HomeMy WebLinkAboutHOOD REP. 9/2/2011PHOENIX FIRE
PROTECTION 115501
PAY FROM THIS INVOICE
21.0 South Cotta Court
Visalia, CA 93292
TEL: (559) 622 -8969
FAX: (559) 622 -9023
LIC # C 16- 779030
Name 11
Address
4
City '% f t Sta Zip
I PCash FAP
Authorized By:
Carbon .
Check#
ot}e' / J Cel1 Fax
Visa or Mastercard
Email
Auth #
Description of _
1
Carbon .
Description OfAutomatic System
Parts & Materials
Fuse Links
Blow Off Caps/Seals
Pressurized Cartridges
l-
IFirewyLF1Extinguisher
Credit -
NA"i
Failures & Recommendations:
The signature below assures that the above stated services have been rendered accordingly. I have
been given authority to allow and approve payment for such required services by the establishment
which has received this service and hereby authorized payment for all services rendered.
Services perfo' e prior to 30 days yfbpiration.
Signature ate
Payment due up®>il - completion.
Hood
Size
I()
Nozzle - 41111111 Links
V
Hood System Report
System Desc>ripUon
Dat f.Servicgg f
Time A.M. P.M.
Annual Semi - Annual Recharge Install Renovation
Location of ( /System \
1
Cylinder Size Slave
Cylinder Size ,- C..
Fuse Links 360F Fuse Links 450F Fuse Links 50OF Other
Fuel Shut -Off Electric Gas Size
11/ Y..
Manufacturer Model Number Wet Dry
Production Date Hydro Date Last Service
Serviced By:
le
Item Inspected
Qagg
Fa Go"
ep
Pull Station ........................... ...............................
Gas Valve / Electrical Cutoff . ............................... ,
Nozzle Location /Appliance Coverage ................. r
TankHydro .......................... ............................... Q
Tank..................................... ...............................
Control Head ........................ ............................... El El
Braketin
Fuse Links - Replaced or leaned ........ ............
Systems Installed to Mfetr's Recommendations ..
Filter ..................................... ...............................
ExhaustFan .......................... ...............................
Makeup Air .......................... ...............................
UL300 .................................. ............................... t ..
Filters - Baffle Style .............. ...............................
K- Class ................................. ............................... ',
Detection Line ...................... ...............................
System Monitored By: Yes No'
PH #
Hood& Duct ........................ ...............................
Other..................................... ...............................
Other..................................... ...............................
Type Appl `` ` Type Appl Type Appl Type App] Type App] Type Appl
Distance
A
Distance Distance
Nozzle Nozzle Nozzle
Distance Distance Distance
Nozzle Nozzle Nozzle _
Parts & Materials
Fuse Links
Blow Off Caps/Seals
Pressurized Cartridges
l-
IFirewyLF1Extinguisher
Credit -
NA"i
Failures & Recommendations:
The signature below assures that the above stated services have been rendered accordingly. I have
been given authority to allow and approve payment for such required services by the establishment
which has received this service and hereby authorized payment for all services rendered.
Services perfo' e prior to 30 days yfbpiration.
Signature ate
Payment due up®>il - completion.
Hood
Size
I()
Nozzle - 41111111 Links
V
Hood System Report
System Desc>ripUon
Dat f.Servicgg f
Time A.M. P.M.
Annual Semi - Annual Recharge Install Renovation
Location of ( /System \
1
Cylinder Size Slave
Cylinder Size ,- C..
Fuse Links 360F Fuse Links 450F Fuse Links 50OF Other
Fuel Shut -Off Electric Gas Size
11/ Y..
Manufacturer Model Number Wet Dry
Production Date Hydro Date Last Service
Serviced By:
le
Item Inspected
Qagg
Fa Go"
ep
Pull Station ........................... ...............................
Gas Valve / Electrical Cutoff . ............................... ,
Nozzle Location /Appliance Coverage ................. r
TankHydro .......................... ............................... Q
Tank..................................... ...............................
Control Head ........................ ............................... El El
Braketin
Fuse Links - Replaced or leaned ........ ............
Systems Installed to Mfetr's Recommendations ..
Filter ..................................... ...............................
ExhaustFan .......................... ...............................
Makeup Air .......................... ...............................
UL300 .................................. ............................... t ..
Filters - Baffle Style .............. ...............................
K- Class ................................. ............................... ',
Detection Line ...................... ...............................
System Monitored By: Yes No'
PH #
Hood& Duct ........................ ...............................
Other..................................... ...............................
Other..................................... ...............................
Type Appl `` ` Type Appl Type Appl Type App] Type App] Type Appl
Distance
A
Distance Distance
Nozzle Nozzle Nozzle
Distance Distance Distance
Nozzle Nozzle Nozzle _
Failures & Recommendations:
The signature below assures that the above stated services have been rendered accordingly. I have
been given authority to allow and approve payment for such required services by the establishment
which has received this service and hereby authorized payment for all services rendered.
Services perfo' e prior to 30 days yfbpiration.
Signature ate
Payment due up®>il - completion.
Hood
Size
I()
Nozzle - 41111111 Links
V
Hood System Report
System Desc>ripUon
Dat f.Servicgg f
Time A.M. P.M.
Annual Semi - Annual Recharge Install Renovation
Location of ( /System \
1
Cylinder Size Slave
Cylinder Size ,- C..
Fuse Links 360F Fuse Links 450F Fuse Links 50OF Other
Fuel Shut -Off Electric Gas Size
11/ Y..
Manufacturer Model Number Wet Dry
Production Date Hydro Date Last Service
Serviced By:
le
Item Inspected
Qagg
Fa Go"
ep
Pull Station ........................... ...............................
Gas Valve / Electrical Cutoff . ............................... ,
Nozzle Location /Appliance Coverage ................. r
TankHydro .......................... ............................... Q
Tank..................................... ...............................
Control Head ........................ ............................... El El
Braketin
Fuse Links - Replaced or leaned ........ ............
Systems Installed to Mfetr's Recommendations ..
Filter ..................................... ...............................
ExhaustFan .......................... ...............................
Makeup Air .......................... ...............................
UL300 .................................. ............................... t ..
Filters - Baffle Style .............. ...............................
K- Class ................................. ............................... ',
Detection Line ...................... ...............................
System Monitored By: Yes No'
PH #
Hood& Duct ........................ ...............................
Other..................................... ...............................
Other..................................... ...............................
Type Appl `` ` Type Appl Type Appl Type App] Type App] Type Appl
Distance
A
Distance Distance
Nozzle Nozzle Nozzle
Distance Distance Distance
Nozzle Nozzle Nozzle _
le
Item Inspected
Qagg
Fa Go"
ep
Pull Station ........................... ...............................
Gas Valve / Electrical Cutoff . ............................... ,
Nozzle Location /Appliance Coverage ................. r
TankHydro .......................... ............................... Q
Tank..................................... ...............................
Control Head ........................ ............................... El El
Braketin
Fuse Links - Replaced or leaned ........ ............
Systems Installed to Mfetr's Recommendations ..
Filter ..................................... ...............................
ExhaustFan .......................... ...............................
Makeup Air .......................... ...............................
UL300 .................................. ............................... t ..
Filters - Baffle Style .............. ...............................
K- Class ................................. ............................... ',
Detection Line ...................... ...............................
System Monitored By: Yes No'
PH #
Hood& Duct ........................ ...............................
Other..................................... ...............................
Other..................................... ...............................
Type Appl `` ` Type Appl Type Appl Type App] Type App] Type Appl
Distance
A
Distance Distance
Nozzle Nozzle Nozzle
Distance Distance Distance
Nozzle Nozzle Nozzle _