HomeMy WebLinkAbout072-180-006 CF FES 11-21-23 Bidwell Marina Wet Chemical Pre-Engineered California Code of Regulations-Title 19 Semi-Annual 1 of 2
Fire Extinguishing System Inspection,Testing,anti Maintenance Report .
Property information A`r��O CAS/�pp,� Contractor or Licensed Owner Information
'Building Name"'ej;th,3 k Ate, -I Name Wilgus Fire Control Inc.
'Address O ( ''B)( t eat CA.A.Ue vv. Yi Address 4544 Mountain Lakes Blvd.
lNE M; City Redding St. CA Zip 96003
(City eel R-8U i t4-- _.._�
{� (License# 462979 (Phone 530-241-2465
'Contact Person 60,4,44 --- 4 I ❑ SFM 'Job# '3(p (y rj
Phone 6-3 a - 31 o _ 3 i L 6 I Qj CSLB 'Misc.
a
System Information � � � �=-
ylinder Size ,. S a&IUD-A. Last Hydrostatic Test Date 'Z LS t 4 Flow Points Capacity Used t 19
I
-
(System Location (�a.'It System Mfr.Pu(1�.e.� ,�,-
.. Model# P� so
Fuel/Heat Shut Off:
Electrical# /' Integral Make
(Gas# Up Air Shut Down „--''
�.:. ,-..� . s(.v-ir• ..:i »..,ra>xibl�,...c � t- 1, Total
. t ,1. `# I!Iiii 1 ;t it'4 -lei r f l!:f !• ii.1Ytt`"t , t �lyar •
Flow Points
(Hoods I 1. I .' ic..r 4 �
'Plenums I I 11 I I - 4-k. I t I t. I k..__._____._..._
'Ducts I t 1 t to." X t 4't I z- b I 2, I t I "7-.
Cooking Appliances
Left to Right with Sizes and Coverage Nozzles
is {y f r l� 7�w .. r it 4,.i,. lsi ii ,y £} }a}prlFNozzle Total
., ,.. :. .•.�['C.i 1 .m i�,i!(-ttl � -r1,L-��... .t+it°.a4'1l ow points Flow Points
I a.0 - tvkt8 1 2.t4. I 2.. I 2, 1 I I
6 e-14t4- 34.t x24
I t-14 14 I •3 I I I I __
I I I II I I
I I I II I 1 I
Fixed Temperature Sensing Elements
(Such as Fusible Links)
W( 1 r -- :'r ca �,•r �' , , :c. ., ih, .r: ' i� -3- 1, Install
$ h K
� � �11 r� r . t �,+�Sh�a �� ��tr1 a • ����� Dale
�- I '6c 1 t!- _ -Z31 I I I
Inspection,Testing, and Maintenance
I =Inspection T =Test M=MairiPw ance P=Pass F=Fail N/A=Not Applicable
ilthit I '` ': - iiti t t+p-lir:Itr lAr . ..' } .1 Dl V s ,!'4 axr>;t' r ot,iy ( P,F,N1A
1.1 I
Manual Actuators are Unobstructed 7 2.2(2)
I (i.e.Remote Pull Station) ~ '� I
1.2 I (Tamper Indicators&Seals Intact l 7.2.2(3) l I I P
1.3 I 'Maintenance Tag in Place I 7.2.2(4) ITitle 19 ii906 I 1 P
1.4 I No Obvious Physical Damage + 7.2.2(5) ,
1 5 I (Gauge Readings within Proper Limits I 7.2.2(6)
(Stored Pressure)
1.6 I 'Blow-Off Caps in Place&Undamaged I 7.2.2(7) I I I Lam_
1.7 ( I (Hoods,Ducts,Filters in Place and Clean I CFC 904.11.6.3 I I I
1 8 t 1 IHaod,Ducts&Protected Cooking Appliances Nave I 7 2 2(t3)
Not Been Replaced,Modified or Relocated
2.1 T �Autamaticorrectt Detection/Manual Actuation Functioned 7.3.3.4
y t.
/
Cr....ACC 9n f ca... 1 1(111.
Wet Chemical Pre-Engineered California Code of Regulations-Title 19 Semi-Annual 2 of 2
Fire Extinguishing System Inspection,Testing,and Maintenance Report
Property Information �Qt F Catr�9� Contractor or Licensed Owner Information
co . z
'Building Name"`"ri ;,LA1 o �'
l nf�`lo.tt-'t,tip 1.1 C' Name Wilgus Fire Control Inc.
(Address D Z {c()3 .tk. c,/ ilev,1tz- ..&`....._--
I �". '' Q., Job# 3 4 9 �+
City t R-'E V C t\ Lr. ltl MP'�'
E � inspection, Testing,and Maintenance
1 =Inspection T =Test M=Maintenance P=Pass F=Fail N/A=Not Applicable
1, `xs l
item `�-r ° "e,e ''� 1 t" al P, ,NIA
2.2 T Fuel Shut-Off Operated Correctlyr _= ��� („ = ��.
p 7.3.3.4 .23 tAA
2.3 T ,Regulator Tested&is within Acceptable Limits 7.3.3.4 I a I ItA I
2.4 T Manual Reset Relay Functioned Correctly 7.3.3.4 1
I (If Applicable)
I I I I
3,1 M 'All Agent Containers within Acceptable Hydrostatic I 7 5 1(1) I {J I I
Test Dates
3.2 M All Auxiliary Pressure Containers and/or Hose I 7.5.1(2)(3) ( I I I1,
Assemblies within Acceptable Hydrostatic Test Dales fk
3.3 M 'Cartridge Weights within Acceptable Limits 7.3.3.1(2) I I I I P
3.4 M 'Liquid Level within Acceptable Limits 7.3.3.1(2)
(Non-pressurized) I I (( I �I
3.5 M INo Signs of Corrosion in Agent Cylinder 7.3.3.1(2) I I (
(Non-pressurized)
3.6 M 'Distribution Piping Unobstructed and Contiguous J 7.3.3.1(3) i I I I P
3.7 M Nozzles are Correct,Clean& Properly Aimed J 7.3.3.1(2) I II
I P
3.8 M Fixed Temp Fusible Metal Alloy Type Detectors Replaced 7.3.4 I I I I p
3 9 M Fixed-Temp(Other Than Fusible Metal Alloy Type)& 7 3 5 10tft
Heat Detectors Maintained or Replaced
3.10 M 'Auxiliary Equipment Such as Water valves ' 7.3.3.1(2) I I i Inc
Functioned Correctly
3.11 M 'Internal Maintenance as Required by Manufacturer i Title 19§904.7 I '-.47. i It'4Pr
D=Deficienc C=Comment indicate 'a
Item _ Date Riser D C Deficiencies and Comments .
.,,,:_,.. $i.,.....;"___t r. ,_ indicate all equipment,devices add parts that y.era repaired CrreplaeelI
i I
II
LI Check here if additional Deficiencies and Comments are listed on Form AES 9. Number attached:
i=l 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 I 1 k'N e-U ---
Signature }• ""
g I"C - k. ---• Date i t'11"e3