HomeMy WebLinkAbout800 FAIRVIEW ROAD (2)Pre - Engineered Restaurant Fire Suppression Systems Report
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Name
Address (
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City P P 1 State, ZIP -2 + \
Telephone 2 7, Store No.
Owner or Manager
DATE OF SERVICE TIME A.M. Pi
2. Duct and plenum covered w /correct nozzles
411
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ANNUAL SEMI- ANNUAL RECHARGE INSTALLATION RENOVATION
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5. Hood /duct penetrations sealed w /weld or UL device T
LOCATION OF SYSTEM CYLINDERS UL 300
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MAN FACTUR MODEL NUMBER WET DRY CHEMICAL
8. Pressure gauge in proper range (If gauged) T 27. Fuel shut -off in on position
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
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10. Hydrostatic test date l
FUS LINKS 360° F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
30. System operational & seals in place
12. Inspect cylinder and mount
FUEL SHOT -OFF ELECTRIC GAS SIZE
32. Clean cylinder & mounts
14. Test for proper operation from remote G 33. Fan warning sign on hood
15. Check operation of micro switch
SERIAL NUMBER LAST HYDROTEST DATE LAST RECHARGE DATE
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
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2. Duct and plenum covered w /correct nozzles
411
3. Check positioning of all nozzles.
1. All appliances properlycovered 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 T/
4. System installed in accordance w /MFG UL listing 23. Proper separation between fryers & flame T
5. Hood /duct penetrations sealed w /weld or UL device T 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 26. All filters in place
8. Pressure gauge in proper range (If gauged) T 27. Fuel shut -off in on position
9. Check cartridge weight (If applicable) 28. Manual & remote set/seals in place
10. Hydrostatic test date l 29. Replace systems covers
11. 6 year maintenance date 30. System operational & seals in place
12. Inspect cylinder and mount 31. Slave system operational LIi
13. Operate system from terminal link 32. Clean cylinder & mounts
14. Test for proper operation from remote G 33. Fan warning sign on hood
15. Check operation of micro switch 34. Personnel instructed in manual operation of system LX
16. Check operation of gas valve 35. Proper hand portable extinguishers
17. Clean nozzles 36. Portable extinguishers properly serviced r
18. Proper nozzle covers in place 37. Service & Certification tag on system y
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.
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SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM CU$TUMER'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