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HomeMy WebLinkAboutFire Suppression Systems Report 5/3/2012Pre= Engineered Restaurant Fire Suppression Systems Report n Fan ..a 'n py ar,-,.T •..+, _-.re n p - r3SL!..4A P^ qq G^ 0-7 '-!e) ^ G T } CUSTOMER Name 6e 5-, n a s Address q City ( e --i \ + -a ' State _64 ZIP Telephone / -'( / Store No. Owner or Manager C P .22 27 0 COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT DATE OF SERE TIME o A.M. P. ANNUAL SEMIA Nod RECHAFjQC% // E INSTALLATION RENOVATION LOCATION OF SYSTEM CYLINDERS L 300 C 04ES NO 1 2 Ir MANUFACTURER MOIJEL NUMBER WET DRPCH'AL CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE C FUSE LINKS 360° F FUSE LINKS 450° F. FUSE LINKS 500° F. B OTHER f"- P FUEL SHUT -OFF ELECTRIC GAS SIZE SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE MANUFACTURER'S MANUAL REFERENCE ' PAGE NUMBER: DRAWING NUMBER: DATE 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: /- / .A e'? t C IC zu. heplacea ruse nnKs 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 27. Fuel shut -off in on position 28. Manual & remote set/seals in place 29. Replace systems covers 30. System operational & seals in place 31. Slave system operational 32. Clean cylinder & mount 33. Fan warning sign on hood 34. Personnel instructed in manual operation of system 35. Proper hand portable extinguishers 36. Portable extinguishers properly serviced 37. Service & Certification tag on system NOTE DISCREPANICES OR DEFICIENCIES BELOW C 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 manug6ith the results indicated above. X SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM' CUSTOMER'SAUTHORIZED AGENT The above service technician certifies that.the system was personally inspected and found conditions to,be as indicated on this report. QMVOCp04V MaVI G JURISDICTION