HomeMy WebLinkAbout-Fire Suppression Systems Report 4/12/2012Pre - Engineered Restaurant -Fire Suppression Systems Report
SERVICE
L A ',;," CITY SERV,'S, INC.
5300 SO. UNION
CA"EMISFoELD, CA 93307 -5426
6 1) 833 -5510 FAX 833 -5512
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CUSTOMER
Name Cx(C LG4CC, `FPt,tCsc E"oow5
Address 23 (
city 45 (-2 V1 State CA- ZI PqDDt
Telephone If ' 327• D Z g Store No.
Owner or.Manager 2 Ay ME-SA
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
DATE OFS VICE TIME A.fj. P.M.
0/19 ,(
21. Check travel of cable nuts /S- hooks
ANNUAL
SEM7ALL
RECHARGE INSTALLATION RENOVATION
LOCATION OF SYSTEM CYLINDERS UL 300
Cir/ 511)e 4DF- - 5100ef4" YES AND
MANUFACTURER MODEL NUMBER WET DRY CHEMICAL
RO
25. Exhaust fan in operating order
7. If system has been discharged, report same
V
26. All filters in place
8. Pressure gauge in proper range (If gauged)
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
PCT SO A9(, PC -1 2 AJ3C
28. Manual & remote set/seals in place
FUSE LINKS 360° F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
11. 6 year maintenance date
J
FUEL SHUT -OFF ELECTRIC GAS SIZE
AItz A11A
32. Clean cylinder & mount
S PPL r
14. Test for proper operation from remote V1,
33. Fan warning sign on hood
SERIAL NUMBER LAST HYDROTEST DATE LAST RECHARGE DATE
34. Personnel instructed in manual operation of system
16. Check operation, of- gas.yalve f
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
1. All appliances properly covered w /correct nozzles 20. Replaced fuse links
2. Duct andplenum covered w /correct nozzles 21. Check travel of cable nuts /S- hooks
3. Check positioning of all nozzles. V/ 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
V
26. All filters in place
8. Pressure gauge in proper range (If gauged)
V
27. Fuel shut -off in on position
9. Check cartridge weight (If applicable) 28. Manual & remote set/seals in place
10. Hydrostatic test date
7-
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 V1.1 32. Clean cylinder & mount
14. Test for proper operation from remote V1,
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.yalve f 35. Proper hand portable extinguishers
17. Clean nozzles r r ~ 36. Portable extinguishers properly serviced
18. Proper nozzle covers in place o 37. Service & Certification tag on system
19. Check fuse links and clean NO 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.
X R,6- A.4;4 ? /2, 111.12•/? l2 : /T I 1 V
SERVICE TECHNICIAN PERMIT NO. DATE:' TIME: AM P
54__
RIZED 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