HomeMy WebLinkAboutFAI23-0004 010-210-028 Butte County Fair 2023 Squyers Fire Protection ,4� SQUYRES Fire Protection, INC.
mi P.O.Box 3176 • Chico,California 95927 • Phone(530)345-1012 • Fax(530)345-1630
Wet Chemical Pre-Engineered California Code of Regulations-Title 19 Semi-Annual 1 OF 3
Fire Extinguishing System Inspection,Testing,and Maintenance Report
Property Information '``- :``,'q?h Contractor or Licensed Owner Information
!', 1 ' i 'mi l{' ^ ''.i
!Building Name AV ( ,.,�y ,.r-s!<+i•A4// ,i (- r Name Squyres Fire Protection, Inc.
�f�' `v '` �� !Address P.O. Box 3176
Address /yy ff�Zr S `iZ�fcfiiRE i",,p...
_,� !City Chico St. CA Zip 95927
City ‘.7.,.6/ , / !License# 275206 !Phone 530-345-1012
Contact Person ' I Tiii SFM 1Job#
Phone gYZ 3/Zt( 1 •: CSLB C- 16 'Misc.
System hnitinnation
,Cylinder Size ": 7 9 Last Hydrostatic Test Date Z'/ , Flow Points Capacity Used 9'
'System Location �,/ryio ,r,li- System Mfr. `i-na l%, Model# f'rL 300
!Fuel/Heat Shut Off: ,f,s •
!Gas# Electrical# Integral Make Up Air Shut Down
Items #of items Dimensions Nozzle INozzle Nozzle Total I Model# Flow Points I Qty 1 Flow Points :`..
!Hoods I / I Z-' 1 .4. 4 I I J 3 I 6
!Plenums I / I -c I /2 I / I 0 / I /
!Ducts I / I /Q/'x/'r 1 zd I .. I / I 2-
Cooking Appliances
Left to Right with Sizes and Coverage Nozzles
Nozzle Nozzle I Total Nozzle Nozzle Total
Appliance Name Appliance Name
Model Flow Points Flow Points Model Flow Points Flow Points
l 4' ./'.-,,cr 24 2- I P I I 6'I 4% I I z I Z
I I ! I I I !
I II I I I !
I II I I I i
I Ii I I i F
Fixed Temperature Sensing Elements
(such as Fusible Links)
Quantity Temp Date I IDatel . all Quantity I Temp Date I
Ins to
- I 4/„E° 11a _ .7 z /ez31 1 1 I
1 I 1-1 I I I
I =Inspection T =Test M=Maintenance P=Pass F=Fail N/A =Not Applicable
Item. # Description I edReference I Date Comments Only I P,F,t+i/A
1.1 I I 'Manual Actuators are Unobstructed 2 /Z }� ,�
ii.e. remote pull station. 722O S4 0 F, NIA
1.2 I I Tamper Indicators&Seals Intact 7.2.2(3) I i I 'F NIA'
1.3 I Maintenance Tag in Place 7.2.2(4) F NIA
I Title 19 l 906 I I
1.4 I I INo Obvious Physical Damage 7.2.2(5) I f I 'F N/A;
Gauge Readings within Proper Limits ( ) F NIA
1.5 I 'Gauge
pressure) 7.2.2 6 I 1 I ,
1.6 I I IBlow-off Caps in Place& Undamaged 7.2.2(7) 1 I *'F NIAI
1.7 I I Hoods, Ducts, Filters in Place and Clean CFC 904.11 6.3 I I I 1F NIA
1.8 I I 'Hood, Ducts&Protected Cooking Appliances Have i 7 2 2(8) I I F NIAI
Not Been Replaced, Modified or Relocated ' ,
2 1 T utomatic Detection/Manual Actuation Functioned 7.3.3.4 I I F NIAj
I Lorrectly 1
V
4SQUYRES Fire Protection, laic.
PI P.O.Box 3176 • Chico,California 95927 • Phone(530)345-1012 • Fax(530)345-1630
-
Wet Chemical Pre-Engineered California Code of Regulations-Title 19 Semi-Annual
Fire Extinguishing System Inspection,Testing,and Maintenance Report 2 OF 3
'cO C1
Property Information At.---- `—tp.r, Contractor or Licensed Owner Information
�a�` 9�:
Building Name &en Gj,,4 it ;,d40,.J -iy Name Squyres Fire Protection, Inc.
Address /97 ,r- 4 � -rF� °,:,Z� Job#
City l ,ei Lf!✓ ,yREfJ'P�`
Inspection;.'des€ . • a -fiance,-_..
I =Inspection T =Test M=Maintenance P=Pass F=Fail N/A=Not Applicable
Item NFFA 17A CA Description ed.Reference I iDae. Comments Only IP,F,I U4.
2.2 T 'Fuel Shut-off Operated Correctly 7.3.3.4 I itifil i .i+ F N/A
2.3 T 'Regulator Tested&is within Acceptable Limits 7.3.3.4 I I ,r IP F
2.4 T Manual Reset Relay Functioned Correctly
(if applicable) I 1 IP P F Nt
�,/
3.1 M IATest DatII Agent Containers within Acceptable Hydrostatic 7.5.1(1) I I P ' N/A
es
3.2 M �AII Auxiliary Pressure Containers and/or Hose 7 5 1(2)(3) I I ilef NIA
lAssemblies within Acceptable Hydrostatic Test Dates
3.3 M 'Cartridge Weights within Acceptable Limits 7.3.3.1(2) I I .iil NIA
3.4 M (Liquid Level within Acceptable Limits 7.3.3.1(2) I I IP F fVi
(Non-pressurized)
3.5 M INo(Non-pressurized)Signs of Corrosion in Agent Cylinder 7.3.3.1(2) I I IP F rile'
3.6 M (Distribution Piping Unobstructed and Contiguous 7.3.3.1(3) I I NIA
3.7 M 'Nozzles are Correct, Clean&Properly Aimed 7.3.3.1(2) I I NIP,
3.8 M 'Fixed Temp Fusible Metal Alloy Type Detectors Replaced 7.3.4 I I. N/A
'Fixed-Temp(other than fusible metal alloy type) I (/� I
3.9 M & Heat Detectors Maintained or Replaced 7.3.5 / P F Ili
(3.10 M Auxiliary Equipment Such as Water valves 7.3.3.1(2) P F Functioned Correctly II I I
3.11 M Iinternal Maintenance as Required by Manufacturer I Title 19§904.7 I 1 ifoi N/A
D=Deficiency C=Comment (Indicate type)
Date Riser D G -.
. -. 5 • `•.and.•, ;. lid>Wm/.aced
I
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Check here if additional Deficiencies and Comments are listed on Form AES9 Number attached:
See Correction Form AES 10 for corrected deficiencies. Number attached:
I 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 ' /,
Signature I Date 1/L5"Ac723
„ � SQUYRES Fire Protection, INC.
IN P.O.Box 3176 • Chico, California 95927 • Phone(530)345-1012 • Fax(530)345-1630
3 OF 3
HOOD SYSTEM MUST BE INSPECTED EVERY 6 MONTHS
/ "7/7
/1 • • __
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The fire suppression system(s)are installed in accordance with manufacturer's instructions, NFPA standards 96 and 17
(CURRENT ISSUE),chapter 20 UMC,article 10 UFC,and all applicable state and local codes. Note below and exceptions
above
REMARKS
Signature , �� Signature
Service Technician Customer
Date ��S/G 67 Signature
Fire Inspector
INVOICE 7 3 5 9
4 •
5QUYRE5 Fire Protection, INC. PO Box 3176 • Chico,California 95927
• Lie.No. 275206 Phone(530)345 1012 Fax(530)345-1630
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BILL TO:�� b n /
r /,J.I� / WORK DONE AT:
/q1 i / a- J-1 ,GJ I
gliNNUAL ❑NEW CUSTOMER ORDER NUMBER B YER'S NAME BUYER'S PHONE TERMS k MONTH DAY YEAR
❑ SEMIANNUAL ❑EMERGENCY 1/rli(� I/`.f OW- III fa/ I NET 10 DAYS I 2,r �az;
❑ QUARTERLY ❑OTHERUNIT EXTENDED EXTENDED
J��
DESCRIPTION QUANTITY PRICE NON-TAXABLE TAXABLE
: / ro° ls so
,17-041,sr` /cc, de" 4p<c/1 -mot
Iv�42i chi ce GG /
/ L,Ta e 5-:0D
yr • , G�/- 3 I it.0 0 .sya 6'
/16,A,, J ,ArA
de / I r o 0 �.r-a i4 JialL► I!/2- HwN//Iri.� ..‘,-,/,4-L ./ s� 11,�o`J Q-00
,.. .?wr/ A4.-C14 s.1 :, -s`" A-61.4 i / I ZJ 6.0 0 25'0.0 0
s, ' C -„„Ai— / I sro ss-a
/Vl // 4, T., �„ / I .sr o 6 ss o o
OW.- (�grlt/� g•0 d /6D•OQ
y44. / i t4x At.).,- / z.r L7 b 2 0v
- 419 1 A Z 1,ea bad
4k- �przl� 7 > 0 /ra `Tre
SUBTOTAL / 79j00 3g6,od
REMARKS: 0 LEFT PINK COPY 0 MAIL PINK COPY TAX IT2r % gy
C"
TOTAL /2 2j 2 ,gy
The Purchaser agrees:(1)That the title to each and every item of merchandise of this purchase shall remain in Squyres F.P. until full payment shown herein
above, including drayage and carriage (freight)and insurance has been made; (2)that if payment is not made as herein above stated full payment shall
become immediately due; (3)that if full payment be then not made on demand, Squyres F.P. may retake possession of each item of merchandise of this
purchase and the purchaser shall forfeit all rights thereto and interest therein; (4)that all money's therefor paid by the purchaser shall be retained by
Squyres as rental for use of said merchandise,and as liquidated damages;(5)that any collection fees necessary to enforce payment hereon shall be borne
by the purchaser;(6)that balances over 30 days old are subject to service charges of 1.5%per month(18%per annum);and(7)that purchaser acknowledges
receipt of copy and understands all of this agreement,including the fact that we exercise extreme caution,use only approved materials in servicing equipment
but assume no liability for malfunction.
SERVICEMAN DATE BY BUYER OR AUTHORIZED AGENT
-�-- 6,f'l/t I L RECEIVED IN GOOD ORDER AND ACCEPTED
LABOR HOURS r . X
PLEASE PAY FROM THIS INVOICE
ORIGINAL INVOICE