316 MAIN STBrough, Paul
From: Brough, Paul
Sent: Tuesday, September 26, 2017 9:06 AM
To: 'Brooke Baker'
Subject: RE: Hood Canopy Compliance
Hello Randy, once the work is complete could you please reach out to me so I can come and inspect your project? Also I
just wanted to make sure that once it is complete and all your appliances are in place and that your cook Hector agrees
then we can address the positioning of the sprinkler heads.
Once again I just want to make sure that we cover all the bases. Thank your Randy and Brooke
I look forward to talking with you soon. Have a great day.
PAUL DAVID BROUGH 1315
INTERIM DEPUTY FIRE MARSHAL
SCFD1/CITY OF EDMONDS
DESK 425-775-7720
DIRECT 425-551-1984
PBROUGH(&FIREDISTRICTI.ORG
From: bbandrb@qmail.com [mailto:bbandrb@qmail.coml On Behalf Of Brooke Baker
Sent: Wednesday, September 20, 2017 3:37 PM
To: Brough, Paul
Subject: Hood Canopy Compliance
Your attachments have been security checked by Mimecast Attachment Protection. Files where no threat or malware was detected are
attached.
Sir,
Thank you for your patience in allowing us to find a solution to our hood canopy issue.
My understanding of the problem is that we have open ends on both sides of our cooking line, which would
make it more difficult to extinguish accidental fires on the cooking line.
My proposal is to install stainless steel partitions on each end of the cooking line, thereby closing off both "open
sides". I have spoken to a representative of Northwest Sheet metal and these partitions can be manufactured
quickly and at a reasonable cost. With this installation no equipment changes are necessary and the cooking
line will meet your requirements. Please reference my drawings on the attachment below which illustrate my
proposed solution.
If this seems to you to be an acceptable solution, please let me know and I will begin a.s.a.p.
Thank you,
Randy Baker
Chanterelle
425.774.0650
PL-PLff-L
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Brough, Paul
From: Brough, Paul
Sent: Tuesday, September 26, 2017 8:35 AM
To: 'Brooke Baker'
Subject: RE: Hood Canopy Compliance
Hello Randy, I took a look at your proposal. Personally I think this is a great way to keep everything contained yet help
keep the cost down while keeping your operation operable. The proposal should collect and contain all the grease latent
vapors and gases and direct them into the exhaust system.
I brought the drawing down to a building engineer to get his thoughts and also put a second set of eyes on it. He feels
just as comfortable with this compromise as I do. We also discussed the process. We do not believe that you would need
a permit for this. Randy if you could, please move forward with this project if you will. I want to thank you for your
cooperation and great proposal. Thank You Very Much.
PAUL DAVID BROUGH 1315
INTERIM DEPUTY FIRE MARSHAL
SCFDI/CITY OF EDMONDS
DESK 425-775-7720
DIRECT 425-551-1984
PBROUGH(a)FIREDISTRICT1.ORG
56
From: bbandrbOgmail.com [mailto:bbandrbOgmail.coml On Behalf Of Brooke Baker
Sent: Wednesday, September 20, 2017 3:37 PM
To: Brough, Paul
Subject: Hood Canopy Compliance
Your attachments have been security checked by Mimecast Attachment Protection. Files where no threat or malware was detected are
attached.
Sir,
Thank you for your patience in allowing us to find a solution to our hood canopy issue.
My understanding of the problem' is that we have open ends on both sides of our cooking line, which would
make it more difficult to extinguish accidental fires on the,cooking line.
My proposal is to install stainless steel partitions on each end of the cooking line, thereby closing off both "open
sides". I have spoken to a representative of Northwest Sheet metal and these partitions can be manufactured
quickly and at a reasonable cost. With this installation no equipment changes are necessary and the cooking
line will meet your requirements. Please reference my drawings on the attachment below which illustrate my
proposed solution.
If this seems to you to be an acceptable solution, please let me know and I will begin a.s.a.p.
Thank you,
Randy Baker
FIRE PREVENTION-
SN&HOAdISH CO. Serving BrierEdrnonds, and
12425 Meridian Ave S
INSPECTION REPORT
F1 Mountlake Terrace
Everett, WA 98208 -
0 EDMONDS
D BRIER
DIST T
Phone (425) 551-1200
0 MOUNTLAKE TERRACE
0 UNINCORPORATED
www.FireDistric tiorg
Fax (425) 551-1272
FRECILIENCY
STATION& SHIFT
LOCATION:
316 Main Street 98020
Annual
17-C
BUSINESS NAME: Chanterelle's
PHONE: 4257740650
SCHEDULED
DATE DUE � Jan 2016
MAILING
LIFIR 0 161 202
ADDRESS:
316 Main Street, Edmonds, WA,�'9802,0.,'.
BUSINESS OWNER: Baker, Randy & Brooke
HOME PHONE,
(0 0 0 1
EMERGENCY-1:
HOME PHONE:
"CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY YES NO
EMAIL:
BUSINESS
LICENSE
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE SYSTEMS: FF -fl/14 iAt-innt1/1A
ate Last Serviced:
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
'j
2
2
3
... . .........................
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
1st RE -INSPECTION
2nd RE -INSPECTION
EXTENSION
FINAL RE -INSPECTION
VIOLATIONS
DATE DUE:
DATE . DUE:
GRANTEDTO:
DATE DUE:
CITED:
PERSON
PERSON
PERSON
CONTACTED:
CONTACTED:
CONTACTED:
1
IN,SPECTOR:
INSPECTOR:
DATE:--
2
DATE:
�DATE:
3
VIOLATIONS
VIOLATIONS,-,
PRE -CITATION
CITATION ISSUED
LETE�� SENI_.��IAE�
R
4
5
CODE
2
6
2 6
DATE:
SECTION:
RETURN RECEIPT
z
3
7
3
7
RECEIVED
6
DISPOSITION:
4
8
4
DATE:
7
LETTER NEEDED [] YES NO
.8
LETTERNEEDED [] YES 0 NO
-1
R
&THood and Duct Services, Inc.
6100 12th Ave. S. Phone (206) 726-0940
Seattle,WA 98108 Fax (206) 767-2607
Occupancy Namei_
Occupancy Address:
Responsible Person:
Building Owner:
Building Owner Address:
Testers Name (Please Print): 3., YQMI.-kt�
System Alarm? Yes E] No E]
Control Panel manufacturer: —
Extinguishing System Manufacturer
Location / Height of Range hood:
COMPLETE Certification Given: REDO YELLOWM WHITE07
FIRE PROTECTION CONFIDENCE TESTING RANGEHOOD
High Pressure Hood Cleaning SYSTEM T��T REPORT
Fire Suppression Installation & Service ri�ENCE TEST Rr REPAIRS
Fire Extinguisher Sales & Service
Range Hood and Fan Service & Repair
Filter Sales & Service DATE: 26 / (Co
City, State, Zip:
Central station monitoring? Yes Ej
— Model Number:—
L) System Size
Phone Numbed
Phone Number:
City, State, Zip:
SFD Certification Number:
scpa(Aq,�
No Monitoring company name:
Location of Alarm Panel:
I.I.L. 300 System? Yes dNo F] LI.L. 300 Compliant? Yes E] No Ee, Chemical Type: Wet g&y F-1
Is pressure gauge indicator in operable range?
Yes E/JA EJ
Is there chemical inside of the cylinder?
Yes .1 No E]
Weigh CO2 or nitrogen cartridge. NA E]
No visible signs of a system fire or system tampering (if signs check no).
�ef No
Check all piping and conduit. Are all piping and conduit immobilized with
Yes � No El
j
proper hangers and brackets?
Are all protective covers present on nozzles?
Yes 12( No E]
Are all nozzles checked in the proper position?
Yes V No
Does system have adequate volume and/or nozzle coverage?
Yes F� No
Are all appliances inside of the hood protection area?
Yes No
Have fuse links been replaced?
Yes No
Was system operational from terminal link?
Yes Nom
Was system operational from manual remote?
Yes No Ej
Was system and micro switch operational? NA[]
Is free from
Yes E] NoFv,/
Yes NoM
system visible and obstruction?
Is the inspection and service tag on the cylinder?
Yes [Z NoM
12 year hydro date of cylinder. %_., ,.�
Were hand portable extinguishers properly serviced? NA E] Yes [t,3" Non
Were all cooking surfaces protected? If not, give owner full Yes Ey No[]
information.
Was operating procedure verbally given to restaurant personnel? Yes 1:;,K No L)
Was UL 300 compliance explained to owner or manager? Yes lir No E]
Gas shuts down upon system activation? NA Ej Yes Z] No F-1
Electric power shuts down upon system activation? NA Ej Yes ff/' No
Range hood tied to building alarm panel? NA V, Yes F-� No
Range hood activation signal received at building alarm panel? NAVYesF No
Class K extinguisher present? Yes E-ll, No[]
Grease buildup in group: V/
. Light — Medium Heavy, recommend cleaning
Date of last cleaning 1U--::-M—LAUAL IA(W
Are cleaning intervals-3-tl�hin NFPA standards? Yes E:/7No 1:1
Previous Confidence Test Company & Technician III -
Problems Found: (if additional room is needed, please add a separate sheet) Al 1 (:P�4 Lte� 4 L-A �-� Y-0%, I/ L4' Itt 4 % 09 FK-U I I
TeMQ- 91Y4,
Customer her, deelimalLrap,'rJ6
Corrections Made: Date Corrected: Corrected By: SFD Certification Number:
This certifies s ! and life I s been properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code
'he is
s ar
standards. Discre a Unc'� e Fot and ha a reported to the building Owner/Responsible Person for corrective action.
I
r. -0940
Signature of Tester: AQ% A Phone # (206)726
Testing Agency: M& Mailing Address: 6100 12th Ave. S., Seattle, WA 98108
Yffo-od a-n-d-Duct Services, Inc.
/1— 1 V —11
The owner is to perform and keep a written record of the following "quick check" fire system inspection to verify the following:
1 . The extinguishing system is in its proper location. The extinguishing cylinder is in 6. The nozzle disc caps and their seals are intact, undamaged and tight.
place and has not been removed or tampered with. 7. The inspection tag or certificate is in place and current.
2. The manual pull stations are unobstructed and in clear view and are labeled for 8. It any deficiencies are found, appropriate corrective action shall be taken immediately.
intended use. 9. A record of the monthly inspections is to be kept reflecting the date inspected, inititals of
3. Insure that all tamper seals are intact and that system is in a ready condition. person performing the inspection and rections required.
4. Observe system, checking that no obvious physical damage or condition exists
that might prevent operation. AUTHORIZED\/
5. The pressure gauge reading on the cylinder shall be in the green operable range. SIGNATURE
FIRE DEPARTMENT COPY
John J. Dowling
From: Brooke Baker [bbandrb@gmail.com]
Sent: Monday, October 24, 2016 10:28 AM
To: John J. Dowling
Subject: Re: Chanterelle compliance in kitchen
Good Morning,
I just wanted to let you know the work requested was accomplished this morning.
Thanks,
Brooke
Chanterelle
On Thu, Oct 20, 2016 at 3: 10 PM, John J. Dowling <jdowling@firedistrictl.org> wrote:
Great news.
Thank you.
J.J. Dowling
Captain / Deputy Fire Marshal
Office: 425-775-7720
0'
swollioMisfil co,
F1 110�0�iwr
DIRTM4W-T
e
"Be a good neighbor. It is always illegal to smoke out your neighbor. If smoke from your fire bothers your neighbors, damages their property or
otherwise causes a nuisance, you must immediately put it out."
The information in this email is confidential and may be legally privileged It is intended solely for the addressee Access Or Use by any other person to
this internet email is not authorized and may be unlaWfUl. If you are not the intended recipient, please delete or destroy this email If You do not wish to
receive fUtUre emails from this sender, please reply directly to this email requesting you be removed from any mailing list.
From: Brooke Baker [mailto:bbandrbC&qmail.com
Sent: Thursday, October 20, 2016 3:07 PM
To: John 1. Dowling
Subject: Re: Chanterelle compliance in kitchen
ii,
Sorry for the delay. I got a bit of a runaround, but now have the recharge scheduled for Monday morning,
October 24th. I will email you again when the work is complete.
Thanks,
Randy
Chanterelle
On Thu, Oct 13, 2016 at 7:05 AM, John J. Dowling <jdowlingAfiredistrictl.org> wrote:
Thank you for the update.
Please reply to this e-mail when the work is complete.
Take care.
J.J. Dowling
Captain / Deputy Fire Marshal
Office: 425-775-7720
SNOIMMISH co
F1
DI T
"Be a good neighbor. It is always illegal to smoke out your neighbor. ff smoke from your fire bothers your neighbors, damages their property or
otherwise causes a nuisance, you must immediately put it out. "
The information in this email is confidential and may be legally privileged. It is intended solely for the addressee. Access or use by any other person to
this internet ernail is not authorized and may be unlawful. If you are not the intended recipient, please delete or destroy this email. If you do not wish to
receive future emails from this sender, please reply directly to this er-nail requesting You be removed from any mailing list
From: Brooke Baker (mailto:bbandrbCd)qmail.com
Sent: Wednesday, October 12, 2016 3: 10 PM
To: John J. Dowling
Subject: Chanterelle compliance in kitchen
Sir;
Got your message, Shelf is going away. Looking for company to recharge system, a.s.a.p. Will advise when
complete. High priority.
Thank You
Randy Baker
brooke
brooke
FIRE PREVENTION
SNOHONTISH C60:
Serving Brier, Edinionds, and
12425 Meridian Ave S
INSPECTION REPORT
XEDMONDS
FIRE
Mozintlake Terrace
Everett, WA 98208
D BRIER
PISM—
H T
Phone (425) 551-1200
�Fax
0 MOUNTLAKE TERRACE
[3 UNINCORPORATED
-
www.-FireDistrictl.org
(425) 551-1272
LOCATION:316 MainStreet 98020
BUSINESS NAME: Chanterelle's
MAILING
ADDRESS: 316 Main Street, Edmonds, WA. 98020
BUSINESS OWNER: Baker, Randy & Brooke
PHONE: 4257740650
HOME PHONE:
FREQUENCY STATION & SHIFT
Annual 17-D
SCHEDULED
DATE DUE 0 Jan N17
UFIR 0 161 202
-Z'
EMERGENCY-1: T?Ak-,,f HOME PHONE:q.Ls- 1011
CURRENT
KEY ACCESS-2: HOME PHONE: 17 CITY YES NO
BUSINESS
EMAIL:
LICENSE
INITIAL INSPECTIONPATE
PERSON CONTACTED:
NAME OF INSPECTOR: C-
FIRE SYSTEMS: FE 4/15 UL300 5/16
Date Last Servic ed: Le.
R
&THood and Duct Services, Inc.
6100 12th Ave. S. Phone (206) 726-0940
Seattle,WA 98108 Fax (206) 767-2607
Occupancy Name: —
Occupancy Address:
Responsible Person:
moz:
COMPLETE Certification Given: RED L�� YELLOW E] WHITE E]
FIRE PROTECTION CONFIDENCE TESTING RANGEHOOD
High Pressure Hood Cleaning SYSTEM TESTAEPORT
Fire Suppression Installation & Service CONFIDENCE TEST 2-0" REPAIRS
Fire Extinguisher Sales & Service
Range Hood and Fan Service & Repair
Filter Sales & Service DATE: 44t,[214111K
City,State,Zip:
PhoneNumber:
Building Owner:
Building Owner Address,
Testers Name (Please Print): -Jrz h4 44
System Alarm? Yes E] Nojfr—' Central station monitoring? Yes E] No
Control Panel manufacturer: Model Number:
Extinguishing System Manufacture, 145, ystem Size
. —LADes ^ P.
Location / Height of Range hood:
Phone Number:
City, State, Zip: A 0 4
SFD Certification Number: SCP_ Xl�pz�y?
Monitoring company name: —
Location of Alarm
'�EiL. 300 Compliant? Yes E] No �bhemical Type: Wet RrD
7 / - I I
Is pres ' sure gauge -indicator in operable range?
YeklorNo 0
12 yeiir hydro date of cylinder.
(75
Is there chemical inside of the cylinder?
Weigh CO2 cartridge.
Yesg-No[] Were hand portable extinguishers properly serviced? NA []
NA :3 :5iZe Were all cooking surfaces protected? If not, give owner full
Yes4EJ-- No [j
Yes?T NoEj
or nitrogen
-q-1
tplro—�o
No visible signs of a system fire or system tampering (if signs check no). Yes
information.
IN6[]
Check all and conduit. Are all and' conduit immobilized
with Yes �'No
Was operating procedure verbally given to -restaurant personnel?
Yes
piping piping
proper hangers and brackets?
Was LIL 300 compliance explained to owner or manager?
NAF�
Yes [�,l No E]
Yes 21 NoF I
Are all protective covers present on nozzles?
Yes L_-
T Noo
Gas shuts down upon system activation?
E]
Are all nozzles checked in the proper position?
Yes [?'-No
Electric power shuts down upon system activation? NAt-j'
Yes No E]
Does system have adequate volume and/or nozzle coverage?
Yes 2r No E]
Range hood tied to building alarm panel? NAff
Yes 0 No
Are all appliances inside of the hood protection area?
Yes L;�' No E]
Range hood activation signal received at building alarm panel? NAE�r
Yes E] No F-1
Have fuse links been replaced?
Was system operational from terminal link?
Was system operational from manual remote?
Yes Ee No E]
Yes Ej No Ew]-
Yes e No F-1
Class K extinguisher present? Yes E—No
Grease buildup in group: mmKd cl 'ng
Light — M di
Date of last cleaning e_
Was system and micro switch operational?
Is system visible and free from obstruction?
NA Yes No F-1
Yes No E]
Are cleaning intervals within NFPA standards?
Yes,2--N-0 El
Is the inspection and service tag on the cylinder?
Yes No Ej
Previous Confidence Test Company & Technician . ... ........... ..
Problem)Fo nd: (If additional room is needed, please add a separate sheet), 3ktaLe_,n Plr� -cfej,,.) Ky 4��re_ VroM j f1Q le-601ijleia
, , I A y __&_ — J-11 "*j V r , il -% A f 4- -97— rr.- __r_T_ .1 -
Customer has declined repairs X
Corrections Made: Date Corrected: Corrected By: SFD Certification Number:
L
A
This certifies that this fire and life safety s S i—p—t.d diability to cover the items listed in this report and is consistent -k Tic Fir epartm Fire Code
standards. Discrepanci an have b ed to the building Owner/Responsible Person for corrective action.
Signature of Tester: Phone # — (206) 726-0940
Testing Agency: R&T Hood and Duo Services, Inc. MailinaAddress: 610012thAve. PA!
e owner is to perform and keep a written record of the following "quick check" fire system inspection to verity the follow!4:
1. The extinguishing system is in its proper location. The extinguishing cylinder is in 6. The nozzle disc caps and their seals are intact, undamaged and tight.
place and has not been removed or tampered with. 7. The inspection tag or certificate is in place and current.
2. The manual pull stations are unobstructed and in clear view and are labeled for 8. If any deficiencies are founq appropriate corrective action shall be taken immediately.
intended use. 9. A record of the monthly insl%ittions is to be ke re rffM-ftte inspected, inititals of
t
3. Insure that all tamper seals are intact and that system is in a ready condition. person performingt,1,9"jwe io ny cc
4. Observe system, checking that no obvious physical damage or condition exists
that might prevent operation. AUTHORIZED
5. The pressure gauge reading on the cylinder shall be in the green operable range. SIGNATURE
FIRE DEPARTMEN
R
&THood and Duct Services, Inc.
6100 12th Ave. S. Phone (206) 726-0940
Seattle,WA 98108 Fax (206) 767-2607
Occupancy Name:
- - ,
Occupancy Address:—IA-L RaL""
Responsible Person:
Certification Given: RED Ej YELLOW[] WHITE
COMPLETE
FIRE PROTECTION CONFIDENCE TESTING RANGEHOOD
High Pressure Hood Cleaning SYSTEM TEST REPORT
Fire Suppression Installation & Service F��ENCE TEST El REPAIRSW
Fire Extinguisher Sales & Service
Range Hood and Fan Service & Repair
Filter Sales & Service DATE: A (y Z 2, c/,/,
City, State, Zip: WK 99020
Building Owner:
Building Owner Address:
Testers Name (Please Print): — Ga� wo�� wi�
System Alarm? Yes E] No El Centra4tation monitoring? Yes E] Noo
Control Panel manufacturer: Model Number:—
V,\5Z.
Extinguishing System Manufacturer A0$L,1 Syste Sil U.L. 300
Location / Height of Range hood: —2 -
e ra 'e range
Is pressure gauge indicator in operable range?
p
Yes
y a s
Non
'ind e r7
Is there chemical inside of the cylinder?
y
y
y
No El
A
Weigh CO2 or nitrogen cartridge. NA
or system tampering 'if signs check n
No visible signs of a system fire or syst am tampering (if signs check n
Yes E'
Yes El
NoD
,/eN
e all Piping and C-ndut immobilize ith
Check all piping and conduit. Are all piping and conduit immobilize ith
Yes n
Yes Ej
Non
proper hangers and brackets?
�t on nozzles'
Are all protective covers present on nozzles?
Yes
Yes E]
No
'roper position
Are all nozzles checked in the proper position?
Yes
Yes E]
No E]
I u e and/ no zle 0 rage,
Does system have adequate volume and/or nozzle c rage?
' m or z co
Yes
Yes
No
Are all appliances inside of the hood protection ar
Yes
Noo
Have fuse links been replaced?
Yes
No Ej
Was system operational from terminal link?
Yes 0
No
Was system operational from manual re te?
Yes E]
Non
Was system and micro switch operat' at? NA
Yes E]
Non
Is system visible and free from ob ruction?
Yes E]
No
'?
Is the inspection and service ta on the cylinder?
y s 0
Yes E]
No
Problems Found: (if additional room is needed, please add a separate sheet)
Phone Number: I tk7---A I 1 -1 — L-2 (e, P L—)
Phone Number:
City, State, Zip:
SFD Certification Number: SCP- 7-C=
Monitoring company name:
Location of Alarm Panel:
;tem? Yes NoE] LI.L. 300 Compliant? Yes E] No E] Chemical Type: Wet/DryE1
t- tz
12 year hydro date of cylinder.
-2al
JG
Were hand portable extinguishers properly serviced? NA r-
Yes E]
No F-1
Were all cooking surfaces protected? If not, give owner full
Yes n
Non
information.
Was operating procedu - re verbally given to restaurant /persnel?
Yes n
No
Was UL300 compliance explained to owner or manag
Yes 0
No E]
Gas shuts down upon system activation? NA[0j
Yes n
Noo
stem act r
Electric power shuts down upon s� ivati NAE]
Yes
No
Range hood tied to building alarm panel? /11 NA Ej
Yes n
No Ej
Range hood activation signal received uilding alarm panel? NAE1
Yes 0
No Ej
Class K extinguisher present?
Yes
Noo
Grease buildup in group:
Light dium— Heavy, recommend cleaning
Date of last cleaning
Are cleaning intery ithin NFPA standards?
Yes E]
No E]
t
Previous Confid ce Test Company & Technician
Irjj
This certifies that this fire and life safety system has been p erly inspected for reliability to cover the items listed in this repon and is consistent with Seattle Fire Department Fire Code
standards. Discrepancies kre not hnV
a laeen re on to the building Owner/Responsible Person for corrective action.
Signature ol - .-Aitt Phone# (206) 726-0940
' r Mailing Address: 6100 12th Ave. S., Seattle, WA 98108
Testing Agencv: R ocid a&A;ir-ti Se ices, Inc.
The owner is to peFform and keep a written record of the following "quick check" fire system inspection to verify the following:
1 . The extinguishing system is in its proper location. The extinguishing cylinder is in 6. The nozzle disc caps and their seals are intact, undamaged and tight.
place and has not been removed or tampered with. 7. The inspection ta f. in place and current.
'g or cert' '?a 0 iate
8. If any deficienci& ive action sm
2. The manual pull stations are unobstructed and in clear view and are labeled for are foup, aggypropriate corrective action shall b ken immedi ly.
le
intended use. 9. A record of the monthly spe ions is to be k I refl cting the inspected, inititals of
r(
ec
3. Insure that all tamper seals are intact and that system is in a ready condition. person performing the i sp n h an orre tio require
4. Observe system, checking that no obvious physical damage or condition exists
that might prevent operation. AUTHORIZED
5. The pressure gauge reading on the cylinder shall be in the green operable range. SIGNATURE -�K
FIRE DEPARTMENT COPY
COMPLETE
R
FIRE PROTECTION
High Pressure Hood Cleaning
&THood and Duct Services, Inc. Fire Suppression Installation & Service
Fire Extinguisher Sales & Service
6100 12th Ave. S. Phone (206) 726-0940 Range Hood and Fan Service & Repair
Seattle,WA 98108 Fax (206) 767-2607 Filter Sales & Service
Occupancy Name: !rN C&N) -t- r--A I
Occupancy Address: ND
Responsible Person:
Building Owner:
Building Owner Address:
Testers Name (Please Print):
Certification Given: RED[] YELLOW Z WHITED
CONFIDENCE TESTING RANGEHOOD
SYSTEM TEST REPORT
I CONFIDENCE TEST [Z REPAIRSLJI
City, State, Zip: L-:-C2S-�o VNO �;j Lk;)i I U- X 6 V
PhoneNumber:
Phone Number:
City, State, Zip:
SIFD Certification Number: SCP- W-07G7C
System Alarm? Yes El No Central station monitoring? Yes No4 Monitoring company name:
Control Panel manufacturer: Model Number: Location of Alarm Panel:
Extinguishing System Manufactur System Size LI.L. 300 Srtem? Ye.X NoE] I.I.L. 300 Compliant? Yes No Chemical Type: Weto Dry
4�� It
Location / Height of Range hood: —17
<J 2003
s !oi!ssure gauge,indic.ator in. operable range? Yef* NoF 12 year hydro date of cylinder.
_p --------- I - - - - .. - - - , - V -No 0
Is there chemical inside of the cylinder? Yes Were hand portable extinguishers� properly serviced? NA Yes
Weigh.C.02'or nitro . gen cartridge. - NA W AY Were all cooking surfaces protected? If not, give owner full Yes No
No visible signs of a syst - em - f ire or system tampering . (if signs check - no). Yes.E4 NoR information. No
Was operating procedure verbally given to restaurant personnel? Yes
_Check all.piping and coodt. Lit. Are all piping and conduit immobilized with Yes Noo
pr9per,hangers and,brackets? Was UL 300 compliance explained to owner or manager? Yes [Z No Ej
Are all protective covers present on nozzles? Yes No Gas . shuts down upon system activation? N I AF I I Ya I §Z Non
Are,:all, nozzles�checkecl in the proper position? Yes 2] Noo Electric power shuts down upon system activation? NAY Yes No
Does system have adequate volume and/or nozzle coverage? Yes Y No E� Range hood tied to building alarm panel? NA 2] Yes NoE],
Are all appliances I - nside of the - hood protection - a . r - ea I ? Yes NoF) Range hood activation signal received at building alarm panel? NAe Yes No F-1
Have fuse link's been replaced?- Yes Noo Cl - ass K exti - n - g - 6 - isher present , ? Yes7l No El
Was- sy_stqm-p I perational f , rolm te . rminal,link? Yes -NoC) j Grease buil�clu
*,hl group:
Was system operational from manual remote? Yes No Light Mediurp— He recommend cleaning
Date of las;�c�ianing 4717-01V � - 51 C
Wa s�vstem and micro switch, operational? NA�] Yes 0 Noo
Is system visible and free fro - m ob . s - truc , tion? Yes V] No E:] Are cleaning intervals wit4in NFPA standards? Yes Le No E]
Previous Confidence Test Company & TechNician W Viv - 7,�
Is t1hajinspection, and service ta onthecylinder? YesX] No
9
jP
i A L1 --- I -j-4--
Z i %s;
L
----------
7-
---�4*t -4
Problems Fou d: (If additional room is needed, please add a separate sheet) Kspo-�- �,K L
- �i- -t- � n�,
1!� r
LX kc jk:3
r
Customer h^n 61@�rdzeaair46
Corrections Made: Date Corrected: C.rr'ected By: SFD Certification Number:
This certifies that this fire and life saf9W system has been pro I * ected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code
,Reryinsp
standards. Discrepancie iAe n ave:;� �eort�e ilding Owner/Responsible Person for corrective action.
Signature of Tester: Phone # (206) 726-0940
Testing Agency: _R&T Hood andDuct Services, Inc. Mailing Address: 6100 12th Ave. S., Seattle, WA 98108
C
The owner is to perform and keep a written record of the following "quick che V fire
Speir
tem inspection to verify the following:
1 .
The extinguishing system is in its proper location. The extinguishing cylinder is in
6. The nozzle disc cap. an
seals are intact, undamaged and tight.
place and has not been removed or tampered with.
7. The inspection tag or g4tificate is in place and current.
2.
The manual pull stations are unobstructed and in clear view and are labeled for
8. If any deficiencies ai�f�und
riate corrective action shall be taken immediately
intended use.
9. A record of the mo nly 1Qs jErC
' ' s
tions i to be kept reflecting the date inspected, inititals of
'IN
3.
Insure that all tamper seals are intact and that system is in a ready condition.
g heym
person performinolThhe in
tion an any corrections required.
4.
Observe system, checking that no obvious physical damage or condition exists . .
AUTHORIZED
that might prevent operation. ..
5.
The pressure gauge reading on the cylinder shall be in the green operable range.
SIGNATURE
FIRE DE-PARTIVIENT -'-.:'Y
COMPLETE Certification Given: RED Ej YELLOW[Z WHITE[]
FIRE PROTECTION CONFIDENCE TESTING RANGEHOOD
High Pressure Hood Cleaning SYSTEM TEST REPORT
&THocid and Duct Services, Inc. Fire Suppression Installation & Service CONFIDENCE TEST V] REPAIRS[]
Fire Extinguisher Sales & Service
6100 12th Ave. S. Phone (206) 726-0940 Range Hood and Fan Service & Repair
Seattle,WA 98108 Fax (206) 767-2607 Filter Sales & Service DATE: //Z 2 ss;/ 2 O/S:'
Occupancy Name: C" QLV-% 11--trIC lit
Occupancy Address: (" fv\ a " rs) 5,T-
Responsible Person: 0CA7,
Building Owner:
Building Owner Address: —
Testers Name (Please Print): C-tcon.,A-Vy- 1Y\o--`iV\,e,,.)S-
System Alarm? Yes[:] Noo Central station monitoring? Yes F-1 No 21
Control Panel manufacturer: Model Number:
Extinguishing System Manufacturer
Location / Height of Range hood:
City, State, Zip: (7- i9l Vn,n - Vk 11�
Phone Number: -7 '7 V
Phone Number:
City, State, Zip:
SIFD Certification Number: scp- A�2 -74;, -7 6-
Monitoring company name:
Location of Alarm Panel:
I.I.L. 300 System? YesjZ NoE] I.I.L. 300 Compliant? Yes[] No5�1 Chemical Type: WeZ Dry Ej
7' T
Is pressure gauge indicator in operable range?
Yes
Is there chemical inside of the cylinder?
Yes Z
No E]
Weigh CO2 or nitrogen cartridge.
NA[]
No visible signs of a system fire or system tampering (if signs check no). Yes 0
No 0
Check all piping and conduit. Are all piping and conduit immobilized
with Yes R
No El
proper hangers and brackets?
Are all protective covers present on nozzles?
Yes Vj
Noo
Are all nozzles checked in the proper position?
Yes E7
j
No
Does system have adequate volume and/or nozzle coverage?
Yes F-1
No
Are all appliances inside of the hood protection area?
Yes [A
No
Have fuse links been replaced?
Yes [7j
No F]
Was system operational from terminal link?
Yes rA
No F]
Was system operational from manual remote?
Yes D/
No E]
Was system and micro switch operational?
NA Yes
No F]
Is system visible and free from obstruction?
Yes
Noo
Is the inspection and service tag on the cylinder?
Yes
No [_1
Problems Found: (If additional room is needed, please add a separate sheet)
- I % 0 % r - I " - - -
Corrections Made: Date Corrected:
Corrected By:
12 year hydro date of cylinder.
-Zj��
Were hand portable extinguishers properly serviced? NAEJ
Yes Z
No []
Were all cooking surfaces protected? If not, give owner full
Yes E]
No I/]
information.
Was operating procedure verbally given to restaurant personnel?
Yes [�
No Ej
Was LIL 300 compliance explained to owner or manager?
Yes [A
No Ej
Gas shuts down upon system activation? NAF]
Yes M
No E]
Electric power shuts down upon system activation? NAE]
Yes V]
No E]
Range hood tied to building alarm panel? NA2g
Yes [:]
No []
Range hood activation signal received at building alarm panel? NA.71
Yes El
No Ej
Class K extinguisher present?
Yes Z]
No
Grease b ild in group:
Heavy,
Light"Z Medium-reqommend
.:.., _
cleaping
Date of last cleaning _Vzo-L5—row-) 3 -AwO, 0-e4l—
2�
.1 fj No El
Are cleaning intervals within NFPA standards? :1 Yes
Previous Confidence Test Company& Technician —6-TL e44Q-
T
Customer
SFD Certification
This certifies that this fire and life safety system has been properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code
standards. Discrepandeaarp nole e o
.J,-md ha%3e been r9port d t the building Owner/Responsible Person for corrective action.
Signature of Tester: --2-K11- Z Phone # (206) 726-0940
Testing Agency: ____fl&T Hood kd Duct Services, Inc. Mailing Address: 6100 12th Ave. S., Seattle, WA 98108
The owner is to perform and keep a written record of the following "quick check" fire system ins ction to verify the following
e arem
1. The extinguishing system is in its proper location. The extinguishing cylinder is in 6. The nozzle disc caps and their s tact, undamaged and tight.
is pi
place and has not been removed or tampered with. 7. The inspection tag or certific is in place and current.
2. The manual pull stations are unobstructed and in clear view and are labeled for 8. If any deficiencies are fi�u propriate corrective action shall be taken i:ediat�y
thl a� .
intended use. 9. A record of the monthly - re to be kept reflecting the date inspected, inititals of
c is
3. Insure that all tamper seals are intact and that system is in a ready condition. person performing th ns c o a any corrections required.
4. Observe system, checking that no obvious physical damage or condition exists
that might prevent operation. AUTHORIZED
5. The pressure gauge reading on the cylinder shall be in the green operable range. SIGNATURE - Y-- ,
FIRE DEPARTMENT COPY
Serving Brier, Edmonds, and
Mountlake Terrace
I
W www.FireDistrictLorz
12425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
FIRE PREVENTION
INSPECTION REPORT
JX EDMONDS
0 BRIER
0 MOUNTLAKE TERRACE
[I UNINCORPORATED
FREQUENCY
STATION & SHIFT
LOCATION:
316 Main Street 98020
Annual I
17-B
BUSINESS NAME:
Chanterelle's
4257740650
PHONE:
SCHEDULEDJan 2015
DATE DUE I`
MAILING
LIFIR 1,161 202
ADDRESS:
316 Main Street, Edmonds, WA 98020
BUSINESS OWNER:
I
(�_ 4 A)p
HOME PHONE: q,125 670? &001
EMERGENCY-1:
1311- �1�
HOME PHONE: CURRENT
KEY ACCESS-2:
HOME PHONE:
CITY
YES NO
EMAIL:
BUSINESS
M
E]
LICENSE
I'll
PERSON CONTACTED:
INITIAL INSPECTION DATE
NAME OF INSPECTOR: C � 51ki (T* O-OL6
FIRE SYSTEMS:
Fff 12/13 UL300 11/14
Ilpy 1(/ 11
HAZARDS FOUND AND LOCATIONS COMMUNICATIONS
A
0
2
2
3
3
4
4
5
5
6
6
7
7
1 AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
In our continuing effort to promote fire safety and prevention within the community, your fire department conducts
regularly scheduled "Fire Safety Survey Inspections" of all businesses and multi -family occupancies in the Cities
covered by Snohomish County Fire District 1.
You are to be congratulated on the relative good condition of your occupancy in regards to fire safety Above you
will find the item(s) that were noted during our inspection which require attention to bring them into compliance
with the minimum standards adopted by the above jurisdictions.
Any overlooked hazards or violations of the fire regulations does not imply approval of such conditions or violation.
If you require additional information or to schedule a re -inspection for Edmonds or the Town of Woodway, call (425)
775-7720; for Mountlake Terrace or Brier, call (425) 754-0434. J
BUSINESS COPY
R
&THpod arW Duct Services, Inc.
6100 12th Ave. S. Phone (206) 726-0940
Seattle,WA 98108 Fax (206) 767-2607
Occu pancy Name: %.- Vjf LA IY I W- / tjf t1-
Occupancy Address: -V6 oorw
Responsible Person: RA Atd�ij
Building Owner:
Building Owner Address:
Testers Name (Please Print):
COMPLETE
FIRE PROTECTION
High Pressure Hood Cleaning
Fire Suppression Installation & Service
Fire Extinguisher Sales & Service
Range Hood and Fan Service & Repair
Filter Sales & Service
SystemAlarm? YesF-j NO Central station monitoring? YesE] No2l
Control Panel manufacturer: - ---. Model Number —
Extinguishing System Manufacture AtScJ C System Size I.I.L. 300
Location / Height of Range hood: e
Certification Given: REDE] YELLOW WHITE
CONFIDENCE TESTING RANGEHOOD
SYSTEM TEST REPORT
CONFIDENCE TEST [Z
DATIE:-.1511- IL3 - /IV
City, State, Zip: CZ M 01V el -j &V/7 -----Zu UC-L ;;i
Phone Number: 221V-06,570
Phone Number:
City, State, Zip:
SFD Certification Number: SCP- da 22-2.0
Monitoring company name:
Location of Alarm Panel:
Yes NoE] I.I.L. 300 Compliant? Yes E] No VT Chemical Type: Wet [2fDry E]
--Yino
No=�
12 year hydro date of cylinder.
Is there chemical inside of the cylinderl
Ye
NoE]
tablqb?Lna!,Li-h�r�pj-p-p--e-d-ys-er-v-ic-ed? ------"NAO'--Yjs
�a 0-
Were all cooking surfaces protected? If not, give owner full Yes E] NO.Z
No visible signs of a system fire or system tampering (if signs check no). Ye§4n
,J, al p :,M6
d6eiiK't ,j6'r andgc7pn,
'jIsEind
No EI
information.
--'so'
a 6 ngp 6-riveballygiv.ri to �qsfauraht per rinelf N0011
IJFf96W0-
Was UL 300 compliance explained to owner or manager? Yes2f No [I
Are all protective covers present on nozzles?
YesZ
No E]
ation. FT Yes
V - � - -- - -' - — -NA
X
- 'N rl
-0—
s�
j
Electric power shuts down upon system activation? NAEJ Yes
No F]
Does system have adequate volume and/or nozzle coverage?
Yes Ej
NoZ
i-,y-es`0 No
'of t
_nc !fheJ6��q4ilpro ec ion area?
i9si er
Yes
No
Range hood activation signal received at building alarm panel? NA Yes [:) No
Have fuse links been replaced?
Yes 0
No El
--diiss:��**r,pre-sent?- Yeso N orD 1
a grationNi L
Grease buildup in group:
Was system operational from manual remotO
Yes [Z
'NA`0
No F-�
Light Medium He,�qre,,q mend cleaning
bf,list cleaning
i
c pperational.-'
W,�sjj,LtePW�4-n-pj i t-h'-
yqs
No
Date
Is system visible and free from obstruction? .- . .-
Yes E]
NO
-1-7 --P-reviousqdrifi
Are cleaning intervals within NFPA standards? Yes [?r No E]
--- ' '--. �b 6-mp ny-& "6
a
nceTest hnician
,ji g qfiit� cylinder'
.,Is'ik6
Yes;?'
No
_o jYe
1AJ
M
OMEN
MMMMMMMMM
NINE
I
ON
MENEENE
MMMMMMMMMMMM
M
Mims
IMM
011111111il
MM
MM
MM
MEN
-
MME1
ME
MMM1MMMMMMMMMMMMM
N
ME
MM
MMM
MEENNONEEmEEMMM
Problems Found: (if additional room is needed, please add a separate sheet) AASAM4 J'.. A&r Ot 206 C6WAji**A1r*r
Corrections Made: Date Corrected:
Corrected By:
SFD Certification
This certifies that this fire and life safetysystem qas been properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code
standards. Discrepaoe!2oW notVZWd have I ct
,#,r .
!7Z reported to the building Owner/Responsib a Person for corrective a ion.
Signature of - - - - Phone # (206) 726-0940
Testing Agency: R&T Hood and —Duct Ser—M03-14c. MailingAddress: 610012thAve.S.,Seaftle,WA98108
The owner is to perform and keep a written record of the following "quick check" fire system inspection to verity the following:
1 . The extinguishing system is in its proper location. The extinguishing cylinder is in 6. The nozzle disc caps and their seals are intact, undamaged and tight.
place and has not been removed or tampered with. 7. The inspection tag or certificate is in place and current.
2. The manual pull stations are unobstructed and in clear view and are labeled for 8: If any deficiencies are o nd, appr . te corrective action shall be taken immediately.
intended use. 9. A record of the monthly pg4ion is be kept reflecting the date inspected, inititals of
3. Insure that all tamper seals are intact and that system is in a ready condition. person performing i nEn a d y corrections required.
4. Observe system, checking that no obvious physical damage or condition exists P
that might prevent operation. AUTHORIZED A
5. The pressure gauge reading on the cylinder shall be in the green operable range. SIGNATURE
FIRE DEPARTMENT COPY
/VA a,,(k
424
sip
Kevin Zwyeber
From:
bbandrb@gmail.com on behalf of Brooke Baker [chanterelle.restaurant@gmaiil.com]
Sent:
Thursday, August 21, 2014 2:56 PIVI
To:
Kevin Zweber
Subject:
Completion of items per request
Good Afternoon,
My husband returned to Chanterelle shortly after your visit, and I explained the conversation you and I had
earlier. We have made the adjustments we discussed. We were able to push the stove back closer to the wall,
and we have moved the shelving away from the "pull tab".
We look forward to seeing you come by again at your convenience.
Please let us know if there is anything else you would like us to do.
best,
Brooke Baker
Chanterelle
Serving Briet; Edmonds, and
SNOHOMISH CO. Mountlake Terrace
FIRE
1 ST Rl Twww.FireDistrictl.org
LOCATION:
316 Main Street QSUD
BUSINESS NAME:
MAILINd
ADDRESS:
316 Main 81rccl, Ldmarmls, WA 08020
BUSINESS OWNER:
NA
i2425 Meridian Ave S
Everett, WA 98208
Phone (425) 551-1200
Fax (425) 551-1272
PHONE: 4267
HOME PHONE:
FIRE PREVENTION
INSPECTION REPORT
OEDMONDS
El BRIER
0 MOUNTLAKE TERRACE
[I UNINCORPORATED
FREQUENCY STATION & S
Antma 17-A
SCHEDULED
DATE DUE II' Jan, 2014
UFIR I,
EMERGENCY-1: Rba, Dena HOME PHONE: '0fj',"85134_4" CURRENT
KEY ACCESS-2: HOME PHONE: CITY YES NO
N& BUSINESS
EMAIL: LICENSE CA El
PERSON CONTACTED: CA 9 INITIAL INSPECTION DATE
NAME OF INSPECTOR:
FIRE SYSTEMS; FE I
5113
HAZARDS FOUND AND LOCATIONS COMMUNIC TI NS
C)
2
2
3
3
4
4
5
5
6
6
7
7
I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X
Ist RE -INSPECTION
DATE DUE
I
2nd RE -INSPECTION
DATE DUE'
EXTENSION
GRANTEDTO-
FINAL RE -INSPECTION
DATE DUE:
VIOLATIONS
CITED -
PERSON
CONTACTED:
PERSON
CONTACTED:
PERSON
CONTACTED:
1
INSPECTOR:
INSPECTOR:
INSPECTOR:
2
DATE:
DATE:
DATE:
3
VIOLATIONS
1 5
VIOLATIONS
1 5
PRE -CITATION
LETTER SENT
CITATION ISSUED
NUMBER:
4
2
6
2
6
DATE:
CODE
SECTION:
5
3
7
3
7
RETURN RECEIPT
RECEIVED
6
14
8
4
8
DATE:
DISPOSITION:
7
LETTERNEEDED [] YES [_
-1 NO
LETTER NEEDED [] YES El NO
8
FIRE DEPARTMENT COPY
COMPLETE
FIRE PROTECTION
High Pressure Hood Cleaning
&THocid and Duct Services, Inc. Fire Suppression Installation & Service
Fire Extinguisher Sales & Service
6100 12th Ave. S. Phone (206) 726-0940 Range Hood and Fan Service & Repair
Seattle,WA 98108 Fax (206) 767-2607 Filter Sales & Service
Occupancy Name:
Occupancy Address: 31
Responsible Person:
Building Owner:
Certification Given: FIEDE] YELLOWE2--WHITEE]
CONFIDENCE TESTING RANGEHOOD
SYSTEM TEST REPORT
I CONFIDENCE TEST r7 REPAIRSL11
City, State, Zip: IV ot" M 0 a G1
Phone Number: -7 7
Phone Number:
Building Owner Address:. — City, State, Zip:
Testers Name (Please Print): 0 .01 SIFD Certification Number: SCP- J�,V
System Alarm? Yes[:] No Er Central s1tation I monitoring? Yes M NoM Monitoring company name:
Control Panel manufacturer: Model Number: Location of Alarm Panel:
U.Lfi 300 System? Yes [rNo M U.L. 300 Compliant? Yes E] No ET� Chemical Type: Wet n—Dry El
Extinguishing System Manufacture Syslem Size,, —
Location / Height of Range hood:
k D -7 A 1-100
is s�ure oau6e,irfdi 't
pre ca or in operable range?__
-Yiaso -** -,
No Cj
Yes 'No[]
-�?
12 year hydro date of cylinder.
Ie
0 1
0 'N I'
Is there chemical inside of the cylinder?
W e hand extinguishers p 1,
_portab_ _rppery serviced?
Were If full
as o L
Yes No
Weigq-,!CO2' ofnitrogen cartri dge:�,,,
NA
all cooking surfaces protected? not, give owner
No visible signs of a system fire or system tampering (if signs check no). Yes No
Check,,all'piping and.donduit: Are all piping and conduit, immobilized with Yes
information.
Was operating procedure verbally given to restaurant personnel? Yes No
propef hangers andbrackets?
'No
—No- IF
Was UL 300 compliance explained to owner or manager?
Yes No
Are all protective covers present on nozzles?
Yes I?r E-
Pas shuts down-uPon system--activati-on?
NA E] Yes 0 NO2-
Are all nozzles checked in the pr9per position?
-Yes Ej _ No
Electric power shuts down upon system activation?
NAn Yes E No
Does syste m have adeq uate volume and/o r n o zzi e cc ve r age?
Yes No
-Ran h -odile6Cc�b ildi-
ge o , u . ng4larmpanel? ,e
NA2-- Yes E] No
A re all appliances i--n'side-of the -hood protection area?-
Yes No E)
Range hood activation signal received at building alarm panel? NA E!T' Yes No[]
Have fuse links been replaced?
Yes [�J- No E]
Class K extinguisher pre se nt?,
Yes No[:]
'Was system:�p rpiionai fibr�te'rminal link?
Yes NoF
Grease buildup in group:
Was system operational from manual remote?
Yes [�!r— No E]
Light ium Heavy, recommend cleaning
CrC
Was system and micro switch operational?__
NAE] Yes a NoF
Dat of last cleaning
a
Are intervals NFPA
[�J'No
Is system visible and free from obstruction?
Yes ERoo� No E]
cleaning within standards?
,t?s
Is th6,inspection and service tag on the cylinder9
Yes [;?0, No
Previous Confidence Test-CdMpany & Technician -�M(Xkk
0
ME
I
ME=
inim
E
E
INIMMIMMENS
EMENIONNIONEOM
ENNIMININIME
NNNN1NNN1MN
0
1
=NEI=
0 I
I
0
0
1 M
0
Vano
NVAIIII1110111
As
NM
MO1
M
NINON
MN
ME=
10111111111111111
101111111111111
NINO
Mimi
0
MNNNMNWNMNMNM
MNMNMX1MNMM=
OMNI
Found: If addition I r is nelded I dd alep,a a a sheet)
I eale a
T 'A OT- 1. n - — C — V — 11
t"Aw- eX -Ntfl,* �6 f 0 uf'fQ-.� ilcleek�vlej
SM cfe'OU A�, lrv4l��tfls 161091hw,
4a I` Fe" MQUal aldok
W 91 . -, L.�-- -I rl _;I -
Corrections Made: Da Corrected By: SFD Certification Num r:
This certifies that this fiFe anj life safety system. fis be properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code
standards. Discreparic not d an av n r to the building Owner/Responsible Person for corrective action.
Ep fi (206) 726-0940
Signature of Tester: I'VE azie — - - - -- Phone #
Testing Agency: A&T Hoo-k! andb6ct Services, Inc. MailingAddress: 610012thAve.S..Seaftle,WA98108
The owner is to perform and keep a written record of the following "quick check"firr"Y'Stem inspection to verify the following:
1 . The extinguishing system is in its proper location. The extinguishing cylinder is in 6. The nozzle �Iisct caps id their seals are intact, undamaged and tight.
place and has not been removed or tampered with. t f. e is in
7. Theinspecion ag c rti icat , , place and current.
2. The manual pull stations are unobstructed and in clear view and are labeled for 8. If any cleficiencie are fou , appropri . ate corrective action shall be taken immediately.
intended use. 9. A record of the ont y' s c io is to be kept reflecting the date inspected, inititals of
3. Insure that all tamper seals are intact and that system is in a ready condition. person perfor ng th action nd any corrections required.
4. Observe system, checking that no obvious physical damage or condition exists
that might prevent operation. AUTHORIZED
5. The pressure gauge reading on the cylinder shall be in the green operable range. SIGNATURE
FIRE DEPARTMENT COPY I