HomeMy WebLinkAbout645 Sullivan Avenue - Life Safety System DO NOT REMOVE BY ORDER OF THE STATE FIRE MARSHAL
Pre-Engineered System Inspection Report
ALLSTAT UIPMENT
Date of Service:ef_� •� f � Time: /f- GNP PM
iin Pro ction
15 Robert Jackson Way Office(860)793-6900 Annual/Semi-Annual Recharge New System circ a one
Plainville,CT06062 Fax fireinc.com 6906
www.alistatefir VALID FOR 6 MONTHS FROM DATE OF SERVICE
www.alistatefireinc.com
Customer/Location S stem Information
Name: �`ff �1 �7 �17i1<! Make:
Address: Model: f���
-- i; Size: `
City, ST,Zip:
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Phone:
Control Head: ,-i .� .ems✓
Owner/Manager:,.. ,'� Location of system: 1
Yes No NIA Yes No NIA
1 Hazard unchanged since last inspection P 13 Manual release proper and operable. Y,
2 System interlocked with building fire alarm. ✓ 14 Microswitches installed QTY ""-'-Tied-in QTY
3 All appliances properly covered w/correct nozzles. �" 15 Gas valve connected to system(MECH:`/ELEC.) ✓
4 Duct(s)&plenum properly covered w/correct nozzles. 16 Piping/conduit securely bracketed.
5 Hood/duct penetrations properly sealed. 77 17 Proper nozzle caps/covers in place. QTY.
6 Grease accumulation: _excessive _heavy _Aormal 18 Exhaust fan in operating condition.
7 Pressure gauge within acceptable range. �` 19 System operational&armed.
8 Cartridge weight within acceptable range. WT. - ' " 20 Fan warning sign on hood.
9 Cylinder within hydrotest date. Due: "{ 21 K-Class fire extinguisher in cooking area.
10 Cylinder properly mounted. >` 22 Personnel instructed on manual operation of system.
11 Detection line proper and operable. t-' 23 Filters compliant with NFPA96 s/
12 Replaced fusible links. QTY -} Temp?_"° 24 System meets U.L.300 standards.
Hazard Protected(Hood, Ducts,Appliances)
A 40 4 i
Safety Notice:Non-compliant systems may fail to extinguish/supress a fire.Below are non compliant conditions which require immediate attention.All State Fire
Equipment assumes no responsibility for system performance if these conditions are not corrected and/or verified by an authorized agent of All State Fire
Equipment.
❑See Attached Proposal to Correct Deficiencies
Comments/Non-Compliance:
All State Fire Equipment Agent;. "<. f _fry/C Date: -�
`',-
Customer's Authorized Agent: Date:
CT LIC.#F30042 MA-CR.1097
rr'�l'r n UL-300 Safe Alert on reverse —Rev.06-19-09 $
NFPA® Customer Acknowledgement and Safety
MEMBER This report may be forwarded to the local authority having jurisdiction.