HomeMy WebLinkAbout466 Evergreen Way - Life Safety System T (3) DO NOT REMOVE BY ORDER OF THE STATE FIRE MARSHAL
Pre-Engineered System Inspection Report
ALLSTAT UIPMENT Date of Service: Time: �.`� AM GPM
New Engla ' Le` er in Fire Protection
13 Robert Jackson Way Office(8 0)793-6900 Annual 1 Semi Annual Re haFgP I Renevatien(eirele one)
Plainville,CT 06062 Fax(860)793-6906
www.allstatefireinc.com VALID FOR 6 MONTHS FROM DATE OF SERVICE
Customer/Location System Information
Name: r` l r SZ' i / Make: dAlslLI
Address: Model: A
City, ST, Zip: E. i; ;F;rim f'�"" Size:
Phone: Control Head:
Owner/Manager: Location of system:
Yes No N/A
Yes No N/A
1 Hazard unchanged since last inspection . 13 Manual release proper and operable.
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,(MEC}./ELEC.)
4 Duct(s)&plenum properly covered w/correct nozzles. 16 Piping/conduit securely bracketed. , L
5 Hood/duct penetrations properly sealed. 17 Proper nozzle caps/covers in place. QTY. 4-
6 Grease accumulation: _excessive _heavy yTi5imal 18 Exhaust fan in operating condition. v'
7 Pressure gauge within acceptable range. 19 System operational&armed. f
8 Cartridge weight within acceptable range. WT Z� V1.1 20 Fan warning sign on hood.
9 Cylinder within hydrotest date. Due: .1r ; 21 K-Class fire extinguisher in cooking area.
10 Cylinder properly mounted. ✓ 22 Personnel instructed on manual operation of system. c
11 Detection line proper and operable. 23 Filters compliant with NFPA96
12 Replaced fusible links. QTY j Temo%-_ OL I 1 24 System meets U.L.300 standards.
Hazard Protected(Hood, Ducts,Appliances): ' /<
/ b
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: i, Date: "
7`�, -
Customer's Authorized Agent: Date:
OF
�f CT LIC.#F30042 MA-CR.1097
IW4Fm
Customer cknowledgement and UL-300 Safety Alert on reverse -Rev.06-19-09
NFPA®
MEMBER This report may be forwarded to the local authority having jurisdiction.
DO NOT REMOVE BY ORDER OF THE STATE FIRE MARSHAL
Pre-Engineered System Inspection Report
A'.'.STAT UIPMENT Date of Service: 4 Time: ' AM L
New Engla ' Le` er in Fire Protection
Plainville,CT06062 Fax(860)793-6906
www.allstatefireinc.com VALID FOR 6 MONTHS FROM DATE OF SERVICE
Customer/Location S stem Information
Name:__ �'�J� i r� f r.�!� Make: A/)-1--1
Address: /� t-y,.•'s-�,:rt r.��, Z:d i , /lam_ Model: /t✓%� a
Ci ST Zi � G,l �1f(11tG
-T Size:
ty, , p: / S
Phone: Control Head: -f'''� ' e`• X"
Owner/Manager: Location of system:
Yes No N/A Yes No N/A
1 Hazard unchanged since last inspection 13 Manual release proper and operable.
2 System interlocked with building fire alarm. 14 Microswitches installed QTY -Tied-in QTY c�
3 All appliances properly covered w/correct nozzles. 15 Gas valve connected to system(MECF.;/ELEC.)
4 Duct(s)&plenum properly covered w/correct nozzles. 16 Piping/conduit securely bracketed.-
5 Hood/duct penetrations properly sealed. r- 17 Proper nozzle caps/covers in place. QTY.
6 Grease accumulation: _excessive _heavy �rmal 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: �2 Oj L. 21 K-Class fire extinguisher in cooking area.
10 Cylinder properly mounted. v 22 Personnel instructed on manual operation of system.
11 Detection line proper and operable. tr 23 Filters compliant with Nf PA96 .
12 Replaced fusible links. QTY Temp`�JG° 24 System meets U.L.300 standards.
Hazard Protected (Hood, Ducts,Appliances):
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.
l ❑See Attached Proposal to Corretrt. eficie s
Comments!Non-Com,pllanc `` '
i
All State Fire Equipment Agent` _ Date:
' Customer's Authorized Agent: Date:
Jj CT LIC.#F30042 MA-CR.1097
5 NFPA® Customer Acknowledgement and UL-300 Safety Alert on reverse —Rev.06-19-09
MEMBER This report may be forwarded to the local authority having jurisdiction.