HomeMy WebLinkAboutFAI15-0059 CALFIRE Suppresion Hood Inspection 2017System Information
Last Hydrostatic Test Date C
Flow Points Capacity Used
System Location tl System Mfr. - \ j L Model # Q - it i - :3
Fuel/Heat Shut Off
Gas # i i i Electrical # i/ Integral Make Up Air Shut Down ✓
-Title 19 Semi -Annual
P 1 of 2
Report
Re
# of Items
pjLnerJaioris"
•Items
:�.
.413I%
Nozzle
Model #,
Nozzle
Flow Points
' Nozzle
Qty'
,�€itF
. hints'
x._
Hoods
I
1
.81 x
1 S°` x i' Z"
l i,;1
1
t
i
Plenums
Ducts
k
Sj i \( 4` k 3"
l v--3
k
1 -
1
Left to Riht
Cooking Appliances
with Sizes and Coveraq�e Nozzles
Appliance-N4r e
tVozzlef r
Mi. el,
do le'
FloW Paints
t '•3ToiBf` Appliance Name
i=low<Pdmts
.`.:Nozzle
-Model
N(t7 , `
lJo l k ,=anti
` tat
oiY Pewits
–r l't S k. t 110— XZ
el
1.5
I
Gauge Readings within Proper Limits
(Stored Pressure)
7 2.2(6)
1
�z•Jjs-11
t t -t x e27-4-
'2- S
1
(.9
7,2.2(7)
1 Z, ,i -t
LJ
42, '-
1
Hoods, Ducts, Filters in Place and Clean
CFC 904.11.6.3
tZ-_i-i
C1
icib
1.8
1
Hood, Ducts & Protected Cooking Appliances Have
Not Been Replaced, Modified or Relocated
7.2.2(8)
A L -2* -11
2 1
T
Automatic Detection/Manual Actuation Functioned
Correctly
7 3,3.4
I �.� 17
Fixed Temperature Sensing Elements
(Such as Fusible Links)
Quantity`
t
Tert?P
:Mft-_.
r .i
bate-
x' " itltate
ate Quantity
.:
Ternp
Mfr u
Date _
0-
4 C C _
Z0t-1
t2. --2--i- 11
..`.
vg
Wet Chemical Pre -Engineered California
,Fire Extinguishing System Inspection,
Code of Regulations
Testing, and Maintenance
-Title 19 Semi -Annual
P 1 of 2
Report
Re
Property Information
A1Lt
`�-t I \:9. �
` �, DYa
,1\ i it ^/1.,`
4 r �• ,zv
F?AE 0P
Contractor or Licensed Owner Information
--�
Name Wilgus Fire Control Inc.
Building Name e(-) (,cyr- (\oz SQA\CO \
Address 1703 Sonoma St.
`Address �'.0 1'l �Tp\6�e- AJ
7.2.2(2)'i-1
City Redding St. Ca. Zip 96001
City m--" -i\a_0,1ek\ , -}-0
License # 462979
Phone 503-241-2465
Contact Person l,SptAC C.-
❑ SFM
Job #
Phone 2'1 l;0
I CSLB
Misc.
inspection, Testing,
= Inspection T = Test M = Maintenance
and Maintenance
,,NFPA I7A-CA -
,e4Reference
P =
Date
Pass F = Fail N/A = Not Applicable
•
Comrherits , '
x
3' N/A;
ttem -,J.
ess ption
1 1
I
Manual Actuators are Unobstructed
(i.e Remote Pull Station)
7.2.2(2)'i-1
1.2
1
Tamper Indicators & Seals Intact
7 22(3)Z'25,'
0
1.3
I
Maintenance Tag in Place
7.2.2(4)
Title 19 §906
r2-7--- 11
1.4
1
No Obvious Physical Damage
7 2 2(5)
,o,N_ i-1
el
1.5
I
Gauge Readings within Proper Limits
(Stored Pressure)
7 2.2(6)
1
�z•Jjs-11
`\
N S\
1.6
1
Blow -Off Caps in Place & Undamaged
7,2.2(7)
1 Z, ,i -t
LJ
1.7
1
Hoods, Ducts, Filters in Place and Clean
CFC 904.11.6.3
tZ-_i-i
C1
icib
1.8
1
Hood, Ducts & Protected Cooking Appliances Have
Not Been Replaced, Modified or Relocated
7.2.2(8)
A L -2* -11
2 1
T
Automatic Detection/Manual Actuation Functioned
Correctly
7 3,3.4
I �.� 17
Form AES 20
Sept. 3, 2013
FA115-0059
030-071-015
VVet Chemical Pre -Engineered
Fire Extinguishing System
Property Information
California Code of Regulations Title 19
Inspection, Testing, and Maintenance
Building Name .�iC, p -Ke -ho` cc \c4: 1
Address 2tSl C PU,Q 1,... PJ
City
AE
•
Semi -Annual
Report
2 of 2
Contractor or Licensed Owner Information
Name
Wilgus Fire Control Inc.
Job #
Inspection, Testing, and Maintenance
M Mm t Hance P = Pass F = Fail N/A = Not Applicable
= Inspection i _ 1 ebi aa
C
Date
item',
D
Des npt(on
t NFPA IThL
etf Ei0elence
;Date
Comrnenfs l L, `
. ,
„F,N/A
2.2
T
Fuel Shut -Off Operated Correctly
7.3.3.4
I'Z• 25-11
2.3
T
Regulator Tested & is within Acceptable Limits
7.3.3.4
1•Z• 24.- ri
2.4
T
Manual Reset Relay Functioned Correctly
(If Applicable)
7 3.3.4
ky.• 11
3.1
M
All Agent Containers within Acceptable Hydrostatic
Test Dates
7 5 1(1)
i2 nl'1
3 2
M
All Auxiliary Pressure Containers and/or Hose
Assemblies within Acceptable Hydrostatic Test Dates
7 5 1(2)(3)
(2,-7111
,
3.3
M
Cartridge Weights within Acceptable Limits
7 3 3.1(2)
1.2.-25i.1-1
here if additional Deficiencies and Comments are listed on Form AES 9. Number attached.
Correction Form AES 10 for corrected deficiencies. Number attached:
(♦ See
3.4
M
Liquid Level within Acceptable Limits
(Non -pressurized)
7.3.3.1(2)
�2�f'�
3.5
M
No Signs of Corrosion in Agent Cylinder
(Non -pressurized)
7.3 3 1(2)
jj
1Z"Z� 1�
'\
IP
3.6
M
Distribution Piping Unobstructed and Contiguous
7.3.3.1(3)
j Z,255.11
3.7
M
Nozzles are Correct, Clean & Properly Aimed
7.3.3.1(2)
rZ,-Z4--(
3.8
M
Fixed Temp Fusible Metal Alloy Type Detectors Replaced
7 3.4
12.2 11
9
M
Fixed -Temp (Other Than Fusible Metal Alloy Type) &
Heat Detectors Maintained or Replaced
7 3.5
'L ZS' -CI
‘1)\ V\3
3.10
M
Auxiliary Equipment Such as Water valves
Functioned Correctly
7 3 3.1(2)
: -t
1Z`2 l
0.) k'\
3.11
M
Internal Maintenance as Required by Manufacturer
Title 19 §904.7
Z_7G. fl
D = Deficiency
Item
C
Date
= Comment
Riser
...
D
Indicate
C
ty.e)
Deficiencies and Comments
Indicate all equipment, devices andparts that there repaired or replaced
4 P P
• Check
here if additional Deficiencies and Comments are listed on Form AES 9. Number attached.
Correction Form AES 10 for corrected deficiencies. Number attached:
(♦ See
I hereby certify that the fire protection equipment listed above has been fully inspected, tested, and maintained on this date by
the company indicated above, in accordance with CCR, Title 19, Sections 901 to 906 and that the equipment is fully operable
except as noted in the "Deficiencies and Comments" section of this form.
Print Name 0, t`i•-• M te.L. r;•
Signature -----(4-1`/— Date 1 -2_ - 2.- — 1 7
Form AES 20
Sept. 3, 2013
FAI15-0059
030-071-015