HomeMy WebLinkAbout1994-05-25 Kitchen Hood Fire System Inspection Report Kitchen Hood Fire stem Inspection & .`Maintenance Report
DATEOF SERVICE TIME A.M. RM.
4
4
ANNUAL SEMI-AAL RECHARGE INSTALLATION RENOVATION
Northland SEMI-271 LOCATION OF SYSTEM CYLINDERS
Fire & Security MANUFACTURER MODEL NUMBER W�
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 2/1 L
FUSE LINKS 380°F FUSE LINKS 450°F FUSE LINKS 500°F OTHER
Name , ;i H
FUEL SHUT-OFF ELECTRIC GAS SIZE
Address 'I i,(... - : H > V ✓
SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE
City ),Nt'C t1
_ MANUFACTURER'S MANUAL REFERENCE
Telephone , , 04::)(j-h=isk Store No.
NOTE:NON COMPLIANT SYSTEMS MAY FAIL TO EXTINGUISH/SUPPRESS A FIRE.
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Owner or Manage i A; t..- TD/3. (S i(<<„
COOKING APPLIANCE LOCATIONS&SIZES:LEFT TO RIGHT
4j',L
yEa NC Nig/ Y/-,s NC N/A,
1.System interlocked with building fire alarm Q Q 20.Check travel of cable nuts/S-hooks Q Q plril
2.Duct and plenum covered with correct nozzles 7"p Q O 21.Piping&conduit securely bracketed 1'Q O
3.Check positioning of all nozzles [{'Q Q 22.Proper separation between fryers&flame 0/0Q
4.System installed per U.L.300 standard&meets // 23.Proper clearance-flame to fitters Q
manufacturers U.L.listing&N.F.P.A standards 0/,0 Q 24.Exhaust fan in operating order Q
5.Hood/duct penetrations sealed with weld or UL device [.t'fJ Q 25.All fitters replaced ;CI Q
6.Check if seals intact,evidence of tampering 112'Q p 26. Fuel shut-off in on position Q
7.If system has been discharged,report same O Q` 27. Manual&remote set/seals in place Q
8.Pressure gauge in proper range Of gauged) Q�j �7 28. Replace systems covers 3 Q Q
9.Check cartridge weight(if applicable) d Q Q 29.System operational&seals in place LY Q Q.
10. Dry system 6 year maintenance date/wet system 12 30.Slave system operational Q Q Pf
year hydro-test date �Q Q 31.Clean cylinder&mount 1/',0 Q
11. Inspect cylinder and mount L3,C] Q 32. Fan warning sign on hood Q'Q Q
12.Operate system from terminal link ��,t7 Q 33. Proper signage and personnel instructed in manual �-/`
13.Test for proper operation from remote Q operation of system 17 Q
14.Check operation of micro switch d Q Q 34. Proper hand portable extinguishers 3,E] Q
15.Check operation of gas valve GO1 Q 35. K class fire extinguisher in cooking area L'f Q
16.Clean nozzles QJ'p Q 36. Portable extinguishers properly serviced C3 Q Q
17. Proper nozzle covers in place p QQ 37.Service&Certification tag on system (y'Q Q
18.Check fuse links and clean [{ Q 38.Safety chains on all gas appliances attached and secured 7'Q Q
19. Replaced fuse links O NOTE DISCREPANCIES OR DEFICINCIES BELOW Q O O
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.
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