HomeMy WebLinkAbout2004-02-25 Kitchen Hood Fire Inspection Reports - Northland Fire & Security y
.Chen Hood Firejse1 Inspection & _ Penance Report
DATE OF SERVICE TIME A.M. P.M.
ANNUAL SEMI-ANI,�UAL RECHARGE INSTALLATION RENOVATION
..!v 'ma.- LOCATION OF SYSTEM CYLINDERS
N itia l = E -.12-1‘4. iL
SeCuriM MANUFACAER MODEL NUMBER WET DRY CHEMICAL
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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 / '
FUSE LINKS 360°F FUSE LINKS 450°F FUSE LINKS 500°F OTHER
Name w?(1()(..1 ..I{\ ()f) ? f "°Y FUEL SHUT-OFF ELECTRIC GAS SIZE
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Address , 76-17 N('Y1 L A aCr . t t
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SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
City (:)f4 �- ? til`aLiC:.._ )-4t- iii"' f C,
r _. __-----_- ___ ._ 1MANUFACTURER'SkAANUAt REFERENCE
Telephone ( �` ) 'I)/- j 2. lc) Store No.
NOTE:NON COMPLIANT SYSTEMS MAY FAIL TO EXTINGUISH/SUPPRESS A FIRE.
Owner01(1 anag (---C;.. /124 .,41�' L Y0
COOKING APPLIANCE LOCATIONS&SIZES:LEFT TO RIGHT
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4
t'
YEE N4 NOVES NO LA '
1. System interlocked with building fire alarm o 0 o N
20. Check travel of cable nuts/S-hooks O
2. Duct
and plenum covered with correct nozzles 21. Piping&conduit. securely bracketed 0
a: Chi
posrtio�ring of all nozzles a, Q 22. Proper separation between fryers&flameCI4. System installed per U.L 300 standard&meets 23. Proper clearance-flame to filtersLeine °Ci
manufacturers U.L listing&N.F.PA standards iflyi Cl 24. Exhaust fan in operating order
5. Hood/duct penetrations sealed with weld or UL device CI 25. All filters replaced �� CI
6. Check if seals intact,evidence of tampering ,1. 26. Fuel shut-off in on position Cf` Q 0
7. If system has been discharged,report same Cl ie C a., 27. Manual&remote set/seals in place Cl
8. Pressure gauge in proper range(d gauged) CI,1 28. Replace systems coversie/ri
C
9. Check cartridge weight(if applicable) ( ' 29. System operational&seals in place I CI
10. Dry system 6 year maintenance date/wet system 12 30. Slave system operational C
year hydro-test date 2(0 CI 31. Clean cylinder&mount ClZ".
11. Inspect cylinder and mount l Cl 32. Fan warning sign on hood CI CI
12. Operate system from terminal link C-1' 0 33. Proper signage and personnel instructed in manual
13. Test fori proper operation from remote XjCli Cl operation of system ,
14. Check operation of micro switch CI 34. Proper hand portable extinguishers ,k1 Cl
15. Check operation of gas valve V Cl 35. K class fire extinguisher in cooking area 13' Cl
16. Clean nozzles Cl 36. Portable extinguishers properly serviced � Cl
17. Proper nozzle covers in place Cl 37. Service&Certification tag on system Q Cl Cl.,
18. Check fuse links and clean Cl 38. Safety chains on all gas appliances attached and secured Cl co nig
19. Replaced fuse links Cl Cl NOTE DISCREPANCIES OR DEFICINCIES BELOW Cl Cl Cl
COMMENTS:
On this date,the above system was tested and inspected in accordance with procedures of the presently adopted editions of.
NFPA 17, 17A, 96 and the manufacturer's manual and was operated according to these procedures with results indicated above.
X .. .. .Lar • �� :F Co ,C. a ' t-;,. 'k I . 4 is
SERVICE TECHNICIAN PERMIT NO. DATE: TIME: AM PM CUSTOMERS A HORIZED 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
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schen Hood Fire _js#ern Inspection & _ Asintenance Report
DATE OF SERVICE TIME A.M. P.M.
ANNUAL SEMI-ANNUIaL RECHARGE INSTALLATION RENOVATION
Northland 2; LOCATION OF SYSTEM CYLINDERS
MANUFACTURER MODEL NUMBER WET DRY CHEMICAL
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 lei) -
FUSE LINKS 360°F FUSE LINKS 450°F FUSE LINKS 500°F OTHER
Name , ,'.7)t,',,-, e- I~( W iZ t 35i
i FUEL SHUT-OFF ELECTRIC GAS SIZE
e
Address 5:e/o7 t el L „ Ye. . V L,.
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
City �_..:.� -715 7
L'. 1 "'tit_ t f C'1 h t l 5 ire
-MANUFACTURER'S MANUAL REFERENCE
.gym
Telephone (i" ' I 4" 7_ ,-'JL) Store No.
NOTE:NON COMPLIANT SYSTEMS MAY FAIL TO EXTINGUISH/SUPPRESS A FIRE.
Ownerna ve, L t ii ,w,l°.,"'r,i `,c,ti-k
COOKING APPLIANCE LOCATIONS&SIZES:LEFT TO RIGHT
he.
(.s,q) t,. IL
r
YES NQ NIA YES NO NIA
1. System interlocked with building fire alarm 0 , C' 20. Check travel of cable nuts/S-hooks 0 I] C
2. Duct and plenum covered with correct nozzles [ ,,IJ 21. Piping&conduit securely bracketed c3/10E--in
.``-3'hhec� pasitioriing of all nozzles o Q Q 22. Proper separation between fryers&flame rj10P
4. System installed per U.L 300 standard&meets 23. Proper clearance-flame to filters Q
Q
manufacturers U.L listing&N.F.P.A standardsrtrp C] 24. Exhaust fan in operating order , ? 0
5. Hood/duct penetrations sealed with weld or UL device C C] 25. All filters replaced I Q
6. Check if seals intact,evidence of tampering C�'L� in 26. Fuel shut-off in on position t
7. If system has been discharged,report same Q i7`C] 27. Manual&remote set/seals in place CO
8. Pressure gauge in proper range(if gauged) O .,C] C' 28. Replace systems covers 11,13p C]
9. Check cartridge weight(if applicable) C C] C] 29. System operational&seals in placeI 'i7 g.,,,,10. Dry system 6 year maintenance date/wet system 12 30. Slave system operational 0
year hydro-test date ogrAn El 31. Clean cylinder&mount 101;0 Q
11. Inspect cylinder and mount C Q 32. Fan warning sign on hood eft Q CI
12. Operate system from terminal link ;191 0 33. Proper signage and personnel instructed in manual
13. Test forl proper operation from remoteoperation of system [ Q
i
14. Check operation of micro switch Q 34. Proper hand portable extinguishers0
15. Check operation of gas valve C C] 35. K class fire extinguisher in cooking area " Q
16. Clean nozzles C Q 36. Portable extinguishers properly serviced gr/g Q
17. Proper nozzle covers in place gilt>0 0 37. Service&Certification tag on system CYC] Q/
18. Check fuse links and clean �7 C] 38. Safety chains on all gas appliances attached and secured C] C] 13
19. Replaced fuse links CYC] C] NOTE DISCREPANCIES OR DEFICINCIES BELOW C] CI Q
COMMENTS:
On this date,the above system was tested and inspected in accordance with procedures of the presently adopted editions of
NFPA 17, 17A, 96 and the manufacturer's manual and was operated according to these procedures with results indicated above.
X cam_. f A Ct t LiA I+ ' ..i L1 3 ,^�A.,
SERVICE TECHNICIAN 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