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HomeMy WebLinkAbout5 John Fitch Blvd - Life Safety System T DO NOT MOVE BY ORDER OF THE STATE FIRE MARSHAL y k Pre-Engineered System Inspection Report ALLSTAT UIPMENT Date of Service: :i Time: / -AM} PM New Engla ' Le er in Fire Protection �� 15 Robert Jackson Way Office(860)793-6900 Annual/Semi-Annual/Recharge./Newstem Renovation(circle one) Plainville,CT06062 Fax(860)793-6906 _ www.allstatefireinc.com _a VALID FOR 6 MONTHS FROM DATE OF SERVICE Customer/Location S stem Information Name: 5.,-/,f Jy J f f` Make: Address: :' ,r ;=,; r%, Model: City, ST,Zip: _ ,' <_,, - �� � ; � Size: f . Phone: Control Head: Owner/Manager: Location of system: Yes No N/A Yes.No N/A 1 Hazard unchanged since last inspection 0'"❑ ,❑ 13 Manual release proper and operable. [ ❑ ❑ 2 System interlocked with building fire alarm. :> 0/ ❑ 14 Microswitches installed QTY_,:!- -Tied-in QTY 3 All hazards properly covered w/correct nozzles. 0 ❑ ❑ 15 Gas valve connected to system(MECH./ELEC.) ❑ ❑ 0` 4 Hood/duct penetrations properly sealed. 0` ❑ ❑ 16 Piping/conduit securely bracketed. ❑ ❑ 5 Grease accumulation: excessive heavy normal 17 Piping obstruction test performed ® ❑ ❑ 6 Pressure gauge within acceptable range. 0" ❑ ❑ 18 Proper nozzle caps/covers in place. QTY. y. 0 ❑ ❑ 7 Cartridge weight within acceptable range. WT. © ❑ ❑ 19 Exhaust fan in operating condition. ❑ ❑ ❑ 8 Cylinder hydrotest due —, - ;,. :6-year maint.due 20 System operational&armed. ❑ ❑: 9 Cylinder properly mounted. 0 ❑ ❑ 21 Fan warning sign on hood. ❑ ❑ ❑ 10 Detection line proper and operable. ❑ ❑ ❑ 22 K-Class fire extinguisher in cooking area. ❑ 11 QTY Fusible Links/Thermal Detector Installed 23 Personnel instructed on manual operation of system. ❑ ❑ _2120 _2800 `3600 _4500 _5000 _other(_°) 24 Filters compliant with NFPA96 IT ❑ ❑ 12 Replaced fusible links-Mfg Date 0 ❑ ❑ 25 System meets U.L.300/1254 standards. 0' ❑ ❑ Hazard Protected: 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:_..- Date: a �:. Customer's Authorized Agent: .` Date: ` CT LIC.#F360042 MA-CR.1097 �" Customer Acknowledgement and UL-300 Safety Alert on reverse —Rev.111913 This report may be forwarded to the local authority having jurisdiction. �m NFPA® Z MEMBER - - -