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HomeMy WebLinkAbout2005-08-26 Northland Fire & Security Inspection Report Kitchen Hood Fire P m Inspection &maintenance Report DATE OF SERVICETIME,,.�.--��II t.45- A P.M. 7-2_6 - Oc" S ANNUAL SEMI;EINNUAL RECHARGE INSTALLATION/� RENOVATION �s,�. LOCcAT�f�OF,$YSTEM��'�'-�RS�� /I© CJ(� Northland = //e /k Wf 141 G- �+ M FACTOR R MODEL NUMB ET DRY CHEMICAL t F Seco rer, PCl.3 o ofepc Your Life Safety Specialists C INDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE 4445 W.77th St.,Suite 125, Minneapolis,MN 55435 (952)893.0905 3 61 / 4 - 9 ( FUSE LINKS 360°F FUSE LINKS 450°F FUSE LINKS 500°F OTHER iy 7- = //J Name V v FUEL SHUT-OFF LECTRIC GAS ' SIZE / -t t(r'G I + CLt Address /33'75' G> 4 N "`- el City al f �)I� f�p t- ��JR NSERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE ��'1 Store No. MANUFACTURER'S MANUAL REFERENCE Telephone 6 1 � �.4.17 .� - le73 64- NOTE:NON COMPLIANT SYSTEMS MAY FAIL TO EXTINGUISH/SUPPRESS A FIRE. Owner or Manager Me le s xa i, vs;e- COOOKING�Q PPLIA�N� LOCATIONS&SIZES:LEFT TO RIGHT ,eA W `tea02 ocuroet' 4 Ftie.r /. rater 1.1 ier- 6; !1 iSt c AiV-a eeiv YES NO NSA YES NO NLA 1. System interlocked with building fire alarm E1 0 CI 20. Check travel of cable nuts/S-hooks £1 0 0 2. Duct and plenum covered withcorrect nozzles , Dr) El El 21. Piping&conduit securely bracketed 0 El E 3. Check positioning of all'nozZles - " d El 22. Proper separation between fryers&flame 0 El El 4. System installed per U.L.300 standard&meets 23. Proper clearance-flame to filters pi 0 El manufacturers U.L listing&N.F.RA standards p El Q 24. Exhaust fan in operating order El 0 0 5. Hood/duct penetrations sealed with weld or UL device 0' In O25. All filters replaced I l El El 6. Check if seals intact,evidence of tampering 26. Fuel shut-off in on position ,l O El 7. If system has been discharged,report same El El If 27. Manual&remote set/seals in place IR 71 E 8. Pressure gauge in proper range(if gauged) in 'I El 28. Replace systems covers 0 0 Q 9. Check cartridge weight(if applicable) 0 ci 0 29. System operational&seals in place El 0 0 10. Dry system 6 year maintenance date/wet system 12 30. Slave system operational 4 El Q year hydro-test date ?l 71 CI 31. Clean cylinder&mount Q9 0 0 i i 1. Inspect cylinder and mount 13 0 0 32. Fan warning sign on hood 113 El 0 12. Operate system from terminal link Fl 0 0 33. Proper signage and personnel instructed in manual -'13. Test-for, o at on from remote - 0 _ operation of - �P� E� � system 11 d la ' 14. Check operation of micro switch lif 0it 34. Proper hand portable extinguishers E' Q El 15. Check operation of gas valve fJ 0 0 35. K class fire extinguisher in cooking area ll El El 16. Clean nozzles to Q El 36. Portable extinguishers properly serviced $ 0 Q 17. Proper nozzle covers in place $1 O 0 37. Service&Certification tag on system 0 Q Q 18. Check fuse links and clean2 EP j38. Safety chains on all gas appliances attached and secured 0 0 P.1 19. Replaced fuse links 0 El NOTE DISCREPANCIES OR DEFICINCIES BELOW O 0 it COMMENTS: On this date,the a►/- stem as tested and inspected in accordance with procedures of the presently adopted editions of 'NFPA 17 7A, • • d th ma/acturer's manual and was operated according to these procedures with results indicated above. ' g'o•rp-tc70;3C islE Kr4iglik‘. ERVICE TECH �CIAN PERMIT NO. DATE: TIME: AM PM CUSTOMERS AUTHORIZED AGENT The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report. WHITE - CUSTOMER • YELLOW- DISTRIBUTOR • PINK-AUTHORITY HAVING JURISDICTION