HomeMy WebLinkAboutFIRE SUPP. SYSTEM 2/23/2011Pre - Engineered Restaurant Fire Suppression Systems Repart
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53!)0 JO. UN'.'C'ri
ep,K";D'FIELD, CA 933307 -5426
833 -5510 FAX 833 -5512
Name )o e ("
1STOM )R
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Address ` ! `\t V kv
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State ZIP
Telephone
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li '1 Store No.
Owner or..Manager ( U S
COOKING APPLIANCE LOCATIONS- LEFT TO RIGHT
DATE OF SERVICE
Z- Z`5 -vt TIMEVk,
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A.M. P.M.
ANNUAL SEMI-A UAL I RECHARGE INSTALLATION FIENOVATION
L CATIp gFISYSTEM C LINDERS
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UL 300
NOOYES
MANUR,QTTUU(RER N/UMBERMOD(EELL WET DRY CHEMICAL
26. All filters in place
CYLINDER SIZE MASTER CYLINDEERR SIZE SLAVE CYLINDER SIZE SLAVE
V 5 t/
FUSE LINKS 360° F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
30. System operational & seals in place
31. Slave system operational II'
T 32. Clean cylinder & mount
FUEL SHUT-OFF
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ELECTRIC GAS SIZE
SERIAL NUMBER LAST HYDROTESTDATE
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LAST RECHARGE DATE
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
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20. Replaced fuse links
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22. Piping & conduit securely bracketed
1. All appliances properly covered w /correct nozzles
2. Duct and plenum covered w /correct nozzles
3. 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 discharged, 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 (D\ 18. Proper nozzle covers in place
19. Check fuse links and clean
COMMENTS: 1 r,nA () \Ae<
20. Replaced fuse links
21. Check travel of cable nuts /S -hooks f'
22. Piping & conduit securely bracketed
23. Proper separation between fryers & flame
24. Proper clearance -flame to filters
25. Exhaust fan in operating order
26. All filters in place
27. Fuel shut -off in on position
28. Manual & remote set/seals in place
29. Replace systems covers
30. System operational & seals in place
31. Slave system operational II'
T 32. Clean cylinder & mount
33. Fan warning sign on hood
34. Personnel instructed in manual operation of system
35. Proper hand portable extinguishers
36. Portable extinguishers properly serviced
37. Service & Certification tag on system
NOTE DISCREPANICES OR DEFICIENCIES BELOW
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 with the results, indicate -d- above.
SERVICE ECHNIGIAN 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.