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Home My WebLink About2018-07-30 Nardini Cooking Hood Fire Suppression System Report ri , N • FIRE EQUIPMENT www.nardinifire.com/sales@nardinifire.com St.Paul,MN COOKING HOOD FIRE SUPPRESSION SYSTEM REPORT Name of Facility: DOMINO'S PIZZA Installation/Service Report Date: 2018-07-30 Street: 5863 NEAL AVE N Time In: 8:51 am Time Out: 9:33 am City: OAK PARK HEIGHTS State: MN Zip: 55082 Semi-Annual © Recharge ❑ Upgrade ❑ Authorized Contact: Kulba,Michael Phone: 6514303030 - Annual ❑ Installation ❑ Test ❑ System#: 1 of: I Last Maintained By: ML Manufacturer: Ansul❑X Kidde/Range Guard❑ Kidde R.G.Control Head Amerex❑ Pyro-Chem❑ Other Sys./Cyl.Location: Kitchen Connected to Fire Alarm/Dialer?: Yes❑No❑X Model(s): R102 3 Gallon #of Tanks: 1 Serial Number(s): S003163 Cartridge Type: 101-20 Wet Chemical: E3 Dry Chemical Cartridge Operated 1 Manifolded?: Yes❑No ZI System(s)Hydro.Date(s): 2014 Pressure: Psi Cartridge(s)Hydro.Date(s): 10/2014 Weight(s) 42 3/4 oz Nozzle(s): Plenum ❑ Duct ❑i Range ❑ Griddle ❑ Fryer ❑ Broiler ❑ Up.Broiler ❑ Chain Broiler ❑ Salamander ❑ Wok ❑ Tilt ❑ Skillet ❑ Kettle ❑ Pizza Oven ❑ Other ❑ Fusible Link(s)/FR Link(s)Qty(s): 165F ❑ 212F ❑ 280F ❑ 360F 450F ❑ 500F❑ Quartzoid ❑ Other❑ Mech Gas Valve(s)/Size(s): Eke Gas Valve(s)/Size(s): 1 in Location: Left of automan Manual Reset Relay: Yes® No ❑ Micro/Pressure Switch Type: Quad Breaker/Relay Located: Shunt Procedures: (Pass—Fail—N/A) P F N/A P F N/A E 1. Hazard properly covered w/correct nozzles. ❑X❑❑ 15. Filters,hoods,and duct clean,with filters in place. X ❑ 0 2. Hood/duct penetration sealed w/weld or UL device. X❑ 16. Gas shut-off complete. X ❑ ❑ 3. Pressure gauge in proper range/Cylinder full. ❑X❑❑ 17. Electric shut-off complete. X ❑ ❑ 4. Cartridge weight within 1/2 oz.of listed weight. ❑X❑❑ 18. Make-up air shut-off complete. E 0 5. Check hydrostatic test date. X❑ 19. Manual and remote release set./Seals in place. LI ❑ 6. Inspect/clean cylinder and mount. a❑❑ 20. Safety plates/Discharge prevention devices removed. E ❑ 7. Operate system from terminal link and manual relay station. 00❑ 21. System(s)operational,properly armed,tagged,sealed. ❑ ❑ 8. Check operation microswitch. X❑❑ 22. Personnel instructed of manual operation of system. LI ❑ 9. Check operation of gas valve. X❑❑ 23. Proper hand portable extinguisher near hood and serviced. E ❑ 10. Clean nozzles./Replace nozzle caps or seals. ❑❑ 24. Authorized contact notified of discrepancies in system. LI ❑ 11. Blow off test. ❑X❑ ❑ 25. System meets UL-300 requirements. LI ❑ 12. Replace fusible links./Inspect Quartzoid links. ❑X❑ ❑ 26. Current drawing/pictures of hazard with report. ❑ LI 13. Check travel of cable,nuts and S-hooks. X❑ 27. Examine tank,threads,vent plug,bursting disc,o-ring. ❑X ❑ El 14. Piping and conduit securely bracketed. The system is in compliance with all applicable codes and standards: Yes ❑X No ❑ A non-compliance tag is attached: Yes ❑ No El Comments: Engstrum,A . �<- Nardini Fire Technician(s) Customer/Authorized Agent—Printed Name Customer/Authorized Agent-Signature