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HomeMy WebLinkAboutB20-1100 047-040-003 CF FA 2020 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 Date: 6/11/2020 Supplemental Pages Attached: No 1. PROPERTY INFORMATION Name ofpropen} Beberian Nut Huller Dryer Address: 8050 Wilson Landing Rd. Chico, CA. 95973 Description of property: Commercial Name of property representative: Address: Phone: Fax: E-mail: 2. INSTALLATION,SERVICE,TESTING,AND MONITORING INFORMATION Installation contractor: Foothill Fire Alarm &Security, Inc. Address: 170 Erma Ct. Chico, CA. 95928 Phone: 530.826.3013 Fax: 530.893.3013 E-mail. alarms@ffprotection.eom service organization: Foothill Fire Alarm&Security, Inc. Address: 170 Erma Ct. Chico, CA. 95928 Phone: 530.826.3013 Fax: 530.893.3013 E-mail, alarms@ffprotection.com Testing organization: Foothill Fire Alarm &Security, Inc. Address: 170 Erma Ct. Chico, CA. 95928 Phone: 530.826.3013 Fax: 530.893.3013 alarms@,ffprotection.com Effective date for test and inspection contract: Monitoring organization: Foothill Fire Alarm&Security, Inc. Address: 170 Erma Ct. Chico, CA. 95928 Phone: 530.826.3013 Fax: 530.893.3013 E-mail alarms@ffprotection.com Account number: Z570170 Phone line I: N/A Phone line 1: N/A Means of transmission: Cellular Entity to which alarms are retransmitted: Butte County Cal Fire Phone: 530-538-711 1 3. DOCUMENTATION On-site location of the required record documents and site-specific software: Document Box 4. DESCRIPTION OF SYSTEM OR SERVICE This is a: ®New system ❑Modification to existing system Permit number: NFPA 72 edition: 2016 4.1 Control Unit Manufacturer: POTTER Model number: AFC-50 4.2 Software and Firmware Firmware revision number: Unknown 43 Alarm Verification ®This system does not incorporate alarm verification. Number of devices subject to alarm verification: Alarm verification set for seconds Copyright©2012 National Fire Protection Association This form may be copied for mdrrdual use other Man for resale II may not be copied for commerc.al sale or distribution. SYSTEM RECORD OF COMPLETION(continued) 5. SYSTEM POWER 5.1 Control Unit 5.1.1 Primary Power Input voltage of control panel: 120VAC Control panel amps: 3 Overcurrent protection: Type: Circuit Breaker Amps: 20 Branch circuit disconnecting means location: Number 5.1.2 Secondary Power Type of secondary power: Batteries Location,if remote from the plant: N/A Calculated capacity of secondary power to drive the system: In standby mode(hours): 24 In alarm mode(minutes): 5 5.2 Control Unit IN This system does not have power extender panels El Power extender panels are listed on supplementary sheet A 6. CIRCUITS AND PATHWAYS Pathway Type Dual Media Pathway I Separate Pathway Class Survivability Level Signaling Line I X B 0 Device Power I X B I 0 Initiating Device I I X B 0 Notification Appliance I I X B 0 Other(specify): 7. REMOTE ANNUNCIATORS Type Location • NIA • • N/A 8. INITIATING DEVICES Addressable or Type Quantity Conventional Alarm or Supervisory Sensing Technology Manual Pull Stations 1 A A N/A Smoke Detectors 0 Duct Smoke Detectors 0 Heat Detectors 1 A A FIXED I RATE OF RISE Gas Detectors 0 Waterflow Switches 1 C A SWITCH Tamper Switches 3 C S SWITCH Copyright 0 2012 National Fire Protection Association_This form may be copied for rndMdlal use other than for resale.tt may not be copied for commercial sale or distribution. SYSTEM RECORD OF COMPLETION (continued) 9. NOTIFICATION APPLIANCES Type Quantity I Description Audible I Visible l Combination Audible and Visible 1 HORN STROBE 10. SYSTEM CONTROL FUNCTIONS Type Quantity Hold-Open Door Releasing Devices N/A HVAC Shutdown N/A Fire/Smoke Dampers N/A Door Unlocking N/A Elevator Recall N/A Elevator Shunt"Trip NIA 11. INTERCONNECTED SYSTEMS ■D This system does not have interconnected systems. ❑ Interconnected systems are listed on supplementary sheet 12. CERTIFICATION AND APPROVALS 12.1 System installation Contractor This system as specified herein has been installed according to all NFPA standards cited herein. Signed: Printed name: Shane DeValera Date: 6/11/2020 O rganization: Foothill Fire Protection Title: Manager Phone: 530.826.3013 12.2 System Operational Test This system as specified herein has tested according to all NFPA standards cited herein. Signed: Printed name: Shane DeValera Date: 6/11/2020 Organization: Foothill Fire Protection Title: Manager Phone: 530.826.3013 12.3 Acceptance Test Date and time of acceptance test: 6/11/2020 10 AM Installing contractor representative: Testing contractor representative: Property representative: . dtti1'1 or bectrt AH.1 representative: Copynghl 02012 National Fire Protection Association This form may be copied For individual use other than for resale.II may not be copied for commercial sale or distribution_ tt s ' (I? a fpo3L