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HomeMy WebLinkAboutFAI15-0001 CF Hood Suppression 2016 Camp Lassen r11 " 11 WiLG US FIRE CONTROL INC. juNi7 2019 SAFEGUARD FIRE PROTECTION Invoice 1703 SONOMA ST. REDDING, CA 96001 By Date Invoice# 6/13/2019 125865 Bill To Ship To GOLDEN EMPIRE COUNCIL 21359 SCOUT RD BOY SCOUTS OF AMERICA BUTTE MEADOWS P.O. BOX 13558 SACRAMENTO,CA 95853-3558 P.O. No. Terms Rep NET 10 REW Qty S/W Part# Description t Price Each Amount 1 Service call Service call 2 Xsery Extinguisher Service K-CLASS 50.00 50.00 12 Xsery Extinguisher Service 2.5# 11.00 32.00 21 Xsery Extinguisher Service 5# 11.00 132.00 1 Xsery Extinguisher Service 10# 11.00 231.00 11.00 11.00 J5' k—giliti ---A-24'C APP i' i t , , - _ If kt ..... _ Pa I Sales Tax (7.25%) $0.00 I Total V $446.00 Phone# Fax# E-mail Web Site (530)241-2465 (530 241-2473 safeguard@wilgusfire.com www.wilgusfire.com WILGUS FIRE CONTROL INC. '° Invoice (� SAFEGUARD FIRE PROTECTION rMM11 t�1703 SONOMA ST. BEDDING, CA 96001 JUN VI 2019 Date Invoice# 6/13/2019 30628 2tf---------------- Bill To Ship To GOLDEN EMPIRE COUNCIL CAMP LASSEN BOY SCOUTS OF AMERICA P.O. BOX 13558 SACRAMENTO,CA 95853-3558 P.O. No. Terms i Rep NET 10 REW Qty S 1W Part# Description Price Each Amount ` . 1 Ysery ANSUL R102 SEMI-ANNUAL SYSTEM SERVICE 6 439088 Fusible Link,360°F(SL Style)Red 135.00 135.00 15 77695 Rubber Blow Off Caps 12.00 75.00T 5.00 75.00T . ,1. 304 iq g i I . Accek 1 -,,,,,. ‘ / / . Sales Tax (7.25%) $10.66 Total X $292.66 Phone# Fax# E-mail Web Site 11 (530)241-2465 (530 241-2473 E-mail www.wilgusfire.com Wet Chemical Pre-Engineered California Code of Regulations -Title 19 Semi-Annual Fire Extinguishing System Inspection,Testing,and Maintenance Report 1 of 2 Property Information pf t:q<<-0 i 1.-. -"k ,Irnay, Contractor or Licensed Owner Information Building Name '- § ;`V.: a Name Wilgus Fire Control Inc. Address �"' S. 4i� `J].�oP,, 'ddress 1703 Sonoma St. k't '= City Redding St. Ca. Zip 96001 License# 462979 Phone (530)241-2465 Contact Person ❑ SFM Job# Phone �t . 6 ® CSLB Misc. System information Cylinder Size , Last Hydrostatic Test Rate l� Flow Points Capacity Used L. . S stem Location r S stem Mtr; t, t. l (311t 1-51 •its► Gas# Electrical# Integral Make Up Air Shut Down 6 a F Hoods 11111111111=111111111 :..,,P,, Plenums 0 --iMall ' �� Appliances Left to R>ht with SiCookingzes and Covera to Nozzles avtr . et:' mJe. 11 - 2-- Wall.iffsw 4. t - FixedTemperature Sensing Elements (Such as Fusible Links) a _ $_ (0,4 Vhf( '. - inspection,Testing,and Maintenance I =Ins section T =Test M=Maintenance p=Pass F=Fail N/A=Not A .livable 1.1 Manual Actuators are Unobstructed 7.2.2(2) i.e.Remote Pull Station 1.2 II Tamper Indicators&Seals Intact 7.2.2(3) 1.3 a Maintenance Tag in Place 7.2.2(4) _ Title 9.906 elm1.4 No Obvious Physical Damage 7.2t2(5) 1.5 U GauStogeredPReressuadingres within Proper Limits _ 1.6 MI Blow-Off Caps in Place&Undamaged 7.2.2(7) _--,Ell 1.7 "'Hoods,Ducts,Filters in Place and Clean CFC 904.11.6.3plin 1.8IIood,Ducts&Protected Cooking Appliances Have of Been Re•laced Modified or Relocated 7.2.2(8) 2 1 © utomatic Detection/Manual Actuation Functioned 7.3.3.4 ir Correctl Form AES 20 Sept.3,2013 a Wet Chemical Pre-Engineered California Code of Regulations-Title 19 Semi-Annual 2 of 2 Fire Extinguishing System Inspection,Testing,and Maintenance Report Property Information 1�,f CAy�o+,1 Contractor or Licensed Owner Information Building Name C ,�C 5` --- i '':icoi. I"i Name Wilgus Fire Control Inc. Address + ' 1, �:'� Job# ++ �f'a4e Mme- Inspection,Testing,and Maintenance I =Inspection T =Test M=Maintenance P=Pass F=Fail N/A=Not Applicable L. 2.2 ©Fuel Shut-Off Operated Correctly 7.3.3.4 2.3 ©Regulator Tested&is within Acceptable Limits 7.3.3.4 _.-- 44 2 4 ©Manual Reset Relay Functioned Correctly 7.3.3.4 ----„ If A..livable 3.1 D 'II Agent Containers within Acceptable Hydrostatic 7,5.1(1) Test Datesrill! 3.2 it Auxiliary Pressure Containers andHose 7.5.1(2)(3) MI • sembles within Acce r ble H drostatic Test Dates 3.3 ©Cartridge Weights within Acceptable Limits IEMIII_ Mill 3.4 ©Liquid Level within Acceptable Limits 7.3.3.1(2) _■_...'r Non •ressurized 3.5 ©No Signs of Corrosion in Agent CylinderMI 7.3.3.1(2) Non •ressurized 3.6 ©Distribution Piping Unobstructed and Contiguous 7.3.3.1(3) IIIIIIIIIIIIIIIIIIIIII5111 3.7 D Nozzles are Correct,Clean&Properly Aimed 7.3.3.1(2) _■■_.. + 1E10FixedTemp Fusible Metal Alloy Type Detectors Replaced 7.3.4 3.9 © eat Detectors Maintained oOther Than ri Re nlbleacedetal Alioy Type)& 7,3.5 3.10 © 'unctiEquipment Such as Water valves 7.3.3.1(2) _._.". I FunctionCorrect! 3.11 ©Internal Maintenance as Required by Manufacturer Title 19§904.7 F 4-- D=Deficient C=Comment indicate Item Date Riser D C Deficiencies and Comments Indicate all equipment,crevices and parts that weta repaired er replaced„ �r 1111111 IIIIII N. N. NE N. iiiiiall ■■ 111111111111 ❑Check here if additional Deficiencies and Comments are listed on Form AES 9. Number attached: ❑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 11111111111111fle) e O�� 1! u,. Signature Date 1 — t Form AES 20 Sept.3,2013