HomeMy WebLinkAboutRange Hood Systems - FIR Inspections - 8/15/2011I ''n�.'.vyywrg�{„-:. .y�,rS.�:i.`•i�..ri'..�-. '� %.SF.'- .._ ,it ^. =t+KYL��3'r`�v'1++.:F�#143ita-"�y�
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KNIGHT FIRE PROTECTION
A DIVISION OF KNIGHT FIRE SPRINKLER oon 9 1
ri iM
�. . ;: 6436 MULLEN ROAD SE
OLYMPIA, WA 98503
(206) 456-2162
FAX 456-2151
LICENSE NO. #KNlGHFS 150LD
'ON GUARD
24 HOURS A DAY'
SEMI-ANNUAL CONFIDENCE TESTING
RANGE HOOD SYSTEMS
FACILIT INSURANCE AGENT INSPECTION DATE
t� A G,t oc is v;11-
ADDRESS / ADDRESS ANNUAL SEMI-ANN
1 C' M w' l D
CITY STATE ZIP PHONE NO. PHONE NO. TIME AM
ill Imo, WA8� _ ; I
gW-
CONTACT LAST HYDRO DATE 0 TEST DUE SIX YEAR MAINTENANCE
SYSTEM MANUFACTURER 28e 350° 360 45e 500° GAS LE TRIC
<p C.
MODEL'PC L ��� HOOD/DUC-T-7 WqR BROILER GRILL BURNER HOT TOP O
YES NO N/A
1. Is system connected to building alarm or otherwise monitored? . . . . . . . . . . . . . El ❑ ❑
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? . . . . . . . . . . ❑ la ❑
5. Check hazards against igezle layout? . . . . . . . . . . . . . . . . . . ❑ ❑ ❑
6. Are all nozzles positioned and angled properly? . . . . . ' . . . . . . . . . . . . ❑ ❑ ❑
7. All protective blow off caps or nozzle covers have been cleaned and/or replaced? . . . . . . . ❑ ❑ ❑
8. Checked action on self closing caps? . . . . . 00P . . . . . . . . . . . . . . . . ❑ ❑ 0
9. Tested system actuation with terminal link for proper operation? . . . . . . . . . . . . . . ❑ ❑ ❑
10. Tested system actuation with manual pull stations for proper operation: ❑ ❑ ❑
11.'All manual actuators are unobstructed and in path of egress? . . . . . . . . . . . . . . . ❑ ❑ ❑
12. Tested system actuation with thermostat for proper operation? . . . . . . . . . . . . . . ❑ ❑ ❑
13. Tested gas valve and cable actuation for proper operation? . . . . . . . . . . . . . . . . ❑ 0 ❑
14. Tested micro switch actuation, and/or manual reset for proper operation? . . . . . I . . ❑ ❑ ❑
15. Verified all cooking appliances are operational? . . . . . . . . . . . . . . . . . . . . ❑ ❑ ❑
16. Removed all cylinders from mounts and inspect? . . . . . . . . . . . . 0 ❑ ❑
(Note any added maintenance needed: )
17. Inspect all chemical agents for contamination? . . . . . . . . . . . . . . . . . . . ❑ 0 ❑
18. Fuse links have been cleaned and/or replaced to the current year?. . . . . . . . . . . . . . 0 ❑ ❑
19. Is the hood and duct free from grease accumulation?. . . . . . . . . . . . . . . . . . . 0 ❑ ❑
20. Checked exhaust fan operation and proper air flow?. . . . . . . . . . . . . . . . . . . 0 ❑ ❑
21. Cuffent service tag is on system and pull station?. . . . . . . . . . . . . . . . . . . . 0 ❑ ❑
22. All new tamper seals and devices are intact?. . . . . . . . . . . . . . . . . . . . . . 0 ❑ ❑
23. Proper hand portable extinguishers properly serviced and certified? . . . . . . . . . . . . . 0 ❑ ❑
24. Is customer cuffe y under a service agreement? . . . . . . . . . . . . . . . . . . to ❑ ❑
Problems Found: C,l F , � ,4,51 t i On this date,the above system was tested and inspected in accordance with procedures of the applicable editions of NFPA stand
and the manufacturer's O&M manual and was operated according to these procedures with results indicated above.
WHITE-CUSTOKM YELLOW-IWIGHf FIRE PM-AVIHORMY HAVING IURISDICnON GOLD-INSURANCE
SERVICE TECHNICIAN CUSTOMER'S AUTHORIZED AGENT
"QUALITY IS REMEMBERED... LONG AFTER PRICE IS FORGOTTEN!"
6w; t
KNIGHT FIRE PROTECTION
y; A DIVISION OF KNIGHT FIRE SPRINKLER
6436 MULLEN ROAD SE
'Ii�i x; is
OLYMPIA, WA 98503
(206) 456-2162
FAX 456-2151 F I L E
LICENSE NO. #KNIGHFS 150LD COPY
.ON GUARD
24 HOURS A DAY'
SEMI-ANNUAL CONFIDENCE TESTING
RANGE HOOD SYSTEMS
FACILITY INSURANCE AGENT INSPECTION DATE
5- 19 - U2
ADDRESS `� ADDRESS ANNUAL SEMI-ANN _
/ to� is 1 V
CITY STATE ZIP PHONE NO. PHONE NO. TIME AM PM
tj
00
CONTACT LAST HYDRO DATE HYDRO TEST DUE SIX YEAR MAINTENANCE
`,:15 ,
SYSTEM MANUFACTURER 280° 350° 360' 4500 500' GAS ELECTRIC
MOD L HOOD/DUCT FRYER BROILER GRILL BURNER HOT TOP OTHER
YES NO N/A
1. Is system connected to building alarm or otherwise monitored? . . . . . . . . . . . . . 04 ❑ ❑
2. Is cylinder pressure gauge and/or weight at acceptable levels? . . . . . . . . . . . . . . 14 ❑ ❑
3. Are all safety tamper seals and devices intact? . . . . . . . . . . . . . . . . . . . 19 ❑ ❑
4. Are there any visible signs that system has been fired or tampered with? . . . . . . . . . . ❑ M ❑
5. Check hazards against nozzle layout? . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑
6. Are all nozzles positioned and angled properly? . . . . . . . . . . . . . . . . . . . ❑ ❑
7. All protective blow off caps or nozzle covers have been cleaned and/or replaced? . . . . . . . ® ❑ ❑
8. Checked action on self closing caps? . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑ ju
9. Tested system actuation with terminal link for proper operation? . . . . . . . . . . . . . . N ❑ ❑
10. Tested system actuation with manual pull stations for proper operation: . . . . . . . . . . . ® ❑ ❑
11.'All manual actuators are unobstructed and in path of egress? . . . . . . . . . . . . . . . 00 ❑ ❑
12. Tested system actuation with thermostat for proper operation? . . . . . . . . . . . . . . ❑ ❑ 9
13. Tested gas valve and cable actuation for proper operation? . . . . . . . . . . . . . . . . ® ❑ ❑
14. Tested micro switch actuation, and/or manual reset for proper operation? . . . . . . . . . . K) ❑ ❑
15. Verified all cooking appliances are operational? . . . . . . . . . . . . . . . . . . . . N ❑ ❑
16. Removed all cylinders from mounts and inspect? . . . . . . . . . . . . . . . . . . 50 ❑ ❑
(Note any added maintenance needed: )
17. Inspect all chemical agents for contamination? . . . . . . . . . . . . . . . . . . . ❑ ® ❑
18. Fuse links have been cleaned and/or replaced to the current year?. . . . . . . . . . . . . . X ❑ ❑
19. Is the hood and duct free from grease accumulation?. . . . . . . . . . . . . . . . . . . 14 ❑ ❑
20. Checked exhaust fan operation and proper air flow?. . . . . . . . . . . . . . . . . . . 00 ❑ ❑
21. Current service tag is on system and pull station?. . . . . . . . . . . . . . . . . ® ❑ ❑
22. All new tamper seals and devices are intact?. . . . . . . . . . . . . . . . . . . . W ❑ ❑
23. Proper hand portable extinguishers properly serviced and certified? . . . . . . . . . . . Il ❑ ❑
24. Is customer currenxd�under a service agreement? . . . . . . . . . . / r ® ❑ ❑
Problems Found: ro)I , .' o— `y rJ Lkry
On this date,the above system was tested and inspected in accordance with procedures of the applicable editions of NFPA stand
and the manufacturer's O&M manual and was operated according to these procedures with results indicated above.
WHITE-CUSTOMER YELLOW-KNIGHT FIRE PINK•AUTHORITY HAVING JURISDICTION __ GOLD-INSURANCE
SERVICE TECI MCj CUSTOMER'S NuTHORIZED AGENT
"QUALITY IS REMEMBERED... LONG AFTER PRICE IS FORGOTTEN!"
* wig►'"�!+��F"'��.sl_'�':-.�:�'�.w+e:,7nr*r... ... ., -
KNIGH
T FIRE PROTECTION
0!4! A DIVISION OF KNIGHT FIRE SPRINKLER
6436 MULLEN ROAD SE
OLYMPIA, WA 98503
(206) 456-2162 r
FAX 456-2151
LICENSE NO. #KNIGHFS150LD ooc 0�
'ON GUARD
?A HOURS A DAY'
SEMI-ANNUAL CONFIDENCE TESTING
RANGE HOOD SYSTEMS
FACIL Y INSURANCE AGENT INSPECTION DATE
( 12e, ( rocev 2- 3- 0 3
ADDRESS I I ADDRESS ANNUAL SEMI-ANN
1 l 311 Lj let ✓'
CI Y TATE ZIP PHONE NO. PHONE NO. TIME AM PM
CONT LAST HYDRO DATE HYDRO TEST DUE SIX YEAR MAINTENANCE
05-e
SY M MANUFACTURER 280' 350° 360'` 450° 5000 GAS / ELECTRIC
MOD5V HOOD/DUCT FRYER BROILER GRILL BURNE� HOT TOP OTHER
YES NO N/A
1. Is system connected to building alarm or otherwise monitored? . . . . . . . . . . . . . ❑ 18tq ❑
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? . . . . . . . . . . ❑ ❑
5. Check hazards against nozzle layout? . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑
6. Are all nozzles positioned and angled properly? . . . . . . . . . . . . . . . . . . . ❑
7. All protective blow off caps or nozzle covers have been cleaned and/or replaced? . . . . . . . I9 ❑ ❑
8. Checked action on self closing caps? . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑ ID
9. Tested system actuation with terminal link for proper operation? . . . . . . . . . . . . . . ❑ ❑
10. Tested system actuation with manual pull stations for proper operation: . . . . . . . . . . . I ❑ ❑
11.'All manual actuators are unobstructed and in path of egress? . . . . . . . . . . . . . . . I ❑ ❑
12. Tested system actuation with thermostat for proper operation? . . . . . . . . . . . . . . ❑ ❑ V
13. Tested gas valve and cable actuation for proper operation? . . . . . . . . . . . . . . . . ❑ ❑
14. Tested micro switch actuation, and/or manual reset for proper operation? . . . . . . . . . . ❑ ❑
15. Verified all cooking appliances are operational? . . . . . . . . . . . . . . . . . . . . I ❑ ❑
16. Removed all cylinders from mounts and inspect? . . . ❑ ❑
(Note any added maintenance needed: )
17. Inspect all chemical agents for contamination? . . . . . . . . . . . . . . . . . . . ❑ ja ❑
18. Fuse links have been cleaned and/or replaced to the current year?. . . . . . . . . . . . . . ❑ ❑
19. Is the hood and duct free from grease accumulation?. . . . . . . . . . . . . . . . . . . ❑ ❑
20. Checked exhaust fan operation and proper air flow?. . . . . . . . . . . . . . . . . . . ] ❑ ❑
21. Current service tag is on system and pull station?. . . . . . . . . . . . . . . . . . . . ❑ ❑
22. All new tamper seals and devices are intact?. . . . . . . . . . . . . . . . . . . . . . ❑ ❑
23. Proper hand portable extinguishers properly serviced and certified? . . . . . . . . . . . . . ❑ ❑
24. Is customer curren y under a service agreement? . . . -1 . . . . . ❑ ❑
Problems Found: MAO �Q S u S-f r�
On this date,the above system was tested and inspected in accordance with procedures of the applicable editions of NFPA stand
and the manufacturer's O&M manual and was operated according to these procedures with results in icated above.
-CUSTOMER YELLOW-KNIGHT FIRE PINK-AUTHORMY HAVING JURISDICTION GO -INSURANCE
SERV) EtHNICIAN CUSTOMER'S AUTHORIZED AGENT
�1
"QUALITY IS REMEMBERED... LONG AFTER PRICE IS FORGOTTEN!"
r
KNIGHT FIRE PROTECTION
!4, A DIVISION OF KNIGHT FIRE SPRINKLER
4 6436 MULLEN ROAD SE
ir p, i
OLYMPIA, WA 98503
(206) 456-2162
FAX 456-2151
LICENSE NO. #KNIGHFS150LD LZV J Z
"ON GUARD 2 /
24 HOURS A DAY"
SEMI-ANNUAL CONFIDENCE TESTING
RANGE HOOD SYSTEMS
FACILITY INSURANCE AGENT INSPECTION DATE
ADDRESS i y ADDRESS ANNUAL SEM
1 D �
CITY STATE I
{ ZIP , PH�QfNE NO. ya PRONE NOL, TRAE AM PM
WA
CONTACT LAST HYDRO DATE HYDRO TEST DUE SIX YEAR MAINTENANCE
SY MANUFAC 280 350° 360° 450° ( 5000 GAS ELECTRIC
— �
MODEL PC1_- ��O HOOD/DUC FRYER BROILER GRII L BURNERS HOT TOP OTHER
.
YES NO N/A
1. Is system connected to building alarm or otherwise monitored? . . . . . . . . . . . . . ❑
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? . . . . . . . . . . ❑ 19 ❑
5. Check hazards against nozzle layout? . . . . . . . . . . . . . . . . . . . . . . . M ❑ ❑
6. Are all nozzles positioned and angled properly? . . . . . . . . . . . . . . . . . . . ® ❑ ❑
7. All protective blow off caps or nozzle covers have been cleaned and/or replaced? . . . . . . . Pa ❑ ❑
8. Checked action on self closing caps? . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑
9. Tested system actuation with terminal link for proper operation? . . . . . . . . . . . . . . ® ❑ ❑
10. Tested system actuation with manual pull stations for proper operation: . . . . . . . . . . . ❑ ❑
11.'All manual actuators are unobstructed and in path of egress? . . . . . . . . . . . . . . . ® ❑ ❑
12. Tested system actuation with thermostat for proper operation? . . . . . . . . . . . . . . ❑ ❑ g�
13. Tested gas valve and cable actuation for proper operation? . . . . . . . . . . . . . . . . ❑ ❑
14. Tested micro switch actuation, and/or manual reset for proper operation? . . . . . . . . . . Q ❑ ❑
15. Verified all cooking appliances are operational? . . . . . . . . . . . . . . . . . . . . p ❑
16. Removed all cylinders from mounts and inspect? . . . . . . . . . . . . . ❑ ❑
(Note any added maintenance needed:
17. Inspect all chemical agents for contamination? . . . . . . . . . . . . . . . . . . . ❑ ❑
18. Fuse links have been cleaned and/or replaced to the current year?. . . . . . . . . . . . . . 51 ❑ ❑
19. Is the hood and duct free from grease accumulation?. . . . . . . . . . . . . . . . . . . 10 ❑ ❑
20. Checked exhaust fan operation and proper air flow?. . . . . . . . . . . . . . . . . . . 60 ❑ ❑
21. Current service tag is on system and pull station?. . . . . . . . . . . . . . . . . . . . ® ❑ ❑
22. All new tamper seals and devices are intact?. . . . . . . . . . . . . . . . . . . . . . ❑ ❑
23. Proper hand portable extinguishers properly serviced and certified? . . . . . . . . . . . . . ® ❑ ❑
24. Is customer currently under a service agreement? . ® ❑ ❑
(.
Problems Found: �, v 5 ,,., j�ss 1�-��J,.,J
On this date,the above system was tested and inspected in accordance with procedures of the applicable editions of NFPA stand
and the manufacturer's O&M manual and was the manufacturer's O&M manual and was operated according these Procedures with results indicated aboveaccording to these procedures with results indicated above
MOM(CUSTOM M YEU.OW-IONIGHT FORE PINK-AUTHORITY HAVING JURISDICTION GOLD-INSURANCE
SERVICE TEC CI CUSTOMER'S AUTHORIZED AGENT
"QUALITY IS REMEMBERED... LONG AFTER PRICE IS FORGOTTEN!"
KNIGHT FIRE PROTECTION, INC.
9702 LATHROP INDUSTRIAL DRIVE SW
OLYMPIA, WA 98512-9188 r-67 ►/l1
(360) 786-8606 Authority Having
FAX 786-8722 Jurisdiction
"ON GUARD LICENSE NO. KNIGHFP044LK TECH 1 TECH 2
24 HOURS A DAY"
SEMI-ANNUAL CONFIDENCE TESTING
RANGE HOOD SYSTEMS
FACILITY INSPECTION DATE
r 2 pc 1ZoG� r� o
ADDRESS ANNUAL AL
CITY STA ZIP PHONE _� THWE AM PM
OWNE NAGER t/v LAST HYDRO DATE HYDRO TEST DUE SIX YEAR MAINTENANCE
SYSTEM MANUFACTURER 280 350,3 360 450 500 GAS ELECTRIC
MODEL HOOD/DUCT FRYER BROILER GRILL BURNERS HOT TOP OTHER
CL—2 v X X
NO N/A
! 1. Is system connected to building alarm or otherwise monitored?
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?
5. Check hazards against nozzle layout?
6. Are all nozzles positioned and angled properly? y.
7. All protective blow off caps or nozzle covers have been cleaned and/or replaced? 4
8. Checked action on self closing caps? _
9. Tested system actuation with terminal link for proper operation?
10. Tested system actuation with manual pull stations for proper operation?
11. All manual actuators are unobstructed and path of egress?
12. Tested gas valve and cable actuation for proper operation?
13. Tested gas valve and from mounts and inspect?
14. Tested micro switch actuation and/or manual reset for proper operation? yC
15. Verified all cooking appliances are operational?
16. Removed all cylinders from mounts and inspect?
(Note any added maintenance needed: ) �_
17. Inspect all chemical agents for contamination?
18. Fuse links have been cleaned and/or replaced to the current year?
19. Is the hood and duct free from grease accumulation?
20. Checked exhaust fan operation and proper air flow? _
21. Current service tag on the system and pull station?
22. All new tamper seals and devices are intact?
23. Proper hand portable extinguishers are properly serviced and certified?
Problems Found: 7:r jFS-r-F— 1--)
On this date,the above system was tested and inspected in accordance with procedures of the applicable editions of NFPA standards and the
manufacturer's O&M manual. This system was operated according to these procedures with results indicated above.
WHITE-CUSTOMER YELLOW-KNIGHT FIRE PINK-AUTHORITY HAVING JURISDICTION GOLD-KNIGHT FIRE
SERVI fE ICIAN CUSTOMER'S AUTHORIZED AGENT
"QUALITY IS REMEMBERED... LONG AFTER PRICE IS FORGOTTEN!"
KNIGHT FIRE PROTECTION, INC. 4 _�, �
T',, U
9702 LATHROP INDUSTRIAL DRIVE SW 'V L
U�SjEMLANNUAJL
IA, WA 98512-9188
360) 786-8606 Authority Having
AX 786-8722 Jurisdiction
'41,
I
"ON GUARDNSE NO. KNIGHFP044LK 'ECH I TECH 2
24 HOURS A DAY
CONFIDENCE TESTING
RANGE HOOD SYSTEMS
FACILITY INSPECTION DATE
11( -t t. ( /C ! c
ADDRESS ANNUAL SEMI-ANNUAL
CITY y STATE ZIP PHONE TIME AyM PM
OWNER/MANAGER LAST HYDRO DATE HYDRO TEST DUE SIX YEAR MAINTENANCE
SYSTEM MANUFACTURER 280 350 360 w 450 500 GAS ELECTRIC
MODEL HOOD/DUCT FRYER BROILER GRILL BURNERS HOT TOP OTHER
- yv x X
YES NO N/A
1. Is system connected to building alarm or otherwise monitored? y
2. Is cylinder pressure gauge and/or weight at acceptable levels?
3. Are all safety tamper seals and devices intact? X
4. Are there any visible signs that system has been fired or tampered with?
5. Check hazards against nozzle layout?
6. Are all nozzles positioned and angled properly?
7. All protective blow off caps or nozzle covers have been cleaned and/or replaced?
8. Checked action on self closing caps?
9. Tested system actuation with terminal link for proper operation?
10. Tested system�actuafair'with manual pull stations for proper operation? }(
11. All manudi"actuators are unobstructed and path of egress?
12. Tested gas valve and cable actuation for proper operation?
13. Tested gas valve and from mounts and inspect?
14. Tested micro switch actuation and/or manual reset for proper operation?
15. Verified all cooking appliances are operational?
16. Removed all-cylinders from mounts and inspect?.
(Note any added maintenance needed: ) �_
17. Inspect all chemical agents for contamination?
18. Fuse links have been cleaned and/or replaced to the current year? X
19. Is the hood and duct free from grease accumulation? _X
20. Checked exhaust fan operation and proper air flow? X
21. Current service tag on the system and pull station? —�
22. All new tamper seals and devices are intact?
23. Proper hand portable extinguishers are properly serviced and certified? 12�—
Problems Found: -e.
On this date,the above system was tested and inspected in accordance with procedures of the applicable edition of NFPA standards and the
manufacturer's O&M manual. This system was operated according to these procedures with results indicated above.
WHITE-CUSTOMER YELLOW-KNIGHT FIRE PINK-AUTHORITY RAVING JURISDICTION GOLD-KNIGHT FIRE
s
Gf SERVICE TECHNICIAN STOR'SrTrEN!
ORIZED AGENT {
"QUALITY IS REMEMBERED... LONG AFTER PRICE IS FOR "
KNIGHT FIRE PROTECTION, INC.
9702 LATHROP INDUSTRIAL DRIVE SW
O A, WA 98512-9188 Slit
n786-872
Authority Having
Jurisdiction
"ON GUARD LICENSE NO. KNIGHFP044LK TECH 1 TECH 2
24 HOURS A DAY"
SEMI-ANNUAL CONFIDENCE TESTING
RANGE HOOD SYSTEMS
FACILITY INSPECTION DATE
ADDRESS ANNUAL SEMI-ANNUAL
k
CITY _ STATE zIP PHONE TIME AM PM
OWNER/MANAGER LAST HYDRO DATE HYDRO TEST DUE SIX YEAR MAINTENANCE
SYSTEM MANUFACTURER 280 350 360 450 500 GAS�/ ELECTRIC
MODEL HOOD/DUCT FRYER BROILER GRILL BURNERS HOTTOP OTHER
z X x
YES NO N/A
1. Is system connected to building alarm or otherwise monitored?
2. Is cylinder pressure gauge and/or weight at acceptable levels? X
3. Are all safety tamper seals and devices intact? _ ,
4. Are there any visible signs that system has been fired or tampered with?
5. Check hazards against nozzle layout?
6. Are all nozzles positioned and angled properly?
7. All protective blow off caps or nozzle covers have been cleaned and/or replaced?
8. Checked action on self closing caps?
9. Tested system actuation with terminal link for proper operation?
10. Tested system actuation with manual pull stations for proper operation?
11. All manual actuators are unobstructed and path of egress?
12. Tested gas valve and cable actuation for proper operation? _ X
13. Tested gas valve and from mounts and inspect? )e"
14. Tested micro switch actuation and/or manual reset for proper operation? —,
15. Verified all cooking appliances are operational? )C
16. Removed all cylinders from mounts and inspect?
(Note any added maintenance needed: ) X
17. Inspect all chemical agents for contamination?
18. Fuse links have been cleaned and/or replaced to the current year?
19. Is the hood and duct free from grease accumulation? X
20. Checked exhaust fan operation and proper air flow?
21. Current service tag on the system and pull station?
22. All new tamper seals and devices are intact?
23. Proper hand portable extinguishers are properly(serviced and certified? _
Problems Found: �jcc,t1 Cz.
On this date,the above system was tested and inspected in accordance with procedures of the applicable editions of NFPA standards and the
manufacturer's O&M manual. This system was operated according to these procedures with results indicated above.
WHITE-CUSTOMER - `" -"7ELLOW-KNIGHT FIRE PINK-AUTHORITY HAVING JURISDICTION - GOLD AINIGHT FIRE
rZ4 SERVICE TECHNICIAN CUSTOMER'S AUTHORIZED AGENT
"QUALITY IS REMEMBERED... LONG AFTER PRICE IS FORGOTTEN!"
KNIGHT FIRE PROTECTION INC. S ��
9702 LATHROP INDUSTRIAL DRIVE SW
OLYMPIA, WA 98512-9188t,�,ti
(360) 786-8606 Authority Having
FAX 786-8722 Jurisdiction
to 0 2 C-1
"ON GUARD
LICENSE NO. KNIGHFPWLK fb,CH 1 TECH 2
24 HOURS A DAY"
SEMI-ANNUAL CONFIDENCE TESTING
RANGE HOOD SYSTEMS
FACILITY INSPECTION DATE
f-
ADDRESS ANNUAL SEMI-ANNUAL
� r�IU f�Cc • / X..
CITY STATE ZIP PHONE TIME AM PM
OWNER/MANAGER LAST HYDRO DATE HYDRO TEST DUE SIX YEAR MAINTENANCE
, -9-A
SYSTEM MANUFACTURER 280 350 360 450 500 GAS ELECTRIC
MODEL HOODIDUCT FRYER BROILER GRILL BURNERS HOT TOP OTHER
Y y >11
YES NO N/A
1. Is system connected to building alarm or otherwise monitored? y
2. Is cylinder pressure gauge and/or weight at acceptable levels?
—
3. Are all safety tamper seals and devices intact? y
4. Are there any visible signs that system has been fired or tampered with?
5. Check hazards against nozzle layout? 1/
6. Are all nozzles positioned and angled properly?
7. All protective blow off caps or nozzle covers have been cleaned and/or replaced? Y
8. Checked action on self closing caps? v
9. Tested system actuation with terminal link for proper operation? T
10. Tested system actuation with manual pull stations for proper operation? y
11. All manual actuators are unobstructed and path of egress? y
12. Tested gas valve and cable actuation for proper operation?
13. Tested gas valve and from mounts and inspect?
14. Tested micro switch actuation and/or manual reset for proper operation? 1l
15. Verified all cooking appliances are operational? �(
16. Removed all cylinders from mounts and inspect?
(Note any added maintenance needed:
17. Inspect all chemical agents for contamination? Y
18. Fuse links have been cleaned and/or replaced to the current year?
19. Is the hood and duct free from grease accumulation? k
20. Checked exhaust fan operation and proper air flow? ),r
21. Current service tag on the system and pull station?
22. All new tamper seals and devices are intact?
23. Proper hand portable extinguishers are properly serviced and certifie ? ?/
Problems Found ,L I, C
On this date,the above system was tested and inspected in accordance with procedures of the applicable editions of NFPA standards and the
manufacturer's O&M manual. This system was operated according to these procedures with results in cated above.
WHITE-CUSTOMER __.f -------YELLOW-KNIGHT FIRE PINK-rAjo AVNGRRRISDIC.T ION GOLD-KNIGHT FIRE
COlSE CE TEMVIeiAN OER'$A ORTZEDAGENT"QUALITY IS REMEMBERED... LONG AFTER PRICE IS FORGOTTEN!"
KNIGHT FIRE PROTECTION
,';.. A DIVISION OF KNIGHT FIRE SPRINKLER 1>'V `� �a�
"'" 6436 MULLEN ROAD SE coo I
OLYMPIA, WA 98503
(206) 456-2162
FAX 456-2151
LICENSE NO. #KNIGHFS 150LD
'ON GUARD
24 HOURS A DAY'
SEMI-ANNUAL CONFIDENCE TESTING
RANGE HOOD SYSTEMS
FACILITY INSURANCE AGENT INSPECTION DATE
c o y
ADDRESS ADDRESS ANNUAL SEMI-ANN
CITY STATE ZIP P/H'ONE NO. PHONE NO. TIME
�) AM
409Q It
CONTACT LAST HYDRO DATE HYDRO TEST DUE SUC YEAR MAINTENANCE
SYSTEM MANUFACTURER 280° 350° 360' 450° 500° GAS ELECTRIC,--
' - GbIE
MODEL HOOD ' FRYER BROILER GRILL BURNERS HOT TOP OTHER
YES NO N/A
1. Is system connected to building alarm or otherwise monitored? . . . . . . . . . . . . . ® ❑ ❑
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? . . . . . . . . . . ❑ ® ❑
5- Check hazards against nozzle layout? . . . . . . . . . . . . . . . . . . . . . . . tl ❑ ❑
6. Are all nozzles positioned and angled properly? . . . . . . . . . . . . . . . . . . . CW ❑ ❑
7. All protective blow off caps or nozzle covers have been cleaned and/or replaced? . . . . . . . ® ❑ ❑
8. Checked action on self closing caps? . . . . . . . . . . . . . . . . . . . . . . . ❑ ❑
9. Tested system actuation with terminal link for proper operation? . . . . . . . . . . . . . . JSt ❑ ❑
10. Tested system actuation with manual pull stations for proper operation: . . . . . . . . . . . ❑ ❑
11.'All manual actuators are unobstructed and in path of egress? . . . . . . . . . . . . . . . I& ❑ ❑
12. Tested system actuation with thermostat for proper operation? . . . . . . . . . . . . . . ❑ ❑
13. Tested gas valve and cable actuatijon for proper operation? ❑ ❑ 9
14. Tested micro switch actuation, and/or manual reset for proper operation? . . . . . . . . . . ❑ ❑
15. Verified all cooking appliances are operational? . . . . . . . . . . . . . . . . . . . . ❑ ❑
16. Removed all cylinders from mounts and inspect? . . . . . . . . . . . . . . . . . . ❑ ❑
(Note any added maintenance needed: )
417. Inspect all chemical agents for contamination? ❑ (� ❑
18. Fuse links have been cleaned and/or replaced to the current year?. . . . . . . . . . . . . . ¢] ❑ ❑
19. Is the hood and duct free from grease accumulation?. . . . . . . . . . . . . . . . . . . W ❑ ❑
20. Checked exhaust fan operation and proper air flow?. . . . . . . . . . . . . . . . . . . ® ❑ ❑
21. Current service tag is on system and pull station?. . . . . . . . . . . . . . . . . . . . ❑ ❑
22. All new tamper seals and devices are intact?. . . . . . . . . . . . . . . . . . . . . . ❑ ❑
23. Proper hand portable extinguishers properly serviced and certified? . . . . . . . . . . . . . (5I ❑ ❑
24. Is customer curre y under a service agreement? . . . . . . . . . . . . . . . . p ❑ ❑
Problems Found:
On this date, the above system was tested and inspected in accordance with procedures of the applicable editions of NFPA stand
and the manufacturer's O&M manual and was operated according to these procedures with results indicated above.
WHITE-CUSTOKM YELAW-KMGKr FOIE PINK-AUTHORITY HAVING JURISDICTION GOLD-INSURANCE
SERVICtE TEmNici-AN CUSTOMER'S AUTHORIZED AGENT
"QUALITY IS REMEMBERED... LONG AFTER PRICE IS FORGOTTEN!"