HomeMy WebLinkAboutFAI CF Hood Suppression 6 2024 Roseleaf Wet Chemical Pre-Engineered California Code of Regulations -Title 19 Semi-Annual 1 of 2
Fire Extinguishing System Inspection,Testing,and Maintenance Report
Property Information ;,��OF C4��p�\F Contractor or Licensed Owner Information
!Building Name Roseleaf Oroville r 1 la i Name Foothill Fire Protection, Inc.
(Address 1900 20th Street +f�j �i`� Address 170 Erma Court
‘,1. F P`=— City Chico St. CA Zip 95928
(City Oroville !License# 783132 !Phone (530)826-3013
(Contact Person Diana Bingham I ❑■ SFM E-2555 IJob# 34838185
Phone(530)444-8511 I ❑ CSLB 'Misc.
•ystem Information
Cylinder Size 3 gal Last Hydrostatic Test Date 2013 Flow Points Capacity Used 8/11
(System Location Wall mt behind hood System Mfr. Ansul Model# R-102
IFuel/Heat Shut Off: Gas
!Gas# 1" Electrical# Yes Integral Make Up Air Shut Down Yes
Items #of Items Dimensions Nozzle Nozzle Nozzle Total
Model# Flow Points Qty Flow Points
Hoods 1 9' 1 F 1 5 5
(Plenums II 1 I 9' I 1 N I 1 I 1 I 1
(Ducts II 1 I 10x14" I 2W I 2 I 1 I 2
Cooking Appliances
Left to Right with Sizes and Coverage Nozzles
Appliance Name Nozzle Nozzle Total Appliance Name Nozzle Nozzle Total
Model Flow Points Flow Points Model Flow Points Flow Points
10 burner range 1 F 1 5 I
II II I
I I I I I I II II I I
I I I I II I I I I
Fixed Temperature Sensing Elements
(such as Fusible Links)
Quantity Temp Mfr Install Quantity Temp Mfr Install
Date Date Date Date
3 450 2/6/24 6/6/24 I I I 2/6/24 6/6/24
I I I II I I I
Inspection, Testing and Maintenance
I = Inspection T =Test M=Maintenance P=Pass F=Fail N/A =Not Applicable
Item Description NFPA CA Date Comments Only P,F,N/A
ed.Referfer CA
1.1 I Manual Actuators are Unobstructed 7 2 2(2) P
(i.e. remote pull station)
1.2 I (Tamper Indicators&Seals Intact 7.2.2(3) I I IP
7.2.2(4)
1.3 I Maintenance Tag in Place Title 19 906� P
1.4 I INo Obvious Physical Damage 7.2.2(5) I I IP
1.5 I (Ga(Storeduge Readingspressure)within Proper Limits ! 7.2.2(6) I I IN/A
1.6 I IBlow-off Caps in Place&Undamaged 7.2.2(7) I IP
1.7 I (Hoods, Ducts, Filters in Place and Clean CFC 904.11.6.3 I IP
1.8 I IHoodNot , DuctsBeenReplaced&Protected CookingModifiedorRelocated Appliances Have ! 7.2.2(8) I I IP
,
2 1 T !Automatic Detection/Manual Actuation Functioned ! 7.3.3.4 I I !P
Correctly
Form AES 20 Sept.3,2013
Wet Chemical Pre-Engineered California Code of Regulations -Title 19 Semi-Annual 2 of 2
Fire Extinguishing System Inspection,Testing,and Maintenance Report
OF C fit4Nt
Property Information :�� 'gyp tF Contractor or Licensed Owner Information
loof
(Building Name Roseleaf Oroville I Name Foothill Fire Protection, Inc.
(Address 1900 20th Street � Job# 34838185
\,?
(City Oroville �,
E Mi'' —.
Inspection, Testing and Maintenance
= Inspection T =Test M=Maintenance P=Pass F=Fail N/A =Not Applicable
Item Description NFPA CA Date Comments Only P,F,N/A
ed.Referfer CA
2.2 T Fuel Shut-off Operated Correctly 7.3.3.4 P
2.3 T Regulator Tested&is within Acceptable Limits 7.3.3.4 P
2 4 T Manual Reset Relay Functioned Correctly 7.3.3.4 P
(if applicable)
3.1 M All Agent Containers within Acceptable Hydrostatic 7.5.1(1) P
Test Dates
3 2 M All Auxiliary Pressure Containers and/or Hose 7.5.1(2)(3) P
Assemblies within Acceptable Hydrostatic Test Dates
3.3 M Cartridge Weights within Acceptable Limits 7.3.3.1(2) P
3.4 M Liquid Level within Acceptable Limits 7.3.3.1(2) P
(Non-pressurized)
3.5 M No Signs of Corrosion in Agent Cylinder 7.3.3.1(2) P
(Non-pressurized)
3.6 M Distribution Piping Unobstructed and Contiguous 7.3.3.1(3) P
3.7 M Nozzles are Correct, Clean&Properly Aimed 7.3.3.1(2) P
3.8 M Fixed Temp Fusible Metal Alloy Type Detectors Replaced 7.3.4 P
3.9 M Fixed-Temp(other than fusible metal alloy type) 7,3.5 N/A
&Heat Detectors Maintained or Replaced
3.10 M Auxiliary Equipment Such as Water valves 7.3.3.1(2) N/A
Functioned Correctly
3.11 M Internal Maintenance as Required by Manufacturer Title 19§904.7 N/A
D=Deficiency C=Comment (Indicate type)
item RC 1=11 Deficiencies and Comments
Indicate all equipment,devices and parts that were repaired or replaced
I
I II J Tank will be due for hydro in 2025
FII7 ((PASS)
II
II
I
❑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 (Morgan Olson
Signature I Date 6/6/24
Form AES 20 Sept.3,2013