES NO 25. Exhaust fan in operating order MANUFACTURER IMODEL NUMBER WET DRY CHEMICAL 27. Fuel shut -off in on position O 28. Manual & remote set/seals in place CY INDER SIZt MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE C-7-, 30. System operational & seals in place 1dI i 31. Slave system operational FUSE LINKS 360* F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER 3 33. Fan warning sign on hood FUEL SHUT -OFF ELECTRIC GAS SIZE M 36. Portable extinguishers properly serviced SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE MANUFACTURER'S MANUAL REFERENCE PAGE NUMBER: DRAWING NUMBER: DATE COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT 21. Check travel of cable nuts /S -hooks 22. Piping & conduit securely bracketed 1. All appliances properly covered w /correct nozzles 2. Duct and plenum covered w /correct nozzles 3. Check positioning of all nozzles. 4. System installed in accordance w /MFG UL listing 5. Hood /duct penetrations sealed w /weld or UL device 6. Check if seals intact, evidence of tampering 7. If system has been discharged, report same 8. Pressure gauge in proper range (If gauged) 9. Check cartridge weight (If applicable) 10. Hydrostatic test date 11. 6 year maintenance date 12. Inspect cylinder and mount 13. Operate system from terminal link 14. Test for proper operation from remote 15. Check operation of micro switch 16. Check operation of gas valve 17. Clean nozzles 18. Proper nozzle covers in place 19. Check fuse links and clean 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. X PERMIT NO. IZED 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 20. Replaced fuse links 21. Check travel of cable nuts /S -hooks 22. Piping & conduit securely bracketed 23. Proper separation between fryers & flame 24. Proper clearance -flame to filters 25. Exhaust fan in operating order 26. All filters in place T 27. Fuel shut -off in on position 28. Manual & remote set/seals in place 29. Replace systems covers 30. System operational & seals in place i 31. Slave system operational ii- i 32. Clean cylinder & mount 33. Fan warning sign on hood 34. Personnel instructed in manual operation of system r 35. Proper hand portable extinguishers M 36. Portable extinguishers properly serviced 37. Service & Certification tag on system d NOTE DISCREPANICES OR DEFICIENCIES BELOW X 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. X PERMIT NO. IZED 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 Pre - Engineered Restaurant Fire Suppression Systems Report SERVICE PpQ, UA P p, P. r•a eve 1111.`1U .RUTY a. 7;7, a e7 -•3y 6i u r. Fj `_?00 SO. U 1,.'J,A EELD, CA 23307 -5425 60i) 833 -5510 FAX 833 -5512 Cl- USTOMER Name T_ V ,CL- l '2V P/y I C Address % '7a %f 5 j City 6- Id State 0) ZIP Telephon L232 s' F: Store No. Owner or Manager COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT DATE OF SERVICE TIME 1 J Aj- P.M. Z 2 i - 21. Check travel of cable nuts /S -hooks ANNUAL SEMI - ANNUAL RECHARGE INSTALLATION RENOVATION LOCATION OF SYSTEM CYLINDERS UL 300 V 21ES NO MANUFACTURER MODELNUMBER WET / DRY CHEMICAL 6. Check if seals intact, evidence of tampering i 25. Exhaust fan in operating order 7. If system has been discharged, report same P( 1 26. All filters in place CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE 9. Check cartridge weight (If applicable) 28. Manual & remote set/seals in place 10. Hydrostatic test date FUSE LINKS 60* F FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER 30. System operational & seals in place 12, Inspect cylinder and mount FUEL SHUT-OFF 31, Slave system operational GASS SIZE 32. Clean cylinder & mount 1 I1 33. Fan warning sign on hood 15, Check operation of micro switch SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE 16. Check operation of gas valve iJ 35. Proper hand portable extinguishers MANUFACTURER'S MANUAL REFERENCE PAGE NUMBER: DRAWING NUMBER: DATE I . All appliances properly covered w /correct nozzles G 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 i 23. Proper separation between fryers & flame 5. Hood /duct penetrations sealed w /weld or UL device i 24. Proper clearance -flame to filters O 6. Check if seals intact, evidence of tampering i 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) 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 i COMMENTS: L 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. X '- %r/ /! ;' Z Ij- y' /% IZ` • J I /I I X J 1 SERVICE TECHNICIAN PERMIT NO. ' DATE: TIME: AM PM WSTOM -SA! H Z D GENT The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report. AUTHORITY HAVING JURISDICTION