HomeMy WebLinkAboutSystem Inspection Reports 2012-2014RALPH I. PERRY,
'NC.96 Falmouth Rd. (Boute 28) . Hyannis, i,lA 02601 . Phone: (508) 775-FIRE ' Ma. Lic. #017 D.O T. # A-850
SYSTEM INSPECTION REPORT
9239
Nexr ln(D Duc ----/.alBrllllJ!{-DaIe q.4,r1
Bill To
Contacl
Model#1 Mlg.{t(
# ofTanks I Dry
Annual
-
Semi -\- Rccharge Ncw-
co2 _
Hood needs to be cleane d d^ Refuses Inspection
Filrers need to b€ cleaned:"L
Creas€ accumulalion: Excessivc- Heavy- Moderate
-
FBible Lils: 360 I 45o
-
other-Seah (
Fuel Shut Off:
-}\-
Gas JZ- Electric
-
Caps
-ryy lLt€C Lt
ADsulcan: Singe- Double)
RG/PC Can: l6sD CO2
Phone
\l
l2gm CO:
Cooking appliance location: Lefi to riglt
< )--*g) ktA
Ralph J. Perry.lnc. must be notified if there is alty change/movemenl in cooking equipment
L
2.
3.
4.
5.
6.
't.
8.
9.
10.
lt.
12.
13.
14.
15.
16.
Arc all appliances covercd by nozzles
Are hood and duct covered by nozzles
Check positioning of nozzles
Hood aJld duct peneuation s€aled
ls system U.L. 300
Proper clearance flame to filters
Nozzle seals irl place
Arc there seal tites in place
Prcssurc gauges ilr proper raDge
Check cartridge weight
Hydmlest due
lnspect cylinder l&Iid aDd mounl
Test for proper op€ration from lerminal link
Test remote maaual opemtion
Micm switch in plac€
Gas valve in place and working
17.
18.
19.
21.
22.
23.
24.
25.
26.
27.
28.
Clean nozzles Do. of I- ducU-plcnum 3- apptiame
Replace fusible link\ / Mfg. date
Check cable. Dut. and S-hook movement
AII piping securcd
All filters in plac€
CaffidgeN2 reinslalled/Safely pin removed
System rcset ard operational
All yellow seals in place
Service and cenification tag on system
Portable extinSuishers up to code
Cla-rs K extinguisher and placard installed
Reviewed automatic & manual opefttion
of system w/customer
Exhaust fan working
Clrstomer instructed on requircd monthly
inspection of system
Customer p€rformin8 monthly inspection
--rJ-r:_____L
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,4.
--1----*=
29
t0
.ll
Non-compliance issuedi Yes / No Reaso[
*Non-Compliance syslemvor systems with discrepancies may fail to extinguish/suppress a fire
Di'cr(prnLic.,'r d(liiie
Ralph i. Pcrry. Inc. is nor o t ooala,rct "..,icc
Extinguisher Inspections:
-
Light lnspections:
-RECHARGES / SERVICE
Total#ofExt:
-
Ext. due service:
-
Service Chg:
-
Cond. Tesl:
-NEW EXTINGUISHERS
Drychem :.51b
-
slb.
-
lolb.
-201b. -
6 yedr- Hydro
-K Claas
-
6L
-
2.5G
-
Hydro
-Halotron 2.51b.
-
5lb.
-
I llb.
-l5.5lb-6
yedr
-
Hydro
-
Partsr Service Collar-Oring
-
Putl Pin
Drychem 2.51b
-
5lb.
-
!01b.-201b
PW- KClass-6L
-
2.5G
Halotron 2.51b.
-
5lb.
-lllb. -l5.5lbco2 stb. _ rolh _r51b. _201b.
Batt('rics:
-Bulbs
FIRE EXTINGUIS}IERS ARE IN COMPLIANCE WITH NFPA IO CODE YES \- NO
Srrvice lechnician I-i(Authorized Lepres{:ntrtive
rcrd fte Cnsromer Acknd*ledgmcnl on relcM sidc hlorc si8nrng4t
according ro tllese prcedurcs wilh lhe resul$ indicar.d abve A
The abovc s€nice tcchnician ce ifies that the sysEn/extinguish€G wcre personally inspected and fodrikondidons to bc s itulicar€d above
A copy of rh rcpon w,ll be lorwarded lo lrl€ lo(d fi.e dcpanmem.
N"-" 5"1,^,4- A,ov,,.J S Z rJtra cz{
CO2 5lb.
-
l0lh-l5lb.
-201b. -Hydro
6rrstomrr's
RALPH I. PERRY
'NC.96 Falmouth Rd. (Route 28) . Hyannis. MA 02601 . Phone: (508) 775-FlFlE . Ma. Lic. #017 D.O.T. # A-850
SYSTEM INSPECTION R EPORT
4 -(o - ia.
6805
F4{rr' ar\3*.,. 54,^,1- $4v,lis ct$a.q l)!lc l\ext Insp. Due
Ars gLA lral,^r S l^rct 1.,-Modcl#g,u \a.t *ordi L&. Ott ry \I ot Tanks Dry
BillTo *,*,Annual
-
s"-i F noharg"
I
New-
Contncl
Grease accumulalion: Excessive
-
Heavy
-
Moderate
d^
Hood needs !o be cleaDed
-
Rerlrses Inspcction
Fihers need to be cleaned:t TyPe
Cooking appliance location: Left to righl:
Fusible LiDks: 360- 450- oth€r-seals-v ,-/Fuel Shul Otr:
-l
Gas
-
Electnc
-
Caps _
Ansul Can: Single
-
Double
-
N2
-
COz
-RG/rc Cart: l6g,D CO2
-
l2gmco2
-
&tg14
S (rn
Ralph J. Perry, Inc. musl be notified if ther€ is any change/movement in cooking equipment.
t.
2.
-l
.1.
5.
6.
1.
8.
9.
l0llll
l3
l.t
t5
t6
Recornmendatiul
Arc all appliances covered by nozd€f
Arc hood and duct covered by nozzles
Check positiooinS of nozzles
Hood and duct penelratioE sealcd
Is system U.L.300
Proper clearance flame lo filters
Nozzle seals in place
Are there se, tiles in place
Pressurc gauges in proper range
Check cartrid8e weiglt
Hydrotcst due
Inspeo cylia&r li{uftnd mount
Test for proper opemtion from icrminal liok
Test remole maflual operatioD
Micro swilcb in place
Gas valve in place ard vrorking
----b+_ff
1'1.
18.
19.
20.
21.
22.
23.
24.
?5.
26.
21.
28.
29.
30.
31.
Clean nozzlcs no, of dtlc plenum applirnc('----fr-r?-t_
Replace fusible links / Mfg. date
Check cable, nut, alld s-hook movemenl
All pipilg secued
AII filters in place
Cartddgen,l2 rcinstalled/Safety pin removed
System reset and operational
All yelow seals in place
Service and certification ta8 on system
Portable extinguishers up to code
Class K extinguisher and placard insBlled
Reviewed aulomatic & manual operalion
of system dcustomer
Exhaust fan working
Customer insructed oo requircd monthly
inspection of systcm
Customcr performing monthly insp€ction
Non-compliance issued: Yes / No Reason
iNon-Compliarce systerx/or syslems with discreparcies may fail to extinSuish/suPPtcss a fire
I)r,.r.nJn.re\ ,,r drficirn, i.,
Rrlph i. Pcm. I'r( rs nol ! huod/ducr scnrce compan). An) drscrepancre. should be rddrcsscd bv r qualifieJ hoodduct cumpillr).
Extinguisher lnspections:
-
Li8ht lospections:
-RECHARGES / SERVICE
Total # ofExt:
-
Ext. due service:
-
Service Chg:
-
Cond. Test:
-NEW EXTINGUISMRS
Drychem 2.51b
-
5lb.
-
lolb.
-201h -
6 year-Hydto
-K Cl.rss
-
6L
-
:.5C
-
Hydro
-Halotron 2.51b.
-
5lb.-l1lb.
-l5.5lb-6
ye.rr
-Hydro -CO2 5lb.
-
l0lb.-l5lh
-201b. -HydroPans: Service Collar
-
OriDg
-
Pull Pin
Drychcm 2.51b
-
5lb.
-
lolh-201b.
Pw- K Clars -6L -
2.5c
Halotron 2.51b.
-
5lb.
-
I llb.
-15.51bcoz 5rb.
-
rolb.
-l5lb.
-----2olb.
Barlcries Bulbs \risc
FIRE EXTINGUISHERS ARE IN COMPLIANCE WITH NFPA IO CODE YES ts NO
Comments: i
..}
\4 L
senice Technician Lic. # q
OD this dare. lhc above systcm wa lested ard irsPecled in acco ancc wi$ prccdures ot thc cunetrr NFPA l7A
a.cording m $es. pncedues with the rcsults iBlicattd abolc.
On fii5 dalc. fie uhtre firetnngurhc^ dd firc (lurPmcnl wcrc t
Thc atarve seNitc lcchnici cenili€s lhat $c slslcnr/extitrguisbcrs
A copy of this repon wil be forwardcd to the lffal firc dePaflmenl'
. Cssaomer's Authorized Represetrtstive
poe rearl rhe Cusomcr acknowled8mcnr ar rcvese
AiD 96 c,iuk,n lnJ lh( rr. rurxlrurcrs mJnual al rrm(4n of inrlallalion aml was operatin8
nspecled or serviced in accordecc wi& pro(cduns ofrtc NFPA l0 ard lhe manufa.lure6 Mual. wi& the rcsuhs odicated lbove
wer€ p"-Mnally inspecred and found condidons to b€ as indicalal above
I
Nl lr
-----.2-
RALPH I. PERRV
'NC.6114
Ih?q..a t,12-TGNrme
96 Falmouth Rd. (Route 28) . Hyannis, MA 0260'1 . Phone: (508) 775-FIRE . Ma. Lic. #O'17 D.O.T. # A-850
SYSTEM INSPECTION REPORT
S.4,rrAa,ros CtA.,eA I)rlc 1'l'tt Nexl lnsp. DucQ,cj gtC fi+/.r 6tn-erf Model #2.sM,,v Mfg
)SD
Dr_vrBiltlbAnnual
-
Semi
Fusible Links: a* I oro
New
Other- Seals
-
l2gm CO2
Recharge
Conlacr Phont'
Hood needs lo be clcaned Refus€s bsD€ctron
Greaseaccumulation: Exces Heavy- Moderate
Fucl Shut off: Y ou y' u* c
-caps -
Ansul Can: Sitrtle- Doublc
-
N2
-
CO2-
Filters need lo be cleancd:
"&-444'1Type RG/PC Canr 16gm CO2
-
Cooking appliaice location: I-eft to riSht:
S.,li\r.&r'(
Ralph ,. Perry. Inc. must be nolified if there is any changdmovement in cooking equipmenl
L
2.
3.
4.
5.
6.
1.
8.
9.
t0
ll
t2
13
14
t5
16
Rccommendalion
Are all appliances covered by nozzles
Arc hood and ducl covercd by nozzles
Check positioning of nozzles
Hood and duct penetration sealed
ts system U.L. 300
Prop€r clearance flame lo filteE
Nozzle seals in plac€
Are there seal tiles in place
Pressure gauges in pmper range
Check cartridge weight
Hydrotest due
Inspect cylinder liquid ard mount
Test for proper operation from terminal link
Tesl remotc manual operation
Micm switch in place
Gas valve in place and working
r'---.-=-
-a
l,1.
t8.
t9.
10.
2t.
22.ll.
2{.
25.
26.
I',t.
18.
Clear nozzles no. of
-
duc tp lenum appliance
Replace fusible links / Mfa. date
Check cable. Dut, and S-hook movement
AI piping securcd
All filters in place
Cartridge/N2 rcinslalled/Safety pin removed
System rcs€t atrd operatioDal
All yellow seals in place
Service and certification la8 on system
Portable extinguishers up to code
Class K extinguisher and placard installed
Reviewed automatic & manual operation
of system w/customer
Exhausl fan workin8
Customer instructed on required monthly
inspection of system
Customcr performing morlhly inspection
29
l0
3I
Non-compliance issued: Yes / No Reason
*Non-Compliance syslems/or systems with discrepancies mny fail to extinguish/suppress a fire
or deficiencicsDiscrepancics
Ralph J. Perry . loc. is nol l hood/duct service company- Any discrcpancies should be addressed by il qualified hood/duct company
Extinguishcrlnspections:- Lightlnspections
RECHARCES / SERVICE
Toral #of Ext Ert. duc \en r,je: Scn ice Chg:
-NEW EXTINGUISHERS
Cond. Test:
-Drychem 2.51b
-
5lb.
-
lolb.-201b.- 6 year-Hydro
-K Cla\s
-
6L
-
2.5G
-
Hldro
-Halotron 2.51b.
-
5lb.
-
I I lh.
-l5.5lb -
6 ycar
-Hydro -Co2 5lb.
-
lolb.-lslb. 201b.
-
Hydro
Patts: Servicecolbr
-Oring -
Pull Pin
Drychem 2.51b
-
5lb.
-
101b.-201b.
Hatotron 2.51b.
-
5lb.
-
I llb.
-l5.5lbco2 5tb. _ torb. _l5rb. _--2olb.
Batteries:
-Bulbs
Misc
FIRE ExTTNGUTsHERS ARE lN coMpLrANcE wrrH NFpA Iocooe vrsE-No
-
,)L
scrvice lechnician Ltc.# ( ('s Auth rizcd Rtpr(,sentatirc
PleN rcad lhe Cuslomer Actnowlcdgmeol on rcveBe side ttelbre signitr8.
accordiru ro rh€se procedurcs with lh€ resulb indica&d abov€
Thc rtove s.nice te{hdcian c.rrifies rbal rllc sysrerd/crtinSuis}E6 r/crs p.r$oal} irupccted and foond corditions to be as itdicaled abolc.
A copy oflhis repon *ill bc fo ard€d ro the local firE dePrnnlcnt.
\
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--:-
PW- KClass-6L
-
2.5C