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HomeMy WebLinkAboutFAI15-0059 CALFIRE Suppression Hood Inspection 2017 (2)System information Cylinder Size Last Hydrostatic Test Date"?...,005g"Flow Points Capacity Used CC1Ve0'm© System Location t 1 System Mfr. k.l L___ Model # L. 11)2, - 3 Wet Chemical Pre -Engineered California ,Fire Extinguishing System Inspection, Code of Regulations - Title 19 Testing, and Maintenance Semi -Annual Report 1 of 2 Property Information i,.� -" CSlpill },�� , �> _ `� ,0E MPS Contractor or Licensed Owner Information Building Name S ;(1..,(t- •AJ C.1Noc 1 Name Wilgus Fire Control Inc. I Address ' "Z., ?� S; C fC -fl >J � Address 1703 Sonoma St. I Tamper Indicators & Seals Intact City Redding St. Ca. Zip 96001 City-�KiA .2—;tv‘ck t L) License # 462979 Phone 503-241-2465 Ducts Contact Person - .5 t: Lt ❑ SFM Job # \ _ \ Phone 2 -ti (00 !4 CSLB Misc. t} ozaten INo ode - fN i 41, 'Flow-P6ints System information Cylinder Size Last Hydrostatic Test Date"?...,005g"Flow Points Capacity Used CC1Ve0'm© System Location t 1 System Mfr. k.l L___ Model # L. 11)2, - 3 Fuel/Heat Shut Off Gas # 1� l Z 1 Electrical # Integral Make Up Air Shut Down .r Items" # of Items imensEbds Nozzle ,:,MOdet #-, Nozzle; Flow Points No7z(e Litt' rf ka�3 ' # 6�',! Hoods I i )i:` M 1.2 I Tamper Indicators & Seals Intact Plenums 1 1c_ % 't s 1 Vi! 1 1 Maintenance Tag in Place Ducts 1 4-V 4 t ii,) \ _ \ No Obvious Physical Damage Cooking Appliances Left to Ri ht with Sizes and Coverage Nozzles Appliance Nam t} ozaten INo ode - fN i 41, 'Flow-P6ints . :, IOW rots APPliance Name : Nozzle Model . - - t't= ffi`r :1 §taf clip. 2x I 1 'Z -"4-c A t k k Blow -Off Caps in Place & Undamaged 7.2 2(7) i2, -N-, 7 (fitd.[e_.s4 xZ1 1.7 I Hoods, Ducts, Filters in Place and Clean CFC 904.11.6.3 17.Z6 -j7 1 8 I Hood, Ducts & Protected Cooking Appliances Have Not Been Replaced, Modified or Relocated 7.2.2(s) V-(7 2 1 T Automatic Detection/Manual Actuation Functioned Correctly_ 7 3 3 4 Z'l 7 Fixed Temperature Sensing Elements (Such as Fusible Links) Quantity Temp Mfi'--; vete .. Install . - ._ Quantity Dete, Temp Mfr , . Date g , ..e-7`--7 LI c - `' 0 11 1 Z-2 -L1 Form AES 20 Sept. 3, 2013 Inspection, Testing, = Inspection T= Test M = Maintenance ;. ':DesCr tion: and Maintenance NEPA 17A. CA- '"edi Reference P = pate. Pass F = Fail N/A = Not Applicable Commerftsnl� � NPV. t Item: 1 1 I Manual Actuators are Unobstructed (i.e. Remote Pull Station) 7 2 2(2) _'Z"Z S•• h 1.2 I Tamper Indicators & Seals Intact 7 2 2(3) CZ --4 .1/ 1.3 1 Maintenance Tag in Place 7.2.2(4) Title 19 §906 i2"�cr v0 %� P 1.4 1 No Obvious Physical Damage 7 2 2(5) 1 j- -,'1 e 1.5 I Gauge Readings within Proper Limits (Stored Pressure) 7 2 2(6) IL-z� i� Nf A - 1.6 1 Blow -Off Caps in Place & Undamaged 7.2 2(7) i2, -N-, 7 7 1.7 I Hoods, Ducts, Filters in Place and Clean CFC 904.11.6.3 17.Z6 -j7 1 8 I Hood, Ducts & Protected Cooking Appliances Have Not Been Replaced, Modified or Relocated 7.2.2(s) V-(7 2 1 T Automatic Detection/Manual Actuation Functioned Correctly_ 7 3 3 4 Z'l 7 Form AES 20 Sept. 3, 2013 FAI15-0059 030-071-015 Contractor or Licensed Owner Information Name Wilgus Fire Control Inc. Job # Wet Chemical Pre -Engineered ,Fire Extinguishing System California Code of Regulations - Title 19 Semi -Annual Inspection, Testing, and Maintenance Report 2 of 2 Property Information Building Name t� - Pr A .)Q 6.;Ct('cV Address \ 2:7 S ; Zai? . 4 -pro City -'.k Yv\e.\t.40 Inspection, Testing, and Maintenance I = Inspection T = Test M = Maintenance P = Pass F = Fail N/A = Not Applicable Item', D Description `: NFPA 17A A :ed 1tefetence Gate . " Comments tan , {r .. ,.. ..��. '� X14/A 2.2 T Fuel Shut -Off Operated Correctly 7.3.3.4 1 Z..Z- fl 4P 2.3 T Regulator Tested & is within Acceptable Limits 7 3.3.4 Az:Z.5i, p P 11 ^ 2.4 T Manual Reset Relay Functioned Correctly (If Applicable) 7.3.3.4 `` 1 L' i� 3.1 M All Agent Containers within Acceptable Hydrostatic Test Dates 7 5 1(1) 1 1Z����� P 3.2 M All Auxiliary Pressure Containers and/or Hose bl Assemblies within Acceptable Hydrostatic Test Dates 7 5 1(2)(3) !Z --�-( 1 �i 3.3 M Cartridge Weights within Acceptable Limits 7.3.3.1(2) JZ. ZZ -1'l ❑ Check here if additional Deficiencies and Comments are listed on Form AES 9. Number attached Form AES 10 for corrected deficiencies. Number attached 3.4 M Liquid Level within Acceptable Limits (Non -pressurized) 7.3.3.1(2) - IZ> I� Signature -,-71"---At,--,,i, - Date Z - ZS-- /7 3.5 M No Signs of Corrosion in Agent Cylinder 7 3 3.1(2) 1.,,,,,5_,-,(Non-pressurized)1.,,,,,5_,-,P 3.6 M Distribution Piping Unobstructed and Contiguous 7.3.3.1(3) jZ-Z5-17 e 3.7 M Nozzles are Correct, Clean & Properly Aimed 7.3.3.1(2) i ,..z$_1'7 3.8 M Fixed Temp Fusible Metal Alloy Type Detectors Replaced 7.3.4 1-2�_ i'i 1. l\ 3.9 M Fixed -Temp (Other Than Fusible Metal Alloy Type) & Heat Detectors Maintained or Replaced 7.3.5 IZ�' i 7 1 �j 3.10 M Auxiliary Equipment Such as Water valves Functioned Correctly 7 3.3.1(2) 2 _ 3.11 M Internal Maintenance as Required by Manufacturer Title 19 §904 7 VI- Z`f -% D = Deficiency ite item C Date = Comment Riser D Indicate G type) Defic<ericfesancG`otrttiletfti' Indicate all equipment, devices and parts that wale iepaireci or replaced i ❑ Check here if additional Deficiencies and Comments are listed on Form AES 9. Number attached Form AES 10 for corrected deficiencies. Number attached • See Correction 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 ) r\Ml` (_\ t ,Z f Signature -,-71"---At,--,,i, - Date Z - ZS-- /7 Form AES 20 Sept. 3, 2013 FAI15-0059 030-071-015