HomeMy WebLinkAboutFIRE SUPP. SYSTEM 8/25/2012Pre - Engineered Restaurant Fire Suppression Systems Report
AAA QUALM SERVICES, INC,
5500 SO. UNION
SAKERSFIEL®, CA 93307 -5426
W11833- 5510 FAX 333 -5512
t + CUSTOMER
Name
Address ( h
City /1'- State ZIP
Telephone
Owner or Manager
Store No.
DATE(S RVICE TIME e l / 5
P.M.
5
3. Check positioning of all nozzles.
ANNUAL SEMI- ANNUAL RECHARGE INSTALLATION RENOVATION
24. Proper clearance -flame to filters
I
25. Exhaust fan in operating order
LOCATION SYSTG / EM YLIND/ERS UL 300
NO
26. All filters in place
6Y,S
MANU ACTUREER ! MODEL NUMBER WET DRY CHEMICAL
28. Manual & remote settseals in place
10. Hydrostatic test date 29. Replace systems covers
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
12. Inspect cylinder and mount 31. Slave system operational
FUSE LINKS 360° F. FUSE LINKS 450° F FUSE LINKS 500° F. OTHER
3 1.
FUEL SHUT -OFF ELECTRIC GAS
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
18. Proper nozzle covers in place 37. Service & Certification tag on system
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
20. Replaced fuse links
2. Duct and plenum covered w /correct nozzles
IllyJL - 5
3. Check positioning of all nozzles. 22. Piping & conduit securely bracketed
4. System installed in accordance w /MFG UL listing
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 1,
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 settseals 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
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
7-
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: (:liaJ) ""'y'
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 man , facturer's manual with the results indicated above.
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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.
AUTHON TV HAVIING JURISDICTIOM