HomeMy WebLinkAboutCF Hood Suppression 2019 I vii 1 11111, .III'. IIi 1., I'.1 .
Report
eport Inspection,Testing,and Mallnteri aPc'e
Fire Extinguistiiiiu Systern
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I Property Information r Contractor or Licensed Owner Information
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'Building Name gelerLi..,,.#,_L 0 1 ti,:, ,- _ r
Name Wilgus Fire Control Inc
Address Cat,tt-to -.5-1--,2_,i ce_11,_ ell. . v Address
,N, , ---,,,,,t 1703 Sonoma St
Wv,..,,NE-ilkt 'City Recidng--
St Ca Zit ...ii;i"-ii''
462979 Pnone 503-241-24b.'::City (1114.ie.:11...c ek. ... _
Contact Person tr-Sig..wy‘ Ott_,Cr t kii,...e._ L:_ce,ise,,4 -
r--.1 cckA Job 4 _
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iPhone "q.*•-.7,4- t_a*S3in 0 CSLE3 IMisc
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System.'Information
Cylinder Size'72:3 444,161/1/4 Nf,, 2.- Last Hydrostatic Test bate '7_,C) i.1 Flow Points Capacity Used
ISystem Location 4. 1.,,..)(1.11 System 1\,44,4 OS ki.t_ Model# je-` t 02.- ... .
ruel/Heat Shut Off .
Electrical# ...," Integral Make Up Air Shut Down ...."
!Gas# r'' ,, ,,,,,,,..„ ...- - - . . .„tsj9zile . • ;1'4.
p- . ; ' ,-,,, -, r , ........ ..,4'..;jal'IC."• '4.''—' IX - -'.,,,' ,,,P.,, .,-(---, --
" ..--111A,,,..144 1,,. F,14.14.44,,, ,,Ar-,,,i.,„.7.:4, - 8 ,c,,4';:ri :-Ajtkw3FOklIs',.. .
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I t` F Plenums ..., 0,-- 1 t•••1
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Duets 4.-, t rj.)( i 2.- t tA.3 -
I Cooking Appliances
I
Left to Right with Sizes and Coverage Nozzles , ,
i rai-4,v,'"4-W":-.r"- f'skiTiti2S41EV•lii 'lilli*'
Ai3141140CIA'tl4me - .1,,ic;iret -,,,, ,,, „...4 tcpiniSi
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4.k, .2. 1 1,..- t,..) 2— 1 ."2: 1 1 ...... ,
2 1 g4- II
-.)4, 'Z. ti 4
/1 2.... il 1
Fixed Temperature Sensing Elements '(Such as Fusible Links)
---• , ' ' '1,:x 7,i-,;-2.-,,,.--ii- :1147%2A. • '1`'0'''''--''tii'qt:-.1. -' Tsims" viz. '`.:.'1°''' i'" --1.1,10..- - ,,,,2:
?. •,••'.4..',•*:',••-,;.-.'-'41, - - - --- „ , _,, ,.....,;1.,,,,I=4,_ ,...,,,,.. 2,— , oan y.,. ‘,,, - ,,,,,,,, :, .. „, -tr A t,,,,,,,„.,,, _, ,, ,,, t,- .
.e-6. 141.5o I .Z0t13° 11Z-4i- 1.111 I I I
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L._ I I t I i
naPeC ,o .' ' n ntenance
Pp,.!s..I(1 and 01 .. . ....„ , . ..,. .
''''''''' ' — i:,a.Ps s #1-,Fait "N/A....No t AbdiAGatre ..,
I z inspection T =Test hi=Main,tenance
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0.1/14-1t, , .1, a, If:',i4F,,„, !apt') -,, •,, ' ''" ;i!edilRIO1010nCe Date C°nlinan. :.,,,,__,.i..:4-0,1!-:'--' 'IP' ' ''''' I
_ ,i-,,,,„-,, -.; ''.%....';L',.7'1.14,,,,.1..,:•.., — X' ,,,,.«.. .. ,
I I Manual Actuators are Unobstrut,ted _ .. ,
7 2 i I, 1 , 1 (i.e.Remote Pull Station} 22 tS-ct-tC( P
1 2 I I 'Tamper Indicators&Seals Inta:-. '2 2(3, I I I 1 .
i 3 I I 'Maintenance Tag in Place ' 2 241' • I 1 1 ? .,
-Due 19 tz906
1 4 I I No Obvious Physical Damage 7 2 2(5)
-(7)
1 5 1 'Gauge Readings within Proper Limits 7 2 2(6)
' (Stored Pressure)
1 6 I lEllow-Off Caps in Place&Undamaged 7 2 2(7)
{.--)
i 7 I 'Hoods,Ducts.Filters in Place and Clean CFC 904 11 6 3
!Hood.Ducts&Protected Cooking Appliances Have 7 2 ) I
Not Seen Replaced.Modified or kelocated 2t8
2 1 I T 'Automatic Detection/Manual Actuation Functioned 7
Correctly
1-orm AES 20
sets ,hehtii a1.Pre-Engineered' California Code of„Regulations Title 19 :Semi-Annual 2 at 2
. F[rei tittguishing System .. Inspectlon,Testing;,ant!Maintenance . - .. ,,;,, , -Report ,. .
F CcA�i1
I Property Informations �, foal Contractor or Licensed Owner Information
" r''Building Name'6ju�c io=T1(t-_ lftt�'t`�` ,'` i Name Wilgus Fire Control Inc. _.VI
}Address (4,,ci d S�'Cet;, PLAL.V-b t.. Job#
lEity 04. CL t ek P Ma I
III IIIYIIii iWiiiL�l II mGi udII1IVIVi
inspection,Testi '�,, i
I Inspection T =Test M=Maintenance F-' 'ass F=Fart N/A t�Not Apptrtaht
�.,.:.�_ { � �.,. H.rt; {?fit..
22 T 'Fuel Shut-Oft Operated Correctly I 7.334 17...'"t tI PO 1.
— 2.3 T 'Regulator Tested&is within Acceptable Limits 7 3.3.4 r '
1 Manual Reset Relay Functioned Correctly 24 •----W...
{ I T I (if Applicable) V
3 All Agent Containers within Acceptable Hydrostatic ( , t1i,1
t M Test Dates
3 II Auxiliary Pressure Containers andior Hose "`"`
3 ` M ssemblies within Acceptable Hydrostatic Test Dates 7 5 1(2)0i
3 3 ' M 'Cartridge Weights within Acceptable Limits 7 3 3 tit) I I I !'�
3 ( M
Liquid Level within Acceptable Limits E'
(Non-pressur;zed 1 7 3 3 1(2)
No(No Signsn of Corrosion-pressurized) in Agent Cylinder
7 3 3 1 tL'
3 5 I
3 6 ( M 'Distribution Piping Unobstructed and Contiguous ?3 3 13i P
37 M 'Nozzles are Correct.Clean&Properly Aimed L 7 3 3 1t2t P
3.8 M 'Fixed Temp Fusible Metal Alloy Type Detectors Replaced' 7 3 a f P
M rHixed-Temp(Other Than Fusible Metal Alloy Type)& 3 5
J 3 5 Heat Detectors Maintained or Replaced
3 10 M 'Auxiliaryvalves 7 3 3 1i2l
Functioned Correctly ______If. ..
uxilia Equtpment Such as Water _
3 11 M 'internal Maintenance as Required by Manufacturer Title 19 c9va , ' ____
r D=Deficiency C=Comment (indicate type)
1:41171_^, t.s(kite— :user D C
Defictedcles;and Comments
, _ . - .,u c„to ati eeigP aetrt ffeviCPS40.00arls.lbof rare repaired or rap: :r.:.7
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r]Checi here it additional Deficiencies and Comments are listed on Form AES 9. Numbei ailachee
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 ( ( (,)i'!1, tAi. C- k&-VrZ--
Signature •e ,a-..� i" Date 12,.. '7, f G^i
Form AES 2t1 Sept 3.2013