HomeMy WebLinkAbout800 FAIRVIEW ROAD (3)t.
Pre- Engineered Restaurant Fire Suppression Systems Report
SERVICE COMPANY DATE OF SERVICE
z 1Z
TIM
L -15-
A.M. P.M.
ANNUAL SEMI - ANNUAL RECHARGE INSTALLATION RENOVATION
22. Piping & conduit securely bracketed
4. System installed in accordance w /MFG UL listing L
I
5. Hood /duct penetrations sealed w /weld or UL device
LOCATION OF SYSTEM CYLINDERS
1 ( 1 JX 7 1 anal
UL 300
YES -ENO
MANUFACTURER MODEL NUMBER WET DRY CHEMICAL
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
8. Pressure gauge in proper range (If gauged) I
r 27. Fuel shut -off in on position
FUSE LIN S 360° F.
5
FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
CUSTOMER
Name l 'J i
FUEL SHUT -OFF ELECTRIC GAS SIZE
Address eon feA I /1~
12. Inspect cylinder and mount 31. Slave system operational R 1
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
City t ' t F= r dQ e 1 cA State <'4 ZIP E n y
14. Test for proper operation from remote
V
33. Fan warning sign on hood
MANUFACTURER'S MANUAL REFERENCE
Telephone Store No.
34. Personnel instructed in manual operation of system .
PAGE NUMBER: DRAWING NUMBER: DATE
Owner or Manager
COOKINr. APPLIANCE LOCATIONS_ LEFT TO FIGHT
c sl Aj r P=
20. Replaced fuse links
2.- Duct and plenum covered w /correct nozzles
7"14
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 L 23. Proper separation between fryers & flame
5. Hood /duct penetrations sealed w /weld or UL device Z, 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 t 26. All filters in place
8. Pressure gauge in proper range (If gauged) I
r 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 f 30. System operational & seals in place
12. Inspect cylinder and mount 31. Slave system operational R 1
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.
SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM vCIJSTOMER'S AUTHORIZED AGENT
The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
aU NQr,'FiV HAWNG JURISDICTION