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HomeMy WebLinkAboutFAI18-0012 CF Suppression Hood Inspection W6lefieical Pre-Engineered California Code of Regulations-Title 19 Semi-Annual rr 1 of 2 Fire Extinguishing System Inspection,Testing,and Maintenance Report 1 Property Information 'k�Qf--CSL/'�pt1 Contractor or Licensed Owner Information Ts-� i- -� v Name Wilgus Fire Control Inc. Building Name 6i,e„i,2 Cc, ., ( i (c- - 2V�-t .C� ,,.,,�-- �r 9 v`, •LS lP Address 1703 Sonoma St. Address �n(.L yrD r7 1 iLA�Z�''��`t '�`•,., a,� 1�E MpP City Redding St. Ca Zip 96001 City V\I\LZ'\C._V�Ck License# 462979 Phone 530-241-2465 Contact Person-1.-,0,, j M ` '`�0---- [i SFM Job# Phone 77;1 ,, ('L 1 . [0 CSLB Misc. • System Information Cylinder Size clik 0.-h. X Z Last Hydrostatic Test Date 2_Q I, < FloW Points Capacity Used'` - 1 0-) System Location ,rayl t (.t\k SystemMfr. ,�k_y-,(,�(, � Model • \{t�, L. Fuel/Heat Shut Off. Gas# Electrical# l Integral Make Up Air Shut Down t,..-- - - No.zle Notate , .d � a Items of en5�» 4:4 ,i '# £%100 1Y iiit$ � � r 3 ,f Hoods Z 7 Plenums e r I 1. l .7-- lj Ducts / 1 Pt B I Z/ 1 k,.> 1. '2— ,z, Cooking Appliances Left to Right with Sizes and Coverage Nozzles Nozzl l"Nozzle < etal `-g`''� 6,Zile ` k. titat Appliance Name -Medel.`' Flow Points FtoW'Points " --Appliance'Name" �•)r�Mdidel0 k l �6trit Ifo t44i1ints 414104,-, �.>Cd f z-.( . � .,•� q.,.r rti=:Lc.ille:i"— z i h c� !j t x t; Q.- - x 212 .:-i zci 0 14 LL t«.tve- 14^? x t . i 1 Fixed Temperature Sensing Elements (Such as Fusible Links) Quantity Temp Mfr Install Quantit "Mk Install Date bate y Terrip... Date Date t, v Inspection,Testing,and Maintenance =Inspection T =Test M=Maintenance P=Pass F=Fail N/A =Not Ap.licable Item Description NEPA 17A CA ` ` ed.Reference Date fi '.a " } ; 1.1 I Manual Actuators are Unobstructed �g �,, .T�,. .�,� zbue r„ „ '' (i.e. Remote Pull Station) 7.2.2(2) J--1�,-(�j' _ 1 2 I Tamper Indicators&Seals Intact 7.2.2(3) ,f5 3-I(v-1S 1.3 Maintenance Tag in Place 7.2.2(4) Title 19§906 ;'(U' Ifs' tom' 1.4 No Obvious Physical Damage 7 2 2(5) 3 .ib_ is 1.5 Gauge Readings within Proper Limits (Stored Pressure) 7.2.2(6) 3--I i:.(4g ` I P 1.6 Blow-Off Caps in Place& Undamaged 7.2.2(7) 3 1b,(k 1.7 Hoods, Ducts, Filters in Place and Clean CFC 904.11.6.3 ' -••16 Irs (� 1.8 Hood, Ducts& Protected Cooking Appliances Have '� ... ........ ...:..... Not Been Replaced, Modified or Relocated 7.2.2(8) 3--(1), i8- ..p.... 2.1 T Automatic Detection/Manual Actuation Functioned Correctly 7.3.3.4 (� r Form AES 20 Sept.3,2013 WeiChemical Pre-Engineered California Code of Regulations-Title 19 Semi-Annual 2 of 2 Fire Extinguishing System Inspection,Testing,and Maintenance ReportF- 1 tit Contractor or Licensed Owner Information Property Information o?' i ,0 5. Name Wilgus Fire Control Inc. Building Name , C; P.ti._ Ce"yk-t"t2. i _ +� v Job# Address is�,r", Q ,<D*--CQ:Q..► cc_ �l J t\c�''.... _ ��'t' `��1�RE RhP City u`\i1 t c,�til i Inspection,Testing,and Maintenance 1 =Inspection T =Test NI=Maintenance P=Pass F=Fail N/A=Not Applicable ' rated _r_ Fuel Shut Off Operated Correctly 7.3.3.4 Mall ©Regulator Tested&is within Acceptable Limits 7.3.3.4MI MI ©Manual Reset Relay Functioned Correctly 7.3.3.4 If A.•livable �AII Agent Containers within Acceptable Hydrostatic 7 5.1(1)OO alIM Test Dates El All AuxiliaryPressure Containers and/or Hose anilli 7,5.1 2 3 IMIIMI •ssemblies within Acce.table H drostatic Test Dates ,(ii, (lc MEICartridge Weights within Acceptable Limits 7.3.3.1(2) = ,'l Liquid Level within Acceptable Limits 7.3.3.1(2) j- iv. ltd Non-sressurized No Signs of Corrosion in Agent Cylinder 7.3.3.1(2) 3 ■_ p (Non-pressurized) �� l`S 3.0 Distribution Piping Unobstructed and Contiguous 7.3.3.1(3) O_ MI 3.7 III Nozzles are Correct, Clean&Properly Aimed 7.3.3.1(2) NI 3 g 11111 Fixed Temp Fusible Metal Alloy Type Detectors Replaced 7.3.4 '316 -lir ©Fixed-Temp(Other Than Fusible Metal Alloy Type)& n 3.9 Heat Detectors Maintained or Re.laced 7.3.5 ' i(. 31111.10 Auxiliary Equipment Such as Water valves 7.3.3.1(2) MIS Functioned Correct) LODI 3.11 ©Internal Maintenance as Required by Manufacturer Title 19§904.7 7,;'- 1lr- ( - c D=Deficiency C=Comment Indicate t •e BGS Cin T fft ooh nehts ,.. • , ,, Indicate ell equipment,devices and parts the!avete repaired or replaced 1 If . --F H [1 Check here if additional Deficiencies and Comments are listed on Form AES 9. Number attached: [1 See Correction Form AES 10 for corrected deficiencies. Number attached: 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 e•�`-- Signature e-,:::::_________ --------- , k to t Date Form AES 20 Sept.3,2013