HomeMy WebLinkAboutRange Hood - FIR Inspections - 3/3/2011 e Hood Systems Report
SERVICE COMPANY DATE O SERy10E TIME P M. P.M.
122_6� �� ��� ANNUAL l SEKVNNUAL RECHARGE INSTALLATION RENOVATION
Amer'Sa a LOGXIOrrNOFJYSTEMCYL,NDE f UL300
3 29 Ave. W { Y'p`�V', CiL U E;YES ❑NO
umw er, WA 98512 ACTURER MODE
UM WETi DRY CHEMICAL
360-943-5634 yr 4,�� X K 27 J
CYLINDE, IZE MA T R CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
TOMER FUSE LINKS 3 F. FUSE LINKS 450°F. FUSE LINKS 500'F OTHER
CU �)
Name �) i'
p FUEL SHUT-OFF ELECTRIC GAS SIZE
Address
SERIAL NUMBER LAST HYDRTET ATE LAST RECHARGE DATE
City l � State\S , ZIP �,0�
MANUFACTURER'S MANUAL REFERENCE
Telephone Store No.
PAGE NUMBER: DRAWING NUMBER: DATE
Owner or Manager
COOKING APPLIANCE LOCATIONS: LEFT TO RIGHT
Q A t�\( �
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 cl an NOTE DISCREPANICES OR DEFICIENCIES BELOW 4-
COMMENTS:
a
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.
RVICE TECHNictAN PERMIT NO. DA E: TIME: AM PM CUSTOMS S AUTHORIZED AGENT
The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report.
AUTHORITY HAVING JURISDICTION
(00666REORDER PART NO❑IF 100
Pre-Engineered Restaurant Fire Suppression Systems Report
SERVICE COMPANY DATE O.F SERVICE TIME A.M. P.M.
ANNUAL SEMI-ANNUAL RECHARGE I INSTALLATION RENOVATION
AmeriSafe LOCATION OF SYSTEM CYLINDERS UL300
3006 29th Ave. SW11 DYES ❑NO
MANUFACTURER MODEL NUMBER WET DRY CHEMICAL
Tumwater, WA 98512 L`
360-943-5634 CYLINDER SIZE MASTER t CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE
CUSTOMER FUSE LINKS 360'F. FUSE LINKS 4500 F. FUSE LINKS 500'F. OTHER
o
Name I
' ` + FUEL SHUT-OFF ELECTRIC GAS SIZE
Address
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
City I�:�,�-i 4~\ State L)Q 11 ZIP``�'�454
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) v 27. Fuel shut-off in on position
9. Check cartridge weight(If applicable) J 28. Manual &remote set/seals in place
10. Hydrostatic test date I 29. Replace systems covers
11. 6 year maintenance date J 30. System operational&seals in place 1
12. Inspect cylinder and mount 31. Slave system operational
13. Operate system from terminal link 32. Clean cylinder&mount J
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 V 35. Proper hand portable extinguishers
17. Clean nozzles 36. Portable extinguishers properly serviced
18. Proper nozzle covers in place d 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.
x Jo
SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM CUSTOMER'S AUTHORIZED AGENT