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SimplexGrinnell
SEMI ANNUAL GAS EQUIPMENT TEST REPORT
FEATHER FALLS CASINO SERVER RM.
3 ALVERDA DR.
OROVILLE, CA. 95966
9/15/2015
SimplexGrinnell
4650 Beloit Drive
Sacramento, CA 95838
916-283-0300
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SimplexGrinnell
4650 Beloit Drive, Sacramento CA 95838 - (916) 283-0300 Fax- (916) 920-2241
GAS EQUIPMENT TEST REPORT
Technician #1 CHRIS James Technician #2
Cell Phone# 530-207-7582 Cell Phone#
September 15, 2015
Customer Name: Property address: (if different)
FEATHER FALLS CASINO SERVER
3 ALVERDA DR. 3 ALVERDA DR.
OROVILLE, CA. 95966 OROVILLE, CA. 95966
Contact Information: Monitoring Information:
Name: MIKE Central Station: Certified
Phone: 530-533-3885 Acct#: 0
Fax: 530-533-4860 Phone: 0
Time of Test 0:00
Operator#& Name: 0
GAS SYSTEM:
Control Panel Status Before Test: CLEAR
Panel Type: NOTIFIER Model: RP-2002
Yes No #of Sys Notes:
Halon X
CO2 X
FM200 "FE-227" X 1 SEE TANK PAGE
Intergen X
Stamped Tank Weight: SEE TANK PAGE Acutal Tank Weight SEE TANK PAGE
#of Nozzels: 3
Disconnect Switch X
Is Power Light On? X
Does the Panel Indicate Normal Condition? X
Is the panel in a Trouble Condition? X
Are all Indicating Lamp Bulbs in Operating Order? X
does the Silence Switch Operate? X
Do the Batteries indicate they are Properly Charged? X
Type Pass Fail Amp/VIt Date
Battery#1 X 7AH 12V
Battery#2 X 7AH 12V
September 15, 2015
FEATHER FALLS CASINO SERVER RM.
3 ALVERDA DR.
OROVILLE, CA. 95966
Device Floor Zone Alarm Trouble Device Location Note:
TROUBLE 2 1 NA PASS LOW PRESSURE
SMOKE 2 1 PASS NA SERVER ROOM
SMOKE 2 2 PASS NA SERVER ROOM
PULL 2 PASS NA SERVER ROOM
ABORT 2 1 NA PASS SERVER ROOM
SMOKE 2 1 PASS NA SERVER ROOM WORK AREA
SMOKE 2 1 PASS NA SERVER ROOM WORK AREA
SMOKE 2 2 PASS NA TELEPHONE ROOM
SMOKE 2 1 PASS NA TELEPHONE ROOM
ABORT 2 3 NA PASS TELEPHONE ROOM
PULL 2 2 PASS NA TELEPHONE ROOM
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SimplexGrinnell
4650 Beloit Drive,Sacramento CA 95838- (916)283-0300 -(916)920-2241
TANK INFO
Date: 9/15/2015
Customer: FEATHER FALLS CASINO SERVER RM.
Address 3 ALVERDA DR.
City, State OROVILLE, CA. 95966
SR# 32996908
Contact: MIKE 530-533-3885
SERIAL# STAMPED WT. LLL TEMP LOCATION
AA368358 208.9 LBS. 9.5" 75.5 DEG MECH. BY SERVER
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SimplexGrinnell
4650 Beloit Drive, Sacramento CA 95838 — (916)283-0300 — (916) 920-2241
Deficiency Report
Date: 9/15/2015
Customer: FEATHER FALLS CASINO SERVER RM.
Address 3 ALVERDA DR.
City, State OROVILLE, CA. 95966
SR # 32996908
Were Do Repairs
Repairs need to be
Made Quoted
Yes/No Yes/No
HOLES IN SHEET ROCK NEED TO BE PATCHED UP, AIR TIGHT.
Needs warning signs outside entry's
tqcci
SimplexGrinnell
4650 Beloit Drive, Sacramento CA 95838 — (916) 283-0300 — (916) 920-2241
FEATHER FALLS CASINO SERVER RM. SR# 32996908
3 ALVERDA DR. IS THERE A DEFICIENCY?
OROVILLE, CA. 95966 YES XX NO
MIKE
Equipment Test Report
Yes No Qty Notes:
NA
If"No" answer, explain under comr
Were Tested Detectors Sensitivity Tested? II NA I
If"No"answer, explain under comments
Did test of Duct Dectors shut down air handling units: NA
Did the monitoring center receive signals? X
Central Station, Fire Department, Lease Line?
Is system reset for normal conditions? X
Is system restored to operational service? X
Operator and Time system put back on line? Operator: Time:
Have proper authorities been notified system is back in service? X
Indicate % of Equipment tested this report 25 50 75 100
Indicate % of equipment tested YTD 25 50 75 100
Comments for any"No" answers or explanations:
Did you receive a copy of your inspection report? YES X NO
If no how would you perfer to receive your report:
Email: troydonnelson@featherfallscasino.com FAX 530-533-4860
We appreciate your business. Thank you!
Customer Date
Ch 'Ja 9/15/15
Inspector Date
IF YOU HAVE ANY QUESTIONS REGARDING THIS INSPECTION AND/OR REPORT PLEASE CONTACT:
Our office at 916-283-0300