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Home My WebLink About2004-07-09 Kitchen Hood Fire Inspection Reports - Northland Fire & Security V Wien Hood Fire , )stem Inspection & ..Jaintenance Report DATE OF SERVICE_ TIME ' A,�A. P.M. ANNUAL/ SEMI-ANNUAL RECHARGE INSTALLATION O RENOVATION Siec '` LOCATION OF SYS Y Northland = 6 ki g(iE-- pt unity MAN FACTURER MODEL NUMBER W/(5 DRY CHEMICALFie & Pusu �> 0 Your Life Safety Specialists CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE 4445 W.77th St.,Suite 125, Minneapolis,MN 55435 (952)893.0905 ?Z' q ( FUSE LINKS 360°F FUSE LINKS 450°F FUSE LINKS 500°F OTHER Name t- U r) T14r` l / FUEL SHUT-OFF ELECTRIC /l AS SIZE Address -51 G"7 P c i( A V J ` 1 C r i / c c h City t"�� I„ �� SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE fi MANUFACTURER'S MANUAL REFERENCE Telephone '.S ? � �7 /02 CI� Store No.� -fig L NOTE:NON COMPLIANT SYSTEMS MAY FAIL TO EXTINGUISH/SUPPRESS A FIRE. Owner or Manager /�4 4/ Icenv le COOKING APPLIANCE LOCATIONS&SIZES:LEFT TO RIGHT I--e t'Jf t.- YES NO N/A YE5 NO NIA 1. System interlocked with building fire alarm 0 CI 0 20. Check travel of cable nuts/S-hooks i1El co 2. Duct and plenum covered with correct nozzles 0# O l7 21. Piping&conduit securely bracketed Ig 0 0 3. Check positioning of all nozzles 11 0 a 22. Proper separation between fryers&flame 0 0 Q 4. System installed per U.L.300 standard&meets 23. Proper clearance-flame to filters 91 0 0 manufacturers U.L listing&N.EP.A standards 91El O 24. Exhaust fan in operating order 0 El 17 5. Hood/duct penetrations sealed with weld or UL device 0 [7325. All filters replaced 111 0 0 6. Check if seals intact,evidence of tampering 0 0 26. Fuel shut-off in on position $1 CI El 7. If system has been discharged,report same 0 0 fel 27. Manual&remote set/seals in place Fr Q 0 8. Pressure gauge in proper range(f gauged) Q 0 628. Replace systems covers Q9 0 0 9. Check cartridge weight(if applicable) 91 El El 29. System operational&seals in place 2 0 0 10. Dry system 6 year maintenance date/wet system 12 30. Slave system operational Q O R1 year hydro-test date fla 0 El 31. Clean cylinder&mount J1 Q O 11. Inspect cylinder and mount rij 0 0 32. Fan warning sign on hood to 0 17 12. Operate system from terminal link 91 Q 0 33. Proper signage and personnel instructed in manual 13. Test forj proper operation from remote ia [ El operation of system 71 0 0 14. Check operation of micro switch 9i 0 034. Proper hand portable extinguishers is 0 Q 15. Check operation of gas valve 91 0 El 35. K class fire extinguisher in cooking area fl 0 0 16. Clean nozzles El El 36. Portable extinguishers properly serviced igi co Q 17. Proper nozzle covers in place pi El E 37. Service&Certification tag on system iti 0 0 18. Check fuse links and clean 50/1 O 0 38. Safety chains on all gas appliances attached and secured 0 0 19. Replaced fuse links El 0 gi NOTE DISCREPANCIES OR DEFICINCIES BELOW Q 17 0 COMMENTS: On this date,the a system was tested and inspected in accordance with procedures of the presently adopted editions of. NFPA 17, 17 , 9 n the ma factu is manual and was operated according to these procures with results indicated above. /� C4ll" x ERVICE TECHNICIA PERMIT NO. DATE: TIME: AM PM C STOMERS THORIZED AGENT 3 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 P.' P.N. Ci!chen Hood Fire istem Inspection & _.Maintenance Report DATE OF SERVICEICy ; TIME A117, ,� P.M. '�-- "/-- ' C ( / ANNUAL J SEMI-ANNUAL RECHARGE INSTALLATION RENOVATION ��,�- LOCATION OF SYS EMCY INDERS Northland = 0,0 2(k 1 (4 / t. Fire & Secunty MAN + If OF MODEL GB WET DRY CHEMICAL Your Life Safety Specialists CYLINDERESIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE 4445 W.77th St.,Suite 125, Minneapolis,MN 55435 (952)893.0905 2 or (J FUSE LINKS 360°F FUSE LINKS 450°F FUSE LINKS 500°F OTHER Name gurpc r / 1 y FUEL SHUT-OFF ELECTRIC GASSIZE Address .-S-47C 7 N eq 1 Av e Y /�I (r ; /LI c e A ,.r SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE city (�k 141"k- ,Weq� , h1- MANUFACTURER'S MANUAL REFERENCE / Telephone ( 5/)43 ? /.z.1 Store Nola//� J �i k NOTE:NON COMPLIANT SYSTEMS MAY FAIL TO EXTINGUISH/SUPPRESS A FIRE. Owner or Manager / d Nil y t\1€ '° P COOKING APPLIANCE LOCATIONS&SIZES:LEFT TO RIGHT 4/6 r //e r it,/( r ye r YX NO NSA YES NO N/A 1. System interlocked with building fire alarm 0 0 0 20. Check travel of cable nuts/S-hooks $3 0 0 2. Duct and plenum covered with correct nozzles 0 O 0 21. Piping&conduit securely bracketed PI 0 0 3. Check positioning of all nozzles 0 0 0 22. Proper separation between fryers&flame 7 0 0 4. System installed per U.L.300 standard&meets 23. Proper clearance-flame to filters a 0 0 manufacturers U.L listing&N.F.P.A standards 0 0 O 24. Exhaust fan in operating order Tz O 0 5. Hood/duct penetrations sealed with weld or UL device 0 0 0 25. All filters replaced In 0 0 6. Check if seals intact,evidence of tampering 0 0 0 26. Fuel shut-off in on position g 0 0 7. If system has been discharged,report same 0 0 r91 27. Manual&remote set/seals in place 0 0 CI 8. Pressure gauge in proper range(rf gauged) 0 0 91 28. Replace systems covers I$ 0 0 9. Check cartridge weight(rf applicable) et 0 0 29. System operational&seals in place al 0 0 10. Dry system 6 year maintenance date/wet system 12 30. Slave system operational 0 0 a year hydro-test date p 0 0 31. Clean cylinder&mount 5111 0; 0 11. Inspect cylinder and mount pi 0 0 32. Fan warning sign on hood Pli 0"0 , 12. Operate system from terminal link 11 0 0 33. Proper signage and personnel instructed in manual 13.Test forproper operation from remote 0 0 0 operation of system 0 0 n 14. Check operation of micro switch r 0 0 34. Proper hand portable extinguishers p 0 0 15. Check operation of gas valve 1 0 0 35. K class fire extinguisher in cooking area 1;i3 0 0 16. Clean nozzles Qll 0 0 36. Portable extinguishers properly serviced NI 0 0 17. Proper nozzle covers in place Ip1 0 0 37. Service&Certification tag on system or 0 0 18. Check fuse links and clean $ 0 0 38. Safety chains on all gas appliances attached and secured 0 0 roir 19. Replaced fuse links 0 0 NE NOTE DISCREPANCIES OR DEFICINCIES BELOW 0 0 0 COMMENTS: On this date, the . •• e syste• was tested and inspected in accordance with procedures of the presently adopted editions of NFPA 17. 7A, •• d th m. fact -I's manual and was operated according to these prcreequres with results indicated above. x /0;e' , /,- 7-9-04- q:2,-*7-5--- Se - \'',/,,CA,„,v, ttit ERVICE TECHNICIA PERMIT NO. DATE: TIME: AM PM CUSTOME S AUTHORIZED AGENT The above service technician certifies that the system was personally inspected and found conditions to be as indicated on this report. I WHITE - CUSTOMER • YELLOW- DISTRIBUTOR • PINK-AUTHORITY HAVING JURISDICTION