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