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RALPH J. PERRY Ir,{C.
po Box 339 . HYANNTS. MA 02601 . 508-175-3473
MA-CR#OI 7 . DOT CERT#A.850
FIRI PROTECTION INSPECTION REPORT/WORK ORDER #N9 20237
NAME
aK.,cL.\<ir& T tQ:crf DATE
LOCATION /,-l sE Rf ]?CCOL]NT 4
-
_--
CHARGE T(. cOD--'
--5' Y ac-,,-. owTL' , .,vra . iraqUY ANNUAL X- NEW EQUP
-
SERVICE RETURNS
TOTAI # OF EXTINGUISHERS
BILL TO EXTINGUISI.IERS DUE SERVICE NEXT YEAR
CUSTOMER PO SPECTION DUE
CONTACT 8,{I PHONE CELL
-SERVICE/LABOR
DRY CHEM 2 % ABC- 5AB' IOABC- 2OAB' IOBC-2OBC-IOPK-2OPK-
co2 5tb _ lolb _ l5lb_201b_Pw _clAss K _ HALoTRoN/2 %lb_5lb_ r r tb_ l s.slb_
MARINE SYSTEM EMERGENCY LIGHTS EXIT LIGHTS OTHER
DRYCHEITI
EMERGENCY I-IGHTS
RECHARGES
CLASS
-
PW HALON/HALOTRON {
EXIT LIGHTS
CO2-COND TESI-MARINE CYLINDER
OTHER
SERVICE
DRYCHEM 2%lh slb_rolL 201
PW________________i CLASS .6 2.5C
HALOTRON 2%Ib-5 l b____r 5%lb
GAUGE BATTERIES
DOT w\t 90
BL SERIES VINYL TYPE
RP SERIES PL,A.STIC TYP
FIRSTAID KIT 816I 8I62-8I63---J.KIT----REFILL-
EYEWASH STATION REFILL INSPECTA SHIELD
6 YEAR MAI.NTENANCF
FNDROTEST
ROTEST
OTES
co2 5lb _ tolb_l5lb_201b_ coND TEST_
SERVICE CO \\,IAI,L HOOK M l-5ib Other
ORINC VEHICLE BLACKET
CHECK S HEAVY DUTY BRACKET
M2-10tb
20lb
PULL PIN BLTLBS
6 YEAR MAINTENANCE
HYDROTEST
REPLACEMENT CO\GR
BATTERY DISPOSAL FEC COVER
OTHER
RECOIUNIENDATIONS:
ndicated above.
&a
F:'fECHNICIAN LIC#CUSI O\1ER'S AUTI{II-]D R}iP RE S IJ N-IAT I V F:
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fhe abo\)e senice technician certiles that the fire extinguishers and e ergency lighrs were personally inspected and Jbund conditions to he as indicd,ed abow
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Cw.e aaro
INSPECTION /
RECHARGE / SERVICE / H}DROTESTTNG
P,,\RTS
SIGNS / L,,\BELS FIRST AID
FIRE -ARE IN COLTPLL{NCE WITH NFPA 1() CODE
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