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5416 CALIFORNIA AVENUE
PHOENIX FIRE PROTECTION H 1704 PAY FROM THIS INVOICE 210 South Cotta Court Visalia, CA 93292 TEL: (559) 622 -8969 FAX: (559) 622 -9023 LIC # C16- 779030 Nam, Addre s '• n ` vl City i>` State Zi t ( ` Cash Check4 Visa or Mastercard Auth # Authorized By: Pho Fax Email Quantity Parts & Materials Fuse Links Q Blow Off Caps /Seals Pressurized Cartridges Fire Extinguisher Size Nitrogen Credit Surcharge luxes & Recommendationns: A 1 Al) e. c /+ n t _ The signature below assures that the above stated services have been rendered accordingly. I have been given authority to allow and approve payment for such required services by the establishment which has received this service and hereby authorized payment for all services rendered. Services performed prior to 30 days of expiration. Signature Date' Payment due upon completion. Hood Size uI Nozzle ® Links 4 0 Type App] e tr tDistance Nozzle Hood System Report System )Descriptllon Date of Serce Time A.M. P.M. a nnual Semi - Annual Recharge Install Renovation Location of Syste Range Guard O G 4 Yn y der Size Fuse L LZs 360F use Links 450F Fuse Links 50OF Other Hydrostatic Testing Fuel Shut -Off Electric Gas Size Quantity Parts & Materials Fuse Links Q Blow Off Caps /Seals Pressurized Cartridges Fire Extinguisher Size Nitrogen Credit Surcharge luxes & Recommendationns: A 1 Al) e. c /+ n t _ The signature below assures that the above stated services have been rendered accordingly. I have been given authority to allow and approve payment for such required services by the establishment which has received this service and hereby authorized payment for all services rendered. Services performed prior to 30 days of expiration. Signature Date' Payment due upon completion. Hood Size uI Nozzle ® Links 4 0 Type App] e tr tDistance Nozzle Hood System Report System )Descriptllon Date of Serce Time A.M. P.M. a nnual Semi - Annual Recharge Install Renovation Location of Syste Cy)nd r Size Slave O G 4 Yn y der Size Fuse L LZs 360F use Links 450F Fuse Links 50OF Other Fuel Shut -Off Electric Gas Size facturer Mod /el Number C 11 Wept _ Dry Prod tion D e Hydro Date 7erviced Servi d ByJ6 Item Inspected Pull Station ......................................................... . Gas Valve / Electrical Cutoff . ............................... Nozzle Location /Appliance Coverage ................. TankHydro ........................... ............................... Tank..................................... ............................... Control Head .......................... ............................./ Braketing .......................... .... L' Fuse Links - Replaced or leaned ...... Systems Installed to Mfctr's Recommendations.. 1=11 Filter ..................................... ............................... El El Exhaust Fan .......................... ............................... ©` 1-1 1:1 Make up Air .......................... ............................... U , UL300 .................................. ............................... Filters - Baffle Style .............. ............................... El 11 K- Class ................................. ............................... Detection Line ...................... ............................... 25 Elmil 1:1 System Monitored By: Yes NoLJ — PH # Hood& Duct ........................ ............................... Other..................................... ............................... Other..................................... ............................... 0 ©, 0 v o Type Appl Type Appl Type Appl_ VType Appl Type App] I 1' Distance Distance Ll L/ Distance / Distance Distance Nozzle Nozzle Nozzle Nozzle Nozzle