HomeMy WebLinkAboutHOOD REPORT 8/15/2011I
PHOENIX FIRE
PROTECTION N1617
PAY FROM THIS INVOICE
210 South Cotta Court
Visalia, CA 93292
TEL: (559) 622 -8969
FAX: (559) 622 -9023
LIC # C16- 779030
I
Name
vC
Address A,
7—?60
A.M. P.M.
Semi - Annual
City PC tate 7i
j Cash
Aut i U r tP
Cylinder Size
Check#
9— visa ]"Visa or Mastercard
Pho I(( Fax
Email
Other
Fuel Shut -Off
Auth #
d System Report
System Description
Dattrof ice Ti e 0 - d A.M. P.M.
Annual Semi - Annual Recharge Install Renovation
Loc ition of System Cylinder Size Slave
Cylinder Size
Fuse Links 360F Fuse Links 450F Fuse Links 50OF Other
Fuel Shut -Off Electric Gas Size
Manufacturer Model Number Wet Dry
Production Date Hydro Date Last Serviced
Servifed By: Quantity Parts & Materials
Blow Off Caps /Seals' Item Inspected
Qaye
Qa Got
Pressurized Cartridges Pull Station ........................... ...............................
Fire Extinguisher Size Gas Valve / Electrical Cutoff . ...............................
Nozzle Location /Appliance Coverage .................
Nitrogen Tank Hydro ........................... ...............................
Tank ..................................... ...............................
Credit Surcharge Control Head ........................ ...............................
IBraketing.............................. ...............................
Fuse Links - Replaced or Cleaned .......................
o r Systems Installed to Mfctr's Recommendations..
tJ Filter ..................................... ...............................
Failures & ee+commendations: r} 5 b /G n Exhaust Fan .......................... ...............................
t, it i IQ Make up Air .......................... ...............................
7
UL 300 .................................. ...............................
G lot/ P . S Filters - Baffle Style .............. ...............................
fp K- Class ................................. ...............................
ar 6I n,r" t Detection Line ...................... ............................... L11 A
The signature below assures that the above stated sery ices have been rendered accordingly. I have System Monitored By: Yes No
been given authority to allow and approve payment for such required services by the establishment PH #
which has received this service and hereby authorized payment for all services rendered. Hood & Duct ........................ ...............................
Other..................................... ...............................
tOther ..................................... ...............................
Services performed prior to,30 days ofexpiration.
fJ ,
Signature Date
Payment due upon completion.
Nozzle Links
Hood
Size
Type App] Type Appl Type Appl Type App] Type App] Type Appl
Distance Distance Distance Distance Distance Distance
Nozzle Nozzle _ _ _ Nozzle _ Nozzle Nozzle Nozzle