HomeMy WebLinkAboutfire and safety inspection 2004RALPH J. PERRY,
'NC.88 Falmouth Rd. (Route 28) . 11r,rnn't. MA 02601 . Phone: (508) 775-FIRE
MA LtC. # 017 D.OT. #A-850
SYSTEM !NSPECTION RT
Inspected by:ltNamcS{. r-F 5.,,r a Date
4x Model #f,.s,Mfg
Addrcss '5 o w"t
o
# ofTanks
Annual
Fusible Links
Fuel Shut Off
Semi
360 :\
D
Recharge
-
New
-
450
-
500- Other-Contact Ph
Gas Electric
t4O
Cooking Appliance Locations: Left to Right
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. 30O
7. Proper clearance flame to filters
8. Nozzle seals in place, intact
9. Are there seal tites in place
10. Pressure gauges in proper range
I l. Check canridge weight
12. Hydrotest due
13. 6 year maintenance due
14. Inspea cylinder liquid and mount
t5. Tesl for properoperation from iirminal 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. All filters in place
24. Canridge/lrl2 reinstalled/Safety pin removed
25. System reset and op€rational
26. All yellow seals in place
27. Service and certification tag on system
28. Ponable extinguishers up to code
29. Class K extinguisher and placard inslalled
30. Reviewed automatic & manual operation
of syslem w/customer
31. Exhaust fan working
32. Customer instructed on required monthly
inspection of system
Comments
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-*
-
Excessive _ Heavy _ Moderatc r<
Filters need to be cleaned u/l J Type
needs to be cl
Grease accumulation
Refuses inspection
Parts had to be replaced
V\
<.
Liquid change
NON.COMPLIANCE ISSUED
Reason
Discrepancies or defi ciencies /t
Type
*Non-Compliance systemVor systems with discrepancies may fail
to extinguish./suppress a fire.
Next inspection due 0
Du<ut
4
On this date, the above system was
manurl el limc of installation , and
,ttti/.
t'l ,,96, Chapter 7 and the manufacturer's
above.
1
resul
Service Technician Lic. #Cus
The above seruice technician certifies that the system was personally inspected found conditions to be as indicated above.
v
Recommendations:
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