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Home My WebLink AboutB21-3124 CF FA (2) VALLEY FIRE SYSTEM RECORD OF COMPLETION Sfcusiw Automatic Alarm Systems A cauwma compar Form Completion Date:03/15/2022 Supplemental Pages Attached:45i 0 R 1. PROPERTY INFORMATION Name of property: Grocery Outlet-Gridley Address: 1550 CA-99 Description of property: 451 0 R Name of property representative: 451 0 R Address: 451 0 R Phone: 451 0 R Fax: 451 0 R E-mail: 451 0 R 2. INSTALLATION,SERVICE,TESTING,AND MONITORING INFORMATION Installation contractor: Valley Fire and Security Alarms Inc. Address: 2708 Mercantile Drive,Rancho Cordova,CA 95742 Phone: 916-608-0977 Fax: 916-608-0978 E-mail: Pdavolt@valleyfireandsecurity.com Service organization:Valley Fire and Security Alarms Inc. Address: 2708 Mercantile Drive,Rancho Cordova,CA 95742 Phone: 916-608-0977 Fax: 916-608-0978 E-mail: Pdavolt@valleyfireandsecurity.com Testing organization: Valley Fire and Security Alarms Inc Address: 2708 Mercantile Drive,Rancho Cordova,CA 95742 Phone: 916-608-0977 Fax:451 0 R E-mail: Pdavolt@valleyfireandsecurity.com Effective date for test and inspection contract: 451 0 R Monitoring organization: Valley Fire and Security Alarms Inc Address: 2440 Glendale Ln,Sacramento,CA 95825 Phone: 916-678-6318 Fax: 451 0 R E-mail: Pdavolt@valleyfireandsecurity.com Account number: 332-4593 Phone line 1: cellular Phone line 2: cellular Means of transmission: Panel Entity to which alarms are retransmitted: 451 0 R Phone: 451 0 R 3. DOCUMENTATION On-site location of the required record documents and site-specific software: Document Enclosure 4. DESCRIPTION OF SYSTEM OR SERVICE This is a: D New system 0 Modification to existing system Permit number: 451 0 R NFPA 72 edition: 2016 4.1 Control Unit Manufacturer: Fire-lite Model number: ES-50X 4.2 Software and Firmware Firmware revision number: 451 0 R 4.3 Alarm Verification 0 This system does not incorporate alarm verification. Number of devices subject to alarm verification: 451 0 R Alarm verification set for 451 0 R seconds NFPA 72(p.1 of 3) ©2016 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale II or distribution.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized NFPA use,contact licensing@nfpa.org. SYSTEM RECORD OF COMPLETION (continued) 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: 120VAC Control panel amps: 20amps Overcurrent protection: Type: Breaker Amps: 20Amp Branch circuit disconnecting means location: Electrical Room Panel Number: Breaker# 5.1.2 Secondary Power Type of secondary power: 12vdc 7Ah Battery located in battery enclosure Location,if remote from the plant: 451 0 R Calculated capacity of secondary power to drive the system: In standby mode(hours): 24 In alarm mode(minutes): 5 5.2 Control Unit E This system does not have power extender panels O Power extender panels are listed on supplementary sheet A 6. CIRCUITS AND PATHWAYS Dual Media Separate Survivability Pathway Type Pathway Pathway Class Level Signaling Line 451 0 R 451 0 R B 1 Device Power 451 0 R 451 0 R B 1 Initiating Device 451 0 R 451 0 R B 1 Notification Appliance 451 0 R 451 0 R B 1 Other(specify): 451 0 R 451 0 R 451 0 R 451 0 R 7. REMOTE ANNUNCIATORS Type Location 451 0 R 451 0 R 451 0 R 451 0 R 8. INITIATING DEVICES Addressable or Alarm or Sensing Type Quantity Conventional Supervisory Technology Manual Pull Stations 1 Addressable Alarm 451 0 R Smoke Detectors 1 Addressable Alarm Photo Duct Smoke Detectors 3 Addressable Supervisory Photo Heat Detectors 451 0 R Addressable 451 0 R 451 0 R Gas Detectors 451 0 R 451 0 R 451 0 R 451 0 R Waterflow Switches 1 451 0 R Alarm N/A Tamper Switches 2 451 0 R Supervisory N/A NFPA 72(p.2 of 3) ©2016 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale 1 e or distribution.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized NFPA use,contact licensing@nfpa.org. SYSTEM RECORD OF COMPLETION (continued) 9. NOTIFICATION APPLIANCES Type Quantity Description Audible 451 0 R Horn Visible 4 Strobe Combination Audible and Visible 10 Horn/Strobe 10. SYSTEM CONTROL FUNCTIONS Type Quantity Hold-Open Door Releasing Devices 451 0 R HVAC Shutdown 3 Fire/Smoke Dampers 451 0 R Door Unlocking 184 0 R Elevator Recall 184 0 R Elevator Shunt Trip 184 0 R 1840R 1840R 1840R 1840R 11. INTERCONNECTED SYSTEMS El This system does not have interconnected systems. ❑ Interconnected systems are listed on supplementary sheet 184 0 R 12. CERTIFICATION AND APPROVALS 12.1 System Installation Contractor This system as specified herein has been installed according to all NFPA standards cited herein. Signed: 184 0 R Printed name: Tom Mills Date: 184 0 R Organization:Valley Fire&Security Alarms Title: Technician Phone: 916-608-0977 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed: Printed name: Tom Mills Date: 184 0 R Organization:Valley Fire&Security Alarms Title: Technician Phone: 916-608-0977 12.3 Acceptance Test Date and time of acceptance test: 184 0 R Installing contractor representative: 184 0 R Testing contractor representative: 184 0 R Property representative: 184 0 R AHJ representative: 184 0 R NFPA 72(p.3 of 3) ©2016 National Fire Protection Association.This form may be copied for individual use other than for resale.It may not be copied for commercial sale LJor distribution.No other reproduction or transmission in any form permitted without written permission of NFPA.For inquiries or to report unauthorized NFP/C use,contact licensing@nfpa.org.