HomeMy WebLinkAboutSuppression System Report - FIR Inspections - 5/8/2015 yu o
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REORDER PART NO.IF 100
Pre-Engineered Restaurant Fire Suppression Systems Report
SERVICE COMPANY DATE S RVJ TIME /,/ A.M. P.M.
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ANNUAL SEMI-ANNUAL RECHARGE INSTALLATION RENOVATION
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AmeriSafe LOCATION OF SYSTEM CYLINDERS UL300
N I} I C ' , yJ R T ES NO
3006 29th Ave. SW MANUFACTURER' MODEL NUMBER WET DRY CHEMICAL
Tumwater, WA 98512 �l ' C W? ✓
360-943-5634 AINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
FUSE LINKS 360°F. FUSE LINKS 450°F. FUSE LINKS 500°F. OTHER
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Name � ` V�+ , FUEL SHUT-OFF ELECTRIC GAS SIZE
Address 7550 E 5 VL \.V/
` / SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
City Lid, V StateAziPp�
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MANUFACTURER'S MANUAL REFERENCE
Telephone Store No
PAGE NUMBER: DRAWING NUMBER: DATE
Owner or Manager
COOKING APPLIANCE LOCATIONS:LEFT TO RIGHT
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1. All appliances properly covered w/correct nozzles J 20. Replaced fuse links v
2. Duct and plenum covered w/correct nozzles 21. Check travel of cable nuts/S-hooks V
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 J
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 �L
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 �L
13. Operate system from terminal link �_ 32. Clean cylinder&mount �!
14. Test for proper operation from remote 33. Fan warning sign on hood _y[_
15. Check operation of micro switch 34. Personnel instructed in manual operation of system V
16. Check operation of gas valve J 35. Proper hand portable extinguishers
17. Clean nozzles L 36. Portable extinguishers properly serviced
18. Proper nozzle covers in place _L 37. Service&Certification tag on system �L
19. Check fuse links a clean NOTE DISCREPANCIES OR DEFICIENCIES BELOW V
COMMENTS:
On this date, this pre-engineered fire suppression system was inspected and operationally tested in accordance with tile fire
suppression system requirements of NFPA 17 or 17 A, 96 and the manufacturer's manual with the re Its indicated ab---T-T
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SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM C Tnp IFIRS AUTHORIZED AGENT
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REORDER PART NO.IF 100
Pre-EnWCe'llaurant Fire Suppression Systems Report
"lid 17 7014
SERVI P N DATE OF SERVICE / I I TIME A.M. P.M.
426 V. CEDAR S f ANNUAL SEMI-ANNUAL RECHARGE INSTALLATION RENOVATION
Am a ri Safe LOCATION OF SYSTEM CYLINDERS UL300
YES
3006 29th Ave. SW MANUFACTURER MODELNUMBER WET �D ❑ O
DRY
Tumwater, WA 98512
360-943-5634 CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
CUSTOMER
FUSE LINKS 3 °F. FUSE LINKS 450'F. FUSE LINKS 500'F. OTHER
`(� `'
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Name / ' f 11� V -Pt 1 �� ����� ' FUEL SHUT-OFF ELECTRIC GAS SIZE
Address
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
City I r'i State l`+' !' ZIP
MANUFACTURER'S MANUAL REFERENCE
Telephone Store No
PAGE NUMBER: DRAWING NUMBER: DATE
Owner or Manager
COOKING APPLIANCE LOCATIONS:LEFT TO RIGHT
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 DISCREPANCIES OR DEFICIENCIES BELOW
COMMENTS:
On this date, this pre-engineered fire suppression system was inspected and operationally tested in accordance with tile fire
suppression system requirements of NFPA 17 or 17 A, 96 and the manufacturer's manual with the results indicated above.
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SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM CUSTOMER'S AQTHORIZED AGENT