HomeMy WebLinkAboutFire Alarm System Report and Range Hood Systems Testing - FIR Inspections - -j 1a33a - to Goy
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KNIGHT FIRE PROTECTION, INC.
9702 LATHROP INDUSTRIAL DRIVE SW
OLYMPIA, WA 98512-9188
(360) 786-8606 Authority Having
FAX 786-8722 Jurisdiction
"ONGUARD LICENSE NO. KNIGHFP044LK TECH I TECH 2
24 HOURS A DAY"
SEMI-ANNUAL CONFIDENCE TESTING
RANGE HOOD SYSTEMS
FACILITY l INSPECTION DATE
��e� Tar - 3/-07
ADDRESS ANNUAL SEMI-A UAL
-2 Z 8 8-7 N+E 5�0. f� ��+ 3 V
C STATE ZIP PHONE - TIME AM/ PM
e / U�t, 9SS�8 36o- '1G�/- bSa3 B; Uv V
OWNER/MA AGER LAST HYDRO DATE HYDRO TEST DUE SIX YEAR MAINTENANCE
5--to e -/
SYSTEM MANUFACTURER 280 350 360 450 500 GAS ELECTRIC
MODE PTV oo �9�T H001 FRYER BROILER GRILL/ BURNW HOT TOP OTHER
✓
YES NO N/A
I. Is system connected to building alarm or otherwise monitored? �C
2. Is cylinder pressure gauge and/or weight at acceptable levels?
3. Are all safety tamper seals and devices intact?
4. Are there any visible signs that system has been fired or tampered with? X
5. Check hazards against nozzle layout? X'
6. Are all nozzles positioned and angled properly? X
7. All protective blow off caps or nozzle covers have been cleaned and/or replaced? 7�
8. Checked action on self closing caps? X
9. Tested system actuation with terminal link for proper operation? J•C
10. Tested system actuation with manual pull stations for proper operation? X
11. All manual actuators are unobstructed and path of egress? C
12. Tested gas valve and cable actuation for proper operation? �c
13. Tested gas valve and from mounts and inspect? X
14. Tested micro switch actuation and/or manual reset for proper operation? x
15. Verified all cooking appliances are operational? J�
16. Removed all cylinders from mounts and inspect?
7 (Note any added maintenance needed: ) c
17. Inspect all chemical agents for contamination? _)
18. Fuse links have been cleaned and/or replaced to the current year? X
11, Is the hood and duct free from grease accumulation?
20. Checked exhaust fan operation and proper air flow? JC
21. Current service tag on the system and pull station? X
22. All new tamper seals and devices are intact? X
23. Proper hand portable extinguishers are properly serviced and certified?
Problems Found: / V(J�I p — S lJ c•-✓`l
On this date,the above system was tested and inspected in accordance with procedures of the applicable editions of NFPA standards and the
man facturer's O&M manual. This system was operated according to these procedures with results indicated above.
WHITE-COST ER YELLOW-KNIGHT FIRE PINK-AUTHORITY HAVI07RISDICIION GOLD KNIGHTFIRE
SERVICFjTE�ICIAN CUSTO R'S AUTHORIZED AGENT
"QUALITY IS REMEMBERED... LONG AFTER PRICE IS FORGOTTEN!"
KNIGHT FIRE PROTECTION, INC. TRANSMITTAL
9702 LATHROP INDUSTRIAL DRIVE SW
OLYMPIA, WA 98512-9188
360-786-8606
FAx 360-786-8722
CONTRACTOR'S LICENSE NO.#KNIGHFP0"LK
"ON GUARD
34 HOURS A DAY"
TO: Mason County Community Development DATE: February 1, 2007 JOB NO.
P.O. Box 186 ATTENTION: Craig Haugen
Shelton, WA 98584 REFERENCE:
Semi- Annual Suppression System Test
COPIES DATE NO. DESCRIPTION
1 1/31 1 Headstart- Belfair
luut
426 W. CEDAIZ ST.
THESE ARE TRANSMITTED FOR YOUR USE.
REMARKS:
COPY TO FILES SIGNED Amy }
IF ENCLOSURES ARE NOT AS DESCRIBED,PLEASE NOTIFY US AT ONCE.
MASON COUNTY FIRE MARSHAL
Mason County Bldg>III 426 W.Cedar
P.O. Box 186 Shelton,Washington 98584
(360)427-9670 Ext.273
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Tri-mTek Systems FOR n
I MCIWOF AaM
8485 Silverdale Way NW M R50 A) 0 WD V
Silverdale WA 99383
Voice: (360)373 8373
Fax:(360) 308 0254 Fire—
ire Alarm System Confidence Report
Central Station Account No. 7,5 77- 2 21 Azmm LEm TLe—
_qFc%,Pid as(major te ..d) ALLYN ZETKE—A'Addren . 4
ELI�frzlp Code. '7RISZ Phone No. 3H)l 3746-4 4 -
rpm
Type of Test: Monthly Quarterly SerrLi-Anaual Acceptance
Number of Initiating circiLdis Number of signaling circuits 4
Fire control panel manufacturer SH R(TKAIMM— Model No. 576 7Central Station trainSrnitter n=ufactur,,SLLLLLWUL1T—
model No. 'I W 7
B.attery Voltage -7 1^( q charge circuit Voltage 2 73 Battery under
Alarms tripped by which initiating circuit
CENTRAL STA71ON
FIRE CONTROL PANEL TRANSMITTER
System operates on AC power U No QNA 0 Yes C2 No
"Alarm,Saence",�.Its in thl.,61S. Uy"" U No Q NA 0 Yu Q No
Less of AC results in tnwbk signal Yes 0 NO U NA Q Y" a No
"M opwtcs M battery QfYM 0 No 0 NA a Yes 0 No
All dnwts cjwcioed for dJc suer. 0)"ry" 0 No Ck NA 0 Y. 0 No
Teit mean rnu,nd.mr.ces spen- (jr ym Q No C1 NA 0 Yes 0 No
All auxiliary equipment operates Vyft 0 No 1) NAB
Y W r...M. W pan,l,av Q E3 No ❑ NA
Ope—tibg insirwd." all's Posted .0 No 0 NA as Q No 0 NA 0 Y= 0 No
-
AutontotietirmdelayefSeneralalarm minuses
n=Initiated Tirne reed red by Centel Station
EQUIPMENT TESTED
PA SLY 00 IN,11=19/
Vks�i A
L
&AFI
�
yo.bkK
SMOW O�
:a
T*'
j
V
SP&Ws,W-I.flo-Ala. il
431,
gp�k�Sup.%UM S.*.�
hn.,PuL1sst..Eve Dampen/Smoke Ampey . .
9 7
Other
TMS IS TO CERTIFY THAT TMS FIRE ALARM SYSTEM/CENTRAL STATlox TRANSMITTER KAS BEEN PROPERLY TESTED AND INSPECTEn,poa
REJABMY TO COVER THE ITEMS LISTED IN TMS REPORT, IS CONSISTENT WITH FIRE ALARM MAIWANAMM STANDARM
44ANINACTURER'S REQUIRMOM.AND ALL COREC710M NAVE RUN I HAVE NOT U8q MADE
Signature of hzpeclor VIEW— 500171A —Date ...........
Problcrns Fouild. &17WV_—_ (W 178L3
C�� I�jj S JW1 SP!E C. 7
Corrections Made
ZO 3E)Vd SW31SAS X31 Idi V9Z',080E09E BE :Z I L007/TE/10
09/10/2007 11: 37 3603080254 TRI TEK SYSTEMS PAGE .02
t n=1 ek NystemS '1s33-1-6 obOoS 3 FOR THE CTT V OF
8485 Silverdale Way NW
Silverdate WA 98383
Voice: (360)373 8373
Fax:(360)308 0254 Fire Alwm System Confidence Report
Ctmtral Station Account No. 757y35
Occupied as(major t==) F Y13 hEAD577)P27' ECAEA
Address=7 NZ HWY 3 zipcode. 9B5Z$ Pbo.No.360 -Z75.5 3
Type,of Test: Monthly Quarterly Semi-Annual Q�)` Acceptance
Number of Initiating circuits 4 Number of signaling circuits 3
Fire Control panel mamfacnnw SUENT KN I G11TModei No. /a 524
Central station transmitter rmmufacttr er 5/LEAJT kN IC>i►1TModel No. 4OZ4
Battery voltage. Z 7. 1 Charge circuit voltage Z 7 3 gallery under load Z25 7
Alarms tripped by whicb initiating einwit ALL
CENTRAL sTAmoN
FIRE CONTROL PANEL TRANsmnT=
Smoke detcron elnned7 ,
System Opcmles on AC I.o. Fyn ❑ No ❑ NA ❑ No
'Alarm Slkncc-rec.dt in tbL eig. ❑ No ❑ NA Y. ❑ No
fors of AG rewlt In trouble slg..al es ❑ No (a NA l}/� O No
SY° n opera ltrr-w bey Gera ❑ No ❑ NA ❑ NO
All dmuit checked for eke,2-P, C) NO Q NA WY. ❑ No
Test meet o+•rluhcturctb spec. Yes ❑ No ❑ NA 37 Yes ❑ No
. 'AD nOdllary equipr..rnroper.ta ❑yyes O No WNA
Key m Ste conrol penal.vsDeb4' V Y- ❑ No ❑ NA
Opus S bvtuetimu poseed 04. ❑ No ❑ NA
Test x rd posed et control panel 0 yn ❑ No ❑ NA I8'Yu ❑ No
Avtpma de ti...e deky or gcnersl.Lrm mint-
Time Wtik ed Tune rcd.ed by Ce.trel Sdtion
EQUIPMENT TESTED
NO.Orumm 5ATI5F^CrQJtY FU I7S
TYFE OF EQUITMeNr TESTED TER NO NA IN RUILOniG
3-lb.Hone.Cl c ,Vase Al m Sp"kY W..er Co, It 7 .
vyrl ALem De toe .
WE
Tepubk iMl-eon
Noel Deters
srneke rletrebn
smoke ll.
. SpdNdn w.rerlbw Alsmn '
4S
-------------
spnOkler supernro.y SMed.n
ht....w pull su,ie,,o
Vo.fib Wn Ce.u.ab ope,.,e
Mnu.dseon '
Eie'r.,o.'Ree.a
F'ue Deu.peea/smoke Dampee
Phene J,cl, ACE
. Ater UC OOOr Rek-
Otho
%TVM 15 To CEIrM THAT TIES I?=ALARM SYSTE I iCENTRAL STAnoN TR'ANSMTITFR HAS BEEN PRolTRLT TIED AND MSPECTID PM
REWABUM TO COVER TIM rrg WSTFD DI TIq$ REPORT, IS CON STENT WITy FIRE ALARM MAINTANANCE STANDARDS
/MANUFACTURER'S I�S-:L REQUdADM AND
/A�LL ODRECIlom HAVEE,AV BEEN/HAVE NOT BM MAD
Signotlac of IaspoctoT /G 4 -rL,, HA M Date B-Z313-7
Problems Forma AS OF r[f1 S IMPE�'Ti ON
Corrections Made
09/12/2012 07:20 3603080254 TRI TEK #2470 P. 007/007
Tri-Tek SystemsO
8527,Kntitc.Lane NW ] o
Silverdale,WA,98383
Voice:(360)373-8373
Fax: (360) 308-0254 Fiore Alarm S�Stei�li! Confid„ a Oir t .
Central Sta#ion Account No. 7c67Z' /IT 3
Occupied as (majorVtenant) ES la 0 14 EALSTA EC E
Address 22 TP-TE HI W AV t�3
Zip Code CrE s2ps Phone No.E Ln _14_7 9 -41 54
Type.of test: Monthly Quarterly Semi-Annual An Acceptance
Number of initiating circuits Number of signaling circuits
Fire control panel manufacturer � � 1AU Model No.
Central Station transmitter manufacturer__�Sl L E kff 1AX) 1477 ,Model No. ( 32�
Battery voltage Z 7• 7. Charge circuit voltage Z 7- 3 battery under load )
Alarms tripped by which initiating circuit �U_ ��
CENTRAL STATION
Smoke detectors cleaned? FIRE CONTROL PANEL TRANSMITTER
System operates on AC power ❑No ❑NA
l� ❑No.
"Alarm Silence"results in tbl_sig_ S U No ❑NA ( ❑No
Loss of AC results in trouble signal ❑No U NA lily` 0 No
System operates on battery s 0 No ❑NA ❑No
All Circuits checked for elec.supv. ❑No ❑NA ❑No
Test meets manufacturer's specs. ❑No ❑NA "N' U No
All auxiliary equipment operates U No i]NA
Key to fire control panel available ❑No ❑NA
Operating instructions posted ,f 0 No 0 NA
Test record posted at control panel plies ❑No ❑NA elles ❑No
Automatic time delay of geneiral alarm minutes Time initiated Time received by Central Station
EQUIPMENT TESTED
NO.OF UNITS SATISFACTORY NO.OF UNITS
TYPE OF EQUIPMENT TESTED YES I NO NA IN BUILDING
Bells,Horns,Chimes,Voice Alarms,Speakers,Water Gongs
Visual Alarm Devices
Trouble Indicators
Heat Detectors 144,
Smoke Detectors
Smoke Beams
Sprinkler Waterflow Alarms
Sprinkler Supervisory Switches
Manual Pull Stations
Ventilation Controls Operate
Annunciators .
Elevgtor Recall
Fire Dampers/Smoke Dampers
Phone Jacks
Automatic Door Release
Other ll
This is to certify that this fire alarm system/Central-station transmitter has been properly tested and inspected for reliability to cover the items listed in this report,is consistent
with fire alarm maintenance standards/manutacturers requirements,and all eorrrre�ctrioonns have been/have not been made.
Signature of Inspector. ,`' j 1► Date F' r�"M l Z.
Problems Found M� f6 nf- X5 11�3��`L um
Corrections Made
04/15/2014 08 : 03 3G03080254 TRI TEK #4137 P. 003/008
Tri-Tek Systems F0 THE CITY OF �f- 1fZ
8527 Knute Lane NW ;Q
Silverdale,WA 98383 :.. - 1 . 3a
Fax ( 60)3 8-025 . Fire Alarm System Confidence Report
Fax: (3fiQ)308-0254. - I
Central Station Account No. 75 —153
^ccupied as(major tenant) E 5YL v. 4V_Ats5JAT.T EC EAR
Address Z2849
Zip Code CMM8 Phone No-
Type of test- Monthly Quarterly Semi-Annual of Acceptance
Number of,initiating circuits - Number of signaling circuits
Fire control`)panel manufacturer '3 1 LEN 7 WU I_4=- ,Model No-,99 37— _
Central Station transmitter manufacturer �LEAJT_ MAY&P Model No. 4eb Z '
Battery voltage Z-70'2� Charge circuit voltage Z7 7 :3 Battery under load Z.574 .
Alarms tripped by which initiating circuit ALA_
CENTRAL STATION
Smoke detectors cleaned? FIRE CONTROL PANEL TRANSMITTER
system operates on AC power &4�,4�s 0 No Ll NA Kes lJ No
"Alarm Silence"results in tbl-sig- I30ees ❑No ❑NA Wes ❑No
doss of AC results in trouble signal "Ve ❑No ❑NA l�s ❑No
System operates on battery ;�` �es ❑No ❑NA des ❑No .
All circuits checked for etec-supv. *�4-'5 ❑No L]NA r_Oks ❑No
Test meets manufacturer's specs s ❑No- :. „. ❑NAs ❑No
� ��
All auxiliary equipment operates �►as ❑No DINA
Key to fire control panel available &.4s ❑No O NA
Operating instructions posted 11 ❑No ❑NA
Test record posted.at control panel a4s ❑No ❑NA 4.14s ❑No
Automatic time delay of general alarm minutes Time initiated Time received by Central Station
EQUIPMENT TESTED _
NO.OF UNITS SATISFACTORY NO.OF[NITS
TYPE OF EQUIPMENT _ TESTED YES NO NA IN BUILDING _
Bells,Horns,Chimes,Voice Alarms,Speakers,Water Gongs
Visual Alarm Devices
i.Trouble Indicators AL
1r?feat Detectors141"
,Smoke Detectors CD _
i,Smoke Beams
! 3orinkler Waterflow Alarms
I.sprinkler Supervisory Switches ---
i Manual Pull Stations
Ventilation Controls Operate
Annunciators
E Elevator Recall
Fire Dampers/Smoke Dampers
Phone Jacks
Automatic Door Release
Other
Thisas to certily that this lire alarm system/ccntral,station transmitter has been property tested and inspected for reliability to cover the items listed in this report,is oonsistent
with-fire alarm maintenance standards 1 manufa�(cturrejer ss(/requirements,and all corrections have been/have not been made. r�Q-- �
Signature of Inspector QLeX _ m Date Q.V..Z613
?Iroblems Found &MIL tf"13 did
Ccrrections Made
10/13/2011 08: 48 3603080254 TRI TEK #1431 P. 003/006
TH Tek Systems r FART cY 0 1.r 43 f2
8527 Knute Law NW
Silverdale,WA 98383
,
s3
Vbice: 360 I'
._-.7 3_
£37 3
Fa�c..4360 308- 2�4 .
Fire Alarm System Confidence nCe RePOrt
Central.Station Account No_ 25 7 �J
Occupied as
(major tenant p ma�or
Address 22
Zip Code 98`5 Z8 Phone No.c3(nn"14-1 -46-49-
Type of test: Monthly Quarterly Semi-Annual An Acceptance
Number of initiating circuits Number of signaling circuits .
Fire control panel manufacturer i Model No. >�
Central Station transmitter manufacturer lL E loll M Model No- LHZ4-
Battery voltage -7. Z._ Charge circuit voltage _ 2:7J', Battery under load Z
Alarms tripped by which initiating circuit A!N
Smoke detectors cleaned? _ FIRE CONTROL PANEL CENTRAL STATIONTRANSMITTER
System operates on AC power Cs ❑No U.NA El No
Alarm Silence"results in tbl.sig. e ❑No ❑NA ❑No
Lass of AC results in trouble signal 7� EJ No 0 NA ❑No
System operates on battery C�X(e ❑No ❑NA ❑No
. All circuits checked for elec.supv. �•iTe/ ❑No El NA ❑No
Test meets manufacturer's specs-
All
It No U NA es U No
All auxiliary equipment operates D Yes ❑No q,Pl
Key to fire control panel available ❑No ❑NA
Operating instructions posted p No ❑NA
Test record posted at control panel ttidres ❑No ❑NA r
eo ❑No
Automatic time delay of general alarm minutes Time initiated_.. Time received by Central Station
EQUIPMENT TESTED
NO.OF UNI M SATISFACTORY NO.OF uNrrS
TYPE OF EQUIPMENT TESTED YES NO NA IN BUILDING
Bells,Horns,Chimes,Voice Alarms,Speakers,Water Gongs
Visual Alarm Devices
Trouble Indicators
Heat Detectors
Smoke Detectors 14,
Smoke Beams
.Sprinkler Waterflow,Alarms
Sprinkler S�
p.ervisory Switches
Manual Pull Stations
Ventilation Controls Operate
Annunciators
.Elevator Recall
Fire Dampers/Smoke Dampers
Phone Jacks Z_
Automatic Door Release
Other
This is to Certify that this fire alarm system/central station transmitter has been properly tested and inspected for reliability io cover the items listed in this report,is consistent
with fire alarm maintenance standards/manufacturer's requirements,and all corrections have yesn/have not been made.
Signature of Inspector �� Date
Problems Found fts THIS i dup
Corrections Made
08/11/2029 00:41 3803080254 TRI TEK #0134 PP}. 0ff05/007
Tri-Tek Systems( FOR THE CYTY OF
8527 Knute Lanc NW
Silverdale,WA 98383 t�3.
Voice:'(360)373-9373 0l6S
Fax:(360)308-0254 . Fire Alarm System Confidence Report
' Central Station Account No, �S 1,?—� ,3
Occupied as(major tenant) L D t43• E fts►STP&�" -CAEP
Address 212 cB 87 6TATIE 140Ali #
Zip Code Phone No. " W ��
Type of test: Monthly Quarterly Semi-Annual Annual Acceptance
Number of initiating circuits . •, Number of signaling,circuits _3
Fire control panel manufacturer ail2EW K1At8�M Model No. 4&�.32A
Central Station transmitter manufacturer I L EANT W 11MTModel No.
Battery voltage Z'7, Charge circuit voltage 7-7 Battery under Ioad Z51
Alarms tripped by which initiating circuit
CENTRAL STAnON
Smoke detectors cleaned? FIRE CONTROL PANEL TRANSMITTER
System operates on AC power s ❑No ❑NA ilrl s O No
"Alarm Silence"results in tb!_sig. gs ❑No 0 NA ❑No
Loss of AC results in trouble signal fib,T/ ❑No ❑NA ❑No
System operates on battery G No ❑NA #4 eB D
No
All circuits checked for e'lec_supv. ❑No ❑NA i4e ❑No
Test meets manufacturer's specs. es O No El ❑No
All auxiliary equipment operates ❑Y ❑No !
Key to fire control panel available D No O NA
Operating instructions posted t�Yes ❑N
Test record posted at control panel �,�,,II o ❑NA D No
gyres ❑No ❑NA es O No
Automatic time delay of general alarm — minutes Time initiated Time received by Central Station
EQuIPMENT TESTED
NO.OF UNITS SATISFACTORY NO.OF UNITS
TYPE OF EQUIPMENT . TESTED YES NO I NA IN BUILDING
Bells,Horns,Chimes,Voice Alarms,Speakers,Water Gongs
Visual Alarm Devices
Trouble Indicators
_.'Heat Detectors J�Q.
Smoke Detectors
Smoke Beams
Sprinkler Waterflow Alarms
Sprinkler Supervisory Switches
Manual Pull Stations
Ventilation Controls Operate
Annunciators
Elevator`Flecall
Fire Dampers/Smoke Dampers
Phone Jacks Z
Automatic Door Refuse
Other
This is to certify that thls fire alarm system/central station transmitter has been property tested and inspected for reliability to cover Vie items listed in this report,is conskmertt
with fire alarm maintenance standards/manufacturer's requirements,and all corrections have been/have not been made.
Signature of Inspector . '<'. Date
Problems Found hm — W ..
Corrections Made
08/25/2009 05: 45 3603080254 TRI TEK SYSTEMS PAGE 03
Tz7i-Tek Systems ��� ,. 5Q R THE crry OF
8527 Knute Lane NW
Silverdale,WA 98383
Voice: (360) 373-8373 Zl'e ence Report
Fax:.(3.60)308-0254
Central Station Account No.7.5 77--I=A 00 a
Occupied as (major tenant) E 5 �
r
Address Z_.3 S-1 M.E. 5TAT- P VJY IF-
Zip Code 1:f78 5-Z 2 Phone No.3 -A*79 -494-S
Type of test: Monthly Quarterly Semi-Annual nnua Acceptance
Number of initiating circuits . Number of signaling circuits -
Fire control panel manufacturer SILENT ANICE)u-C Model No. L:72941
Central Station transmitter manufacturer - ILWT 1' A 4;Jk= Model No. Z 3 2 4
Battery voltage Z'7• I Charge circuit voltage Z7_3 Battery under load
Alarms tripped by which initiating circuit A_L L_
CENTRAL STATION
FIRE CONTROL PANEL TRANSMITTER—
Smoke detectors cleaned? /�
System operates on AC power C54 s ❑No ❑ NA s ❑No
"Alarm Silence"results in tbl.sig. 21S ❑No ❑ NA s ❑No
Loss of AC results in trouble signal ;?Is ❑No O NA s ❑No
System operates on battery � e s ❑No ❑ NA s ❑No
All circuits checked for elec.supv. LXYes ❑No ❑ NA s ❑ No
Test meets manufacturer's specs. As ❑No 1❑/NA , es ❑ No
All auxiliary equipment operates ❑Y s ❑No IlNA
Key to fire control panel available s ❑No C]NA
Operating instructions posted Yes ❑No ❑NA Ws
s. ❑ No
Test record posted at corttrbf panel des ❑No . ❑NA ❑ No
Automatic time delay of general alarm minutes Time initiated Time received by Central Station
EQUIPMENTTESTED
NO.OF UNITS SATISFACTORY NO,OF UNITS
TYPE OF EQUIPMENT TESTED YES NO NA IN BUILDING
Bells,Horns,Chimes,Voice Alarms,Speakers,Water Gongs
Visual Alarm Devices
Trouble Indicators
Heat Detectors
Smoke Detectors
Smoke Beams
Sprinkler'Waterflow Alarms
Sprinkler S rvisory Switches
Manual Pull Stations
Ventilation Controls Operate
Annunciators
Elevator Aecall
Fire Dampers/Smoke Dampers
Phone Jacks
Automatic Door Release
Other
This is to certify that this fire alarm system/central station transmitter has been properly tested and inspected for reliability to cover the items listed in this report,is consistent
with fire alarm maintenance standards J manufacturer's requirements,and all.corrections have been/have not been made.
Signature of Inspector i Date -ZS ZZU
Problems Found
Corrections Made