HomeMy WebLinkAboutFire Sprinkler Report - 2/18/11 �If�t��ESOTA COt��/VAY N .
575 MINNEHAHAAVENUE WEST PRE ENGINEERED SYSTEMS REPORT ���� ,..
ST. PAUL, MN 55103
952-345-FIRE • FAX 952-345-2499
BILL TO � ( ����, �G.�d-F�� �Gl��DD � SS ��Jf / �.C'�.0 `t �� : �
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PHONE ��� � Y' `� 7 ���� CONTACT �
INVO E DAT P#/ PURCHASE ORDER # ACCOUNT # SITE # AUTHORIZED BY
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ANNUAL SEMI-ANN L RECHARGE 1NSTALLATION RENOVATtON MASTE Y�.. SLAVE CYL SLAVE CYL
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LOCATION OF S I_ F�iS ��. �// � .! 360 LINK 450 LINK 500 LINK OTHER
�/'`1 �• v(% v (�
MA T MODE � WET C, HE�y DR M FUEL SHUT-OF ELECTRIC� GAS�'� SIZE .,
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U 300 Y UL 1254 Y N CO2 OTHER SERIAL LAST HYD TEST TE LAST RECHARGE DATE
INSPECTION CHECK LIST
1. ALLAPPLIANCES PROPERLY COVERED w/CORRECT NOZZLES � 1A. CHECK OPERATION OF MICRO SWITCH T � ^
2. DUCT AND PLENUM COVERED w/CORRECT NOZZLES 15. CHECK OPERATION OF GAS VALVE v
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 wM/ELD 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 BRACKETE O rd/
8. CHECK CARTRIDGE WEIGHT (IF APPLICAB�E) � OPER SEPARATION BETWEEN FRYERS I, ��"
9. HYDROSTATIC TEST DATE �tL� 28f �HAUST FAN IN OPERATING ORDER
10. 6-YEAR MAINTENANCE DATE �� / 23. FUEL SHUT-OFF IN ON POSITION
11. INSPECT CYLINDER AND MOUNT �.G� 24. MANUALAND 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/MISAPPL•iCATION 3. ADDITIONAL PROTECTION REQUIRED
2. FUEL SHUT-OFF OR ELECTRICAL DISCONNECT REQUIRED 4. VENTiLAT10N 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 ❑ PKlSK ❑
LB DRY CHEM REG ❑ ABC ❑ PK/SK ❑
LB DRY CHEM REG ❑ ABC ❑;,. `�;; PK/SK ❑
LB CO2
LB CO2 �
WET CHEM SYS'1�' DRY CHEM SYS ❑
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SERVICE CALL
ORDERED SHIPPED DESCRIPTION UNIT PRICE AMOUNT
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TOTAL SERVICE $
SERVICE TECHNICIA TOTAL MATERIALS
CUSTOMER SIGN U ��� ^ STATE SALES TAX
NOTICE: A COP THIS REPORT MAY BE SENT TO LOCAL FIRE SHIPPING & HANDLING
MARSHAL WHE EQUIRED BY AUTHORITY HAVING JURISDICTION C„RpND TOTAL $
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