HomeMy WebLinkAbout4044 MINGPre- Engineered Restaurant Fire Suppression Systems Report
SERVICE COMPANY
0. 6 1'
CUSTOMER
Name 1 tt1_p(
Address YIN I (i I
ul City State ZIP
Telephone Store No.
Owner or Manager
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
DATE OF SERVICE TIM -- -- A. P.M.
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23. Proper separation between fryers & flame
ANNUAL SEMI - ANNUAL RECHARGE INSTALLATION RENOVATION
26. All filters in place
0r 27. Fuel shut -off in on position
LOCATION OF SYSTEM CYLINDERS UL 300
YES NO
29. Replace systems covers
MANUFACTURER MODEL NUMBER WET DRY CHEMICAL
501 K
32. Clean cylinder & mount
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
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34. Personnel instructed in manual operation of system
FUSE LINKS 360° F. FUSE LINKS 450° F. FUSE LINKS 500° F OTHER
36. Portable extinguishers properly serviced
FUEL SHUT-OFF ELE C GAS SIZE
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
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21. Check travel of cable nuts /S -hooks
22. Piping & conduit securely bracketed
23. Proper separation between fryers & flame
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,
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COMMENTS: al 10499,
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 resultiindicated above.
X 01-
SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM 'CUSTOMER'S AUTHORIZED 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
20. Replaced fuse links
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21. Check travel of cable nuts /S -hooks
22. Piping & conduit securely bracketed
23. Proper separation between fryers & flame
I 24. Proper clearance -flame to filters
25. Exhaust fan in operating order
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26. All filters in place
0r 27. Fuel shut -off in on position
28. Manual & remote set/seals in place
29. Replace systems covers
r 30. System operational & seals in place
E 31. Slave system operational
32. Clean cylinder & mount
1 33. Fan warning sign on hood
34. Personnel instructed in manual operation of system
7- 35. Proper hand portable extinguishers .
36. Portable extinguishers properly serviced
37. Service & Certification tag on system
NOTE DISCREPANICES OR DEFICIENCIES BELOW
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 resultiindicated above.
X 01-
SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM 'CUSTOMER'S AUTHORIZED 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