HomeMy WebLinkAbout5764 STINE ROADRange Hood Systems, Report
SERVICE COMPANY DATE OF SERVICE TIME A.M P.M.
ANNUAL SEMI-ANNUAL
V
RECHARGE INSTALLATION RENOVATION
AAA Q A ITY SERVICES, INC. tlV LOCATION OF SYSTEM CYLINDERS UL 300
22. Piping & conduit securely bracketed
i r' 67- ` 1 Or C I I,- Jib A(Q8 AG1unn3eeS y EYES NO
5800 SO. UNION
23. Proper separation between fryers & flame
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MANUFACTURER
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MODELNUMBER
UQC(( 5
WET DRY CHEMICAL
BA fERSFIELD, CA 93307 -5426
661) 833 -5510 FAX 833 -5512 t ((- AA I'C L < C U
7. If system has been discharged, report same i
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CYLINDER SIZE MASTER
S -5 ,,ALCcsq,-
CYLINDER SIZE SLAVE
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CYLINDER SIZE SLAVE
IVIA
o ` V 2
T
27. Fuel shut -off in on position
FUSE LINKS 360° F FUSE LINKS 450° F. FUSE LINKS 500° F.
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OTHER
CUSTOMER
10. Hydrostatic test date 29. Replace systems covers V
11. 6 year maintenance date
Name i -` Crc (/ C ATP
30. System operational & seals in place
12. Inspect cylinder and mount V 31. Slave system operational
FUEL SHUN7F ELECTRIC GAS SIZE
Address '' , Iti1 ;Z Of•1
14. Test for proper operation from remote 33. Fan warning sign on hood
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SERIAL NUMBER LAST HYDROTEST DATE LAST RECHARGE DATE
City =l k State ZIP L:2 vl
17. Clean nozzles
MANUFACTURER'S MANUAL REFERENCE
Telephone Store No.
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1 - -_D PAGE NUMBER: DRAWING NUMBER: DATE
Owner or Manager 7N L51 tV V f- ' a v
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
On this date, this range hood 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.
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V111"
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5 At Awe (> rpm
20. Replaced fuse links
On this date, this range hood 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.
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1. All appliances properly covered w /correct nozzles 20. Replaced fuse links
2. Duct and plenum covered w /correct nozzles 21. Check travel of cable nuts /S -hooks d`
3. Check positioning of all nozzles. 22. Piping & conduit securely bracketed
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 V
7. If system has been discharged, report same i
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26. All filters in place
8. Pressure gauge in proper range (If gauged) 27. Fuel shut -off in on position v'
9. Check cartridge weight (If applicable) 28. Manual & remote set/seals in place
10. Hydrostatic test date 29. Replace systems covers V
11. 6 year maintenance date V • 30. System operational & seals in place
12. Inspect cylinder and mount V 31. Slave system operational N 6
13. Operate system from terminal link 32. Clean cylinder & mount
14. Test for proper operation from remote 33. Fan warning sign on hood
15. Check operation of micro switch kl 34. Personnel instructed in manual operation of system
16. Check operation of gas valve 35. Proper hand portable extinguishers
17. Clean nozzles 36. Portable extinguishers properly serviced d
18. Proper nozzle covers in place 37. Service & Certification tag on system
19. Check fuse links and clean ti y NOTE DISCREPANICES OR DEFICIENCIES BELOW
COMMENTS:
On this date, this range hood 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.
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