HomeMy WebLinkAboutrange hood report �� NARQIN ! FIRE EQUIPMEN�T COIVIPANY
ST. PAUL, MN. 612-483-6631 • ❑�FARGO, N.D. T01 -235-4224
RANGE HOOD F� RE SUPPRESSION SYS�'EM
I NSTALLATI ON / MAIIVTENANCE REPORT
❑INSTALLATION �SEMI-ANNtJAL MAINTENANCE ❑ANNiJAL MAINTENANCE
Date of installation/maintenance ,1,2� '��� Time in ,��� Time out
1 . Name/phone of facility ' B -e
2. Address of facility o� �.d L�. r�` ��2�
'
3. City, state, zip Lc�a
4 . Mfg. of system ANS �_ KIDDE � RANGE GUARD OTHER
S . Dry Chemical Wet Chemical � Cartridge Operated
6. Where system is located /�/�jr�-1-i p �p
7 . Model of system RF �� , .���' S Hydro date � �
8. Last maint . date;�'�_ by ��✓���`n_f �cr,� Co.
9 . Manual release(s) operable? �Y.e�� ❑ No; Automatic relea e operable?
�Yes � No
10. Mechanical fuel shut-off device(s) operatior,al? �es � No ❑N/A
11 . Electrical fuel shut-off device(s) operational? ❑Yes ❑No�N/A � �r
12. Do devices in 10/11 shut-off all fuel under hoods? y�'Yes No /� �/v
JL'' �
13. Fusible links, how many?�_360° ; 500° Last replaced �._.)t(yt�
14 . Nozzles checked for proper coverage and clearance? �1Ces ❑ No
15 . Nozzle quantity/types �`Duct / Plenum UP Broiler
Char Broiler Regular surface Other
16. Cyl . Weight(s) � Cyl . pressure Cart . weight �6 l� p�
17. Do exhaust fans appear to operate properly? �.es [] No
18. Is hood clean? ;�Yes ❑No; Are filters clean? �Ces ❑ No
19. Is sketch of hood and appliances on back of report ith dimensions?
�Ye s � No �
20. Does system meet N.F.P.A. 17 and 96 codes? ,�Yes [� No
21 . Nas system been sealed and tagged properly? ,�i�s � No
22. Does the hand portable fire ext. in kitchen meet N.F.P.A. l0A? �s (] No
23. If "no" answers appear above, is non-compliance tag attached? [] Yes ❑ No
24. Comments , Recommendations
- K��.Q n�v � �n ��
Installer-Inspectors Signature Customers Si�nature Printed r'ame
' � tVARDINI FIRE EQUIPMEN�T COMPANY
�ST. PAUL, MN. 612-483-6631 • ❑�FARGO, N.D. T01 -235-4224
RANGE HOOD FlRE SUPPRESSION SYSTEM
INSTALLATION / MAIIVTENANCE REPORT
�INSTALLATION �SEMI-ANNUAL MAINTENANCE ❑ANNUAL MAINTENANCE
�
Date of installation/maintenance /�-- " � �� Time in �� O Time out //.x��J
1 . Name/phone of facility /�r`nne�"e;�v�� n e.✓t�.P �o� �! e lqt'-�-5
2. Address of facilityo'Zo��p /V�r�ts�inr� l,r,`J� ����w��S/� ��''2 `1r��' 7.�G/
3. City, state, zip L�.� � 3� �
4 . Mfg. of. system ANS �_ KIDDE RANGE GUARD OTHER
S . Dry Chemical Wet Chemical Cartridge Operated
6. Where system is located �G�C � O�� •
7. Model of system f ' �, � Hydro date �'�
8. Last maint . date1�u��- �'c� by ' ,� Co.
9 . Manual release(s) operable? ;�Yes ❑ No; Automatic release operable?
�Yes � No
10. Mechanical fuel shut-off device(s) operatior,al? �Yes � No ❑N/A �
/
11 . Electrical fuel shut-off device(s) o perational? ❑Yes ❑No„�N/A � �!�
12 . Do devices in 10/11 shut-off all fuel under hoods? �Yes ❑ No
13. Fusible links, how many?_�360° ; 500° Last replaced �c.�►�t. Q ��
14 . Nozzles checked for proper coverage and clearance? [�Yes ❑ No
15 . Nozzle quantity/types Duct Plenum UP Broiler
Char Broiler o2 Regular surface Other
16. Cyl . Weight(s) �i� � ( - Cart. weight ���r2 dZ--
17. Do exhaust fans appear to operate properly? ,�Yes � No
18. Is hood clean? �es ❑No; Are filters clean? �Yes ❑ No
19 . Is sketch of hood and appliances on back of report with dimensions?
Ye s � No
20. Does system meet N.F.P.A. 17 and 96 codes? i�Yes No
21 . Has system been sealed and tagged properly? �'Yes ❑ No
2,2. Does the hand portable fire ext. in kitchen meet N.F.P.A. l0A? ,�yes � No
23. If "no" answers appear above , is non-compliance tag attached? � Yes ❑ No
24 . Comments , Recommendations
/T ��5���i.� ^ ����, (''lr-1�ean�.
Installer-Inspectors Signature Customers Si�nature Printed 'Name