3 APPX C 2019 Sample of Inspection Checklist 1 May 2020.pdf

INSPECTION CHECKLIST PAGE 1 OF 1 PAGES

TITLE/SUBJECT/ACTIVITY/FUNCTIONAL AREA

Hood and Duct Cleaning (To be completed by a Fire Inspector I or higher)

OPR

CEF

DATE

May 2020

NO ITEM

(Assign a paragraph number to each item. Draw a horizontal line between each major paragraph.)

YES NO N/A

1 LOWER DUCT SYSTEM - looking up

2 UPPER DUCT SYSTEM - looking down from roof opening

3 SPECIFIC AREAS OF CONCERNS:

a. Look up and down from access points

b. Was duct cleaned to bare metal?

c. Are fans and fan housings free of grease?

d. Are motors free of grease?

e. Are filters/grease traps free of grease?

f. Did employees wipe down hoods so they are free of dust and grease?

g. Are suppression system piping and fusible links free of grease?

h. Did contractor clean grease residue from extractor duct lining and exterior walls/roof?

i. Are fire suppression nozzles pointed directly at cooking surface?

j. Are manual pull stations for each hood secure?

k. Are fire suppression bottles in the "set" position?

Inspection conducted IAW NFPA 96, Ventilation Control and Fire Protection of Commercial Cooking Operations - 2017 edition or later edition.

Building Number Hood I.D. # Frequency

Establishment Name

Inspector (Rank/Name) (Signature)

REMARKS

Contractor Signature

Notes:

1. One checklist is required per hood.

2. Upon notification of a hood and duct inspection the Fire Inspector or Facility Manager has a 20 minute window to conduct an inspection.

Aviano AB, Italy – In house generated form.