HomeMy WebLinkAbout10750 STOCKDALE HWYJORGENSEN CO
STATE FIRE MARSHAL A -0309
CONTRACTORS' LICENSE C 16 C 10 C7
OBAKERSFIELD
(661) 327 -4352
OFRESNO
(559) 268 -6241
OMERCED
(209) 383 -6647
13MODESTO
(209) 529-0835
Nano: 1'- *'!S
0
Address: 1,3 7 Sj Stjr K ck -elf th-o
City: o� KP w S `l c 1 C. o.
Jurisdiction: K 1- " y
RANGE'
�-S
Code: r
('.[NIXING APPLTANCFS LOCATION- LEFT TO RIGHT WITH SIZES
HOOD` SYSTEM
� � 0 "'1257 _C_�
REPORT
Jan I ()
DATE of SERVER
I -- !X_ Ind
TOM
1I•;313
3 r C i,� e
AM
5
-I r %A I
MANUFACTURER
Ih Y'
7
AA
MODE.NUIaRD!
K �
t
DRY
M24DER MILASIRR
011R+A CYLINDER
LOCATION OFGAS VALVE
3.775Y3
.e c eiit
PUBS LINK
1.oQ�rY.
POSE LIM
.wQmr.
POSE I&M
looQTY.
OTHER
LINKS
RPrt.AC�
FUEL slLtrr-
oPF
1 y- r
`
YU NO�
YES . � EECTxIC
MANUAL PURL OPERABLE
DETECTION LINER
OPERABILUNPRAYE)
AIL NOZZLES RP.MOV= CLEANED PER I CO
t MANUFACTIMES SPECIFICATIONS
NO
NO
YE NO
v
LOCATION OF SYSTEM
ANSUL SEAL CART.
5 �A C. 3f
lr
'YE910•••..NG ��
HOOD
SUE Ft
DUCT
B�
MANAGERS
NAME
PHONE
NUMBER
I i1 E r
z '�- i
3 r C i,� e
4
5
-I r %A I
6
r,; . r
7
AA
8 ..
I a J v
V"RT EACH SYSTEM WHHANY OF THESE PROBLEMS•
_�-0 Additional nozzles am required for:
I . Are all external hood penetrations sealed, welded or sealed
with a UL device? NO
2. Is pressure gauge inoperable range? . S NO
3. Record 6 year.ihaiMenance du
❑ Electric or Gas cut -otimust be in `_'1 Q
aLW ed'to prevent,a lire from' :. 1• .. °', }' nt. :• .)r ;•.•'5 :1+ W °� "••'�jC
4: Redd Hydrostadictiue,.date.'
reigniting per N.F.P.A. 96,17& 1 7Acodds
Year i*ileto>,test,i
❑ Additional fire dtitectais are required to'assure reliable fire .6. Are cartrid 's we within
detection '1: Is the proper extipgui� her =iirpl
❑ This system is designed for coverage with no more than alight grease
buildup. Grease buildup appears excessive. We recommend the exhaust
system be professionally cleaned. Initials
❑ Bocause of the age and/or condition of this fire comrol system it may
fail and should be replaced with a new system. Initials
❑ ON THIS DATE CUSTOMER WISHES NOT TO HAVE THIS
SYSTEM
Comments:
C A.-C, �--t
8. Are the exhaust fans working?
ible limits? Y$ NO
ser�cid?�-,. NZ NO
NO
9. Next due date for extinguisher service.
10. Next due date for extinguisher hydro.
11. Is this system a U.L. 300? S NO
❑ With the introduction of Vegetable oil in place of animal fat, U.L.
has changed it's standard to extinguish grease fins. We understand you
art using this type of oil. We recommend upgrading to the new standard
to man you have the proper fue protection Initials
On this date the above system was inspected in accordance with the
State Fire Marshal regulations, the manufacturer's manual, and
Jorgensen C . Vmce manual.
SERVIC9 TECHNICIAN
I have been instructed n and understand the operation of this system.
CUSTOMER'S AUTHORIZED AGENT'
The above service tech== caitifies that the 4*= was pmonaily umpeated and found conditions to be as mdiosted is this repart.
WHITE — CUSTOMER COPY CANARY — JORGENSEN -PINK — AUTHORITY HAVING JURISDICrrON
JORGENSEN CO RANG, E HOOD SYSTEM REPORT
STATE FIRE MARSHAL
16 CI
CONTRACTORS LICENSE C 16 CIO C7 (1 �I �`��..•• 1 tJ VV ��JJIIJJ V
DATE oP s®evics Tam
OBAKERSFIELD (661) 327 -4352 -.:i a�:` i �. �,� •.�i,J.
Upow S.
' ... .. NtaaM......
OFRESNO (559) 268-6241 , DAY
Y 10 �.7=
❑MERGED (209) 383 -6647 CTi.011= seM MASTER arimx cn5 mix . > ANN a� aes v,u ve:
❑MODESTO (209) 5290835
M0.41V.' 4500tY.. 50otYnr. :: ; a ri. VA
Name:
j MAMMLPISLOPMAIMA nEM=W'IM ALLNOZZLES REMOVPD6.CLAANFlt I
i OPFJIABIJE%lWMAYFD !'MMMWACT�AtBSiSPBCO'ICAnONS
Address: ! J 7 �O � J C k dwe �"t1►'` . .. '�es ''°:.. NO rio�
�► h l IWATION OP SYSTIrd - ANSUL SEAL CAF
city: ism y[ `e i 1r%Q , t� a S _ YES No
FK= DUCT
Jurisdiction: ,("�"� SUE �•. " SUE by
Code: I NAME I Nuke=
COOKING APPLIANCES LOCATION: LEFT TO RIGHT WITH SIZES
i
V jv '' 1 e Iraq
z
s
a
,
5
6
7
8
ZEPORT EACH STS7EW R?THANY OF THESE PROBLEMS
' 0 Additional nozzles are required for:
❑ Electric or Gas cut -off must be installed to prevent a fire from
reigniting per N.F.P.A. 96,17 &17A codes.
❑ Additional fire detectors are required to assure reliable fire
detection.
❑ This system is detsigmd for coverage with no more than a light grease
buildup. Grease buildup appears excessive. We recommend the exhaust
system be professionally cleaned. Initials
❑ Because of the age and/or condition of this fire control system it may
fail and should be: replaced with a new system. Initials
❑ ON THIS DATE CUSTOMER WISHES NOT TO HAVE THIS
SYSTEM SERVICED. ,; ')
Comments: 'Le7e, G /roc.' ri
1. Are all external hood penetrations sealed, welded or sealed
with a UL device? IZP NO
2. Is pressure gauge in operable range? Aft NO
3. Record 6 year maintenance due date.
4. Record Hydrostatic due date. )6. J 14
5. Record 12 Year regulator test due date. "'°-
6. Are cartridge's weights within acceptable limits? ft NO
7. Is the proper extinguisher in place and serviced? YE
NO
8. Are the exhaust fans working? Y% NO
9. Next due date for extinguisher service.
10. -Next due date for extinguisher hydro.
11. Is this system a U.L. 300? NO
❑ With the introduction of Vegetable oil in place of animal fat, U.L.
has changed it's standard to—extinguish grease fires. We understand you
art using this type of oil. We recommend upgrading to the new standard
to assume you have the proper fire protection Initials ,--�
On this date the above system was inspected in accordance with the I have been instructed on understand the operation of this system.
State Fire Marshal regulations, the manufacturer's manual, and
Jorgensen,Go. service mian clan.
SERVICES TTECHNICIAN �_.. —.--- CUSTOMER'S AUTHORIZED AGENT
The above service tedsomm certifies that the system was personally inspeotad and found cw tiow to be as i &cded in this report.
WHITE — CUSTOMER COPY CANARY — JORGENSEN PINK— AUTHORITY HAVING JURISDICITON
Al