HomeMy WebLinkAboutFAI18-0012 CF Hood Suppression 2021 Et at'..'.7 0)1:**,-.:,',60,414;..j.04.1 'itiiiiiitizi.e'a ROgulatiOpe7.::Title-143-:, ,'i'„..:, era FMUa 1 of 2
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ii:1„-tr1111 piLpip),_-.1_101,,,Iislejn,,,,,,,,,, 17.4rrattt!nsp...n cti on,Testing and Maintenance . Report
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Property Information At', ' --''',,,C)t' Contractor or Licensed Owner information ,
Building Name'3tak C CA. _ . C, "t jA!\
Name
Wilgus Fire Control Inc
lAddreSs 6/04 cie...c., Address 1703 Sonoma St
I .1k7,4)rie"
' ,.‘..-- City Rodaina St Ca Zip 9600"
...._...-
ICitY Olk a fill kz,..e% .... _ _ License# 462979 Phone '503-241-2465
'Contact Person 4•7:15.CS se...V...- SFM 1
.,..i Joe 4 .0 <s-1,___
'Phone ""•ii3,. C4C11 S G.q/ ro CSLB Misc _ . ....
-
,.UP '! I ...,,,
".. ..
Cylinder Size! qg. tisk V 7... Last Hydrostatic Test Date t( ".7) Flow Points Capacity Used 1 c System Location LA.)C.kk System Mir -A. Iiis. C i„,, t_, Model 4 tiL. - ko 2_
1Fuel/Heat Shut Off: ...., -
IGas# ,0***- Electrical# ..e- Integral Make Up A,r Shut Down
. - - gi:K•.-i,A:Witil tat I;
. --t•-p, -, - ''''"-, -, ",,,,0114,1A"-:'; " - ' ' .4 .i•:, le.. I Nozzle ' • - '.'Nozzle , Ili,-7,.;.i.O.,,, r,,,,,,..;..,•,-; 1
:,;N:,:,,'''''1.:,, ,,'..,,''„Y' , , ,,,,‘,,, l't.i.r :.,, _ ,,", 1... .., :,4,!'illt:OTC low Points Oty ,-;.,.Tp-.ints1,..., 1
}Hoods 1 "L. I '1 ' 'I 1 1 1 --
IPtenums I ".)..... I '1t ci I i *-3 k 2- .
.....
IDucts I 2- 10 fit it' r2.- 1 t til l 2.. I -2-
I Cooking Appliances
Left to Right with Sizes and Coverage Nozzles-,.....1,-0.%' ,I•* 1 ' -.:,}4.-N.,.., .-..-..-t, tact
1,r.',,, '.:-,,,t;•-i-1,...,,,2f4kV4 ''-,,. ,-.1.,,,„ir,,,, r.,,r , 6,„,,,,,,:, ; ,,,A,oilance Name -I Nozz e I
T ..- '1,r4i144-0,,,, -. -`-:,71.".",,":- 'r' `:,'-PliiiMPOilitS IP las - " Model I.FloW.•,,,....N.:14t190Ill..t:sj
'D.-ZaCktr2._.Itlit 2.41 1.-CtO I 2_ I 7.. II 1 ....
'13041(4-a- 2-I. x lcd k 1.-.1 1 N 1 LjI1 _
&._14...y. 2-I 1 '2.61 () I I- 1 2.. II
I I
& X 2t.13 12x 2...c4 r) 1 Z. 1 '1 1'1 II , i
ft:3,,g..ftgAi... ks s__L,s. I i t,...), I ‘ 1 2- 1 I I I ,
Fixed Temperature Sensing Elements
(Such as Fusible Links ,
fL,L ,,,‘.: -.‘,".."41,11. .,,, --r;.' :fif-:.: 1.; ,,,, .Mfr . I,-I. • ' Meal! '
1, 'I,AWt7')-;11 'I'ii R I I ' Date I I'I Date Quantity i' Temp
I (g" 1 LI c 0 I eZ-0 i 9 10)- 1 - 24 II 1 I I
I I I I I I I L. I
inspection,Testing,and Maintenance
-4.,: ...:,.-„,-,.;:... . :,...,„,......,.........K.:...--i.14.1
; . Inspection T =Test M=Maintenance 0....pass P=pail AL,4 , riot
.• ' I .1: ' I.- ' - . I NFPA 17A CA
Atern __„ ,Description -., I Date Comments,Only-, '',. P,F,NIA
. ' ed.Reference
1 1
'Manual Actuators are Unobstructedted
1 I ' 2'2 I
I (i.e.Remote Pull Station) tO;121
1 2 I 'Tamper Indicators&Seals Intact I - ;.., 2 ":-; I \ I I P
1 3 I 'Maintenance Tag in Place I
1 7 2 2i4Ii
I Tide 19§906 1 e
1.4 I fro Obvious Physical Damage I 7 2 2i5i I II
e :
I 5 I IGauge Readings within Proper Limits ' I
21.5) tj ‘,._IA
(Stored Pressure)
1 6 I IBlow-Off Caps in Place&Undamaged I 7 2 2 ....
- --k---:,
1 7 I IHoods,Ducts,Filters in Place and Clean I CFC 904 11 5 3 P I
1,8 I Hood,Ducts&Protected Cooking Appliances Have
Not Been Replaced,Modified or Relocated 7 2,2(6) 1 P
2 1 T 'Automatic Detection/Manual Actuation Functioned I.., 1
ICorrectiv V 1
I
Porm AES 20 Sept 3 2,"ji."•;
t
�11, C ngineered California Code'of Regulation•s-T,tleh19.. �x r ern tin x rri, ,
'+ '-',--,-,1;,
Y RI t S <i1A d' A. �Y p� " ,tkJ
t bji ' yala») --,': I Speedo tTesung �OMailitenance;tk+ :3Y"1,te V.14 L.S`Ar a_ti_z: ':" _`l4f`G
Property Information •ti. 14 Contractor or Licensed Owner Information
j;k-: -',W.,12,11i.
'Building Nam ,, 0, „',114 , i it C'ink — , IS. i (Name WilgusT Fire Control Inc
!Address ty64 .0 •"�v.-i, H. - O- 4 ,:g 1Job# C /
(City 1/14C ,qct t 1 et. Filie M I
1 - inspection T =Test M - Ma, tena^ce s ,Th., )4 - 4ppilcabte
to
item t� -'1 NFPA 17A CAroTM
° ' • ed..Reference Date Comments Only i; ,, 1 .
2 I Ftiei Shut-Off Operated Correctly I - 3 3 a 1 t -7- i I P
2.3 T Regulator Tested&is within Acceptable Limits I 7 3 3 4 I 1 P
--t-2$- I T _11Manuai Reset Relay Functioned Correctly I 7 -3 4I I e
! I (If Applicable)
All Agent Containers within Acceptable Hydrostatic
3 1 h1 Test Dates I 7 S 1(+,t 1__ i
II Auxilia Pressure Containers and/or Hose
3.2 M seethes within Acceptable Hydrostatic Test Dates I , 5
1(2)(3)
3.3 ( M !Cartridge Weights within Acceptable Limits f 7 3 3 1(2) I I I t'�
3.4 M Liquid Level within Acceptable Limits 73 3 1(2) [
(Non-pressurized)
3 a M INo Signs of Corrosion in Agent Cylinder + ?3.3 1(2)
(Non-pressurized)
1
3.6 rt IDistneubon Piping Unobstructed and Contiguous ( 7 3 3 ,i3) 1 t
3.7 M (Nozzles are Correct,Clean&Properly Aimed ( 7 3 3 1(2) I ()
3 8 ( M (Fixed Temp Fusible Metal Alloy Type Detectors Replaced1 '3., I (
I
3 9 M ,3 c(Fixed-Temp(Other Than Fusible Metal Alloy Type)& 1 • �a
Heat Detectors Maintained or Replaced I N 1
3 to M Auxiliary Equipment Such as Water valves I 7 3 3 1+2 I I
!Functioned Correctly
3 11 ( M (Internal Maintenance as Required by Manufacturer 1 Title 19 9Qa 7 I I P
I D=Deficiency C=Comment (tndicate type)
?-"a ._ `1�± ,_ �1 r �"`yl . .4{.�. f.j. .. J,..i! >..1.5=-.1 r..,. (,i. i K..., »a � d�'°"" ` t
I 1 t t
I
1 1
+ I 1 I
I I ;' i
❑Check here it additional Deficiencies and Comments are listed on Form AES 9. Number attached
0 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 Yam, I r t fix L ( t
Signature I 774(",'(4 Date !! 11 .
Form AES 2y Sept.3.2013