Laserfiche WebLink
Kitchen Hood Fire System Inspection & Maintenance Report <br /> DATE OF SERVICE TIME A.M. RM. <br /> o,-pENDAR1F <br /> t7 F ! mac° N 0 RTFI LAN D ANNUAL SEMI-ANNUAL RECHARGE INSTALLATION RENOVATION <br /> NQS ;¢, Yy FIRE & SECURITY <br /> LOCATION OF SYSTEM CYLINDERS <br /> 990 Lone Oak Road, Suite 114 <br /> Eagan, MN 55121 MANUFACTURER MODEL NUMBER WET CHEMICAL` DRY CHEMICAL <br /> Phone: (651) 287-8555 -', ; ,_-,,...- X <br /> Fax: (651) 287-8540 CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE <br /> www.nfs-mn.com ':'( 11 t t,1,. „„ <br /> MANIFOLDERJ1 PIRANHA WATERFLOW PRESSURE <br /> - ❑YES ❑ NO <br /> Name <br /> FUSE LINKS 360°F FUSE LINKS 450°F FUSE LINKS 500°F OTHER <br /> • <br /> Address ; - -4 - i . . •�tF' --:: Th <br /> MECHANICAL GAS VALVE(S)&SIZE(S) ELECT.GAS VALVE(S)&SIZE(S) MANUAL RESET RELAY <br /> City /t i, i ) i' ;1 3 '+ : 1 r ❑ YES ❑ NO <br /> SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE <br /> Telephone , >� - • - i., 5 Store No. <br /> OWrter or`IVlehager MANUFACTURER'S MANUAL REFERENCE <br /> NOTE:NON COMPLIANT SYSTEMS MAY FAIL TO EXTINGUISH/SUPPRESS A FIRE. <br /> COOKING APPLIANCE LOCATIONS&SIZES:LEFT TO RIGHT <br /> YES NO N/A YES NO N/A <br /> 1. System interlocked with building fire alarm -2`❑ ❑ 20. Proper separation between fryers&flame /12' ❑ El <br /> 2. Duct and plenum covered with correct nozzles p r❑ El 21. Proper clearance-flame to filters ❑ ❑ <br /> 3. Check positioning of all nozzles -f2'"❑ ❑ 22:Exhaust fan in operating order ? ❑ ❑ <br /> 4. System installed per U.L. 300 standard& meets 23. All filters replaced El ❑ <br /> manufacturers U.L. listing & N.F.P.A. standards ,Z.-❑ ❑ 24. Fuel shut-off in on position /" ❑ ❑ <br /> 5. Hood/duct penetrations sealed with weld or UL device ,Z-❑ ❑ 25. Manual & remote set/seals in place ', E ❑ <br /> 6. Check if seals intact, evidence of tampering ❑„21' ❑ 26. Replace system covers r,,J2.❑ ❑ <br /> 7. Pressure gauge in proper range (if gauged) ❑ ❑ 27. System operational &seals in place ❑ <br /> 8. Check cartridge weight(if applicable) . '❑ ❑ 28. Slave system operational 'LI,,,C7"" <br /> 9. Dry system 6 year maintenance date/wet system 29. Clean cylinder& mount "❑ El <br /> 12 year hydro-test date d ❑ ❑ 30. Fan warning sign on hood ,e1 El ❑ <br /> 10. Inspect cylinder and mount pet El El 31. Proper signage and personnel instructed in <br /> 11. Operate system from terminal link .LJ ❑ CI _ manual operation of system , ''❑ CI12.Test for proper operation from remote ,Pr❑ ❑ .4Proper hand portable extinguishers , f` ❑ ❑ <br /> 13. Check operation of micro switch „IZ❑ ❑ '33T1K class fire extinguisher in cooking area ❑..11-- <br /> 14. Check operation of gas valve ,,0 ❑ ❑ 34. Portable extinguishers properly serviced ,''❑ ❑ <br /> 15. Clean nozzles X ❑ ❑ 35. Service&Certification tag on system ,f '❑ ❑ <br /> 16. Proper nozzle covers in place X CI 11136. Safety chains on all gas appliances attached and secured '❑ CI17. Replaced fuse links ❑ ❑ 37. Status of grease buildup in the hood and duct opening <br /> 18.Check travel of cable J❑ ❑ V Clean ❑ Light ❑ Medium ❑ Heavy ❑ Excessive <br /> 19. Piping &conduit securely bracketed 2(❑ ❑ * NOTE DISCREPANCIES OR DEFICIENCIES BELOW* <br /> COMMENTS: I--, - ,` <br /> On this date, the above system was tested and inspected in accordance with procedures of the presently adopted editions of <br /> NFPA 17„:17A,,,.96 apd the manufacturer's manual and was operated according to these procedures with results indicated above. <br /> X , "1' (--..,_ i,`/: -)a <br /> S1 pt TECHNICIAN PERMIT NO. DATE: TIME: AM PM CUSTOMERS AUTHORIZED AGENT <br /> The bo'ie service technician certifies that the system was personally inspected and found conditions to be as indicated on this report. <br /> WHITE-CUSTOMER • YELLOW- DISTRIBUTOR • PINK-AUTHORITY HAVING JURISDICTION <br />