TE-11-8_KITCHEN HOOD SYSTEM ANNUAL INSPECTION.pdf

63rd Readiness Division Fire Protection Systems

Kitchen Hood System Annual Inspection

FACID

Building Number

Date of Inspection

System Manufacturer Date Installed

Type of extinguishing agent

Equipment Protected:

(check all that apply)

Complete the remainder of this page once inspection is complete.

IV. Annual Kitchen Hood System Inspection Summary:

Y N

Kitchen Hood System considered acceptable based on inspection and performance tests Form is attached listing the deficiencies and corrections needed

Comments:

Potassium carbonate Potassium acetate

Combination potassium carbonate/potassium acetate

Deep fat fryer(s) Upright broiler(s)

Griddle(s) Grill(s) Range Top Other

63rd Readiness Division Kitchen Hood System Inspection

I. Inspection Tasks:

Wet chemical cylinder Normal pressure: psi Manufacturer’s minimum pressure: psi Normal weight: lbs Manufacturer’s minimum weight: lbs

Y N/A N

Connected to fire alarm system?

Automatic shutdown of cooking equipment?

If yes, is it Gas or Electric?

Nozzle caps are in place.

System components have no obvious physical damage.

Nozzles aim at cooking surfaces they protect.

Manual actuators are not obstructed.

Tamper indicators and seals are intact.

Maintenance tag or certificate is in place.

Pressure gauges are in operable range.

Expellant Gas Cartridge (if applicable) Pressure of nitrogen: psi Weight of carbon dioxide: lbs Fusible Link(s) (if applicable) Number of Fusible Links Temperature of Fusible Link(s) Deg F

II. Maintenance & Testing:

Y N/A N

Actuating Test:

Actuating test conducted Actuating test results satisfactory Cooking equipment shutdown satisfactory Fire Alarm activated Grease Fan continues to activate Fusible Link Replaced Hydrostatic Testing:

Date of Last Hydrostatic Test Last Hydrostatic Test (or installed) within 12 years

III. Completion:

Wet system restored and left in service Date Time

Inspector Name

Inspector Signature

Witness Name

Witness Signature