HomeMy WebLinkAboutFIRE SUPPR. SYSTE REP. 12/2/2011Pre - Engineered Restaurant Fire Suppression Systems Report
5300 SO. Uhl ON
BAKERSFiELD, CA 93307 -5425
601) 633 -5510 FAX 833 -5512
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CUSTOMER
Name _ .K,( c o Oaf
Address 6)&) l% 2 iO
City -7"A IC <, (tie- Id State " _ ZIP
Telephone Store No.
Owner or Manager
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
DATE OF SERVICE TIME A.M. P.M.
12 -Z- 11
20. Replaced fuse links
ANNUAL SEMI - ANNUAL RECHARGE fNSTALLATION
i
RENOVATION
LOCATION OF SYSTEM CYLINDERS UL 300
5. Hood /duct penetrations sealed w /weld or UL device
YES NO
24. Proper clearance -flame to filters
6. Check if seals intact, evidence of tampering
MANUFACTURER MODEL NUMBER WET DRY CHEMICAL
26. All filters in place
L '16d,
27. Fuel shut -off in on position
9. Check cartridge weight (If applicable) 28. Manual & remote set/seals in place
10. Hydrostatic test date
CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
Y. G ("_'
30. System operational & seals in place
12. Inspect cylinder and mount
FUSE LINKS 360° F. FUSE LINKS 450° F. FUSE LINKS 500° F. OTHER
32. Clean cylinder & mount
L
33. Fan warning sign on hood
FUEL SHUT-OFF ELECTRIC GAS SIZE
35. Proper hand portable extinguishers
17. Clean nozzles
I
36. Portable extinguishers properly serviced
18. Proper nozzle covers in place 37. Service & Certification tag on system
SERIAL NUMBER LAST HYDROTEST DATE LAST RECHARGE DATE
1 !
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
YeV42( rf P rp
COMMENTS: A Or, 1 n Vn c r) r 1 0 el
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 result9ndicated above.
X", I::.y;
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
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 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 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: A Or, 1 n Vn c r) r 1 0 el
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 result9ndicated above.
X", I::.y;
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