HomeMy WebLinkAbout1119 18 STREETRange Hood Systems Report
COMPANY
AAA QUALITY SERVICES, INC.
5800 SO. UNION
BAKERSFIELD, CA 93307 -5426
(661) 833 -5510 FAX 833 -5512
(�CIJSTOME�
Name
Address
City V t) `t (� �- State/ ZIP
Telephone zs Store No.
Owner or Manager
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
DAZ OF SERVIC
TIME
A.M.
P.M.
-Z�1 v
d��
'
21. Check travel of cable nuts /S -hooks
ANNUAL
SEMI-QyD1UAL
I RECHARGE
INSTALLATION
RENOVATION
LOCATION PF �YSTEMCYLINDERS �
UL 300
ES ❑ NO
5. Hood /duct penetrations sealed w /weld or UL device
NUFACT�UREIRR
O�DEEL NUMBE1
NIL
j�WET
DRY CHEMICAL
CYLINDER SIZE MASTER
CYLINDER SIZE SLAVE
CYLINDER SIZE SLAVE
v
26. All filters in place
FUSE LINKS 360° F.
FUSE LINKS 450° F
L
FUSE LINKS 500° F.
OTHER
FUEL SHFQT F
ELECTRIC
GAS
SIZE
(�(-
10. Hydrostatic test date
�
z fr
SERIAL NUMBER
LAST HYDRO TEST DATE
LAST RECHARGE DATE
30. System operational & seals in place
O
12. Inspect cylinder and mount
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
d, Uu.ti _,PiS
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.
-L
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
i
13. Operate system from terminal link
X
32. Clean cylinder & mount
i
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
i
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:
On this date, this range hood fire suppression system was inspected and operationally tested in accordance with the fire
suppre ' n system requirements of NFPA17 or 17A, 96 and the manufacturer's manual, with the results indicated above.
X /
SERVIC TECHNICIAN PERMIT NO. DATE: TIME: AM O ER'S A NT
The above service technician certifies that the system was personally inspected and fo conditions to be as indicated on this report.
CUSTOMER COPY
Range Hood Systems Report
AAA QUALITY SERVICES, INC.
5800 SO. UNION
BAKERSFIELD, CA 93307 -5426
(661) 833 -5510 FAX 833 -5512
CUSTO ER
Name y` t L \k
Address - \ ` ` c
City f� K rr ' J StateA ZIP
Telephone Z' rZ' l U l Store No.
Owner or Manager
RAJA-
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
DATE OF SERVICE �
-- ZS- Gv
TI
0
A.I�Q
P.M.
AN AL
SEMI.�DIPJUAL
RECHARGE
INSTALLATION
RENOVATION
LOCATION
Y M CYLI
UL 300
iOF l
14 l
^� `
�
� ES ❑ NO
FA TU_tER
MODEL NUMBER /
//(
WET
DRY CHEMICAL
u,c��
�(r '
25. Exhaust fan in operating order
CYLINDER SIZE MASTER
Ll
CYLINDER SIZE SLAVE
CYLINDER SIZE SLAVE.
FUSE LINKS 360° F.
FUSE LINKS 450° F.
FUSE LINKS 500° F.
OTHER
27. Fuel shut -off in on position
7,
9. Check cartridge weight (If applicable)
FUEL SHUT -OFF
ELECTRIC
GAS
SIZE
29. Replace systems covers
11. 6 year maintenance date
SERIAL NUMBER
LAST DATE
LAST RECHARGE DATE
fr
i
TEST
2
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
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)
i
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
i
31. Slave system operational
13. Operate system from terminal link
s
32. Clean cylinder & mount
14. Test for proper operation from remote
33. Fan warning sign on hood
15. Check operation of micro switch
i
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
J
19. Check fuse links and clean
'"�
NOTE DISCREPANICES OR DEFICIENCIES BELOW
--'
COMMENTS:
On this date, this range hood 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 indicated above.
Try
SERVICE TEGrINICIAN PERMIT NO. DATE: TIME: AM PM O R'S ALI HORI D AGENT
The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
CUSTOMER COPY
Range Hood Systems Report
AAA (QUALITY SERVICES, INC.
5800 SO. UNION
BAKERSFIELD, CA 93307 -5426
(661) 833 -5510 FAX 833 -5512
(� CUSTOM R
Name 1 C� tJ GVJ�
Address
city ��� State(-'k ZIP 3107
Telephone Store No.
Owner or Manager ---
DATA OF�S7ERVICE `
G` 7 �` to
TIM (�/�
,c `-' `J
20. Replaced fuse links
A.M.
P.M.
ANNUAL
SEMI- ANNUAL
RECHARGE
INSTALLATION
RENOVATION
LOCATION NOF�YrM CYLINDrS ' �oo r
-L
6t1YES L 300 ❑ NO
M(= -ltlER
L N UMB ER�
WE
5. Hood /duct penetrations sealed w /weld or UL device
DRY CHEMICAL
CYLIN ER SIZE MASTER
CYLINDER SIZE SLAV5
6. Check if seals intact, evidence of tampering
CYLINDER SIZE SLAVE
25. Exhaust fan in operating order
7. If system has been discharged, report same
26. All filters in place
FUSE LINKS 360° F.
FUSE LINKS 450° F. .
FUSE LINKS 500°
F.
OTHER
9. Check cartridge weight (If applicable)
✓
28. Manual & remote set/seals in place
10. Hydrostatic test date
FUEL SHUT -OFF
ELECTRIC
S
SIZE
9(1
30. System operational & seals in place
X
f r
SERIAL NUMBER
31. Stave system operational
LAST HYDRO TEST DATE
13. Operate system from terminal link
LAST RECHARGE DATE
32. Clean cylinder & mount
14. Test for proper operation from remote
_L
33. Fan warning sign on hood
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
21. Check travel of cable nuts /S -hooks
3. Check positioning of all nozzles.
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
-L
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. Stave system operational
7-
13. Operate system from terminal link
32. Clean cylinder & mount
14. Test for proper operation from remote
_L
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
i
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
l
COMMENTS:
On this date, this range hood 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 indicated above.
X /r"O*fl
SERVICE
The above se
6�75 -10 N'J) o, �`
PERMIT NO. DATE: - TIME: AM
AGENT
technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
(CUSTOMER COPY
Range Hood Systems Report
AAA QUALITY SERVICES, INC.
5800 SO. UNION
BAKERSFIELD, CA 93307 -5426
(661) 833 75510 FAX 833 -5512
V� , CUSTOMER
Name _6 V3 C) e
Address
City r ` E 10 State 6,� -ZIP 3 30 �
Telephone 3 7-3 ZP7 0 I Store No:
Owner or Manager
DATA SER ICE
'C
TIM
, (_
�.
P.M.
ANNUAL
SEMI-ANNUAL
X
RECHARGE
INSTALLATION
RENOVATION
LOCATION OF SYSTEM CYLINDE
�A
UL 300
❑ NO
eCYES
�� ��
ANUFAC ER
MODEL NUMBER
WET
DRY CHEMICAL
26. All filters in place
6- Ll (S
27. Fuel shut -off in on position
CYLINDER SIZE MASTER
CYLINDER SIZE SLAVE
CYLINDER SIZE SLAVE
1>
'
29. Replace systems covers
FUSE LINKS 360° F.
FUSE LINKS 450° F.
I (-�
FUSE LINKS 500° F.
OTHER
FUEL SHUT -OFF
ELEZMIC
GAS
SIZE
32. Clean cylinder & mount
_2j 1
SERIAL NUMBER -7
HYDRO TEST DATE
LAST RECHARGE DATE
MANUFACTURER'S MANUAL REFERENCE
PAGE NUMBER: DRAWING NUMBER: DATE
COOKING APPLIANCE LOCATIONS:
LEFT TO RIGHT
e -c
tua `L W 0
c,v o k- Uj 0
V,-) rk)&
Ic
k
r
t
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
18. Proper nozzle covers in place
19. Check fuse links and clean
COMMENTS:
On this date, this range hood 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 indicated above.
SERVIC TECH Nit IAN PERMIT NO. 'DATE: TIME:
'S
The above service technician certifies that the system was personally inspected and found conditions to be as indicated orr -this report.
CUSTOMER COPY
20. Replaced fuse links
l
21. Check travel of cable nuts /S -hooks
22. Piping & conduit securely bracketed
r
23. Proper separation between fryers & flame
24. Proper clearance -flame to filters
25. Exhaust fan in operating order
26. All filters in place
l
27. Fuel shut -off in on position
28. Manual & remote set/seals in place
1>
'
29. Replace systems covers
30. System operational & seals in place
31. Slave system operational
i
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 range hood 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 indicated above.
SERVIC TECH Nit IAN PERMIT NO. 'DATE: TIME:
'S
The above service technician certifies that the system was personally inspected and found conditions to be as indicated orr -this report.
CUSTOMER COPY