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HomeMy WebLinkAboutFire Sprinkler Inspection 04.21.14 PRE- ENGINEERED FIRE SYSTEM MINNESOTA CONWAY FIRE E. SAFETY INSPECTION and MAINTENANCE REPORT 575 MINNEHAHA AVENUE WEST • ST. PAUL, MN 55103 651- 288 -0777 • 1- 800 - 223 -2587 ANNUAL SEMI-ANNUAL RECHARGE INSTALLATION RENOVATION 1 -,i , S Ja. NAME _ : 1 , i I ( r, i d - \ s, ., 1 it ( - 1 ,C i LOCATION OF SYSTEM CYLINDERS ADDRESS ' ' `7 i , . } \ ' (' , `;,, )'„ MANUFACTURER MODEL NUMBER WET CHEMICAL DRY CHEMICAL CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE CITY MANIFOLDED PIRANHA WATERFLOW PRESSURE 1_,' � ' ' ." I l (9 ❑ YES ❑ NO TELEPHONE / STORE NO FUSE LINKS 360° F FUSE LINKS 450° F FUSE LINKS 500° F OTHER i OWNER OR MANAGER -" , I MECHANICAL GAS VALVE(S) & SIZE(S) ELECTRICAL GAS VALVE(S) & SIZE(S) MANUAL RESET RELAY NON- COMPLIANT SYSTEMS MAY FAIL TO 41 ❑YES ❑ NO I LAST HYDRO TEST DATE ELECTRIC CONNECTED EXTINGUISH /SUPPRESS A FIRE. ' ,,.--) I t,/ Ay( 1 AYES ❑ No COOKING APPLIANCE LOCATIONS and SIZES (LEFT To RIGHT) it "'+r. (s`J .+ ; 7 YES NO N/A YES NO N/A 1. System interlocked with building fire alarm ❑ 0 ❑ 20. Proper separation between fryers and flame ❑ ❑ [. 2. Duct and plenum covered with correct nozzles 12 ❑ ❑ 21. Proper clearance - flame to filters ❑ ❑ 3. Check positioning of all nozzles ❑ ❑ ❑ 22. Exhaust fan in operating order in ❑ ❑ 4. Systems installed per U.L. 300 standards and meets 23. All filters replaced I1 ❑ ❑ manufacturer's U.L. listing and N.FP.A. standards ® ❑ ❑ 24. Fuel shut -off in on position ® ❑ ❑ 5. Hood /duct penetrations sealed with weld or 25. Manual and remote set/seals in place cit ❑ ❑ U.L. device ® ❑ ❑ 26. Replace system covers 0 ❑ ❑ 6. Check if seals intact, evidence of tampering ❑ 0 ❑ 27. System operational and seals in place ® ❑ ❑ 7. Pressure gauge in proper range (if gauged) ,® ❑ ❑ 28. Slave system operational ❑ ❑ p 8. Check cartridge weight (if applicable) ❑ ❑ 0 29. Clean cylinder and mount © ❑ ❑ 9. Dry system 6 -year maintenance date 3 0. Fan warning sign on hood © ❑ ❑ Wet system 12 -year hydro test date ® ❑ ❑ g 10. Inspect cylinder and mount ® ❑ ❑ 31. Proper signage and personnel instructed in 11. Operate system from terminal link ® ❑ ❑ manual operation of system ❑ ❑ 12. Test for proper operation from remote Ei ❑ ❑ 32. Proper hand portable extinguishers p ❑ ❑ 13. Check operation of micro switch ® ❑ ❑ 33. K -Class fire extinguisher in cooking area ❑ ❑ I I1� Cl e5kppeiation of gas valve t , ❑ ❑ 34. Portable extinguishers properly serviced VI ❑ ❑ 11' "I' 't 35. Service & Certification tag on system ' ' ' • j21 ❑ ❑ 15. Clean nozzles LA b ' ❑ 16. Proper nozzle covers in place ❑ ❑ 36. Safety chains on all gas appliances attached and secured ® ❑ ❑ j 17. Replaced fuse links ® ❑ ❑ 37. Status of grease build -up in the hood and duct opening 18. Check travel of cable ® ❑ ❑ ❑ CLEAN ® LIGHT ❑ MEDIUM ❑ HEAVY ❑ EXCESSIVE 19. Piping and conduit securely bracketed ® ❑ ❑ * NOTE DISCREPANCIES OR DEFICIENCIES BELOW * COMMENTS I -} jj s S�g r ,� 1 { { r,11t i � - ' t { � � i ., r '^t �f ,"� �4 r`�. � ,�''' a .. ! Al � l x �'- . �j,_� j i t `,�f? t t : } T - 7 t, I/ `- - I- 2 / d/ °`-, I 1 ".."^-' SERVICE TECH PERMIT NO. DATE CUSTOMER'S AUTHORIZEGENT THE ABOVE SERVICE TECHNICIAN CERTIFIES THAT THE SYSTEM WAS PERSONALLY INSPECTED AND CONDITIONS WERE FOUND TO BE AS INDICATED ON THIS REPORT WHITE - CUSTOMER YELLOW - DISTRIBUTOR PINK - AUTHORITY HAVING JURISDICTION