CLIN 01 VA -Grnd Junc CLC Kitchen Hood 2121 N Ave FAIL.pdf
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This is a Kitchen Hood Fire Inspection Report for the VA Medical Center (CLC Hood) located at 2121 North Ave, Grand Junction, CO 81501, conducted by Integrity Fire Safety Services on March 17, 2026. The inspection was performed by technicians JJ/CR under job number 42102653 for the Grand Junction Fire jurisdiction, with primary contact Tia Clemmer, Healthcare Engineer, at 970-852-7243.
The inspection covered a wet chemical ANSUL R-102 fire suppression system installed in 2010 with a 6-year hydro test due date that is past due and requires replacement. The system includes a 1½ gallon CO2 cylinder (2008 model year) and a 35½ oz cartridge. The hood configuration consists of a 40'x36" plenum, 8x8 duct size, and three nozzles (1N/Plenum/1W) at 42 inches height covering a 36"x24" appliance area with 260-degree coverage. All major system components passed inspection including fusible link testing, manual pull station activation, electrical shutdown operation, exhaust fan functionality, and filter replacement. However, two deficiencies were identified: a minor deficiency regarding the past-due hydro test on the CO2 tank, and a critical deficiency for a Class K kitchen fire extinguisher that is non-compliant and requires a 6-year hydro test. The system is otherwise fully functional and compliant with NFPA 96 2017 Edition standards. The semi-annual inspection interval applies, with monitoring services provided through account #2615QB via 1.800.631.2299.
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JURISDICTION GRAND JUNCTION FIRE
BUILDING/PROPERTY NAME VA MEDICAL CENTER (CLC HOOD)
STREET, CITY,STATE, ZIP CODE 2121 NORTH AVE GRAND JUNCTION CO 81501
KITCHEN HOOD FIRE INSPECTION REPORT
JOB NUMBER
PO NUMBER (IF ANY) NA
DATE PERFORMED 3/17/2026
INSPECTOR(S) INITIALS JJ/CR
42102653
TITLE HEALTHCARE ENGINEER TITLE
PHONE NUMBER 970-852-7243 PHONE NUMBER
TIA CLEMMER NAME NANAME
NFPA REFERENCES AND PROCEDURE
YOUR KITCHEN HOOD EXTINGUISHING SYSTEM(S) ARE REQUIRED TO BE THOROUGHLY INSPECTED, TESTED AND MAINTAINED EVERY 6 MONTHS BY AN APPROVED SERVICING
COMPANY IN ACCORDANCE WITH THE FOLLOWING NFPA CHAPTER REFERENCES:
NFPA 96 2017 EDITION
TESTING MUST INCLUDE CONTROL EQUIPMENT, INITIATING DEVICES, HVAC/ ELECTRICAL/GAS SHUTDOWN, LINKAGE REPLACEMENT (ANNUALLY) AND ALARM NOTIFICATION
APPLIANCES. SEE THE BELOW LIST OF VARIOUS TESTING DEVICES:
✓ VISUAL AND FUNCTIONAL TESTING OF THE INITIATING COMPONENTS.
✓ VISUAL INSPECTION TO VERIFY PROPER SUPPRESSION APPLICATION.
✓ VISUAL INSPECTION & VERIFICATION OF CYLINDER SERVICE DATES.
✓ REPLACEMENT OF COMPONENTS PER CODE REQUIREMENTS (SEMI-ANNUALLY).
✓ VISUAL AND FUNCTIONAL TESTING OF ALL SHUNT OPERATIONS AND SHUTDOWN.
✓ ALARM SIGNAL TRANSMISSION TO CENTRAL STATION VERIFICATION (IF APPLICABLE)
✓ VISUAL AND FUCNTIONAL VERIFICATION OF ALARM SIGNALS SENT TO THE FIRE ALARM PANEL.
✓ VISUAL INSPECTION OF PORTABLE EXTINGUISHER UNITS AND VERIFICATION OF PROPER CLASS RATING FOR APPLICATION.
MONITORING
PHONE NUMBER 1.800.631.2299
MONITORING
ACCOUNT NUMBER #2615QB
SITE CONTACT INFORMATION
PRIMARY CONTACT SECONDARY CONTACT
EMAIL TIA.CLEMMER@VA.GOV EMAIL
X
YES X NO
Y N N/A
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
X
YES YES YES
NOTE #:GREASE ACCUMULATION
TEMPCOUNT
VERIFIED OPERATIONS NOTE #:
LOW MODERATE EXCESSIVE
36" X 24"
DUCT SIZE NOZZLE TYPE 1N/PLENUM/1W DUCT8 X 8
DIMESIONS
NOZZLE #
NOZZLE HEIGHT
FLAT TOP
42"INCH
40'X36"
PROPER HAND HELD PORTABLE EXTINGUISHER(S)
PROPERLY SERVICED? (CLASS K IN KITCHEN?)
3 TOTAL
SYSTEM DIMENSIONS
PLENUM SIZE
ALARM ELEC./LIGHTS APPLIANCES
360°
APPLIANCE
NOZZLE #
NOTE #
EACH HAZARD PROPERLY COVERED WITH CORRECT NOZZLES
K
ITC
H
EN
H O
O D
FIR
E IN
SP
EC
TIO
N
R
EP
O R
T
INTERNAL INSPECTION & CHEMICAL WEIGHT VERIFIED (ANSUL)
ACTUATION HOSE INSPECTED FOR DAMAGE
VERIFIED EXHAUST FAN IS OPERATIONAL
VERIFIED MAKE-UP AIR IS OPERATION (PAINT BOOTH)
ELECTRIC SHUTDOWN OPERATIONAL
INSPECTION & SERVICE TAG ON SYSTEM CYLINDER/MANUAL PULL
SYSTEM RESET TO NORMAL OPERATION
NO DEFICIENCES WITH OPERATION OR COVERAGE
PROPER OPERATION OF WORKING GAS VALVE(S)
FAN WARNING SIGN ON HOOD
ALL FILTERS ARE REPLACED
ALL NOZZLE CAPS/SEALS ARE REPLACED & CLEAR OF BLOCKAGE
CHECKED PRESSURE GAUGE INDICATOR FOR OPERABLE RANCE
MANUAL PULL STATION OPERATION & SUCESSFULLY ACTIVATED SYSTEM
CONFIRMED ALL CONDUIT & PIPING IS SECURED
PROPER BLOWN DOWN PERFORMED
INSPECTION INTERVAL
ANNUAL SEMI-ANNUAL
SYSTEM INFORMATION
SYSTEM TYPE WET CHEMICAL CARTRIDGE DATE 2010
H O
O D
C H
EC
K
LIST A
N
D
IN
FO
R
M A
TIO
N
BUILDING NAME VA MEDICAL CENTER (CLC HOOD) DATE 3/17/2026 TECH(S) JJ/CR JOB #
SYSTEM SHOWS NO VISIBLE SIGNS THAT IT HAS FIRED OR BEEN TAMPERED WITH
SYSTEM DESIGN HAS NOT BEEN CHANGED
FUSIBLE LINK TESTED & SYSTEM ACTIVATED UPON TEST
TEST DATE/LAST HYDRO
SYSTEM IS COMPLIANT
42102653
MANUFACTURER
ELECTRICAL SHUNT LOCATION ROOM 147 / ELECTRICAL PANEL
REPLACE FUSIBLE LINKS ( SEMI-ANNUAL INSPECTION)
DATE:LINEAR ACTUATOR MANUFACTURER DATE:
DATE:DATES ON MODULAR BATTERY
ANSUL CARTRIDGE WEIGHT 35 1/2 OZ
MODEL ANSUL R-102 6 YR/HYDRO DUE DATE PAST DUE/NEEDS NEW CARTRIDGE
PAST DUE / 1 1/2 GAL. CYLINDER 2008 YR U.L. 300 COMPLIANT
HOOD INSPECTION CHECKLIST
QUESTION
Integral to your Safety. Because it Matters.
303.557.1820 www.integrityfiresafetyservices.com
1.
2.
1.
D
EFIC
IEN
C
IES A
N
D O
B
SER
V A
TIO
N
S
SEVERITY
JJ/CR JOB # 42102653
Minor
Critical
DEFICIENCY LIST & PROPOSED SOLUTIONS MAKE/MODEL
HYDRO PAST DUE ON CO2 TANK
CLC KITCHEN FIRE EXTINGUISHER NOT COMPLAINT( 6YR. HYDRO TEST NEEDED ) K/CLASS 6LT
BUILDING NAME VA MEDICAL CENTER (CLC HOOD) DATE 3/17/2026 TECH(S)
K
ITC
H
EN
H O
O D
FIR
E IN
SP
EC
TIO
N
R
EP
O R
T
GENERAL NOTES & SITE OBSERVATIONS SEVERITY
ANSUL HOOD SYSTEM IS FULLY FUNCTIONAL BLANK
Listed above are any General Notes to report. This section also contains any issues that were found during inspections and either require a substantial investment to correct
(permits, engineering, etc.) than the above-listed deficiencies, or may have been previously approved in its as-is condition by the Authority Having Jurisdiction. Please contact our office if you would like information, consultation, or services for any items contained therein.
Integral to your Safety. Because it Matters.
303.557.1820 www.integrityfiresafetyservices.com
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