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Home My WebLink AboutFire Insp. 6/20/2011 ,itchen Hood Fire System Inspection & Maintenance Report DATE OF ERVI TIME A.M. P.M. oEpENDggtF ANNUA SEMI- ANNUAL ' RECHARGE INSTALLATION RENOVATION NORTHLAND Airs # a LOCATION OF SYSTEM CY INDERS � , . Y y F I R E & S E C U R I T Y j f eletXk 4445 W. 77th St., Suite 125 MANUFACTURER MODEL NUMBER WET CHEMICAL DRY CHEMICAL Minneapolis, MN 55435 �v g. i O - (952) 893.0905 CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE �� y MANIFOLDED .. PIRANHA WATERFLOW PRESSURE Name PY\-)ilkir 1f'r j i (° L H i-2- ❑ YES NO FUSE LINKS 360 °F 1 FUSE LINKS 450 °F FUSE LI S 500 °F OTHER Address j07 -.-o \ .41 A' -6e MECHANICAL GAS VALVE(S) & SIZE(S) ELECT. GAS VALVE(S) & SIZE(S) MANUAL RESET RELAY City v f 0,,, 1....., \it...4._ f b vj DYES ❑ NO SERIAL NUMBER LAST HYDRO TEST DATE ' LAST RECHARGE DATE Telephone1- 2- - 4 Store No. j q5 Owner or Manager �3f l Sc. I.-, 1 \ MANUFACTURER'S MANUAL REFERENCE NOTE: NON COMPLIANT SYSTEMS MAY FAIL TO EXTINGUISH/ SUPPRESS A FIRE. COOKING APPLIANCE LOCATIONS & SIZES: LEFT TO RIGHT ICE{ iK 3 YES O WA YES NO WA 1. System interlocked with building fire alarm ❑ 111 ❑ 20. Proper separation between fryers & flame `R ❑ ❑ 2. Duct and plenum covered with correct nozzles Igz ❑ ❑ 21. Proper clearance -flame to filters ❑ ❑ 3. Check positioning of all nozzles 'RI ❑ ❑ 22. Exhaust fan in operating order 'QR°❑ ❑ 4. System installed per U.L. 300 standard & meets 23. All filters replaced ❑ ❑ manufacturers U.L. listing & N.F.P.A. standards ❑ litt ❑ 24. Fuel shut -off in on position •-• • ❑ ❑ 5. Hood/duct penetrations sealed with weld or UL device Vi ❑ ❑ 25. Manual & remote set/seals in place •-• ❑ ❑ 6. Check if seals intact, evidence of tampering ❑ NP ❑ 26. Replace system covers ❑ ❑ 7. Pressure gauge in proper range (if gauged) ❑ ❑ `t b 27. System operational & seals in place I V ❑ ❑ 8. Check cartridge weight (if applicable) `PI ❑ ❑ 28. Slave system operational ❑ ❑ 'P 9. Dry system 6 year maintenance date/ wet system 29. Clean cylinder & mount xp ❑ ❑ 12 year hydro -test date 08 lP ❑ ❑ 30. Fan warning sign on hood YI ❑ ❑ 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 '$ ❑ ❑ 32. Proper hand portable extinguishers ' ' ❑ ❑ 13. Check operation of micro switch N r ❑ ❑ 33. K class fire extinguisher in cooking area ❑ ❑ 14. Check operation of gas valve `j ❑ ❑ 34. Portable extinguishers properly serviced ❑ ❑ 15. Clean nozzles ' ❑ ❑ 35. Service & Certification tag on system 0 ❑ ❑ 16. Proper nozzle covers in place ❑ ❑ 36. Safety chains on all gas appliances attached and secured ❑ ❑ 17. Replaced fuse links ❑ ❑ 37. Status of grease buildup A the hood and duct opening 18. Check travel of cable ' ❑ ❑ ❑ Clean ❑ Light Medium ❑ Heavy ❑ Excessive 19. Piping & conduit securely bracketed )Zb ❑ ❑ * NOTE DISCREPANCIES OR DEFICIENCIES BELOW r COMMENTS: THIS FIRE SUPPI ::. CoRRCNT U.L. :. ` ".` i'... • ",. r .r PROPERLY EXTINGUISH A COOr..r... A. >.:1% FIRE DUE TO MODERN COOKIP Jf is 4-."e7 APPL 1AjWFC IT IS RECOMMENDED THAT YOU REPLACE/UPGRADE YOUR SUPPRESSInN SYSTEM WITH s u I inn APPROVFD WET CHEMICAL SYSTEM AND MINIMAL UABIUTY IN THE EVFNT OF A MAKING ARFA FIRE. On this date, the above system was tested and inspected in accordance with procedur of a presently ado • ed editions `''' NFP' ,17, 1 ' , 96 and the manufacturer's manual and wa operated according to thes r edures wi,t,.- Its indicabove. r r R " ERVIC. / ECHNICIAN PERMIT NO. DATE: TIME: AM PM M ER O RIZED AGENT The above service technician certifies that the system was personally inspected and found con iti s t be as indicated on this report. WHITE - CUSTOMER • YELLOW - DISTRIBUTOR • PINK - AUTHORITY HAVING JURISDICTION ,itchen Hood Fire System Inspection & Maintenance Report DATE TZ o /I ERCE TIME A.M. P.M. eN °Ae( ANNUUA L SE I- ANNUAL RECHARGE INSTALLATION RENOVATION „ NORTHLAND 7 d� �^ F I R E & S E C U R I T Y L ATION OF SYSTEM CYLINDERS 4445 W. 77th St., Suite 125 MANUFACTURER MODEL NUMBER WET CHEMICAL DRY CHEMICAL Minneapolis, MN 55435 \ k2- !�z X.' (952) 893.0905 CYLINDER SIZE MASTER CYLINDER SIZE SLAVE CYLINDER SIZE SLAVE MANIFOLDED PIRANHA WATERFLOW PRESSURE Name Tr i 1 vl Li} 2-2- ❑ YES 1010 FUSE LINKS 360 °F FUSE LINKS 450 °F FUSEfINKS 500 °F OTHER Address `'j( - 12 h 1 kr.0 9r 4 3 MECHANICAL GAS VALVE(S) & SIZE(S) ELECT. GAS VALVE(S) & SIZE(S) MANUAL RESET RELAY City ! c-pt i i 1' G ❑ YES ❑ NO Telephone ci'5Z-'7- 3312.. Store No. SERIAL NUMBER LAST HYDRO TEST DATE LAST RECHARGE DATE Owner or Manager .„ 1 Yh t TSG.VN Y1A C. " MANUFACTURER'S MANUAL REFERENCE NOTE: NON COMPLIANT SYSTEMS MAY FAIL TO EXTINGUISH/ SUPPRESS A FIRE. COOKING APPLIANCE LOCATIONS & SIZES: LEFT TO RIGHT l t _ YES WA YES NO WA 1. System interlocked with building fire alarm ❑ pu ❑ 20. Proper separation between fryers & flame )1 ❑ ❑ 2. Duct and plenum covered with correct nozzles ❑ ❑ 21. Proper clearance-flame to filters ❑ 3. Check positioning of all nozzles Ne❑ ❑ 22. Exhaust fan in operating order ❑ ❑ 4. System installed per U.L. 300 standard & meets 23. All filters replaced i3 ❑ ❑ manufacturers U.L. listing & N.F.P.A. standards ❑ lyt ❑ 24. Fuel shut -off in on position ❑ ❑ 5. Hood/duct penetrations sealed with weld or UL device d3 ❑ ❑ 25. Manual & remote set/seals in place ❑ ❑ 6. Check if seals intact, evidence of tampering ❑ 1*G ❑ 26. Replace system covers 99 ❑ ❑ 7. Pressure gauge in proper range (if gauged) ❑ ❑ W 27. System operational & seals in place ? ❑ ❑ 8. Check cartridge weight (if applicable) 1g ❑ ❑ 28. Slave system operational ❑ ❑ yI1) 9. Dry system 6 year maintenance date/ wet system 29. Clean cylinder & mount ❑ 1 0 12 year hydro -test date 0 li ' ❑ ❑ 30. Fan warning sign on hood ❑ ❑ 10. Inspect cylinder and mount ` id ❑ ❑ 31. Proper signage and personnel instructed in 11. Operate system from terminal link n} ❑ ❑ manual operation of system 0,0 ❑ 12. Test for proper operation from remote '0 ❑ ❑ 32. Proper hand portable extinguishers ❑ ❑ 13. Check operation of micro switch - ❑ ❑ 33. K class fire extinguisher in cooking area -If ❑ ❑ 14. Check operation of gas valve X ❑ ❑ 34. Portable extinguishers properly serviced ' ❑ ❑ 15. Clean nozzles X ❑ ❑ 35. Service & Certification tag on system n, ❑ ❑ 16. Proper nozzle covers in place ❑ ❑ 36. Safety chains on all gas appliances attached and secured ' ❑ ❑ 17. Replaced fuse links xt. ❑ ❑ 37. Status of grease buildup in the hood and duct opening 18. Check travel of cable `irk ❑ ❑ ❑ Clean ❑ Light `Medium ❑ Heavy ❑ Excessive 19. Piping & conduit securely bracketed x ❑ ❑ * NOTE DISCREPANCIES OR DEFICIENCIES BELOW COMMENTS: THIS FIRE SUPPRESSION sth t . .S N.. ■ CORRENT U.L. -300 STAYDA ;D;; AND MAY NUT PROPERLY EXTINGUISH A COOKING AREA FIRE DUE TO MODERN COOKING OILS AND APPLIANCES. IT IS RECOMMENDED THAT YOU REPLACE/UPGRADE YOUR SUPPRC;SION SYSTCM WITH A.U.L 300 APPROVED WET CHEMICAL SYSTEM AND MINIMAL UABILITY IN THE EVENT OF A COOKING CEO FIRE On this date, the above system was tested and inspected in accordance with procedure- of e presently adopted editions of NFPA 7, 17A 96 and the manufacturer's manual and was operated according to these •r. •1= • ures w' • - indicated above. 41� rill e ` ERVI =r CHNICIAN PERMIT NO.. DATE: TIME: AM P C ` 4 T� ERS ., T ORIZED AGENT The above service technician certifies that the system was personally inspected and found ... diti•ns to as indicated on this report. WHITE - CUSTOMER • YELLOW - DISTRIBUTOR • PINK - AUTHORITY HAVING JURISDICTION