HomeMy WebLinkAbout1102 UNION AVENUE (2)Range Hood Systems Report
EXCELLENT FIRE PROTECTION
531 SUPPLY ROW
TAFT CA 93268
(661) 765 -4343
C16-747594
Address 1102 c I Inke,,
City �1__R State �� ZI P� �
Telephone 3:23_n7au Store No.
Owner or Manager
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
Grill
DATE OF SERVICE
20. Replaced fuse links
TIME
2. Duct and plenum covered w /correct nozzles Yes
A.M.
I P.M.
ANNUAL
SEMI-ANMWL�j
N12tHARGE
K TALLATION
RENOVATION
LOCATION OF SYSTEM
ORLINDERS
24. Proper clearance -flame to filters
UL 300
❑YES ❑ NO
M A R
MBER
WET
Yes
7. If system has been discharged, report same -N/.A
DRY CHEMICAL
C M KtIZE MASTER
L DER SIZE SLAVE
27. Fuel shut -off in on position
CYLINDER SIZE SLAVE
FUSEL 0° F.
FUSE LINKS 450° F.
FUSE LINKS 500° F.
OTHER
FUEL SHUT -OFF
ELECTRIC
GAS
SIZE
SERIAL NUMBER
Yes
12. Inspect cylinder and mount
LAST HYDRO TEST DATE
Yes
LAST RECHARGE DATE
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER:
DATE
1. All appliances properly covered w /correct nozzles mss-
20. Replaced fuse links
Yes
2. Duct and plenum covered w /correct nozzles Yes
21. Check travel of cable nuts /S -hooks
e�
3. Check positioning of all nozzles. Yes
22. Piping & conduit securely bracketed
4. System installed in accordance w /MFG UL listing Yes
23. Proper separation between fryers & flame
Yes
5. Hood /duct penetrations sealed w /weld or UL device _
24. Proper clearance -flame to filters
Yes
�
6. Check if seals intact, evidence of tampering
25. Exhaust fan in operating order
Yes
Yes
7. If system has been discharged, report same -N/.A
26. All filters in place
Yes
8. Pressure gauge in proper range (If gauged)
27. Fuel shut -off in on position
Yes
Yes
9. Check cartridge weight (If applicable)
28. Manual & remote set/seals in place
Yes
Yes
10. Hydrostatic test date
29. Replace systems covers
Yes
Yes
11. 6 year maintenance date
30. System operational & seals in place
Yes
Yes
12. Inspect cylinder and mount
31. Slave system operational
Yes
Yes
13. Operate system from terminal link Ys
32. Clean cylinder & mount
N/A
14. Test for proper operation from remote es
33. Fan warning sign on hood
Yes
15. Check operation of micro switch
Yes
34. Personnel instructed in manual operation of system
Yes
16. Check operation of gas valve
35. Proper hand portable extinguishers
Yes
Yes 17. Clean nozzles
es
36. Portable extinguishers properly serviced
Yes
18. Proper nozzle covers in place
37. Service & Certification tag on system
Yes
19. Check fuse links and clean N/
NOTE DISCREPANICES OR DEFICIENCIES BELOW
Yes
COMMENTS:
On this date, this range hood fire suppression system was inspected and operationally tested in accordance with the fire
suppression syste5 requirements of NFPA17 or 17A, 96 and the manufacturer's manual, with the results indicated above.
X
10/8/10
5:15
Stftttl ECHNICIAN PERMIT NO. DATE:
TIME: AM PM CUSTOMER'S AUTHORIIZE0 AGENT
The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
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