HomeMy WebLinkAboutFIRE SUPPRESSION SYSTEM 11/5/2012Pre - Engineered Restaurant Fire Suppression Systems Report
C. I /
AAA (DUAMY SERMES, MC.
5800 SO. UNION
BAKERSFIELD, CA 93307 -5426
661) 833 -5510 FAX 833 -5512
CUSTOMER
Name u " n I
Address _ rY Fes; Ind 1
City State ZIP
Telephone Store No.
Owner or Manager
MnKINr, APPI IANCF I nrATinNS• I FFT Try PlrPT
DATE O SERVICE TIME
20. Replaced fuse links
P.M.
Lam
21. Check travel of cable nuts /S -hooks
3. Check positioning of all nozzles.
ANNUAL SEMI - ANNUAL RECHARGE INSTALLATION RENOVATION
LOCATION OF SYSTEM CYLINDERS UL 300
d OYES NO
U r r
7. If system has been discharged, report same
MANUFACT RER MODEL NUMBER WET DRY CHEMICAL
G0AVI
9. Check cartridge weight (If applicable) 28. Manual & remote set/seals in place
CYLINDER SIZE MASTER CYLINDER SLAVE CYLINDER SIZE SLAVE
11. 6 year maintenance date
SIZE
30. System operational & seals in place
FUSE LINKS 360° F. FUSE LINKS 450° F. FUSE LINKS 50" F OTHER
5 1
FUEL SHUT -OFF ELECTRIC GAS SIZE
16. Check operation of gas valve 35. Proper hand portable extinguishers
17. Clean nozzles
SERIAL NUMBER LAST HYYD,ROTEST DATE LAST RECHARGE DATE
V
19. Check fuse links and clean
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
rin
20. Replaced fuse links
2. Duct and plenum covered w /correct nozzles
Lam
21. Check travel of cable nuts /S -hooks
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
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
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
7. If system has been discharged, report same 26. All filters in place
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 mountT 31. Slave system operational
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 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
18. Proper nozzle covers in place 37. Service & Certification tag on system
19. Check fuse links and clean NOTE DISCREPANICES OR DEFICIENCIES BELOW
COMMENTS:
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 withAe results indicated above.
P I x., I I a
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