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Home My WebLink Aboutfire system inspections - 2002 2004 2005 and 2008tltlf \RALPH J. PERRY, 'NC. WORK ORDER # 6 Rd. (Route 28) . Hyannis, MA02601 . Phone: (508) 775-FIRE MA LtC. # 017 D.O.T. # 4-850 SYSTEM INSPECTION REPORT i N L*? € -c ou" '{Y'a? Model # l. K # ofTanks Annual Semi 360 Inspected by KC. Mfg {c Wer V-D.y Recharge _ New _ ame Address Contact ,r( Phone Fusible Links Fuel Shut Off ffi""i?-other-Gas Cooking Appliance Locations: Left to Ralph J- Pcrry, lnc. must be nolificd if lhcre is any chang€y'movernenr rn cookang cquipmcnr Are all appliances covered by nozzles l-/ Hood needs to be cleaneclI 2 3 4 5 6 7 8 9 Are hood and duct covered by nozzlet Check positioning of nozzles Hood and duct p€netrations sealed ls system U.L. 300 Proper clearance flame to filters Nozzle seals in place. Are there seal tites in place Pressure gauges in proper range Canridge/N2 reinstalled/Safety pin removed System reset and operational All yellow seals in ptacc Service and cenification tag on system Ponable extinguishers up to code Class K extinguisher and placard installed Reviewed automatic & manual operation ,.1 , -./_tll-'/ l/-L/ -t/ L----:z-:i<ar-''' W--" Z _,/' -rZ Refuses inspection Pans had to be ,"pt"""d I L , a k< -3 '- '-eAE_10. Check canridge weight I l. Hydrotest due 12. 6 year maintenance due 13. Inspect cylinder liquid and mount U-.'' 14. Test for proper operation from terminal link l--' 15. Test remote manual operation ,?.2 16. Micro switch in place t -'17. Gas valve in olace and workins L/- ia. iL,l"r.iJ,.. "]Lar"-Jpr- u^ I ^ppti^n"" T 19. Replace fusible links --q'20. Check cable, nut, and S-hook movement v-' 21. All piping secured _: 22. All filters in place NON-COMPLIANCE ISSUED Reason Ralph J. Perry. Inc. is no! a hood./duct servlce company es should be addressed by a qualified hood./duct company or deficiencies Type w Liquid change Any drscrepancr Discrepancies 23. 24. 25. 26. 21. 28. 29. It *Non-Ccmpliance systems/or systems with discrepancies may fail to extinguish,/suppre Next inspection due ss a fire 0 Recommendationsof system w/customer 30. Exhaust fan working 31. Customer instructed on required monthly inspection of system Comments €*J-, and inspected in accordance with pr ation. and was ted accordin s Lic. # 17, l7A,96, Chapter 10 2001 edition and the results indicated above hrl ervice Technician sentahve Please reai the Cuslomer Acknowledgenrcnt on rcvcrs! sidc beforc signing-The above service technician certiltes that the system was personally inspected and found conditions toL as indicated above.A copy of this report will be forwarded to the local fire depanment. d,l Grease accumulation ,Ercessive Heavy Mldqrate -Filters need ro be cleaned ' ,rO" =, 7i(r. J Customer's Authorized CUSTOMER ACKNOWLEDGMENT The customer understands that, unless indicated otherwise on the reverse, the seNice per- formed on the Customer's equipment by a Representative of Ralph J. Perry lnc. will indicate that the Fire Suppression system was mechanically functioning during the period of time in which Ralph J. Perry, lnc. Representative was performing said servic€. The Cuslomer acknowledges that Ralph J Perry, lnc. does not guarantee, imply or suggest that the Customer's Fire Suppres- sion System will extinguish all fires regardless of origin. The Customer further acknowledges that Ralph J. Perry lnc. shall have no responsibility whatsoever to the Customer or to any other person for personal in,jury or death or damage to or loss of property or value, resulting from any causes beyond reasonable control, including, without limitatron, if the Fire Suppression System is outdated, has been tampered with, altered or has been improperly used, repaired or main- tained, or if the hazard areas protected by the Fire Suppression System has been altered or changed. -) SYSTEM INSPECTION REPORT y^ , ll t\, 1 tt t ,J r' ///1A,. 't f,.r,. Date (f"i r,< RALPH I. PERRY 'NC.96 Falmouth Rd.(Rowe28) . Hyannis, MA02601 . Phone:(508)775-FIRE MA LrC. # 017 D.O.T. # A-850 tfry 7 Model # /. >< Inspected by: Mfg \( c r't fL0-C.Dn,r,t-Address Contact # ofTanks i Wet t/'- Dry - ra. I Phone Annual P Semi- Recharge - New - Fusible Links 360 I 450 - 500 - orher- Fuel Shut Off r' Cas Lz- Electric -Cooking Appliance Locations: Left to Right-" Ralph r. Peny. Inc. must be notified ifthere is any change/movemenr in cooking equipment L Are all appliances covered by nozzles 2. Are hood and duct covered by nozzles 3. Check positioning of nozzles 4. Hood and duct penetrations sealed 5. Is system U.L. 300 6. Proper clearance flame to filtcrs 7. Nozzle seals in place. 8. Are there seal tites in place 9. Pressure gauges in proper range 10. Check canridge weight ll. Hydrotest due Hood needs to be cleaned Grease accumulation _VU'-' \/' L,.-td- L- a-- ,/ Excessive _ Heavy _ Modcratc Filters need to be cleaned Typ.na/< Refuses inspection Pans had to be repl ^r"d / L. , /'J f,rn lt 12. 6 year maintenance due Z 13. Inspect cylinder liquid and mount t'''z 15. Test remote manual operation t?'- 16. Micro switch in olace \-/' l?. Gas valve in place and working \--,. , 18. Clean nozzlei no. of.tlduct I plenum I appliance V' 19. Replace fusible links 20. Check cable, nut, and S-hook mov0ment 21. All piping secured 22. All filters in place 23. Canridge/I.I2 reinstalled./Safety pin removed 24. System reset and operational 25. All yellow seals io place 26. Service and cenification tag on system 27. Portable extinguishers up to code 28. Class K extinguisher and placard installed 29. Reviewed automatic & manual operation of syslem w/customer 30. Exhaust fan working 31. Customer instructed on required monthly inspection of system Comments NON-COMPLIANCE ISSUED Reason Liquid change ,/ t- L-- l-' t-- t/-- L-/& Ralph J. Perry. Inc. is not a hood/duct service company. Any discrepancies should be addressed by a qualified hood/duct company Discrepancies or deficiencies Type *Non-Compliance systemyor systems with discrepancies may fail Next inspection due U ltt,.t OG RecommendationsL-,- a d4/dl o,(LJal .{a cko this date.ted aod inspected in accordance w ation,and was 17, l7A,96, Chapter l0 2001 edition and the results indicated above. 1 ice Technician Lic. #Customer's sentatlve Pbqse Ead tlle Customer AcknowlcdtcnEnt on reverse side beforr signhg The above service technician certifies that the system was personally inspected and found conditions to be as indicated above. A copy of this repon will be forwarded to the local fire department. to extinguish/suppress a fire. ctEfoirEBAgKLowLE*ffi The Customer understands that, unless indicated otherwise on th'e reverse, the seruic€ per- formed on the Customer's equipment by a Ropresentative of Ralph J. Perry, lnc. will indicate that the Fire Suppression System was rnectranically functioning during the period ol time in which Ralph J. Perry, lnc. Representative was performing said service. The Customer acknowledges lhat Balph J. Perry, lnc. does nol guarantee, imply or suggest that the Customer's Fire Suppres- sion System will extinguish all fires regardless of origin. The Customer further acknowledges that Ralph J. Perry lnc. shall have no responsibility whatsoever to the Customer or to any other person for personal injury or death or damags to or loss of property or value, resulting trom any causes beyond reasonable control, including, without limitation, if the Fire Suppression System is outdated, has been tampered with, altered or has been improperly used, repaired or main' tained, or it the hazard areas protected by the Fire Suppression System has been altered or changed. -L I RALPH ]. PERRY 'NC.96 Falmouth Rd. (Route 28) . Hyannis, MA02601 . Phone: (508) 775-FIRE MA LrC. # 017 D.O.T. # 4-850 Namc )aLra l*,,SYSTEM INSPE\\rck r) CTION REPORT Date C'tt tY Annual r' Fusible Links Fuel Shut Off Inspected by LrO Model # /, tf Mfg ILG Addrcss t&-# of Tanks / W"r 1..,'Dry- Contac Phonc Scmi- Recharge - New _ 360 / 450 - 5oo- othert/' Cas Electric y' Cooking Appliance Locations: Left lo Righl (2/.i44 Ralph J. Perry. Inc. must bc notified if lherc is any change/moverr:nt in cooking equipment l. Are atl appliances covered by nozzles 2. Are hood and duct covered by nozzles 3. Check positioning of nozzles 4. Hood and duct penetrations sealed 5. Is system U.L. 30O 6. Proper clearance flame to filters 7. Nozzle seals in place. 8. Are rhere seal tites in place 9. Pressure gauges in proper range 10. Check cartridge weight ll. Hydrotest due 12. 6 year maintenance due I3. Inspect cylinder liquid and mount 14. Test for proper operation from terminal link 15. Test remote manual operation 16. Micro switch in place 17. Gas valve in olace and workins 18. Clean no.rl., no. oflar"t i plenum-Lappliance 19. Replace fusible links 20. Check cable, nut, and S-hook movement 21. All piping secured 22. All filters in place 23. Canridge/1.{2 reinstalled/Safety pin removed 24. System reset and operational 25. All yellow seals in place 26. Service and cenification tag on system 27. Portable extinguishers up to code 28. Class K extinguisher and placard installed 29. Reviewed autornatic & manual operation of system w/customer 30. Exhaust fan working 31. Customer instructed on required monthly inspection of system Comments Excessive _ Heavy _ M Filters need to be cleancd Type Refuses inspection Parts had to be rcplaccd t/,.- _-€).-#l' : ?,,c -- -n-t-'' -v--vE v-'' lq ---=- ---zlr- U- L-- L/---vw_-< Hood needs to be cleaned Grease accumulation oderatetktTa< Liquid change NON.COMPLIANCE ISSUED Reason Ralph J. Perry, lnc. is not a hood/duct service company. Any discrepancies should be addressed by a qualified hood/ducr company. Discrepancies or defi ciencies Type *Non-Compliance systems/or systems with discrepancies may fail to extinguish/suppress a fire.oNext inspection due Recommendations ;l E"r'{ 7. On ls date,the above and inspected in accordance with ation, and according NFPA 17, l7A,96, Chapter l0 2001 edition and ures with the results indicated above. Service Technic Lic. #Customer's Authorized Plca& ll3d tlNe Custorncr AchowlcdtcfEnt oo rrycrsc sidc bcforc aigDitrt. The above service technician certifies that the system was personally inspected and found conditions to be as indicated above. A copy of this repon will be forwarded to the local fire department. / 9b-/ lttto- CUSTOMER ACKT6frG;;ilEfr;: The Customer understands that, unless indicated otherwise on ih" i"r"r.", the seruice per- formed on the Customer's equipnrent by a Representative of Ralph J. Perry, lnc. will indicate that the Fire Suppression System was mechanically functioning during the period of time in which Ralph J. Peny, lnc. Representative was perlorming said service. The Customer acknowledges that Ralph J. Perry, lnc. does not guarantee, imply or suggest that the Customer's Fire Suppras- sion System will extinguish all fires regardless of origin. The Customer further acknowledges that Ralph J. Perry, lnc. shall have no responsibility whatsoever to the Customer or to any other person for personal injury or death or damage to or loss of property or value, resulting from any causes beyond reasonable control, including, without limitation, if the Fire Suppression System is outdated, has been tampered with, altered or has been improperly used, repaired or main- tained, or if the hazard areas protected by the Fire Suppression System has been altered or changed. F-rrF, ..E-.q Name RALPH J. PERRY,INC. 88 Falmouth Rd. (Rowe 28) . Hyannis, MA02601 . Phone: (508)775-FIRE MA LtC. # 017 D.O.T. #A-850 P-, k..r. atY:5 M INSPECTION R G PORT f.qK I Date Model # # of Tanks Annual Inspected b tYlt. Mfe (r, DryAddress Contact Wct Phone Semi Recharse New 360 450 - 500- other_Fusiblc Links Fuel Shut Off Gas ElectricCooking Appliance Loca(ions: Left t l. Are all appliances covered by nozzles 2. Are hood and duct covered by nozzles 3. Check positioning of nozzles 4. Hood and duct penetrations sealed 5. Is system NFPA 96 6. Is system U.L. 300 7, Proper clearance flame to filters 8. Nozzle seals in place, intact 9. Are there seal tites in place 10. Pressure gauges in proper rangell. Check cartridge weight 12. Hydrotest due I 3. 6 year maintenance due 14. lnspect cylinder liquid and mount 15. Test for proper operation from ter$inal link 16. Test remote manual operation 17. Micro switch in place 18. Cas valve in place and working 19. Clean nozzles covers in place 20. Replace tusible links 21. Check cable, nut, and S-hook movement 22. All piping secured 23. All filters in place 24. C/nidgelN? reinstalled/Safety pin removed 25. System reset and operational 26. All yellow seals in place 27. Service and certification tag on system 28. Portable extinguishers up to code 29. Class K extinguisher and plasard installed 30. Reviewed autoniatic & manual operation ofsystem w/customer 31. Exhaust fan working 32. Customer instructed on required monthly inspection of sysiem Comments Hood needs to be cleaned Grease accumulation Excessive kra /iJhOI+,-TxJ+--v-i a_/ + Heavy Filters need to be cl Refuses inspection Parts had to be replaced eaned LA 1 &Liquid change rv -n--J- NON.COMPLIANCE ISSUED Reason Discrepancies or defi ciencies 14.|'a<-. Type *Non-Compliance systemvor systems with discrepancies may fail to extinguish/suppress a fire.!1O^ra floNext inspection due ,{ On this date, the above system was tested and in ted in accordance with procedures ofthe NFPA 17, l7A, 96, Chapter 7 and the manufacturer's manual at time of in lation,according to these procedures with the resultlin{c,6'ted abover2 R.cZ Service clan Lic. #Customer The above service technician cenifies that the system was personally inspected and found conditions to be as indicated above Right I Recommendations: Wet Name RALPH ]. PERRY 'NC.88 Falmouth Rd. (Route 28) . 11rnn'". MA 02601 ' Phone: (508) 775-FIRE MA LrC. # 017 D.O.T. #A-850 SYSTEM INSPECTION REPORTRtt."* U?,*,-, 6e-.L,.Datc Inspected by /u4 "T.i1---:-l"' '-ra'--Y(J-r',--\a-r' Model # ) 's.>MI-c Address Dry# ofTanks R AnnualJf'L* Contact Phone Cooking Appliance Locations: Left to Right Fusiblc Links Fuel Shut Off Semi Recharse New 360 t 450 500 orherc^ lt""*" - l. Are all appliances covered by nozzles 2. Arc hood and duct covered by nozzles 3. Check positioning of nozzles 4. Hood and duct penetrations sealed 5. Is system NFPA 96 6. Is system U.L. 300 7- Proper clearance flame to lllters 8. Nozzle seals in place, intact 9. Are there seal tites in place 10. Pressure gauges in proper range ll. Check cartridge weight 12. Hydrotest due 13. 6 year maintenance due 14. Inspdtt cylind€r liquid and mounl 15. Test for proper operation from terminal link 16. Test remote manual operation 17. Micro switch in place 18. Gas valve in place and working 19. Clean nozzles covers in place 20. Replace fusible links 21. Check cable, nut, and S-hook movement 22. All piping secured 23. AII filters in place 24. CanridgeA,l2 reinstalled/Safety pin removed 25. System reset and operational 26. All yellow seals in place 27. Service and cenification tag on system 28. Portable extinguishers up to code 29. Class K extinguisher and placard installed 30. Reviewed aulomatic & manual operation of system w/customer 31. Exhaust fan working 32. Customer instructed on requircd monthly .iospection of system Comments Hood needs to be cleaned Crease accumulation no Excessive - Heavy - Moderate $ Filters need to be cleaned c Type Refuses inspection Pans had to be replaced Liquid change a+ =..* --T--T - '/t,'-o ttL4 ul / / V tl ,lIt'IIl-fr / _il_ NON.COMPLIANCE ISSUED Reason o Discrepancies or defi ciencies *Non-Compliance systemVor systems with discrepancies may fail to extinguish/suppress a fire. Next inspection due / -^... /<->l.t . On this date, the above system was tested and inspected in accordance with proced of the t7, 17 7 and the manufacturer's manuai at time of installation, and was according to these thelte Service Technician Lic. #Customer The above service technician cenifies that the system was personally inspected and found conditions to be as indicated above ffi,1 l/ AO Type /hq ol ( Recommendations: procedures wiih ?--(J (V