HomeMy WebLinkAboutFire Sprinkler Report - 4/15/11 (2) � �
NiINi�lESQ NVV14Y No. ��
575 MINNEHAHAAVENUE WEST PRE ENGINEERED SYSTEMS REP�
ST. PAUL, MN 55103
952-345-FIRE • FAX 952-345-2499 ` �
--� SERVICE � � 2v � `
BILL TO � �� ADDRESS ��L=� �
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PHONE CONTACT SLLn
O ATE SP # PURCHASE ORDER # ACCqjJ� SITE # AUTHORIZED BY
NN L SEMI- NUAL RECHARGE INS�LATION FENOVATION MASTER CYL �� �-� S: ::++++ SLAVE CYL
OF SYSTEM CY iNDERS �r� 360 LIN 450 LINK 500 LINK OTHER F
CHEM DRY CHEM FUEL SHU�OFF ELECTRIC G�Sj SIZE
�L �(,�+Q�V� C�(� �C ,.,_ r�C
UL 300 N UL 1254 Y N CO2 OTHER SERIAL # LAST HYDRO TEST DA7E LAST RECHARGE DATE
il��PECTlON �HECK LI�T �-
1. ALLAPPLIANCES PROPERLY COVERED w/CORRECT NOZZLES � 14. CHECK OPERATION OF MICRO SWITCH �
2. DUCT AND PLENUM COVERED wICORRECT NOZZLES ✓ 15. GHECK OPERATION OF GAS VALVE
3. CHECK POSITIONING OF ALL NOZZLES 16. CLEAN NOZZLES �
4. SYSTEM INSTALLED IN ACCORDANCE w/MFG UL LISTING 17. PROPER NOZZLE COVERS IN PLACE
5. HOOD/DUCT PENETRATIONS SEALED w/WELD OR UL DEVICE 18. CHECK FUSE LINKS AND CLEAN �
6. IF SYSTEM HAS BEEN DISCHARGED, REPORT SAME '� 19. REPLACED FUSE LINKS
7. PRESSURE GAUGE IN PROPER RANGE (IF GAUGED) � 20. PIPING AND CONDUIT SECUREIY BRACKETEO �
8. CHECK CARTRIDGE WEIGHT (IF APPLICABLE) 21. PROPER SEPARATION BETWEEN FRYERS AND FLAME
9. HYDROSTATIC TEST DATE � 22. EXHAUST FAN IN OPERATING ORDER ✓
10. 6-YEAR MAINTENANCE DATE ! 23. FUEL SHUT-OFF IN ON POSITION �
11. INSPECT CYLINDER AND MOUNT �- 24. MANUAL AND REMOTE SET/SEALS IN PLACE �
12. OPERATE SYSTEM FROM TERMINAL LINK _�� 25. SLAVE SYSTEM OPERATIONAL = �ky�
13. TEST FOR PROPER OPERATION FROM REMOTE 26. SERVICE AND CERTIFICATION TAG ON SYSTEM
SYSTEM DEFICIENCIES
1. IMPROPER INSTALLATION/MISAPPLICAT�ON 3. ADDITIONAL PROTECTION REQUIRED
2. FUEL SHUT-OFF OR ELECTRICAL DISCONNECT REQUIRED 4. VENTILATION SYSTEM NEEDS CLEANING/REPAIR
5. OTHER
RECHG HYDRO 6 YR SERV DESCRIPTION UNiT PRICE AMOUNT
WET CHEM
LB DRY CHEM REG ❑ ABC ❑ PK/SK ❑
LB DRY CHEM REG ❑ ABC ❑ PK/SK ❑
LB DRY CHEM REG ❑ ABC ❑ PK/SK ❑
LB DRY CHEM REG ❑ ABC ❑ PK/SK ❑
LB CO2
LB CO2 �
WET CHEM SY� DRY CHEM SYS ❑
SERVICE CALL �"'-"�--
ORDERED SHIPPED DESCRIPTION UNIT PRICE AMOUNT
31,�v
n��,,,�, o-z_
TOTAL SERVICE $
SERVICE TECHNICI � �- ~
TOTAL MATERIALS $
CUSTOMER SIGNATUR s �rerE SALES TAX $
NOTICE: A COPY OF THIS REPORT MAY BE SENT TO LOCAL FIRE SHIPPING & HANDLING � _
MARSHAL WHEN REQUIRED BY AUTHORITY HAVING JURISDICTION �ReN� TOTAL $
nn Nnr Qev► ►n►vn►r_F rn Fn� � nw
nlliN(�ESOT/�a CONVU�Y No. �� �`
575 MINNEHAHAAVEN E w T PRE ENGINEERED SYSTEI��REPORT ����
ST. PAUL, MN 55103
952-345-FIRE • FAX 952-345-2499 �
� p SERVICE �
BILL TO � � �' � ` �� ��� ADDRESS
� ' �t,C�_ ..S`�
, ' � 3
PHONE CONTACT
Ifdy ICE SP # PURCHASE ORDER # ACCOUN � SITE # AUTHORIZED BY
�'t
AN AL SEMI-ANNUAL RECHARGE INSTALLATION RENOVATION MASTER CY � SIAVE CYL SLAVE CYL
IOM•OF SYSTEM YLI DERS 360 LIN 450 LINK 500 LINK Q�R
�
� SH�J-OFF ELECTR� G SIZE
(�t
CO2 OTHER SERIAL # LAST HYD TEST DATE LAST RECHARGE DATE
L 300 N UL 1254 Y N �--- �
INSPECTION CHECK LIST
1. ALLAPPLIANCES PROPERLY COVERED w/CORRECT NOZZLES t'� 14. CHECK OPERATION OF MICRO SWITCH /
2. DUCT AND PLENUM COVERED w/CORRECT NOZZLES f 15. CHECK OPERATION OF GAS VALVE �
3. CHECK POSITIONING OF ALL NOZZLES � 16. CLEAN NOZZLES
4. SYSTEM INSTALLED IN ACCORDANCE w/MFG UL LISTING ✓ 17. PROPER NOZZLE COVERS IN PLACE �
5. HOOD/DUCT PENETRATIONS SEALED w/WELD OR UL DEVICE � 18. CHECK FUSE LINKS AND CLEAN -�
6. IF SYSTEM HAS BEEN DISCHARGED, REPORT SAME ✓ 19. REPLACED FUSE LINKS �
7. PRESSURE GAUGE IN PROPER RANGE (IF GAUGEO) � n 20. PIPING AND CONDUIT SECURELY BRACKETED �
S. CHECK CARTRIDGE WEIGHT (IF APPLICABLE) �}I 21. PROPER SEPARATION BETWEEN FRYERS AND FLAME �
9. HYDROSTATIC TEST DATE ✓ 22. EXHAUST FAN IN OPERATING ORDER
10. 6-YEAR MAINTENANCE DATE ✓ 23. FUEL SHUT-OFF IN ON POSITION �
ti. INSPECT CYLINDER AND MOUNT L 24. MANUAL AND REMOTE SET/SEALS IN PLACE �
12. OPERATE SYSTEM FROM TERMINAL LINK �� 25. SLAVE SYSTEM OPERATIONAL �
13. TEST FOR PROPER OPERATION FROM REMOTE � 26. SERVICE AND CERTIFICATION TAG ON SYS7EM �
SYSTEM DEFICIENCIES
1. IMPROPER INSTALLATION/MISAPPLICATION 3. ADDITIONAL PROTECTION REQUIRED
2. FUEL SHUT-OFF OR ELECTRICAL DISCONNECT REQUIRED 4. VENTILATION SYSTEM NEEDS CLEANING/REPAIR
5. OTHER
RECHG HYDRO 6 YR SERV DESCRIPTION UNIT PRICE AMOUNT
WET CHEM
LB DRY CHEM REG ❑ ABC ❑ PK/SK ❑
LB DRY CHEM REG ❑ ABC ❑ PK/SK ❑
LB DRY CHEM REG ❑ ABC ❑ PK/SK ❑
LB DRY CHEM REG ❑ ABC ❑ PK/SK ❑
LB CO2
LB CO2 �
WET CHEM SYS��. DRY CHEM SYS ❑
SERVICE CALL
ORDERED SHIPPED � DESCRIPTION UNIT PRICE AMOUNT
O'2- �
� �
TOTAL SERVICE $
SERVICE TECHNIC TOTAL MATERIALS $
CUSTOMER SIGNATU STATE SALES TAX �
NOTICE: A COPY OF THIS RE T MAY BE SENT TO LOCAL FIRE cHIPPING & HANDLING $
MARSHAL WHEN REQUIRED BY AUTHORITY HAVING JURISDICTION rRAND TOTAL � -
__._..... _.._., DO NOT PAY! INVO/CE TO FOLLOW