HomeMy WebLinkAboutFire Sprinkler Report - 4/15/11 n�s�n��so�r� co�w�...� � No. �� �
575 MINNEHAHAAVENUE WEST PRE ENGINEERED SYSTEMS REPORT y `�
ST. PAU L, M N 55103 °'-�----�� �( o[i
952-345-FIRE • FAX 952-345-2499
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IC ATE SP # PURCHASE ORDER # ACCOUNT SITE # AUTHORIZED BY
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A NUA SEMI�JJNUAL RECHARGE INSTALLATI RENOVATION MASTER CYL ..' � SLAVE cyL._ SLAVE CYL
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LOCAjI F SY T M CYLINDERS 360 LINI�.� 450 LINK 500 L INK OTF�R
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M UFACTURER MODEL� WETCHEMJ DRYCHEM FUELSHUT- FF ELECTR1C/� G SV��
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UL 300 N UL 1254 y N CO2 OTHER SERIAL # LAST DRO TEST D E LAST RECHARGE DATE
INSPECTION CHECK LIST �
1. ALLAPPLIANCES PROPERLY COVERED w/CORRECT NOZZLES ✓� 14. CHECK OPERATION OF MICRO SWITCH �
2. DUCT AND PLENUM COVERED w/CORRECT NOZZLES � 15. CHECK OPERATION OF GAS VAIVE
3. CHECK POSITIONING OF ALL NOZZLES �� i6. CLEAN NOZZLES �
4. SYSTEM INSTALLED IN ACCORDANCE w/MFG UL LISTING ✓ 17. PROPER NOZZLE COVERS IN PLACE '�
5. HOOD/DUCT PENETRATIONS SEALED wNUELD 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 SECURELY BRACKETED �
8. CHECK CARTRIDGE WEIGHT (IF APPLICABLE) /� � � 21. PROPER SEPARATfON BETWEEN FRYERS AND FLAME �
9. HYDROSTATIC TEST DATE -421[s._ 22. EXHAUST FAN IN OPERATING ORDER �
10. 6-YEAR MAINTENANCE DATE ✓ 23. FUEL SHUT-OFF IN ON POSITION �
11. INSPECT CYLINDER AND MOUNT '� 24. MANUAI 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 SYSTEM ��
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
LS CO2
WET CHEM SYS� DRY CHEM SYS ❑
SERVICE CALL .��
ORDERED SHIPPED DESCRIPTION UNIT PRICE AMOUNT
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TOTAL SERVICE $
SERVICE TECHNI ^ TOTAL MATERIALS
CUSTOMER SIGNATURE STATE SALES TAX
NOTICE: A COPY OF THIS REPORT MAY SENT TO LOCAL FIRE SHIPPIN & HANDLING
MARSHAL WHEN REQUIRED BY AUTHORITY HAVING JURISDICTION GRAND TOTAL $
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