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HomeMy WebLinkAboutFAI15-0010 Overhead Sprinkler Hydro Test 2018 . c-A t IS---oolo p it,S ' 1zo—oK-6 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 -OF_CAL/�;ll ,�f.' �o9r' Contractor or Licensed Owner Information `Z� Building Name Cec4xP_()Jr�� SCVNEE1 �`� - ID Name Wilgus Fire Control Inc. (Address Is 1-1 EQ (`,C'l���b. e� v 'P Address i ��Rt NiPQ`� � 1703 Sonoma St. 'City Redding St. Ca Zip 96001 'City V1I,Aclq \ . C..‘ ;License# 462979 Phone 'Contact Person `- `k i [1I 530 241-2465 _ l SFM !Job# 'Phone (•?j - 77,v 4_Li 1 0 CSLB IMisc System Information Cylinder Size . C l D vx_ Last Hydrostatic Test Date System Location t i A )r. 'Z®� Flow Points Capacity Used -� ( l System Mfr. f ,3 LA I._ Model# 12_ - t 'Fuel/Heat Shut Off: ` • 1 - 'Gas# k 11 Electrical# ✓ Integral Make Up Air Shut Down ✓ Items #9f�.Items Dtmenaions odela Nozzle I Nozzle ? s7.,` �-' ,I` Morel# - Flaw Points 0.i b 'Hoods I 1. I 4 '.� .q" I Qty F fiVi✓ rnts� (Plenums 1 1 I j I ( l� I Ducts 1 I 7- I ` - 1 I '-© x i 2- I t t,J t I 1 i t Cooking Appliances Left to Right with Sizes and Coverage Nozzles A h _Ivozzie "� ��� pp priceName tae l wY�taf Appiiance;Name ( `Nozzle ,A�io tel ' ,.. Points. Flow Points 'ModelI,,- Nb �� e f 4 21 X 3 LI i 2'-t h I � I F.{ fov+i Olt' �fo l oints I II I 1 I I I II i I I I 1 I II I Fixed Temperature Sensing Elements I { (Such as Fusible Links) .,(:1 uantity f, Temp mfr. tnstall Mfr install 11 f Date Date Quantity I Temp -- I 0 i 2 a ( -7 I t o -1.p-I‹I I I Date + mate I II I I I 1 _ _ w.. nspection,Testing,and aintenance I =Inspection T =Test M=Maintenance P=Pass F=Fail N/A =Not Applicable Item 'Description - " NFPA 17ACA I '� ed.Reference Date Comments Oni :'` iI I !Manual Actuators are Unobstructed 1 y ,?'P,FN/A;I i.1 I I 1 (i.e. Remote Pull Station) 7.2.2(2) /„_�Q 1.2 I I Tamper Indicators&Seals Intact t1 7.2.2(3) � ,Z.,0 I 1.3 I I (Maintenance Tag in Place 7.2.2(4) I Title 19§906 C • Z ' I l 1.4 t I �No Obvious Physical Damage t 7 2 2(5) G- Z. 0 I I I 1.5 I I 'Gauge Readings within Proper Limits (Stored Pressure) 1 7.2 2(6) zo I kiA I I 1.6 1 I Blow-Off Caps in Place& Undamaged O I 7 2 2 I I1.7 I (Hoods, Ducts, Filters in Place and Clean CFC904.11.6.3i to _!14- 2 b I 1 f 1 ZyI 1 8 I I (Hood, Ducts&Protected Cooking Appliances Have I " I Not Been Replaced, Modified or Relocated I 7.2.2(8) / 12 1 I T 'Automatic Detection/Manual Actuation Functioned ►Correctly I 7.3.3 4 I r . 1 1 /, Form AES 20 Sept.3,2013 'Wet ChimiCal Pre-Engineered California Code of Regulations-Title 19 Semi-Annual 2 of 2 Fire Extinguishing System Inspection,Testing,and Maintenance Report of CAt.6 1A Property Information Contractor or Licensed Owner Information J Q� \o 9Z ti `( C i (Name Wilgus Fire Control Inc. (Building Name („ttika(� A3o C1`Y�loo\ Address ki,law ht V\Q— —,ate 7i„ :,..‘/r (Job# Q ©� �c� 'fiPREMPp , !City vvtacctt ;a_ „ I ion Tr=Test M=Mainten eStln P=Pass F=Fail N/A =Not Inspection, g,and Maintenance I Inspection Maintenance Applicable -Item c1 '.1n DeSC .ptibn ti ` , Date > CommentOiiiyl ,,. * €.Pik N/A, I 2.2 T (Fuel Shut-Off Operated Correctly 7.3.3.4 (5-.2° I 2.3 T (Regulator Tested&is within Acceptable Limits 7.3.3.4 b_ z 0 I e 2.4 T (Manual(If Reset Relay Functioned Correctly 7.3.3.4 I �'-) ( Applicabl ) � � © I 3.1 M All Agent Containers within Acceptable Hydrostatic 7 5 1(1) F,, Z3 Test Dates to 3.2 M IAII Auxiliary Pressure Containers and/or Hose 7 5.1(2)(3) - • _0 I IQ i, (Assemblies within Acceptable Hydrostatic Test Dates t 3.3 M (Cartridge Weights within Acceptable Limits 7.3.3.1(2) 19 - Z C' I te 3.4 M 'Liquid Level within Acceptable Limits 7 3 3.1(2) _ p (Non-pressurized) 3.5 M 'No Signs of Corrosion in Agent Cylinder 7.3.3.1(2) 16 _2,D I lc) (Non-pressurized) 3.6 M (Distribution Piping Unobstructed and Contiguous 7.3.3.1(3) I I! -'2 0 I e 3.7 M (Nozzles are Correct, Clean&Properly Aimed 7.3.3.1(2) Its -1- I I 3.8 M (Fixed Temp Fusible Metal Alloy Type Detectors Replaced 7.3.4 I(,� - 20 I I Q�(Fixed-Temp(Other Than Fusible Metal Alloy Type)& 7 3 5 I($' ZO I I�I y ,3.9 M Heat Detectors Maintained or Replaced 3.10 M 'Auxiliary Equipment Such as Water valves 7.3.3.1(2) I(A -ZO I I W I- Functioned CorrE•ctiv { 3.11 M Ilnternal Maintenance as Required by Manufacturer Title 19 §904.7 I(,t_-a I I D=Deficiency C=Comment (Indicate type) item Date Riser D C Deficiencies and Comments Ind:care all equipment,devices and parts that were repaired or replaced I I 1 .... Ii I 1 I I I 1 I I I I ❑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 iTCC-1 YA yN\t.LA` .-2-- -- Signature Date `�(�`.- 27,0 i I Form AES 20 Sept.3,2013