23830 HWY 99 STE 100FIRE PREVENTION
CITY OF EDMONDS SAFETY SURVEY
121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 (425) 771-0215
FIRE DEPARTMENT
4S' t
FREQUENCY STATION 1, SHIF
LOCATION: 23830 Highway 99 100 7 20 C
BUSINESS NAME: Ledo Nails PHONE: 4257749999 SCHEDULED
DATE DUE 01 08/01/10
6 OFIR o� 557 8006
MAILING -23�30717 hwaj* 641
ADDRESS:
Edmonds 98026
BUSINESS OWNER: Nguyen, Nhan HOME PHONE: 20 65465149 ACTIVE
EMERGENCY-1: HOMVPHONE:
I
KEY ACCESS-2: H 0 M E P I ?O'N'i'E:
/A>.
INII IAL INSPECTION DATE
PERSON CONTACTED:
NAME,Q
f I N S7 CTO R:
FIRE FE4::�Z
SYSTEMS: '.r. ANNUAL
HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS
ENTER CODE ONLY ONCE I�
VIOLATION CODE
2
2
3
3
4
4
5
5
6
6
7
7
8
8
1st RE -INSPECTION
DATE DUE:
2nd RE -INSPECTION
D E DUE:
EXTENSION
GRANTED TO:
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED:
PERSON
CONTACTED:
PERSON
ONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE-
DATE:
3
VIOLATIONS
1 5
VIOLTTIONS
1 5
PRE-CITAT10N
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
7
RETURN RECEIPT
RECEIVED
6
7
4
4
8
DATE:
DISPOSITON:
8
� LETTER NEEDED 0 YES NO
LETTER NEEDED [] YES NO
FIRE DEPARTMENT COPY
471 '
AV AF"PlflE
RRE AND SAFETY SYSTEMS, INC
COMMERCIAL KITCHEN
CONFIDENCE TRIP TEST CERTIFICATION
WET CHEMICAL FIRE SUPPRESSION SYSTEM
Job Name:
Location:
System Size and Manufacturer: ?4da I A7(y/ M/
Hydrostatic Test Date: --- /r
Master Control Head Tested
Tandem Control Head Tested /V A,
Pneumatic Slave Heads Tested
Manual Pull Tested V
Electric Shutdown Tested— V
Make Up Air Shutdown Tested V
Gas Valve Tested
Link Detection Tested I /
6 Litre "K"Type Fire Extinguisher Installed V
2-1/2 Gallon "K"Type Fire.Extinguisher Installed /0
INSTRUCTIONS POSTED j_/
Witnessed By:
x z1Z-Awz _i�(IWWIK
Field Technician — Alpine Fire & Safety Systems
X
Inspection Officer —Title
X. .12
Date /
P.O. Box 265 -, Burlington,;Washington 98233 e (360) 755-5444