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HomeMy WebLinkAboutFAI20-0005 CF FA 12-12-2022 (Annual) Fire Alarm Supplementary Form ��f, ,; Security Systems A VYANET OPERATING GROUP, INC.COMPANY Location Code: 045-821-1994 Contact: TRISH STILWELL Company: Eagle Security Systems Contact Address: 880 HAZEL ST Address: 3268 Esplanade Ste A GRIDLEY,CA 95948 Chico,CA 95973 Phone: 530 846 7800 Company Phone: 530-345-6395 Email: HAZEL@CHIPHOUSING.ORG Inspector Carlos Palomera Property Evaluated: HAZEL HOTEL(Business) 156551 NICET I,Expires:3/1/2025 880 HAZEL ST Date of Work: 12/12/2022 GRIDLEY,CA 95948 Frequency: Annual Description: Fire Alarm Supplement(INITIATING DEVICES) Deficiency Summary There are no reported deficiencies for this submission General Comments There are no general comments for this submission VYANET Operating Group,Inc.,410 SW Columbia,Suite 120,Bend,OR,97702 Phone:541-812-6409 Page 1 of 4 1� Eagle Security Systems ��� =� E AG L E 3268 Esplanade Ste A ' Security Systems DChico,CA 95973 A VYANET OPERATING GROUP,INC.COMPANY Phone:530-345-6395 Fire Alarm Supplementary Form The work covered on this form is(select one): Annual Date of Work 12/12/2022 ccount Information Facility Name: Property Type: Location Code: HAZEL HOTEL Business 045-821-1994 Service Address: 880 HAZEL ST,GRIDLEY,CA,95948 Owner: Owner's Phone: TRISH STILWELL 530-846-7800 Owner's Address: 880 HAZEL ST,GRIDLEY,CA,95948 FLegend PS-Pull Station SD-Smoke Detector DD-Duct Detector MM-Monitor Module(Ansul,temp,CO,etc) CM-Control Module I WF-Waterflow ITS-Tamper Switch I HD-Heat Detector I SC-Signal/Sounder Control Other I SPKR-Speakers I STROBE-Strobes I HORN-Horns/Horn-Strobes I BATT-Batteries Type inir Total Tested Not Passed Failed Total Tested Not Passed Failed Tested Tested HD 12 12 IO 12 IO PS I1 11 IO 11 IO SD 138 138 IO 138 IO I ITS 11 11 IO 11 10 WF 11 11 to 11 to I I I I I I 1 Address Location Notes Frequency Last Tested Test Results Comments SD 1 1 -Apt 1 Annual 12/12/2022 Pass SD 2 1 -Apt 1 Annual 12/12/2022 Pass SD 4 1 -Apt 2 Annual 12/12/2022 Pass SD 6 1 -Apt 3 Annual 12/12/2022 Pass SD 7 1 -Apt 3 Annual 12/12/2022 Pass SD 9 1 -Apt 4 Annual 12/12/2022 Pass SD 10 1 -Apt 4 Annual 12/12/2022 Pass SD 12 1 -Apt 5 Annual 12/12/2022 Pass SD 13 1 -Apt 5 Annual 12/12/2022 Pass SD 15 1 -Apt 6 Annual 12/12/2022 Pass SD 16 1 -Apt 6 Annual 12/12/2022 Pass SD 18 1 -Apt 7 Annual 12/12/2022 Pass ©2014 FormLink Systems,Inc., Fire Alarm Supplement vl.1 Page 2 of 4 1�����"'. Eagle Security Systems ��� =� EAGLE 3268 Esplanade Ste A - Security Systems 0Chico,CA 95973 A VYANET OPERATING GROUP,INC.COMPANY Phone:530-345-6395 Type ' Address Location Notes M Frequency Last Tested Test Results Comments SD 19 1 -Apt 7 Annual 12/12/2022 Pass SD 21 1 -Apt 8 Annual 12/12/2022 Pass SD 23 1 -Apt 9 Annual 12/12/2022 Pass SD 24 1 -Apt 9 Annual 12/12/2022 Pass SD 26 1 -Apt 10 Annual 12/12/2022 Pass SD 27 1 -Apt 10 Annual 12/12/2022 Pass SD 29 1 -Apt 11 Annual 12/12/2022 Pass SD 30 1-Apt 11 Annual 12/12/2022 Pass SD 32 1-Apt 12 Annual 12/12/2022 Pass SD 34 1 -Apt 13 Annual 12/12/2022 Pass HD 34.4.1 1 -Elevator Shaft Annual 12/12/2022 Pass HD 34.4.2 1 -Elevator Control Room Annual 12/12/2022 Pass SD 35 1 -Apt 13 Annual 12/12/2022 Pass SD 37 1-Elevator Room Annual 12/12/2022 Pass SD 38 1-Elevator Shaft Annual 12/12/2022 Pass SD 41 1 -FACU Annual 12/12/2022 Pass SD 42 1 - 1st Floor Elevator Lobby Annual 12/12/2022 Pass SD 43 1 -2nd Floor Elevator Lobby Annual 12/12/2022 Pass TS 44 1 -Butterfly Valve Annual 12/12/2022 Pass WF 45 1 -Waterflow Annual 12/12/2022 Pass SD 46 1-Space B Annual 12/12/2022 Pass SD 47 1 -Space A Annual 12/12/2022 Pass SD 48 1 -Space A Annual 12/12/2022 Pass SD 49 1 -Space C Annual 12/12/2022 Pass SD 50 1 -Space C Restroom Annual 12/12/2022 Pass SD 51 1 -Space C Workroom Annual 12/12/2022 Pass SD 52 1-Space D2 Annual 12/12/2022 Pass SD 53 1 -Space D1 Annual 12/12/2022 Pass SD 54 1 -Women's RR Annual 12/12/2022 Pass SD 55 1 -Men's RR Annual 12/12/2022 Pass PS 57 1 -Lobby Annual 12/12/2022 Pass Comments Any deficiencies or other problems found with the devices must be explained using the comment specific for each device.Additional comments can be added here. Please see the summary section at the ton of the form for the comments. ©2014 FormLink Systems,Inc., Fire Alarm Supplement v1.1 Page 3 of 4 Eagle Security Systems ta) =� EAGLE 3268 Esplanade Ste A Security Systems Chico,CA 95973 A VYANET OPERATING GROUP,INC.COMPANY Phone:530-345-6395 Inspector's Information Inspected By Carlos Palomera I state that the information on this form is correct at the time and place of my inspection,and that all equipment tested at this time was left in operating condition upon completion of this inspection except as noted in the Comments. Signature of Inspector Date 12/12/2022 ©2014 FormLink Systems,Inc., Fire Alarm Supplement v1.1 Page 4 of 4