HomeMy WebLinkAbout3605 MT VERNONRange d Systems
SERVICE COMPANY
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Name i C. ; p i 7
Address 7 1 h cJ S _M_ : 12 V
City GC StateC a ZIP
Telephone ,-_^S . Store No.
Owner or Manager _ l :"E
COOKING APPLIANCE LOCATIONS- LEFT TO RIGHT
DATE OF SERVICE
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TIME A.M. P.M.
21. Check travel of cable nuts /S -hooks
22. Piping & conduit securely bracketed
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11-11' 23. Proper separation between fryers & flame
ANNUAL SEMI- ANNUAL RECHARGE INSTALLATION RENOVATION
25. Exhaust fan in operating order
7. If system has been discharged, report same
8. Pressure gauge in proper range (If gauged)
26. All filters in place
27. Fuel shut -off in on position
LOCATION OF SYSTEM CYLINDERS UL 300
11. 6 year maintenance date
12. Inspect cylinder and mount
VES NO
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13. Operate system from terminal link 32. Clean cylinder & mount
MA UFACTUFIER MO L KUMBE ET
33. Fan warning sign on hood -
DRY CHEMICAL
e1 - 0 VAC L C-CC)
34. Personnel instructed in manual operation of system
35. Proper hand portable extinguishers
36. Portable extinguishers properly serviced
37. Service & Certification tag on system
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19. Check fuse links and clean"
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NOTE DISCREPANICES OR DEFICIENCIES BELOW gam
COMMENTS:
CYLINDER SIZE MASTER ° CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
FUSE LINKS 3p60° F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
FUEL SHUT•
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ELECTRIC GAS SIZE
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SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
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1. All appliances properly covered w /correct nozzles 1Z 20. Replaced fuse links
2. Duct and plenum covered w /correct nozzles
3. Check positioning of all nozzles.
21. Check travel of cable nuts /S -hooks
22. Piping & conduit securely bracketed
4. System installed in accordance w /MFG UL listing 11-11' 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
8. Pressure gauge in proper range (If gauged)
26. All filters in place
27. Fuel shut -off in on position
9. Check cartridge weight (If applicable)
10. Hydrostatic test date
28. Manual & remote set/seals in place
29. Replace systems covers
11. 6 year maintenance date
12. Inspect cylinder and mount
30. System operational & seals in place
31. Slave system operational
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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
16. Check operation of gas valve
17. Clean nozzles
18. Proper nozzle covers in place
34. Personnel instructed in manual operation of system
35. Proper hand portable extinguishers
36. Portable extinguishers properly serviced
37. Service & Certification tag on system
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19. Check fuse links and clean" NOTE DISCREPANICES OR DEFICIENCIES BELOW gam
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.
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SERV C T CHNICIAIV P RMIT NO. DATE: TIME: AM PM CUSTOM Fi'S AUTHORIZED- AGENT
The above service technician certifies that the system was personally inspected and found conditions to/be as indicated on this report.
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