HomeMy WebLinkAboutsystem inspection 2004 and 2005Nitme
Address
RALPH J. PERRY,
'NC.88 Falmouth Rd. (Route 28) . Hyannis, MA 02601 . Phone: (508) 775-FIRE
MA LtC. * 017 D.O.T. # A-850
SYSTEM INSPECTION REPORT
Dale -0 Inspected by , 4!o
39 '?{r ;x Model #Mfg lt a,
# of Tanks Wet t/ Dryh)r LJtAr,rA/,,,*i1,\d Annual- Semi y' Recharge
-
New
-
Fusible Links 360 3 450- 500- orher-
Fuel ShutOff L/- Gas l-/ Electric _
Contact nnv-Phone
Cooking Appliance Locations: Left to Right
C&l
l. fue all appliances covered by nozzles2. 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- 3007. Proper clearance flame to filters
8. Nozzle seals in place, intact9. Are there seal tites in place
10. Pressure gauges in prop€r rangell. Check canridge weight
12. Hydrotest due
13. 6yearmaintenance due
14. Inspecrcylinderliquid and mount
15. Test for proper operation from terminal 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 fusible links
21. Check cable, nut, and S-hook movement
22. All piping secured
23. All filten in place
24. Caflridge4.{2 rcinstalled/Safety pin removed
25. System reset and operational
26. All yellow seals in place
27. Service and cenilication tag on system
28. Porrable extinguishers up to code
29. Class K extinguisher and placard installed
30. Reviewed automatic & manual operation
of system w/customer
31. Exhaust fan working
32. Customer instructed on required monthly
insp€ction of system
Hr'
Hood needs to be cleaned
Grease accumulation
t.L'''JZt-/_tz
NOt-/t/-@_
_JZ
-
Aort
Tz__vt-/VZt--v
t'''+-v
ll
-t/--v
=L.'/@
Reluses inspection
Pans had to be replaced 3 .?00
Liquid change
NON.COMPLIANCE ISSUED
-
Reason
Discrepancies or defi ciencies
Type
*Non-Compliance systemVor systems with discrepancies may fail
to extinguish/suppress a fire.
Next inspection due L,,
Recommendations
{',
Comments at
On this date,the was tested and inspected in accordance with procedures
ing to these procedures with
ofthe NFPA 17, l7A, 96, Chapter 7 and the manufacturer's
tsl CA above.at (imc , and was operated accord?.)4
Service Technician Lic. #
The above service technician cenifies that the system was personally inspected conditions to be as indicated above
e
Excessive _ Heavy _ Moderare _
Filters need to be cleaned
-
tyw /rAly' /O
Ll
t J
t,
RALPH I. PERRY
'NC.96 Falmouth Rd.(Route 28) . Hyannis, MA02601 . Phone: (508)775-FIRE
MA LrC. # 017 D.O.T. #A-850
SYSTEM INSPECTION REPORT
Name .Sr-''arZ lnn Srry's Date -t Inspected bydrMfg ,TG
I
t
fiflno Model #
ss Wet l?-Dry
-
Contact Phone
Annual- Semi y' Recharge
-
New
-
Fusible Links 3fi 3 450- 5oo- other-
Ou", tnu, * a-- Gas ,z' Electric
-Cooking Appliance Locations: l.eft to
Ralph J. Pery, I
l. Are all aoolianccs covered bv nozzles
I fi:l;#.fl::;i;;"1i*-*
4. Hood and duct penetrations sealed
5. Is system U.L. 30O
6. Proper clearancc flame to filters
7. Nozzle seals in place.
8. Are there seal tites in place
9. Pressure gauges in proper range
4ea
ifther€ is any change/movernent in cooking equipment
Refuses inspection
<l
lia".ce \--'
Pans hgd to be replaceddn L,^l
l-.'/
L-
L""
-ATD_JZr-/-
AlA
N.'--
t
L-/'
r_-/'
^./1)
-r-z-__q
-}-t
I
tJ.
=L/
\--/
\--.--
__tz/ot9L
-JZ
(l
L,4
| (v\
10. Check cartridge weight
I l. Hydrotest due
12. 6 year maintenance due
13. Inspect cylinder liquid and mount
14. Test for proper operation from terminal link
15. Test remote manual op€ration
16. Micro switch in place
17. Gas valve in place and-working
t8. Clean mzzles no. of-sl duct d ptenu.-r*pp
19. Replu fusible linls
20. Check cable, nut, and S-hook movement
21. All piping secured
22. All filters in place
23. Cartridge/N2 reinstalled/Safety pin removed
24. System reset and operational
25. All yellow seals in place
26. Service and certilication tag on system
27. Ponable extinguishers up to code
28. Class K extinguisher and placard installed
29. Reviewed automatic & manual operation
of system w/customer
30. Exhaust fan working
31. Customer instructed on requted monthly
inspection of system
Liquid change
NON.COMPLIANCE ISSUED
-Reason
Ralph J. Perry, Inc. is not a hood/duct service company.
Any discrepancies should be addressed by a qualified hood/duct company
Discrepancies or defi ciencies
Type
*Non-Compliance systemyor systems with discrepancies may fail
to extinguish./suppress a fire.IorNext inspection due P
Recommendations
Comments
L a o
and inspected in accordance with procedures ofthe NFPA 17, l7A,96, Chapter l0 2001 edition and
installation,according to these the results indicated above.
Lic. #C s Authorized Representative
On was
hnician
Plcasc
The above service technician certihes that the system was personally inspected
A copy of this report will be forwarded to the local ftre departrnent.
ab,s
tlle Custorrcr ActnourlcdgcnEnl on Gvcrsc sidc bcforE siSning.
found conditions to be as indicated above.
//1,rn
# ofTanks
Hood needs to be cleaned
-
Grease accumulation
Excessive
-
Heavy
-
Moderate
-Filters ne€d ro be cleaned
-
typ. --13/m4Z-
2
t-/
u/
)/\2
r