HomeMy WebLinkAboutB21-3505 041-230-009 CF FA 2023 in any form permitted without written permission of NFPASi.Far inquiries or to report unauthorized use.contact licensingianfpa.org.
DOCUMENTATION 72-39
SYSTEM RECORD OF COMPLETION
This form is to be completed by the system installation contractor at the time of system acceptance and approval.
It shall be permitted to modify this form as needed to provide a more complete and/or clear record.
Insert N/A in all unused lines.
Attach additional sheets, data,or calculations as necessary to provide a complete record.
Form Completion bale: 7/21/2°22 Supplemental Pages Attached: N/A
1. PROPERTY INFORMATION
Name of property: PG&E Table Mountain RPAC Substation
Address: 945 Cottonwood Road.Oroville.California 95965
Description of property: Utility
Name of property representative: Chase Chaussee
Address: 945 Cottonwood Road,Oroville,California 95965
Phone: 1(530)635-4871 Fax: E-mail:
2. INSTALLATION,SERVICE,TESTING,AND MONITORING INFORMATION
Installation contractor.
Cusco Fire Protection
Address' 4320 Anthony Court.Suite 8.Rocklin,CA 95677
Phone. 916-652.1306 Fax, 916.652.1307 E-mail: www,coscafire.com
Costa Fire Protection
Service organization:
Address' 4320 Anthony Court,Suite 8.Rocklin,CA 95677
Phone. 916.652.1306 916.652.1307Fn E lwww.coscofire.com
j Testing organization- Cusco Fire Protection
• Address' 4320 Anthony Court.Suite 8,Rocidin.CA 95677
•
Phone 916-652.1306 Fax- 916.652.1307 E-mail: www.coscofire.com
Effective date for test and inspection contract:
Monitoring organization:
Address-
Phone' FaY' E-mail-
Account number: Phone line 1• Phone line 2:
Means of transmission'
Entity to which alarms are retransmitted: Phono-
3. DOCUMENTATION
On-site location of the required record documents and site-specific softwar document can under FACP
e
4. DESCRIPTION OF SYSTEM OR SERVICE
•
This is a: 1 New system J Modification to existing system Permit number:
NFPA 72 edition:
4.1 Control Unit
Manufacturer. Notifier Model number NFS-320
4.2 Software and Firmware
Firmware revision number V29
4.3 Alarm Verification Ei This system does not incorporate alarm verification.
Number of devices subject to alarm verification• Alarm verification set for seconds
2015 National Fire Protection Association NFPA 72(p.1 of 3)
FIGURE 7.8.2(a) System Record of Completion. (SIG-FUN)
2016 Edition
6r arty farm perminad vMfiout written permission of NFPA®.For prgruries or to report unauthorized use,contact licensing@nfpa.org.
72—}() NATIONAL FIRE ALARM AND SIGNALING CADE
SYSTEM RECORD OF COMPLETION (continued)
5. SYSTEM POWER
5.1 Control Unit
5.1.1 Primary Power
Input voltage of control panel: 12OVAC Control panel amps: 3-9
Overcurrent protection: Type: Circuit Breaker Amps: 20A
Branch circuit disconnecting means location: Panel 12 Number: Circuit 13
5.1.2 Secondary Power
`Type of secondary power: Sealed Lead Add Battery
Location,if remote from the plant: inside FACP
Calculated capacity of secondary power to drive the system:
In standby mode(hours): 24 Hours In alarm mode(minutes): 5
5.2 Control Unit
J This system does not have power extender panels
J Power extender panels are listed on supplementary sheet A
B. CIRCUITS AND PATHWAYS
Dual Media Separate Survivability
Pathway Type Pathway Pathway Class Level
Signaling Line I I ] g
Device Power I I I N/A
Initiating Device I I I g
Notification Appliance I I I g
Other(specify):
7. REMOTE ANNUNCIATORS
Type I Location
8. INITIATING DEVICES
Addressable or Alarm or Sensing
Type Quantity Conventional Supervisory Technology
Manual Pull Stations 1 Addressable I Alarm I switch
Smoke Detectors 2 Addressable I Alarm I photoelectric
Duct Smoke Detectors N/A I I
Heat Detectors N/A I I I
Gas Detectors N/A I I I
Watertlow Switches I N/A I I
Tamper Switches N/A I I I
®2015 National Fire Protection Association NFPA 72lp.2 of 3)
FIGURE 7.8.2(a) Continued
�w..� 2016 Edrtion
in any form permitted without written permission of NFPA09.For inquiries or to report unauthorized use,contact kcensingainfpa.org.
DOCUMENTATION 72-11
SYSTEM RECORD OF COMPLETION (continued)
9. NOTIFICATION APPLIANCES
Type I Quantity I Description
Audible I N/A I
Visible I N/A I
Combination Audible and Visible 1 2 I 1 qty ceiling mount red and 1 qty wall mount red weatherproof
10. SYSTEM CONTROL FUNCTIONS
Type Quantity
Hold-Open Door Releasing Devices N/A
HVAC Shutdown 1
Fire/Smoke Dampers N/A
Door Unlocking N/A
Elevator Recall N/A
Elevator Shunt Trip N/A
•
11. INTERCONNECTED SYSTEMS
el This system does not have interconnected systems.
J Interconnected systems are listed on supplementary sheet .
12. CERTIFICATION AND APPROVALS
12.1 System Installation Contractor
This system as s ifie in has been installed according to all NFPAFP standards cited herein.
Signed: /I�� Printed name.,0417 Zr^ Date:/�-/4-P-j
Organizati n:Go'SGa !�1 r-t- Title: e.I Phone: 916.652.13os
12.2 System Operational Test
This system as specific, h in has tested according to all NFPA standards citeeddd herein.
Signed: l//I�—� Printed name:/K�6�ar/�r f��i�1v24 Date/A" /4" /7
916.652-1306
Organization:��l O f/�-t- Title:fs.G� Phone:
12.3 Acceptance Test �.r�
Date and time of acceptance test: /D/O // _ ! • YG / i
Installing contractor representativ
Testing contractor representative-
Property representative: //� ,.. I�__ r f
AH3 representative: Lam"\
I
(�9 2015 National Fire Protection Association NFPA 72(p.3 of 3)
FIGURE 7.8.2(a) Continued
2016 Edition a