HomeMy WebLinkAbout3200 GOSFORD STREETPre - Engineered Restaurant Fire Suppression Systems Report
5390 v0. UN1i0i4
@A! `i+: ;ELD, CA 93307 -5426
1)833-5510 FAX 833 -5512
CUSTOMER
Name
Address _ ),Q QU Gos rn,rj
City 13 K F 1. D State, ZIP,/
Telephone ( L-1.) d 3 - `r3 Store No.
Owner or Manager
DATE OF SERVICE TIME A.M. P.M.
o - .5 - I I 9.- ya I -
ANNUAL SEMI - ANNUAL RECHARGE INSTALLATION RENOVATION
23. Proper separation between fryers & flame
I
5. Hood /duct penetrations sealed w /weld or UL device
LOCATION OF SYSTEMCYLINDERS UL 300
6. Check if seals intact, evidence of tampering
04ES NO
25. Exhaust fan in operating order
MANUFACTURER MODEL NUMBER WET, DRY CHEMICAL
8. Pressure gauge in proper range (If gauged)
a . Y-6
27. Fuel shut -off in on position
CYLINDER IZE MASTER COY/ DER SIZE SLAVE CYLINDER SIZE SLAVE
10. Hydrostatic test date
FUSE LINKS 360° F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
a 0 0
FUEL SHUT -OFF ELECTRIC GAS y" SIZE
P 4/
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
20. Replaced fuse links
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2. Duct and plenum covered w /correct nozzles 21. Check travel of cable nuts /S -hooks
3. Check positioning of all nozzles.
1. All appliances properly covered 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
4. System installed in accordance w /MFG UL listing 23. Proper separation between fryers & flame V14
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 26. All filters in place
8. Pressure gauge in proper range (If gauged) 27. Fuel shut -off in on position
9. Check cartridge weight (If applicable) 28. Manual &. remote set/seals in place_
10. Hydrostatic test date 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 32. Clean cylinder & mount
14. Test for proper operation from remote 33. Fan warning sign on hood
15. Check operation of micro switch L_ 34. Personnel instructed in manual operation of system
16. Check operation of gas valve 35. Proper hand portable extinguishers
17. Clean nozzles 36. Portable extinguishers properly serviced
18. Proper nozzle covers in place 37. Service & Certification tag on system
19. Check fuse links and clean ALA_ NOTE DISCREPANICES OR DEFICIENCIES BELOW
COMMENTS: M( "o
On this date, this pre- engineered fire suppression system was inspected and operationally tested in accordance with the fire
suppression ssysrem requirements of NFPA17 or 17A, 96 and the manufacturer's manual with the results indicated above.
MER'SSERVICETECHNICIANPERMITNO. DATE: TIME: AM P GUST AUTHORIZED AGENT
The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report. i'
AUTHORITY HAVING JURISDICTION