HomeMy WebLinkAboutFAI16-0002 042-070-197 CF Hood 2022 rrkC i b- aocjz Gy 2 -07° - I C17
Wet h th ahPre-Engineered California Code of Regulations-Title 19 Semi-Annual 2 of 2
Fire Extinguishing System Inspection,Testing,and Maintenance Report
Property Information ,;<u� CAt;�o i Contractor or Licensed Owner Information
•Building Name ('JJ; A, ,/' 23 an fC Le ir (A )'''
Name Wilgus Fire Control Inc.
•(Address )it 0 i.J I".-„r 44 ,,c�' ' y` ,/`ter Job#
(City " 0 \--Amts..
Inspection,Testing,and Maintenance
1 =Inspection T =Test M=Maintenance P=Pass F=Fall N/A=Not Applicable
item '
2.2 T Fuel Shut-Off Operated Correctly 7.3.3.4
2.3 I T !Regulator Tested&is within Acceptable Limits I 7.3.3.4 I I I
Manual Reset ReiayFunctloneztCorret.tly
2 4 T 1 7.3.3.4 }
I (If Applicable) I
I
3.1 I M !Test Dant tes Containers within Acceptable Hydrostatic I 7.5.1(1) I I I i
3 2 I MIAu Auxiliary Pressure Containers andtor Hose I 7 5 1(2)(3) I Iti
ssemblies within Acceptable Hydrostatic Test Dates 1 3.3 I M !Cartridge Weights within Acceptable Limits I 7.3.3.1(2) I I I ik{{
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3.4 MLiquid Level within Acceptable Limits 7.3.3.1(2) '�
I 'Liquid
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3 5 M No Signs of Corrosion in Agent Cylinder 7.3.3.1(2)
(Non pressurized) I I I I
I3.6 M 'Distribution Piping Unobstructed and Contiguous I 7.3.3,1(3) I I I t
I3.7 M !Nozzles are Correct,Clean&Properly Aimed I 7.3.3.1(2) I I I
I3 8 M 'Fixed Temp Fusible Metal Alloy Type Detectors Replaced! 7.3.4 I I I 3 9 . J�
I !Fixed-Temp(Other Than Fusible Metal Alloy Type)& I 7.3.5 /t/I I I l/�`�
M Heat Detectors Maintained or Replaced
3.10 I M !Auxiliary Equipment Such as Water valves I 7.3.3.1(2) I I
Functioned Correctly �}'f
3.11 M 'Internal Maintenance as Required by Manufacturer I Title 19§904.7 I I IA'
D=Deficienc C=Comment Indicate t •e
Miser D C Deficiencies and Comments
z Indicate all equipment devices and pods that were repaired or replaced
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i (Check here if additional Deficiencies and Comments are listed on Form AES 9. Number attached:
l l See Correction Form AES 10 for corrected deficiencies. Number attached:
1 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 #fr 0'/2a,„d - et,'
Tr-
Signature I ri+idl Date C —c
Form AES 20 Sept.3,2013
Wet Chemical Pre-Engineered California Code of Regulations -Title 19 Semi-Annual 1 Of 2
Fire Extinguishing System Inspection,Testing,and Maintenance Report
Property Information •.o of, Contractor or Licensed Owner Information
-y�,� rn (1t 7i y 4+
'Building Name CA oao !t' '' 7 t t r ,�t.,. i Name Wilgus Fire Control Inc.
Q r �
(Address))/L2 tit') ) a t;'/ j,!',,,e. 1~Wit..`>p � Address 4544 Mountain Lakes Blvd.
I 1`:-r' City Redding St. Ca Zip 96003
'City C'A,77 e,e,, (License# 462979 IPhone (530)241-2465
(Contact Person I ❑ SFM IJob#
(Phone 3117, 71 Li l I Ilj CSLB IMisc.
5
System information . —.� v
Cylinder Size ,r Last Hydrostatic Test Date, 2-2. Flow Points Capacity Used i
(System Location 1.(/74 E+v System Mfr. :M=34.,t,, Model# ,K10 3-,
IFuel/Heat
Electrical# Integral Make Up Air
eat Shut Off:
Gas# Shut Down
mSW - cap f y.w r �i ,. . .
������ 4 �,� � .. ���, � z= .��,," qa :n Flow Points
Hoods I f I fl ,k 1`7
(Plenums I r I I Ii/ I I I ' I 2.
'Ducts I I )I ""1-.1:-; I al I I I Cooking Appliances
Left to Right with Sizes and Coverage Nozzles
1 *IL:
ii a Y as-1w �l�li; T � ._ r � "• rw� F u t _-- -c� a""� lo zzie Nozzle
Total
"y f er)ce N ae � i Appliance Name Modal Flow Pomia I , F' ints
i9,, �' I 1 r I I I -5 II I
t cI '(Gc. I IA/ 11 I 1" I I I I I
I • I I II I I
I I 1 I I
I I I II
Fixed Temperature Sensing Elements
(Such as Fusible Links)
4 ! g ( Mfr I Install I I Mfr I Install
A .,� 4 r.F ,:,.Date Date H ,a.., R?S C Temp ty Date Date
, •
I t.to
I I I I l i I I I
Inspection, Testing,and Maintenance
I =Inspection T =Test M=Maintenance P=Pass F=Fail N/A=Not Aophczable.` (fitments Only
Manual Actuators are Unobstructed O I
1.1 I I I (i.e.Remote Pull Station) ( 7.2"2 2 li
1.2 I I !Tamper Indicators&Seals Intact I 7 2 2(3) I 11
1.3 I I (Maintenance Tag in Place I Title 19(ta906 I___c_
1.4 I I INo Obvious Physical Damage I 7.2.2(5) J
1.5 I Gauge Readings within Proper Limits 7 2.2(6) I A.r/)
I I(Stored Pressure) I /�V-/
1.6 I I (Blow-Off Caps in Place&Undamaged I 7.2.2(7)
,,i
1.7 I I (Hoods,Ducts,Filters in Place and Clean I CFC 904.11.6.3 t!
'H
ood,Ducts&Protected Cooking Appliances Have I ( )
1.8 I Not Been Replaced,Modified or Relocated 7.2.2 8 /
2,1 I T 'Automatic Detection/Manual Actuation Functioned I 7.3,3.4 `
Correctly ,
Form AES 20 Sept.3.2013