HomeMy WebLinkAbout4128 CHESTER AVENUE (6)Pre- Engineered Restaurant Fire Suppression Systems Report
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CA 93307 123
Cv) /` 633 -5510 FAX 833 -5512
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Name nS&I e, Diu \mss
Address 0 9) C h C- S i e c- AVI:? . A- I
City State C +A ZIPS!
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Telephone R(„1 Store No.
Owner or Manager n r1
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
DATE OF SERVICE TIME A.M. P.M.
2. Duct and plenum covered w /correct nozzles
2 : 0 L) L__
ANNUAL SEMI - ANNUAL RECHARGE INSTALLATION RENOVATION
23. Proper separation between fryers & flame
5. Hood /duct penetrations sealed w /weld or UL device
LOCATION OF SYSTEM CYLINDERS UL 300
j` Q \ V- -A of k c)0d i rES No
MANUFA URER MODEL NUMBER WET DRY CHEMICAL
A W5v\ L- R - l o zz
8. Pressure gauge in proper range (If gauged)_
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
28. Manual & remote set/seals in place
FUSE LINKSKS 360° F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
FUEL SHUT -OFF ELECTRIC GAS SIZE
12. Inspect cylinder and mount 31. Slave system operational fQ
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
14. Test for proper operation from remote L
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
1. All appliances properly covered w /correct nozzles i 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 i
4. System installed in accordance w /MFG UL listing 23. Proper separation between fryers & flame
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 i
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 fQ
13. Operate system from terminal link 32. Clean cylinder & mount
14. Test for proper operation from remote L 33. Fan warning sign.on hood
15. Check operation of micro switch 34. Personnel instructed in manual operation of system I
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 TAl1A NOTE DISCREPANICES OR DEFICIENCIES BELOW
COMMENTS: J C; ! b i' I l ' F' i / rA Al o H n `, -1
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 results indicated above.
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.
j%UVM0R07V NAVl (,U'G JURISDICTION