HomeMy WebLinkAboutFIRE SUPPRESSIN SYSTEM REP 9/24/2012Pre - Engineered Restaurant" Fire Suppression Systems Report
hM QUAUTY SERVICES, INC.
5300 S0. UNNION
BAKERSFIELD, Cry 93307 -5426
661) 833 -5510 FAX 833 -5x12
Name I-10 P _: - 0
Address q ?_ -Z I -S • f 7 _ 5+
City l`7 ,- t:L State n ZIP _'13_3024
Telephone Store No.
Owner or Manager
D[ ATE OF SERVICE TIME A. A.M. P.M.
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ANNUAL SEMI - ANNUAL RECHARGE INSTALLATION RENOVATIONI
LOCATION OF SYSTEM CYLINDERS UL300
0 f ; loo 4:> QYES NO
MANUFACTURER MODEL NUMBER WET DRY CHEMICAL
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
33,1 721
FUSE LINKS 360° F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
0 3
FUEL SHUT -OFF ELECTRIC GAS SIZE
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
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MANUFACTURE 'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
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1. All appliances properly covered w /correct nozzles
2. Duct and plenum covered w /correct nozzles
P. 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 " d: ischarged, 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
COMMENTS:
20. Replaced fuse links
3 21. Check travel of cable nuts /S -hooks
22. Piping & conduit securely bracketed .
23. Proper separation between fryers & flame 1
24. Proper clearance -flame to filters f
t 25. Exhaust fan in operating order
26. All filters in place J--
d 1 27. Fuel shut -off in on position
28. Manual & remote set/seals in place
29. Replace systems covers
i 30. System operational & seals in place -
31. Slave system operational
i- 32. Clean cylinder & mount
9 33. Fan warning sign on hood
34. Personnel instructed in manual operation of system
35. Proper hand portable extinguishers Q
36. Portable extinguishers properly serviced
37. Service & Certification tag on system
N NOTE DISCREPANICES OR DEFICIENCIES BELOW
Vto F ? 111 1 1 ..d t/ "-' ( 1) r, ^ '' , 11 . _. A, 1 T • 4
On this date, this pre- engineered fire suppression system was inspected and operationally, tested in accordancewith the fire
suppression system requirements of NFPA17 or 17A, 96 and the manufacturer's manual with the results indicated above.
X ' "'} I C,I -L f-f L l•( tit
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.
AUiTHOR11 TV HAV(I G dURMDIiCTIOM