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456 ADMIRAL WAY STE 101 (2)SNOf1O1%11S14 CO. FIRE "T a Way Serving Brier, and 12425 Meridian Ave S Mountlake Terrace Everett, WA 98208 Ph one (425) 551-1200 L7 A JL16JL%.# A www.FireDistrictl.org Fax _(425) 551-12 72 LOCATION: 456 Admiral Way Suite 101 98020 BUSINESS NAME: Anthony's Beach Cafe PHONE: 4257714400 MAILING 456 Admiral Way, Suite 10 1, Edmonds, WA 98020 ADDRESS: FIRE PREVENTION 19SPECTION REPORT EDMONDS BRIER 0 MOUNTLAKE TERRACE 0 UNINCORPORATED STAIFV SHIFT r FRA'AuuEalcy I SCHEDULED Aug 2017 DATE DUE � -161 201 U FIR 10 BUSINESS OWNER: ACME PHONE: 5 Op-�L (!)\ Q0 L�z Burns, Steve 2067930649 EMERGENCY-1: I HOME PHONE: 17 rCURRENT YES NO KEY ACCESS-2': 0jz,,j I s HOME PHONE: CITY BUSINESS IV"l Ej EMAIL: LICENSE )n-j PERSON CONTACTED: INITIAL INSPECTION DATE NAME OF INSPECTOR: a. I I Date Last Serviced: milt 511—+ FIRE,PREVENTION Serving Brier, Edmonds, and 12425 Meridian Ave S INSPECTION REPORT SNOHOrV11SH CO. Mozintlake Terrace Everett, WA 98208 kA EDMONDS F1 13 BRIER Phone (425) 551-4200 0 MOUNTLAKE TERRACE [I UNINCORPORATED DI S, TL www.FireDistrictl.org Fax (425) 551-1272 LOCATION: 456 Admiral Way Suite 100 98020 BUSINESS NAME: Anthony's Beach Room MAILING 456 Admiral Way, Suite 100, Edmonds, WA 98020 ADDRESS: BUSINESS OWNER: Burns, Steve EMERGENCY-1 - ()4 . KEYACCESS-2 EMAIL: PERSON CONTACTED: NAME OF INSPECTOR: it W 4257785499 PHONE: HOME PHONE: HOMEPHONE: 2067930549 HOME PHONE: 17 FREQUENCY STATION & SHIFT Annual I 17-B SCHEDULED Aug 2017 DATE DUE 0 233 UFIR 0 CURRENT CITY YES NO BUSINESS -1;71 LICENSE )t�,j 1:1 INITIAL INSPECTION DATE 5/n //? SNOHOMIS11 CO, FIRE DIST] Serving Brier, Edmonds, and ,,,Mountlake Terrace www.FireDistrictl.org 12425 Meridian Ave S Everett, WA 98208 Phone (425) 551-1200 Fax (425) 551-1272 FIRE PREVENTION INSPECTION REPORT OEDMONDS 0BRIER 0 MOUNTLAKE TERRACE [3 UNINCORPORATED " FREQUENCY TATION & SHIFT � LOCATION: .456 Admiral Way Suite 101 98020 BUSINESS NAME: PHONE: SCHEDULED 0 Anthony's Beach Cafe 4257714400 DATE DUE A- -9 2Q! 6 MAILING FIR ADDRESS: 161201 456 Admiral Way, Suite 101, Edmonds,- WA 98020 BUSINESS OWNER: HOME PHONE: Bergau, Dawn EMERGENCY-1: HOME PHONE: KEY ACCESS-2: Burns, Steve HOME PHONE: ."'CURRENT 206.7930649,, CITY YES NO I& BUSINESS EMAIL: �Aejja(,VMI�.& V1 yl !4 AA LICENSE PERSON CONTACTEM, VAIN INITIAL INSPECTION DATE NAME OF INSPECTOR: V+ tro FIRE SYSTEMS:. FE 13 HD UL300 11/15 [DaZeF0ai08ewWwtbcATIONS COMMUNICATIONS Af N6 2 2 3 4 -4 5 5 6 6 7 7 I I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X I RPLE�PUE ' PERSON CONTACTED: !NS �ECTOR: DATE: 6 17 LETTER NEEDED YES NO DATE DUE: PERSON CONTACTED - INSPECTOR: DATE: VlOaT16K�7,-- '5 2 3 7 LETTERNEEDED [] YES NO EXTENSION FINAL.RE-INSPECTION VIOLATIONS GRANTEDTO: DATE DUE: CITED: . ...... .... ... ... .... PERSON CONTACTED: INSPECTOR7-- 2 DATE: 3 P _______d_1T_ATIdN_1SSUED RE -CITATION . 54 __�E7101.�q�T _ _�!W413ER: CODE DATE: RETURN RECEIPT ��CEIVED DAT DISPOSITION: �7 8 TRUCK 6100 12th Ave. S High Pressure Grease Exhaust System Service NUMBER Seattle,WA 98 1 Fire Suppression Installation & Service ��'5 t 91FL A,- 7 11 "0 - E Phone (206) 726-0940 Fire Extinguisher Sales & Service A R A6011ift Fax (206) 767-2607 Range Hood and Fan Service & Repair T Mood and Duct Services, Inc. www.rthood.com Filter Sajlds & Service BL LN LI L L JOB NAME ANTHONY'S - BEACH i[;AFE 45b ADMIRAL WKY EIDMC)NDS, WA9802C LOCATION - - I i M V201 5 SERVICE DATE - F-IR&THOOD 76112015 DATE OF LAST SERVICE [I OBSERVABLE INACCESSIBLE AREAS # OF HOODS 4 NAME #1 IMAIN #2 MAIN #3 FW�ER #4 Bilki_;K HOOD 9 FEEZ_T 8 FEET 7 FEET 4 FEET # OF ACCESS PANELS LENGTH #1 #2 #3 #4 BEST ROOF 2ND FLOOR REAR OF KITCHEN INSIDE ROOF ACCESS:/YES / NO ACCESS LOCATION: CZPF=r.lAI INI.qTPI IrTIONI.q2 SILVERS"' SET UP PRESSURE WASHER ON EAST SIDE OF BUILDING. CONTACT SHAWN - KITCHEN MGR LOCATION PHONE NO. _j4_25) 771-4400 BACKUP PHONE NO. (1�53-) 302-7848, SCHEDULED JOB TIME 11:00 SALESPERSON -HT,,IJSP- LEAVE STIUKERS WITH PAPERV4011K "' CLEAN UP SPRAY OFF ON ROOF BRIN G BACK GREASY WAYER TO THE SHOP, HOOD # WRAPHOOD DRAPEAPPLIANCE CHEMICAL SPRAYED PRESSURE WASHED SCRAPED CHEMICALWIPED CHEMICAL SCRUBBED WATERWIPED POLISHED SOAK FILTERS SHOOT FILTERS 1 '_2'__ -3 __ 4 9 N (Y-)N 1,9N �DYN ON qN',VN �;N f 'YA ('-')NfyXqN Y � '�N Y N 0 '�)N '9N ,V N V N 'Y) N LD N YN__UN%N7YN JYN 3)N!�)N R)N aY N aNj �Y? N t��"N V 'LYA.S? NN�FN f' N N N _ N1 Yo Y(NfYRYq %OF GREASE REMOVED ' i5'_ E:Z) DO HOOD(S) LEAK (DRIP)? �e�-S-/NO FILTERS REINSTALLED YES NO BURNT GREASE WATER -WASH HOOD UVHOOD # OF MISSING FILTERS FILTER CONDITION CONDITION! 1 2 3 4 M-000 002210 WINE199 RUMMM M.-Immo (G=GOOD, F=FAIR, P= CHEMICAL SPRAYED PRESSURE WASHED SCRAPED CHEMICALWIPED CHEMICAL SCRUBBED # OF ACCESS PANELS # OF INACCESSIBLE APs DUCT LENGTH IN FEET I . A Y N Y N Y N Y,,WYNYNYN ,aYNYNYN VNYNYNYN Y�WYNYNYN SEALED ACCESS PANELS QYES,/ NO % OF GREASE REMOVED % OF AREA NOT ACCESSIBLE BURNT GREASE ROUND DUCT CLASS 11 DUCTS LEAKING DUCTS FIRE WRAPPED INACCESSIBLE AREAS DUCT 1 DUCT 2 DUCT 3 DUCT 4 MNEDIflow" 1 2 .1 4 &A Y N Y NjY N Y&YNYNYN Y fN.,T N Y N Y N Y (17� N Y N Y N Y?Nl� NY - N Y N Y _YN Y N Y N __ - �.. � __ EX'H CHEMICAL SPRAYED PRESSURE WASHED SCRAPED CHEMICALWIPED CHEMICAL SCRUBBED FAN REMOVABLE REMOVEFAN # OF ACCESS PANELS A b-) _" * - __7 1 2 a 4 -Y,'N Y N Y N I Y N '-Y/N Y N Y N Y N Y,-NYNYNYN LA Y N Y N Y N 9NYNYNYN YPN- _YN Y N Y N YRYNYNYN :5--- FANS -OPERATION TEST (CEINO FANS -LEFT RUNNING TO DRY 0YES/NO -D FAN DAMAGE OBSERVED YESA 0 DISASSEMBLE TO CLEAN EXPOSED WIRES NEED FLEX CONDUIT NEED ACCESS PANEL NEED HINGE POLLUTION CONTROL UNIT SQUIRREL CAGE 1 2 1 4 �)N Y N Y N Y N Y Y N Y N Y N YG—YNYNYN YW�Y—NYNYN Y NIYNYNYN L Y 6NTY - N Y N Y N . N Y (G=GOOD, F=FAIR, P=POO PHYSICAL CONDITION T CLEANINGACCESS ELECTRICAL CONDITION FAN BELT CONDITION WE APPRECIATE YOUR BUSINESS AND WELCOME ANY COMMENTS AS TO HOW WE CAN SERVICE YOU BETTER IN THE FUTURE. IN OUR EFFORTS TO ENSURE THAT THE HOOD AND DUCT CLEANING HAS BEEN DONE TO YOUR SATISFACTION, WE REQUEST THAT YOU APPROVE OF THE SERVICE BY SIGNING BELOW. COMMENTS TO CUSTOMER: CUSTOMER SERVICE TECH- SIGNATUII�)��"� DATE: //-I//- FIRE DEPARTMENT COP'y COMPLETE FIRE PROTECTION R High Pressure Hood Cleaning C. 0 &THood and Duct SerAces, In 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: Responsible Person: Building Owner: Certification Given: REDD YELLOW 0 WHITE PTI CONFIDENCE TESTING RANGEHOOD SYSTEM TEST REPORT CONFIDENCE TEST REPAIRS Ej] DATE: 0 4 j-/j C City,State,Zip: V V / I - V vo Phone Number: Lt-L5-771 — Y 'It 00 Phone Number: Building Owner Address: A I City, State, Zip: Testers Name (Please Print): re--rvir 91 9p" ect- SFD Certification Number: SCP- System Alarm? Yes [�rN-E] Central station monitoring? Yes [!rNo E] Monitoring company name: 5j-g 14 2A Cot- H-i- Control Panel manufacturer: Model Number* Location of Alarm Panek A C4e� Extinguishing System Manufacturehy4er s stemSize— L14-.300 System'? Yes E7rNoE] I.I.L. 300 Compliant? Yes [J'No El Chemical Type: Wet E5'1� El Location / Height of Range hood: AtZmAl Y " AT.9,4 Is,pressurelgaugatindicator inoperable range? 'Yes 12r- Noo Is there chemical inside of the cylinder? s [Zr- No E] Weigh CO2 o - r nitrogen'cartridge. NA No visible signs of a system fire or system tampering (if -signs check nr7e,s ?T' Nob Check, all- piping, and conduit. Are all pipin - g a I nd conduit int . mobilized with Yes [?I" Noo proper hangers -and brackets?,, Are Yes No all protective covers present on nozzles? Are'a . llbozzles,checke&in the DroDer position? Yes [�,r' No Ej Does system have adequate volume and/or nozzle coverage? Yes 2r No E] Are allap I ,pliances insida'ol"the hood protection area? Yes [n' No Have fuse Ii nks been replaced? Yes Z' No E] Was systernoperational from terminal link? Yes No Was system operational from manual remote? Yes No Was systemand micro switch operational? NAE] Yes E�" No C] Is system visible and free from obstruction? Yes [?!r' No Ej Is the inspection and service tag on the cylinder? Yes �� No M 12 year hydro date of cyli rider. Were hand portable extinguishers _properly serviced? NA E] Yesf--r NoEl Were all cooking surfaces protected? If not, give owner full YesET No F-1 information. Was operating pr I ocedure verbally given to restaurant personnel.? Yes 0' No E] Was UL 300 compliance explained to owner or manager? Yes [?r No E] Gas shuts down upon system activation? NA E] Yes E�r No E] Electric power shuts down upon system activation? NA F� Yes E?— No E] Range hood tied to buildi ng alarm panel? NAE] Yes 3— No Range hood activation signal received at building alarm panel? NAE] Yes [�� No E] Class K extinguisher present? Yes [4--No E] Grease build!Aw group: Light — u Heavy, recommend 7/y/y cleaning Date of last cleaning Are cleaning intervals within NFPA standards? Previous Confidence Test Company & Technician Yes ME Noma MEMEMEMEMMM MEN= M M USE M EM MINIMIME11ME ME Problems Found: (if additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: Corrected By: Customer has declined SFD Certification Number: This certifies that this fire and lite safety system ft a perly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code �Lbj a standards. Discrepancip �Petedrd hP be � rep Ldto the ing Owner/Responsible Person for corrective action. Signature of Tester: —j— - 9 ;--YIA , Phone # (206) 726-0940 Testing Agency: A0 Ko—od iind D&!%Rviies, Inc. MailingAddress: 6100 12th Ave. S., Seattle, 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 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 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 CHEMICAL SPRAYED( PRESSURE WASHED,,, SCRAPED,, CHEMICALWIPED,' CHEMICAL SCRUBBER, # OF ACCESS PANELS # OF INACCESSIBLE APs DUCT LENGTH IN FEET 'Y')'N Y N Y N Y N '�)N Y NjY NJY N �_Y)N Y NJY NJY N -Y)N Y N Y N Y N :YXN:YNYNYN CHEMICAL SPRAYED( PRESSURE WASHED� SCRAPED( CHEMICALWIPED' CHEMICAL SCRUBBEZ FAN REMOVABLE REMOVE FAN # OF ACCESS PANELS 'Y3NYNYNYN N Y N Y N Y N 'Y,NYNYNYN Y N Y N Y N Y N 'V N Y N Y N Y N _YN y � N Y N Y N Y. N Y N Y N POST SERVICE CONDITION FiCiE�t-�itR-Vit-tC-ON-D-I-TIO-N SEALED ACCESS PAINIELSr-YPED No FANS - OPERATION TEST t'YESj NO FANS - LEFT RUNNING TO DRY 'Y6S/ NO POST SERVICE CONDITION % OF GREASE REMOVED FAN DAMAGE OBSERVED YES / ONO % OF AREA NOT ACCESSIBLE % OF GREASE REMOVED INDICATE UNUSUAL CONDITIONS 1 2 3 4 DO HOOD(S) LEAK (DRIP)? YES IN-00 I-IN-DICATE,UNUSUA.L CONDITIONS- DISASSEMBLE TO CLEANI Y N Y N Y N Y N 1 2 3 4 -1- - - NUtri�)HUNC�)IALLtU NO BURNT GREASE ROUND DUCT CLASS 11 DUCTS INb_1CATE UNUSUAL CONDITIONS LEAKING DUCTS 1 2- 3 4 FIRE WRAPPED BURNT GREASE WATER -WASH HOOD UVHOOD # OF MISSING FILTERS FILTER CONDITION DO rarz, 710"Irdol W.AwArtirall mmmm mmmim TRUCK 6100 12th Ave. S. High Pressui� G�ease Exhaust Sysiern Service Seatt n & Service fl E� NUMBE Ie,WA 98108 Fire Suppression Installatio F 'A� I] �&C Phone (206) 726-0940 Fire Extinguisher Sales & Service -A Fax (206) 767-2607 Range Hood and Fan Service & Repair Mood and Duct Services, Inc. www.rthood.com Filter Sales & Service k SUMMARY: CONDITION OF SYSTEM RED 0 Y E L. L 0 W7' oil D_\'k JOB NAME— Apy�-omqS. #LkN%AAA Tkvv_kkca&� CONTAC — -r' -' . 1. ' JINE NO. L6(c q7j':� -3 -71 - -(-/-/Cc LOCATION )A 'INA\ 10 0-1— L.", LOCATION PH SERVICE DATE BACKUP PHONE NO. _25 [2-R&T HOOD DATE OF LAST SERVICE'D OBSERVABLE 2_ Z, t 'S SCHEDULED JOB TIME INACCESSIBLE AREAS SALESPERSON # OF HOODS NAME # 1 06 CQ — #2 #3 ltgA 64 HOOD # OF ACCESS PANELS -LENGTH #1 — #2 #3 #4 BEST ROOF INSIDE ROOF ACCESS: /NO ACCESS LOCATION: Icy SPECIAL INSTRUCTIONS SERVICES PERFORMED BY TECHNICIANS -- --------- BEGINNING GREASE BUILDUP: HOOD(S) — LIGHT'MEDIUM! HEAVY, DUCT(S) —LIGHT/ MEDIUM/ HEAVY, FAN(S) —LIGHT/ MEDIUM/ HEAVY EXHAUST HOOQ($) 79F EXHAUST- DUCT SYSTEM , EXH UST FAN(S A- _T:_ HOOD # 1 2 3 4 1 2 3 A 1 2 3 4 WRAP HOOE�� DRAPE APPLIANCE( CHEMICAL SPRAYEE( PRESSURE WASHED( SCRAPED,- CHEMICALWIPED� CHEMICAL SCRUBBED4 WATER WIPED,, POLISHED� SOAK FILTERS( SHOOT FILTERS W,10702 01-01 P21-0-0921am OEM Dzium"Umm Roman wimmio imm'm MEMO 10,22 9 m 0 MGMEMPOIq 0194040vul INACCESSIBLE AREAS rRy NJY N Y N �(_V�Y N I Y N Y N X.-N-)Y Y-'6� N Y N I Y N I Y N Y N Y N Y*,,'Y N I Y N Y N N7yNjYNYN r-Aru�)LU VVINt NEED FLEX CONDUIT NEED ACCESS PANEL NEED HINGE POLLUTION CONTROL UNIT SQUIRREL CAG DUCT 1 PHYSICAL CONDITION DUCT 2 CLEANING ACCESS DUCT 3 ELECTRICAL CONDITION DUCT 4 FAN BELT CONDITION (G=GOOD, F=FAIR, P=POOR) WE APPRECIATE YOUR BUSINESS AND WELCOME ANY COMMENTS AS TO HOW WE CAN SERVICE YOU BETTER IN THE FUTURE. IN OUR EFFORTS TO ENSURE THAT THE HOOD AND DUCT CLEANING HAS BEEN DONE TO YOUR SATISFACTION, WE REQUEST THAT YOU APPROVE OF THE SERVICE BY SIGNING BELOW., COMMENTS TO CUSTOMER: iA Q, CU5TOME SERVICE TECH: SIGNATUR DATE: N YIT)Y N Y N Y N Y: Y N Y N Y N -'N')Y Y Y_ N Y N,Y - N Y Y, N ��)YNYNYN .Y-NYNYNYN FIRE DEPARTMENT COPY COMPLETE 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: F 11, ) X U&S-n-2) INS -j D& Occupancy Address: LA n Lo , Responsible Person: bk.. S H A Rsl Building Owner: Building Owner Address: �-- City, State, Zip: - - Testers Name (Please Print: SIFD Certification Number: scp-GU3'4!R System Ak ��No El Central station monitoring? Yes M""No [I Monitoring company name: Control Panel manufacturer: _UQdVLNumber: Location of Alarm Panel: WN A �L � �w Mko +� 0,0 Extinguishing System Manufacturert Jl*q) System? Yes ZNo El U-L. 300 Compliant? Yes [j�No El Chemical Type: Wet F!J'Dry Location Height of Range hood: 1A %AQ Yes I C) sure, gauge�indicator inoperable range� No[:] 12 year hydro date of cylinder. No F-1 Were'hand portable NA Yos es _extinguishers proper] serviced? N Is there chemical inside of the cylinder? y Weigh CO or rilte6g6ri'dartricig ey Yes �e 2 a. NAY were all cooking surfaces protected? If not, give owner full No N - o visible , signs of a syst - ern fire or system tampering (if signs check no). Yes 10� No r! information. 6CJ- - I Yes Check all piping and conduit. Are all piping and conduit immobilized with Yes W Was operating procedure verbally given to restaurant personne ? - - - No [I proper hangers and brackets? les � Was LIL 300 compliance explained to owner or manager? -j No Lj Are all protective covers present on nozzles? Ye s No -Gas shuts down upon system activation? 7 Yes Non Are all nozzles checked in the proper posi I tio - n? - Yes R, No[3 Electric power shuts down upon system activation? NA[]-- Yes No El Does system have adequate volume and/or nozzle c overage? Yes Y, No El . Range, hood . tie . d . to, building alarm pan - el? NA[j- Yes r I --Ir NoM Are all appliances; inside of the hood protection area? Yesp�' No Range hood activation signal received at bu - ild ing a I larm panel? NAD Ye s F N o El b n uisher present? Yes �( No Have fuse links been replaced? Yes No F� ass K exti g. Was system operational from terminatIjinO. Yes --No Grease bui�ldp in group: Was system' operational from manual remote? Yes No El Light Medium Heavy, recommend cleaning Was systerriand m cro switch"operational? --- NA [I Yes Noo R#te� of last cIeahing,A?-V-- Is system I vis I ible and free I - rom obstruction I Yes LE&�,, NoE]- Are cleaning intervals within NFPA standards? 'Yes No E] Is the inspection and servic . a tag on the cylinder? Yes No Previous Co , nfidence Test Comp . a - ny & Technicianni\.�.Ya'4 —0 C-0 1�- P A 22 A, b� TT I �1 1-1y� if r-I!, 41. ot L �:r If -t ---------- Certification Given: RED E] YELLOW 0 WHITE CONFIDENCE TESTING RANGEHOOD SYSTEM TEST REPORT F6�ENCE TEST Eg REPAIRS D] nATFA / N / ZO ( 65 At City, State, Zip: Phone Numbeal Phone Number: )vR-Aes, ---L_-t�0-.t(.(9_!-- (Z- -1 VAO 5e-1! -- ---- - JJ--;-L'!�"3---!j-':!7-1r I --i-[ ...... 'J 1 Problems Found: (if additional room is needed, please add a separate sheet) hjE Customer Corrections Made: Date Corrected: Corrected By: SFD Certification Number: This certifies that this f1m and life afe syeWjZj1has been properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code s s) s standards. DiscreKncie, ran te nd a to the building Owner/Responsible Person for corrective action. f T--11\ If A (206) 726-0940 Signature of T Phone # Testing Agency: Hood and Duct Services, Inc. Mailing Address: 6100 12th Ave. S., Seattle, WA 98108 Ar 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 ingpection and a;g,�orrecfions 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 TRU 6100 12th Ave. S. RIK— - High Pressure Grease Exhaust System Service MB Seattle,WA 98108 SERVOCE Fire Suppression Installation & Service Phone (206) 726-0940 Fire Extinguisher Sales & Service A :�,Jr2 6),767-2607 Range Hoocl-an� Fan Service & Rep t 0 , "M 4�, =�M 4b Mood and Duct Services, Inc. h d Filter Sales& Service ONT REP WHITE 0 SUMMARY: CONDITION OF SYSTEM RED N YELLOW Vl�l JOB NAME�_ ANTHONY'S REACH CAPE - N.11 DE 2 CONTACT-26HA14AN LOCATION -4-56 ADMIRAL. XNAY EDMONDS, INA 98A7ZI JOB PHONE NO. 425) ? I I - 44 1141 SERVICE DATE 2ND PHONE f' 2SR) 309-729AA 0 B&T HOOD DATE OF LAST SERVICE E]OBSERVABLE n 11201 12 0 151 SCHEDULED JOB TIME '91 N INACCESSIBLE AREAS SALESPERSON 14ni isP # OF HOODS NAME #1 MAIN #2 hill A I NJ #3 Ek"W--p #4 n[SH HOOD #OF ACCESS PANELS LENGTH #1 Q FEET. #2 A EFF-1 #3 7�FRC7 #41 4 FFFT BEST ROOF INSIDE ROOF ACCESS: YES/N0 ACCESS LOCATION: 2ND Ef DOR REAR DEK1T$-HFw LEA\!'E,sT1(-.KFRs WITH PAPFRVJnRW "I FAN I IRSPRAY OFF kR1t4f4j:1Af-V f-IREA.SYWATED I SERVICES PERFORMED BY TECHNICIANS BEGINNING GREASE BUILDUP: HOOD(S)-LI HT/,MEE)1UM2 -LIGHT/ME FAN(S) -LIGHT �MEDIUM� HEAVY ±�!JDUCT(S) __._-400D(Sf EX-M EXHAUsT-71 EXHAUST-P-AMS11 - HOOD # , 1 .2 . 3 4-1 1 2 3 4 .,j 2 3 4 WRAPHOOD DRAPE APPLIANCEI CHEMICAL SPRAYED PRESSURE WASHED� SCRAPED( CHEMICAL WIPED SCRUBBED (CHEMICAL)' WATER WIPED POLISHED SOAK/DISH FILTERS SHOOT FILTERS CHEMICAL SPRAYED� PRESSURE WASHED' SCRAPE CHEMICAL I CHEMICAL SCRUBBED' FAN REM BL 4 . REMOVE FAN� _�v I LWVI #OFACCESSPANEL8 POST SERVICE C . ONDITION POST SERVICE C&A_&T-10N 10� FANS - OPERATION TEST(�OS/ NO' SEALED ACCESS PANELSA'EW NO F - LEFT RUNNING TO DRYJE R NO % OF GREASE REMOVED COWLING - DAMAGE OBSERV D YES P-0-80, E-CONDITiO E ___ , RVIC N % OF INACCESSIBLE AR, EAS /�701 % OF GREASE REMOVED INDICATE UNUSUAL CON61VONS 2� 3 4 LJU nUULJkO) Lr-Mr% kUrlir-) f C5-17/ 114U 111INUMOMUM UN UM6_!eVI-q DISASSEMBLE TO CLEAN 1�� 1 2- 3 4 1�1 FILTERS REINSTALLED I NO BURNT GREASE :ROUND DUC� CLASS 11 DUCTS CONDITIONS' LEAKING DU( 'TS 1 2 -3 4 FIRE WRAPPED BURNT GREASE� WATER -WASH HOOD # OF MISSING FILTERS 'FILTER CONDITION 10000 021WIMM"Im IMMOMM RM022101tv MUNCIM OWN= 9010MVIM 0000013 FROVEAMM FA 1AMNAM 41 var,2130 a w CHEMICAL SPRAYED PRESSURE WASHED SCRAPED, CH EMICALWIPED. ( CHEMICAL SCRUBBED( # OF ACCESS PANELS DUCT LENGTH IN FEET INACCESSIBLE AREAS Nam MUMMM MVIAMM Varwlmm Arm [a M 0-WEEMM "AMMIT31110 '� IN YJN )Y N I Y N YNYN Y N Y N Y N Y N "Y N Y N Y 'All I Y N Y N N� �N r_ArU-..)r_U VVINC NEED FLEX CON DUIT NEED ACCESS PANEL NEED HINGE, POLLUTION CONTROL UN[T SQUJE59L CAGE OMFMMM 213MM Ma-umm w-RIAMM 01MOMMM Uff][TAPIMM w1ulmomm Y 'Y' X N Y N ,Y,�P'*fij Y N I Y N Y'l-N)' Y Y N I Y N Yfh,,'Y'N,Y NJY N Y".N YR'Y'NIY N Yj�X,MY NjY N I NjY NJY N 0 PHYSTICZUI�ZN (y, U I I [2- CLEANING ACCESS /A_ IYVC_e�l I-]-- I -YO,�, ,,4�GOOD,,,F FAIR,'P=Pd0RF FAN BELT CONDITION WE APPRECIATE YOUR BUSINESS AND WELCOME ANY COMMENTS AS TO HOW WE CAN SERVICE YOU BETTER IN THE FUTURE. IN OUR- EFFORTS TO ENSURE THAT THE HOOD AND DUCT CLEANING HAS BEEN DONE TO YOUR SATISFACtION, WE REQUEST THAT YOU APPROVE OF THE SERVICE BY SIqNING BELOW. COMMENTS TO CUSTOMER: CUSTOMER SIGNATUR DATE - SERVICE TECH: FIRE DEPARTMENT COPY MUM= mmol'sul W-10-FT =IN TRU(f k 6100 12th Ave. S. High Pressure Grease Exhaust System Service NUMBER Seattle,WA 98108 Fire Suppression Installation & Service Phone (206) 726 Fire Extinguisher Sales & Service -09,40 -ty Fax (206) 767-2607 Range Hood and Fan Service & Rep A Filter Sales & Service Mood and Duct Services, Inc. www.rthood.com 'K�' , REPORT JOB NAME CONTACT LOCATION 'I'SO) wAw. �-mswn.&s *m qs�Dao JOB PHONE NO. SERVICE DATE 2ND PHONE b, e48 [E R&T HOOD DATE OF LAST SERVICE F-1 OBSERVABLE 10 130 SCHEDULED JOB TIME qrv� INACCESSIBLE AREAS # OF HOODS SALESPERSON NAME #1 #2 'CnLkN V) #3 #4 HOOD # OF ACCESS PANELS. LENGTH #1 #2 #3' 44 BEST ROOF INSIDE ROOF ACCESS: YES/NO ACCESS LOCATION: SPECIAL INSTRUCTIONS Q C f \ky\`hQ '11 6 k -\q J dp�A�& 's\ I �'kr_ �'r) --iv- U"�'k n lf��IS on, \ie �"o vx V,?F �� BEGINNING GREASE BUILDUP: HOOD(S)-LIGIU/MERP EXHAUST- HOOD(S),j___EXHA HOOD # WRAPHOOD DRAPEAPPLIANCE CHEMICAL SPRAYED PRESSURE WASHED SCRAPED CHEMICALWIPED SCRUBBED (CHEMICAL) WATER WIPED POLISHED SOAK/DISH FILTERS SHOOT FILTERS MUM M_ [MMAWN 33100110M ft-1 WX MOW A] [a M w W_ �j rM P-M WIM"A a 2MIMMIE1 % OF GREASE REMOVED HEAVY DUCT(S) - ISTwCT_SYS1 1 CHEMICAL Sf RAYED PRESSURE WASHED SCRAPED CHEMICAL WIPED CHEMICAL SCRUBBED # OF ACCESS PANELS DUCT LENGTH IN FEET UM / HEAVY I FAN(S) - 2 - __ :3 4-"-1* SIMMM ommm 10-IMMM lklimmm 11HIMMM womm mmmm CHEMICAL SPRAYED PRESSURE WASHED SCRAPED CHEMICALWIPED CHEMICAL SCRUBBED FAN REMOVABLE REMOVEFAN # OF ACCESS PANELS / MEDIUM / HEAVY I 2 3 4 POST SERVICE CONDITION POST SERVICE CONDIT1QN, SEALED ACCESS PANELS YES / NO FANS -OPERATION TEST NO LEFT RUNNING TO DRY YES % OF GREASE REMOVED COWLING - DAMAGE OBSERVED�ZZI (NO % OF INACCESSIBLE AREAS -1 2 3 4 -t-UNUMAL, CONDITIONS DO HOOD(S) LEAK (DRIP)? �ES �INO INDIUT DISASSEMBLE TO CLEAN YIN Y NjY N[Y 4 N 2 3 I-ILI thO Mr-INZ.) IALLLU It"i 114U BURNT GREASE ROUND DUCT CLASS 11 DUCTS INDICATE UNUSUAL CON'difIONS LEAKING DUCTS 1 2 3 4— FIRE WRAPPED BURNT GREASE WATER -WASH HOOD # OF MISSING FILTERS FILTER CONDITION INACCESSIBLE ARI NY NJY NJY N Y1 1, NY NY k Y Y N Y NAY N Y N Y N Y N Y N 'YjNYNYNYN YjYNYNYN Y r_Ar-U0r_IJ VVINCO NEED FLEX CONDUIT NEED ACCESS PANEL NEED HINGE POLLUTION CONTROL UNI'L SQUIRREL CAGE � �QY NJY N Y N Y (ff - ,V NJY� N Y N YN,IYNIYNYN Y1.DI,'jY N Y N Y N. 4IN �Y N Y N_Y N ]N Y N Y NjY N ku=uUULj, F=FAIH, r=rVUH) 1 PHYSICAL CONDITION 2 CLEANING ACCESS __4 — -j 3 r_Lt_U I NIUAL UUMA I IUINI (G=GOOD, F=FAIR, P=P60R) 4 FAN BELT CONDITION WE APPRECIATEYOUR BUSINESS AND WELCOME ANY COMMENTS AS TO HOW WE CAN SERVICE YOU BETTER IN THE FUTURE. IN OUR -EFFORTS TO ENSURE THAT THE HOOD AND DUCT CLEANING HAS BEEN.DONE TO YOUR SATISFACTION, WE REQUEST THAT YOU APPROVE OF THE SERVICE BY SIGNING BELOW, COMMENTS TO CUSTOMER: SERVICE TECH: SIGNATURE FIRE DEPARTMENT COPY DATE: TRUCK NUMBER 6100 126 Ave. I Seattle,WA 98168 Pressure Grease Exhaust System Service F, Suppression Installation & Service SERVUCF.' kone (206) 726-0940 -R �(2 6),767-2607 Oh, Fire Extinguisher Sales & Service Range Hood and Fan SeiVice & Repair /A REPORT &T d C'M Filter Sales & Service SUMMARY: CONDITION OF SYSTEM RED 0 YELLOWI,�' WHITE E .J.@,@ NAME CONTACT LOCATION CAM-MV-0\ T\ k-A : 1Z WVZ)Ir�. N JOB PHONE NO. SERVICE DATE I K) -'-30 � \A 2ND PHONE S2�) '�A)_A 72,q�� 0 R&T HOOD DATE OF LAST SERVICE 0 OBSERVABLE SCHEDULED JOB TIME I INACCESSIBLE AREAS SALESPERSON # OF HOODS �A - NAME #1, - #2 M\\Y-\ — #3 444PAFN Wq�k'44YXICV-- # OF ACCESS PANELS - HOOD LENGTH #1 12 - #2 Q — #3 #4 INSIDE ROOF ACCESS: "E /NO. BEST ROOF ACCESS LOCATION: SPECIAL INSTRUCTIONS 0 21ANIC ".,c, ",Yx)- OV os-'\Ae Q k C rvkk. sOC 6 V-,% I lk.\ %nr\ te nk, BEGINNIN%PREASE BUILDUP: HOOD(S) - HOOD # � WRAPHOOD DRAPE APPLIANCE CHEMICAL SPRAYED PRESSURE WASHED SCRAPED CHEMICALWIPED SCRUBBED (CHEMICAL)i WATER WIPED POLISHED SOAK/DISH FILTERS SHOOT FILTERS -2 -14 -4 MEMO M GO ral I Zi KAI VD NA ion 10" w " R., "IFFARM U DMIRI-TRIPUM IQ % OF GREASE REMOVED DO HOOD(S) LEAK (DRIP)? (YE /�O F1 LTE RS R E I NSTALLED (i�Y`@)S- / NO BURNT GREASE WATER -WASH HOOD # OF MISSING FILTERS FILTER CONDITION 1 2 2 4 IMIK110ME-A ro'kiffal " , WaMNAM OIEJ9129 PIPOOR) / HEAVY I DUCT(S) - LIGHT 1 -2 3 CHEMICAL'SPRAYEDi PkLSS7URE WASHED, SCRAPED CHEMICAL WIPED CHE�ICAL SCRUBBED # OF ACCtSS PAINILS %DUCT LENGTH IN FEET SEALED ACCESS PAN % OF GREASE REMOVED % OF INACCESSIBLE 2 3 BURNT GREASE ROUND DUCT CLASS 11 DUCTS LEAKING DUCTS FIRE WRAPPED INACCESSIBLE AREAS /NO 1 2 3 4 WER110" RQ FARM" ffa V9 0 [to w M_ aw" 17,0010" w"wff__0 / HEAVY I FAN(S) - LIGHTQMEDIUMj HEAVY 2 3 4 CHEMICAL SPRAYED PRESSURE WASHED SCRAPED CHEMICALWIPED CHEMICAL SCRUBBED FAN REMOVABLE REMOVE FAN # OF ACCESS PANELS FANS - OPERATION TEST / SJ/ NO LEFT RUNNING TO DR, YE$/NO DISASSEMBLE TO CLEAN ,EXPOSED WIRES NEED FLEX CONDUIT NEED ACCESS PANEL NEED HINGE POLLUTION CONTROL UNIT CLEANING ACCESS ELECTRICAL CONDITION FAN BELT CONDITION 2 3 4 WE APPRECIATE YOUR BUSINESS AND WELCOME ANY COMMENTS AS TO HOW -WE CAN SERVICE YOU BETTER IN THE FUTURE. IN OUR EFFORTS TO ENSURE THAT THE HOOD AND DUCT CLEANING HAS BEEN DONE TO YOUR SATISFACTION, WE REQUEST THAT YOU APPROVE OF THE�SERVICE BY SIGNING BELOW. COMMENTS TO CUSI A d 'A SERVICE CUSTOMER FIRE DEPARTMENT DATE: R &THocid 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: Building Owner: COMPLETE Certification Given: RIEDE) YELLOW WHITE FIRE PROTECTION CONFIDENCE TESTING RANGEHOOD High Pressure Hood Cleaning SYSTEM TEST REPORT Fire Suppression Installation & Service r&6�ENCE TEST Z REPAIRS D Fire Extinguisher Sales & Service Range Hood and Fan Service & Repair Filter Sales & Service DATE: zo A City, State, Zip: A _S '9 W 111 Building Owner Address: -- Testers Name (Please Print): d01e%jv* V\,ko,4��X "i-S f SystemAlarm? YesjK NoEl Central station monitoring? Yeswr NoF] Control Panel manufacturer: Model N1,j! bar- TOL A, Extinguishing System Manufacturei Location / Height of Range hood: is pressur aauae inclicato - r in operable ran __ e? 11 a 11 1—, . - 9_ Yes[z NO Is there chemical inside of the cylinder? YesZ No El Weigh CO x or nitrogen cartridge. NAZ ,2 No visible signs of a system fire or system tampering (if signs check no). Yes No F� Check all pipingand conduit. Are all piping and conduit immob ilized with Yes No proper *gees and,br6bkets? Are all protective covers present on nozzles? Yes No Are all nozzles checked in the proper position? Yes No Does system have adequate volume and/or nozzle coverage? Yes [7 No E] Are all appliances inside of the hood protection area? Yes No E] Have fuse links been replaced? Yes No F-1 Was system operational fromterminal link? Yes [;4 Noo Was system operational from manual remote? Yes 0 Noo Was system and micro switch operational? NA E] Yes E6 No E] Is system visible and free from obstruction? Yes [� No Is the inspeption and service tag on the cylinder? ves 1Z NoIj Phone Number: 1 Y iL i I / / I - Phone Number: — City, State, Zip: SFD Certification Number: SCP- 16�j Monitoring company name: Location of Alarm Panel: YesoNoE] I.I.L. 300 Compliant? Yes,2 Non Chemical Type: Weg Dry[-] 12 year hydro date of cylinder. -Were hand portable xtinguishersproperly serviced? NAO YesZ " NoD Were all cooking surfaces protected? If not, give owner full Yes 4 No information. Was operating procedure v . erbally giv. , an to - restaurant - p - ersonnel? Yosqj NoM Was UL 300 compliance explained to owner or manager? Yes n No Ej Gas shuts down upon system activation? I—, NAF-1 Yes [7 No [I Electric power shuts down upon system activation? NAE] Yes No E] Range hood tied to building alarm panel? NAE1 Yes 11 No7 Range hood activation signal received at building alarm panel? NAD Yes F4 No 1:1 Class K extinguisher present? Yes - 2r Nom Grease b ildup i oup: Lightft��_ Kledium— eavy, recommend cleaning Date of last cleaning 2C>1 - ?-'3-\ IF I % Are cleaning intervals withi N A standards? - Previous Confidence Test Company & Technician R3 7 Pl Ye sZ f 7i'_ NoF ko N j. --F _7 T I r7_1 7 1 1 Ek, +TI e>'re?'t-4 7- 1 1 7Z Problems Found: (if additional room is needed, please add a separate sheet) Corrections Made: Date Corrected: Corrected By: --3— — Customer has declined repairs X SFD Certification Number: This certifies that this fire and Ii system has be�n properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code standards. Discrepancie re iq avoge re rted to th ilding Owner/Responsible Person for corrective action. Signature of Tester :_ A� A Phone # (206) 726-0940 &T ; - 0 Testing Agency::::: R oodd and)Dtict 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 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 arglintact ' undamaged and tight. 01 a place and has not been removed or tampered with. 7. The inspection tag or certificate is in p and curreDL, 2. The manual pull stations are unobstructed and in clear view and are labeled for 8. If any deficiencies are found, appr ria corre iv c on shall be taken immediately. intended use. 9. A record of the monthly inspection s t be k 11 ting the date inspected, inititals of 3. Insure that all tamper seals are intact and that system is in a ready condition. person performing the inspectio�n�dco r i s 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 TRUCK 6100 12th Ave. S. High Pressure Grease Exhaust System Service NUMEIJER Seattle,WA 98108 Fire Suppression Installation & Service SERVICE R Alii� Fax 206) 767-2607 Range Hood and Fan Service -k. �epair A Mood and Duct Servicm, Inc. ITI Filter Sales & Service . I BEGINNING GREASE HOOD(S)-UGHT/MB0U o u ` %OFGREASE REMOVED ' ^ 0OHOOO(�LEAK (DRIP)? 0ES)/NO CHEIVICAL SPRAYED U t�WASHED:.I CHEMICALWIPED ' SEALED ACCESS PANELS E - %QFGREASE REMOVED � K % INACCESSIBLE AREAS- |8INACCESSIBLE AREAS -LIGHT/M CHEMICAL SPRAYED PRESSURE WASHED SCRAPED F -REMOVABLE AN REMOVE FAN #OF ACCESS PANELS [ NEED FLEX CONDUIT NEED ACCESS PANEL NEED HINGE POLLUTION CONTROL UNIT � K SOU|RREL(AGE� VNN Y 11 ` - � � . �U� � IN OUR EFFORTS- TO ENSURE. THAT TH EHOOD AND DUCT.CLEANING HAS BEEM DONE-TQ YOUR'SAtISFACTION,_ WE REQUEST CO MMENTS to CUSTOMER: CUSTOMER SERVICE TECH: SIGNATURE DATE: )"_w A/— n .. ....--... n ' 1 PHYSICAL CONDITION �U 2 U CLEANING ACCESS �U -K_-~-..-.. ------_- ' ELECTRICAL CONDITION F=F�n` - �' ' ^ ,,y�.4 � U _jFAdUBELT. CONDITION nutrio n1=1mu/*cetu " ymu ANT GREASE DUCT ^' ` CLASS UDUCTS LEAKNGDUCTS[ ' BURNT GREASE WATER -WASH HOOD #OFMISSING FILTER S FILTER CONDITION FIRE PREVENTION INSPECTION REPORT Serving Briei: Edmonds, and 12425 Meridian Ave S 0 EDMONDS RE Mountlake Terrace Everett, WA 98208 0 BRIER F1 0 MOUNTLAKE TERRACE Phone (425) 551-1200 0 UNINCORPORATED STR T wwwFireDistrictl.ory Fax (425) 551-1272 FREQUENCY STATION & SHIFT LOCATION: .156 Adi-niral Way Suite 100 2302113 I BUSINESS NAME: -Vimo=go—, Ak4-(,, ly F1.1a PHONE: 425Tf K<K, SCHEDULED Aup 2014 DATE DUE 1' - MAILING LIFIR � 23-3 ADDRESS: 45FS Admiral Way, Suilra 1013, �-damrids-. WA 08 0213 BUSINESS OWNER: HOME PHONE: EMERGENCY-1: HOME PHONE: e--CURRENT KEY ACCESS-2: HOME PHONE: CITY YES NO BUSINESS EMAIL: LICENSE PERSON CONTACTED: CA^,�j 4.- INITIALTPECT�N DATE NAME OF INSPECTOR. j 7 �-IRESYSIEMS: FE_Lt)_j3 HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS :T", C, 2 2 3 3 4 4 5 5 6 16 7 7 I AGREE TO CORRECT THE ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: EXTENSION GRANTEDTO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: I 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 DATE: CODE ' SECTION: 5 3 7 3 -6 7 RETURN RECEIPT RECEIVED 6 4 18 4 18 DATE: DISPOSITION: 7 LETTER NEEDED E] YES NO LETTER NEEDED E] YES [I NO 8 FIRE DEPARTMENT COPY John J. Wesffall From: John J. Westfall Sent: Friday, January 10, 2014 1:44 PM To: Bjorback, Leif Cc: 'steve@anthonys.com'; Kevin Zweber Subject: BLD20130313 Anthony's Beach Cafe FP for Dumbwaiter Installation 4s� OA-,% 4,�,_ Discussion and resolution regarding the requirements for fire protection in the dumbwaiter shaft. The 2013 edition of NFPA 13 HBK is used for evaluation. The restaurant is existing and Anthony's Beach CaM shares tenancy with Anthony's Restaurant and Port of Edmonds Operations offices. Proposed is a freight lift one story tall used for moving supplies to second floor and rubbish to first, thereby dedicating the original elevator to passenger only. The shaft is one hour rated and the constructed lift assembly provides 90 minute FR providing opening protective when constructed to detail. The lift will not operate with upper or lower doors open, completing shaft enclosure during transport. The lift is noncombustible and hoistway is limited combustible. A pit at bottom of shaft has been constructed to accept the lift. The dumbwaiter is electrically -controlled by a motor affixed to the top of the lift. The lift control panel is attached to the 2 nd floor on a shaft wall outside the hoist way in the kitchen area. There is approx. W gap at the front of the opening when the assembly is opened for loading, allowing debris to drop into pit. Installation of a sprinkler at the top of shaft mandates that electrical circuits be shut when sprinkler is activated. A heat detector also at the top of shaft providing electrical shunt will be required. Shunt action may be controlled by an open head and butterfly valve controlling that head and electric supply to motor. Pit sprinklers are often provided in hydraulic lift (not electric) installations, where combustible fluids could spill NFPA 13 8.15.5.2. NFPA 13 provides room for omission of sprinklers in elevator shafts. The additional cost of special installations and the benefit "must be weighed against the small number of fires in elevator shafts" NFPA 13 8.15.5 HBK commentary. Consideration is made due to the possibility of fire growth and spread inside to outside of the shaft. The building around shaft is fully protected with sprinklers. A fire escaping shaft will be held in check by sprinklers. The dumbwaiter cannot be used for personnel or fire responders, so due consideration for rescue or fire operations is null. The dumbwaiter shaft is a rated enclosure with the hazards of electric motor problems, or potential ignition of ordinary combustible pit debris. In this case, a sprinkler at the top of the shaft only leads to additional systems required to assure the protection water will not apply to electric motor parts. A fire inside the "covered" lift or in the pit underneath is not readily extinguished prior to burning through the shaft enclosure. In my estimation, a lone heat detector tied to the monitored building fire alarm system and installed at the top of the elevator shaft will suffice as early warning for fire responders to provide immediate notification of fire condition. Responders will then keep fire spread in check. John I Westfall Fire Marshal Fire Prevention Services 425-771-0213 Desk 425-775-7721 Fax 425-231-3644 Mobile Wfommm CO, TRUCK 6100 12th Ave. S High Pressure Grease Exhaust System Service )ervice LL Ll LE—_� Fire Suppression Installation & S , -9 NUMBER Seattle,WA 98108 — [F V, cc Phone (206) 726-0940 Fire Extinguisher Sales & Service AAA" Fax (206) 767-2607 Range Hood and Fan Service & Repair LI-1 L R A L6 Mood and Duct e ices, Inc. www.rthood.com Filter Sales & Service SUMMARY: CONDITION OF SYSTEM RED 0 YELLOW Fla, WHITE 0 JOB NAME 2)0- rA(_h C CA Ve, CONTACT Sbo_A_� LOCATION LASU MCff�JOI (,A)0-Q JOB PHONE NO. A 41 AqCD LA \ V)._) I _�j SERVICE DATE I - Q %_ 2ND PHONE QA&THOOD DATE OF LAST SERVICE El OBSERVABLE -30 _ktl SCHEDULED JOB TIME INACCESSIBLE AREAS SALESPERSON #OFHOODS NAME #1 MkrA A n #2 CTVX� ("1 #3 W-Ar #4 HOOD I �f 1 ().1 (-)'1 #4 #OFACCESSPANELS �A LENGTH #1 q4 I ()" #2 #3 BEST ROOF -)fok cr- -K Pot Ir csw� INSIDE ROOF ACCESS: E /NO ACCESS LOCATION: C) ir-��r ft) ,- - I I SPECIAL INSTRUCTIONS !2�j 1�j ex-c'. \.,o Dt ei;� xte_ 1A)0 00 C(45L _'Skde bb I A A nr,\ - C )Ie A f) '::�OY_CA A A CA Of C�Al C)6f I C, l( A) �Ah r�(_, OP I --\- X JLAX�jo,�- bi(_Ad� -:)D e-�n T') a SERVICES PERFORMED 13� TECHNICIANS BEGINNING GREASE BUILDUP: HOOD(S) -LIGHT/ MEDIUM/ HEAVY I DUCT(S)- LIGHT/ MEDIUM/ HEAVY 7FAN(S) -LIGHT/ MEDIUM/ HEAVY EXHAUST HOOD(S) EXHAUST DUCT SYSTEM(S) EXHAUST FA S)______ HOOD # 1 2 3 4 1 2 3 4 1 2 3 4 WRAPHOOD DRAPE APPLIANCE4 CHEMICAL SPRAYED, PRESSURE WASHED I SCRAPED, CHEMICALWIPED SCRUBBED (CHEMICAL)4 WATER WIPED� POLISHED� SOAK/DISH FILTERS SHOOT FILTERSI� CHEMICAL SPRAYED, PRESSURE WASHEDj SCRAPED� CHEMICALWIPED CHEMICAL SCRUBBED # OF ACCESS PANELS DUCT LENGTH IN FEET J)N Y N Y N Y N 9YN Y N Y N Y N N Y N Y N Y N �5 Y N Y N Y N NN Y N Y N Y N I ro-- - CHEMICAL SPRAYED PRESSURE WASHED SCRAPED CHEMICALWIPED( CHEMICAL SCRUBBED FAN REMOVABLE REMOVE FAN # OF ACCEE�S PANELS 1jNYNYNjYN �Y) q Y N Y NJY N IY� N Y N Y NJY N ��) N Y N Y NJY N J��YNYNYN YNYNYNYN _�SYNYNYN a — --- --- POST SERVICE CONDITION POST SERVICE CONDITION SEALED ACCESS PANELS,/ �E NO FANS - OPERATION TEST (�YES NO % OF GREASE REMOVED LEFT RUNNING TO DRY � �E NO 0 O`S_ _TS E R_ V-1 C_ E__ C_ -0 --- N-b-I T-1 -0 _N COWLING -DAMAGE OBSERVED YES(q % OF GREASE REMOVED % OF INACCESSIBLE AREAS INDICATE UNUSUAL CONDITIONS Al r% 1^ A 'f� I I NJ 1 2 3 4 IJU r1UUUI,0) Lr-/Arl tUrlir-) f 1 OUIAL. to Mull 11 140 'DISASSEMBLE TO CLEAN FILI ERS REINS, IALLtZU EVI NO BURNT GREASE� 10770FRI MDR= w mmmm 0"21 W 4 mo M RIMMEMM ISMAIAM WMEAM MZMAM 7PT-WOM 1:017AMOM PDOOZAM ROUND DUCT CLASS 11 DUCTS -I WD-1-CAT7t-U—NUg-UA-L-(jO-14[�it7ldkS LEAKING DUCTS 1 4 1 FIRE WRAPPED BURNT GREASE(-b N Y N Y N Y N INACCESSIBLE AREAS 'YIN Y JU ' 'I Y NJY Y NJY NJY NJY N N Y/R Y NJY NJY Y N N ��N Y NJY j N Y N Y IN Y N Y N 77� YIN Y N Y N r-Al-VOMIJ VVINCO NEED FLEX CONDUIT NEED ACCESS PANEL� NEED HING E POLLUTION CONTROL UNIT SQUIRREL CAGEj Y- AY N Y-N Y N YINJ Y N Y N Y N Yr,� N _� N Y N 3N7YNYNYN Y(NJY N Y N Y N YAP N TN Y N N Y N Y N Y "' WATER -WASH HOOD19N �N Y N Y N jt;i=uvvu.,)r=rmiri, ____ 1 PHYSItAIMN'DITION # OF MISSING FILTERS 41C) FILTER CONDITION 2 CLEANING ACCESS 3 ELECTRICAL CONDITION I GTG� F = F A I R, ' 4 FAN BELT CONDITION __4r WE APPRECIATE YOUR BUSINESS AND WELCOME ANY COMMENTS AS TO HOW WE CAN SERVICE YOU BETTER IN THE FUTURE. IN OUR EFFORTS TO ENSURE THAT THE HOOD AND DUCT CLEANING HAS BEEN DONE TO YOUR SATISFACTION, WE REQUEST THAT YOU APPROVE OF THE SERVICE BY SIGNING BELOW. COMMENTS TO CUSTOMER: 6, VIV CUSTOMER SERVICE TECH: SIGNATURE DATE: FIRE DEPARTMENT COPY 6100 12th Ae. S. OR% High Pressure Grease Exhaust System Service Phone (206) 726-09,4 Fire Extinguisher Sales & Service NUMBEPt _'J Se.attle,WA 98108 10 Fire Suppression Installation & Service Filter Sales & Service R Fax (206) 767-2607 Range Hood and Fan Service & Repair r�3 Mood and Duct, Services, Inc. www.rthood.com 11-1 k� P, SUMMARY: CONDITION OF SYSTEM RED 0 YELLOW 0 WHITEM., e, JOB NAME Dn�kt� I kk'V`�' C CA CONTACT - LOCATION JOB PHONE NO.�AaS 1 -1 �A SERVICE ATE 2ND PHONE ?S Z'R&T HOOD DATE OF LAST SERVICE'. []OBSERVABLE SPHEDULLD.JOB71ME ANACCESSIBLE AREAS SALESPERSON # OF HOODS NAME #1 #2 — #3 #4 HOOD j #OFACCESSPANELS LENGTH #1 #2 !1� Ci' — #3 :1� D #4 BEST ROOF r'. t INSIDE ROOF ACCESS: 7E /NO ACCESS LOCATION: 01D C) f ok )�,, N C \_`i`CZ� SPECIAL INSTRUCTIONS f IF 5SA A 1-�, )CA D�_- \0i )i d'A fv- A 4") lk D S Q(a4 4 Urwe. S)n0ow-s a�(U) 0 SERVICES PERFORMED BY TECHNICIANS BEGINNING GREASE BUILDUP: HOOD(S)-LIGHT6!rED3�_1U /HEAVY DUCT(S)-LIGHT� (M_74 D /HEAVY FAN(S) -LIGHT EDIU /HEAVYI EXHAUST HOOD(S) EXHAUST DUCT SYSTEM(S) EXHAUST FA-Npr H100 D # 1 2 3 4 1 2 3 4 1 2 3 4' WRAP HOODj DRAPE APPLIANCE T CHEMICAL SPRAYED� PRESSORE WASHEV, 9CRAPED� CH[EMICAL'WIPED' SCRUBBED (CHEMICAL)� WATER WIPEDi PbLISHEIY SOAK/DISH FILTER? SHOOT FILTERS CHEMICA.L SPRAYEC� PRESSUREWASHE T SCRAPED *CHEMICAL WIPED CHEMICAL',SCRUBBED FAN 1. REMOVAB;'LE REMOVE FAN #,OF ACCESS PANELS POST SERVICE CONDITION POST SERVICE CONDITHON .. . ... ..... SEALED ACCESS PANELS ` YES/. NO FANS - OPERATION TEST YES LEFT RUNNING TO DRY YES 0 0/(OOF GREASE REMOVED POST SfRVICt__',ONP ION DAMAGE OBSERVED YES NN COWLING % OF INACCESSIBLE AREAS -CONDITIONS INDICATE UNUSUAL v oi�,w % OF GREASE REMOVED 1 .2 -.3 .4 IJU r1UyUk0) Lr-/-\r\ 'ku. I P) r NU 11MUKoPkIll C UNUOUIAL V-, NUII I 1 110 QISASSEMBLE,TO CLEAN -11_�'.2 ;�-3-A __7 FILTERS. REINS IALLED /. NO BURNT GREAS� ROUND DUCT CLASS 11 DUCTS INDICATE UNUSUAL CON61TIONS LEAKING DUCTS 1 2 3 4 FIRE WRAPPED BURNT GREASE Yf� Y N Y N Y N. INACCESSIBLE AREA 0"EMIMM, MiMmm 0-m-f-Emm VEMEM MMI-ftEREM 8MOZIUMM ORMIMM rizim"Mm Wifflumm MAMOM 00- omm CHEMICAL SPRAYED,' PRESSURE.WASHE[f SCRAPED CHEMICALWIPED CHEMICAL SCRUBBED # OFACCESS PANELS DUCT LENGTH IN FEET� ammmm mmmm rommm MUMMM Irlammm 9sm M n* mmm :�NYNYNlYN �'jNYNYNYN Y N N Y N )MYNYNYN I Yr4 Y N Y N Y N N Y N Y N Y N �NN Y N Y N Y N N Y N Y N Y N Y7, � Y N Y N Y N YgY N Y'N Y N �a Y N Y N' Y N Y11Y N'Y-N Y N Y N r_ArU0r_U'VVIri.r_0 NEED FLEX CONDUIT NEED ACCESS PANEL( NEED HINGE POLLUTION CONTROL UNIT SQUIRRELCAGI?' Y N Y N Y N 1 Y N . Y N � N Y, Y N Y-N Y N 'V� Y N Y N Y N Y(I�YNYNYN Y?� Y NFY7N Y N rN WATER -WASH HOOD Y N Y N Y N kU=UUUU' r=r/A1ri1-r=rVVr1) PHYSICAL CONDITION # OF MISSING FILTERS Atj FILTER-CONDITIO . N 2- CLEANING ACCESS 3 ELECTRICAL CON DITIONj_-_1 (G=GOOD, F FAIR , 4 FAN BELT CONDITION WE'APPRECIATE YOUR'BUSINESS AND WELCOME ANY COMMENTS AS TO HOW WE CAN SERVICE YOU BETTER IN THE FUTURE. IN OUR EFFORTS TO ENSURE THAT THE HOOD AND DUCT CLEANING HAS BEEN DONE TO YOUR SATISFACTION, WE REQUEST THAT YOU APPROVE OF THE SERVICE BY SIGNING B Ow. COMMENTS > TO CUSTOMER: CUSTOMER SERVICE TECH: SIGNATURE FIRE DEPARTMENT COPY TRUCK 6100 12th Ave. S. ll� - High Pressure Grease Exhaust System Service S*eattle,WA 98108 Fire Suppression Installation & Service NUMBE�R Phone (206) 726-09 2- L 1 1L 7 [1 40 Fire Extinguisher Sales & Service Filter Sales & Service _9 r, Q0 [In Tr 17 ri R Fa� (206) 767-2607 Range Hood and Fan Service & Repair A :1-) _r Mood and Duct e ices, Inc. www.rthood.com 1K [:7� [IL JOB NAME CONTACT sbau )n JOB PHONE NO.�A245 -XIN DD )n ALA SU A�64 c rAl LA crcn CA I LOCATION SERVICE DATE 30 2ND PHON a5- "W\5 D'R&T HOOD DATE OF LAST SERVICE El OBSERVABLE A -A --A 'D, SCHEDULED JOB TIME 1c)/*!yan INACCESSIBLE AREAS SALESPERSON # OF HOODS NAME #1 MCUO #2 f`(NCAAr-N — #3 fl_" — #4 HOOD — #3 101 1 — #4 # OF ACCESS PANELS LENGTH #1 #2 BEST ROOF INSIDE ROOF ACCESS: (9ES)/ NO ACCESS LOCATION: CA Ro (--,f SPECIAL INSTRUCTIONS C__.')ek_ r - -7 9_1 'I I (A (It 'i PY" \001( V_ __NT) Sn 0jP - - BEGINNING GREASE BUILDUP: HOOD(S) - LIGHTQI�Djl�U/ HEAVY I DUCT(S) - LIl EXHAUST HOOD(S) EXHAUST DUCT SYSfE_ HOOD # 1 2 3 4 WRAP HOOD( DRAPE APPLIANCE/ CHEMICAL SPRAYEDI PRESSURE WASHED( SCRAPED', CHEMICALWIPEDj SCRUBBED (CHEMICAL),i WATER WIPEDf POLISHED SOAK/DISH FILTE* SHOOT FILTERj '9N li�N 2�11 Y N A? N y Y N — N ?; N Y N YNjNkNYN �+-� Niff) N Y N NfYj jj_� N Y N "PI*5N�Y)NYN N�VN '�) N Y N . N Y N N N��W)N Y N I POST SERVICE CONDITION I % OF GREASE REMOVED DO HOOD(S) LEAK (DRIP)? YES N C9 FILTERS REINSTALLED rE,q/ NO TE UNUSUAL CONDITIONS 1 2 1 4 BURNT GREASE WATER -WASH HOOD # OF MISSING FILTERS FILTER CONDITION MW�r%V�M 7INFII&MMM NMOMM (G=GOOQ� �-FAI , P=POOR) CHEMICAL SPRAYE PRESSURE WASHE SCRAPE CHEMICALWIPE CHEMICAL SCRUBBE # OF ACCESS PANEL DUCT LENGTH IN FE FEW ON= k ID mnalsom P 0 ST_- S E _R-V_ -1 6E_ _Cb h 61-T-1-0- _N_ SEALED ACCESS PANELS(_� Y�E /�S NO % OF GREASE REMOVED ;z % OF INAUUt:Z:�IbLE AREAS 1 2 3 4 Tt- UNt BURNT GREASE ROUND bUC'T CLASS 11 DUCTS LEAKING"DUCTS FIRE,WRAPPED INACCESSIBLE AREAS 2 3 4 ,ql N� y N Y N �Kd Y LWY&, Y N Y�f`1)1 Y6N Y,/,N Y N Yj' �& -YrN Y N Y(V YnP Y N _N�AIR,11(f �JY N HEAVY I FAN(S)-- LIGHt-N EXHAUST W I CHEMICAL SPRAYED PRESSURE WASHE SCRAPED" CHEMICALWIPED CHEMICAL SCRUBBED FAN REMOVABLE( REMOVE FANI # OF ACCESS PANELS, HEAVY 2 3 4 mmgmm 70EMMM InTmalm VVINIMAM M I LA JR Im EXAMIAMM WOMM momm FibST_§tRVICE CONDITION FANS - OPERATION TEST ZO/ NO LEFT RUNNING TO DRY YES/.NO COWLING - DAMAGE OBSERVED YES 6PI DISASSEMBLE TO CLEAN EXPOSED WIRES NEED FLEX CONDUIT NEED ACCESS PANEL I.NEED HINGE POLLOTION'60NTROC U-N'I"T" SQUIRREL CAGE 2 3 4 MOW= 11100010M M11MMIM W WE 0 M M412MOT M 0=21101 011M WARNUM-M (G=G00D,W,7-_FNF*P=P00R) PHYSICAL CONDITION CLEANINGACCESS ELECTRICAL CONDITION FAN BELT CONDITION WE APPRECIATE YOUR BUSINESS AND WELCOME ANY COMMENTS AS TO HOW WE CAN SERVICE YOU BETTER IN THE FUTURE. IN OUR EFFORTS TO ENSURE THAT THE HOOD AND DUCT CLEANING HAS BEEN DONE TO YOUR SATISFACTION, WE REQUEST THAT YOU APPROVEOF THE SERVICE B�Y �SIGNNG BELOW. 4 COMMENTS TO CUSTOMER: axey 'f CUSTOMER / i SERVICE TECH!,ol -LI i , SIGNATURE_'_,�C DATE: FIRE DEPARTMENT COPY 63 R &THood and Duct Services, Inc. 6100 12th Ave. S. Phone (206) 726-0940 Seattle,WA 98108 Fax' (206) 767-2607 Occupancy Name: j Occupancy Address: Responsible Person: /Wvl�c 446w- Building Owner: COMPLETE FIRE PROTECTION High Pressure Hood Cleaning Fire Suppression Installation & Service Fire Extinguisher Sales & Service Range Hood and Fan Service & Repair Filter Sales & Service Certification Given: RED E] YELLOWE] WHIT CONFIDENCE TESTING RANGEHOOD SYSTEM TEST REPORT CONFIDENCE TESTZr :R::EP:�AIRSE] Phone Number: DATE: Building Owner Address: City, State, Zip: Testers Name (Please Print): SFD Certification Number: SCP- 7% �z -3 System Alarm? YesX No E] Control Panel manufacturer — Central station monitoring? YesK No El Monitoring company name: L Model Number: Location of Alarm Panel: Re7— Extinguishing System ManufacturerX. V. ;4 �4 IW4 0/g$49rWSystern Size :ef7! LI.L. 300 System? Yes Location / Height of Range hood: / I Xr, S,46,5� —&*;i— ID &� U.L. 300 Compliant? Yes/NoE] Chemical Type: wet Obry El r;/&Z- S, t Is pressure -gauge indicat0r.n1operable range? Yesv - No 12 year hydro date of cylinder. Z "Y' /0 Is there chemical inside of the cylinder'? Yes No E] Were hand portable extinguishers properly serviced? NAO Yesg, No[3 Weigh CO2 or nitrogen cartridge -- ---- NAF/ Were all cooking surfaces protected? If not, give owner full YesX No E] No visible signs of a system fire or system tampering (if signs check no). Yes -- - � - -- - -1 -- �0-1 --W Check all piping and conduit. Are all piping and conduit immobilized with YesZ No F-1 co information. in bally given to restaura t personnel? W8s_9perating prqcequTyer1 Yes N 0 proper hangers an brackets? Was LIL 300 compliance explained to owner or manager? Yes No Are all protective covers present on nozzles? Yes No Gias shuts down upon system activation? KA Yes No r-1 Are all nozzles checked in the proper position? YeSA No Electric power shuts down upon system activation? NA E] Yes,3 No Does system have adequate volume and/or nozzle coverage? Yes No E3 Range hood tied to building alarm panel? NAO Yes Z Noo q Are all appliances inside of the ho ' od protection area?_ Ye s 12— No Ej Range hood activation sig - nal re - ceived at building alarm panel? NA El Yes4 NoF -1 Have fuse links been replaced? YesZ No F� 'Lqlsss.�K extinguisherpresent? YesZ] _NoEj I Was system operaticipal fr . om . ter .1 mi , nal link? YesZ NoL]-_, Grease buildup in group: Was system operational from manual remote? YesZ N A n Ye No F] No -n Light M dill .,Heavy, recommend cleaning D ' of last cleaning ate Was system- and micro switch operational? Is system visible and free from obstruction? s Yes No Ej - _ Are cleaning intervals within NFPA standards? Previous Confidence Company Technician Yes X No E] Is the�inspectionand service tag on the cylinder? Yes N 0 Test U -A T I X 7T 4 A --T -T 4141 'I T Problems Found: (if additional room is needed, please add a separate sheet) Customer has declined repairs X Corrections Made: Date Corrected: Corrected By: SFD Certification Number: 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. Discrepancies are d to the building Owner/Responsible Person for corrective action. Signature of Tester: Phone # — (206) 726-0940 Testing Agency: MailingAddress: 610012thAve.S.,Seaftle.WA98108 ... R&T Hooffn coeryk-eg, Inc. The owner is to pefform 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 found, appropriat all be taken immediately. intended use. 9. A record of the monthl ins ct' to be kept reflectin t ni itals of 3. Insure that all tamper seals are intact and that system is in a ready condition. person performing th s I and an equired. 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 T7 FIRE DEPARTMENT COPY 1 APPLICATION FOR PERMIT FOR MATERIALS OR PROCESSES January 3, 2012 Please verify and correct the following information: Name of Company (DBA): Anthony's Beach Cafe Edmonds Location : 456 Admiral Way #101 In conformity with the -terms-of-the-International— Fire Code, application is hereby made to store, use Places of Assembly - Occupant Load: 145 or maintain the following activity, storage or pro- cesses: c/o Anthony's Restaurants Mailing Address: P.O. Box 3805 Bellevue, WA 98009 EFD UFIR #: 1611458OB201 (for office use) Your Signature Your Name (print) D1 AAa 'QL4, 6 n Your Title 4-p/14W. Please make corrections, attac $40 ayable to the City of Edmonds and mail to: (ireoMarshal Department of Fire Prevention 121-5 th Avenue North Edmonds, WA 98020 FOR OFFICE USE ONLY Rec'd 2- It D Check# ��30q R "A" � &THood and Duct Services, Inc. 6100 12th Ave. S. Phone (206) 726-0940 Seattle,WA 98108 Fax (206) 767-2607 on COMPLETE Certification Given: REDO YELLOWX WHITE�EEMI FIRE PROTECTION CONFIDENCE TESTING RANGEHOOD SYSTEM TEST REPORT High Pressure Hood Cleaning Fire Suppression Installation & Service FCONFIDENCE TESTO REPAIRSE] Fire Extinguisher Sales & Service Range Hood and Fan Service & Repair Filter Sales & Service DATE: Occupancy Name: 0664!Q�K 'I I-X�-tr L:67n-- Occupancy Address: Responsible Person: Building Owner: Building Owner Address: Testers Name (Please Print): 141 Ay"146ew System Alarm? Yes No El Central station monitoring? Yeso' No 0 Ix Control Panel manufacturer: Model Number: — City, State, Zip: Phone Number: Phone Number: City, State, Zip: SFD Certification Number: SCP- Monitoring company name: --Q>VM& L- Location of Alarm Panel: A&K, a5c-yeeir Extinguishing System Manufacturer System Size JIV e I.I.L. 300 System? YesXNoE] U.L. 300 Compliant? Yes Ej No2f Chemical Type: WetZDryo Location / Height of Range hood: T411� Is pressure gauge indicator in operable range? Yeso o0 12 year hydro date of cylinder. Is the - r e c - hem , ical ins i d , e . of the cylinder? Ye;/ No E] We . re he . nd - po . rtab . le'extinguis . he rs peope . rly serviced? NA F-1 Yes,X- Noo Weigh CO2 or nitrogen cartridge. NA Were all cooking surfaces protected? If not, give owner full NoF� No visible signs of a system fire or system tampering (if signs check no). Yes2r - I - - r Check all. piping and -conduit. Are all piping and conduit immobilized with Yes;? No [:] -- - � No[:] information. - -- --- -- -, was operating procedure verbally given to restaurant personnel? Yesz NoEl proper hangers andbrackets? Was LIL 300 compliance explained to owner or manager? YesX No E] Are all protective covers present on nozzles? YesZ No F-1 'd as s huts down u po n's - s-ve- m a- ctivat-I on ? y YesFZ No Are all nozzles checked in the proper position?_ Yes Z Electric power shuts down upon system activation? NAE] YesZ Noo Does system have adequate volume and/or nozzle coverage? Yes e ___No[-] No E] Range hood tied tobuildin alarmpanel? NACD Yes [Z Noo Are all appliances inside of the hood protection -area?- Yes 1Z No Range hood activation signal received at building alarm panel? NA [] -- Yes � 4e No El Have fuse links been replaced? Yes2T No E] , Class -K,e-xt-in-g"uis—her--pr—es-e-n-t?- Yes No Was system operational from terminal link? Yes�Z No Grease buildup in group: Light Med.0m.-4 Heavy, recommend cleaning Was system operational from manual remote? Yes Z No F� -ZZZ� Was system and micro switch operational? _ NA Yes No Date of last cleaning �� Are cleaning intervals within a�A standards? Yes No Is system visible and free from obstruction? Yes;�j No E] Is the inspection and service tag on the cylinder? Yes No Previous Confidence Test Comppiny,&-Techni cian Elm E=NEE MEN Elm M mom 'ME 0 loom OMEM MINIM IMMUNE MIKEEMENEEN Mill 0 MMMEMOM Problems Found: (If additional room is needed, please add a separate sheet) MAIII&I- o? Ala- pqe�l; Nur t;:AVr- oFr- urotj AMtrrj0A1- OF:P* q63-31-2- �,WnT-11? A,(L- -M 5*J -,'boU* Customer has declined repairs X Corrections Made: Date Corrected: Corrected By: SFD Certification Number: 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. Discrepancies are d and e onsible Person for corrective action. Signature of Tester: 2!!� Phone # (206) 726-0940 Testing Agency: R&T Hood M#jEuct SVf;Fid5S, Iri—C- MailingAddress: 6100 12th Ave. S., Seattle, WA98108 The owner is to perform and keep a written record of the following I . The extinguishing system is in its proper location. The extinguishing cylinder is in place and has not been removed or tampered with. 2. The manual pull stations are unobstructed and in clear view and are labeled for intended use. 3. Insure that all tamper seals are intact and that system is in a ready condition. 4. Observe system, checking that no obvious physical damage or condition exists that might prevent operation. 5. The pressure gauge reading on the cylinder shall be in the green operable range. "quick check" fire system inspection to verify the following: 6. The nozzle disc caps and their seals are intact, undamaged and tight. 7. The inspection tag or certificate is in place and current. 8. If any deficiencies are found, appropriate c rre . e a . sh taken immediately. 9. A record of the monthly inspections is t, �? � . I he ate cted, inititals of person performing the inspectio io eiq ire AUTHORIZED SIGNATURE 5il!gpf FIRE DEPARTMENT COPY I APPLICATION FOR PERMIT FOR MATERIALS OR PROCESS March 7, 2011 Please verify and correct the following information.- =.C. IEVE MAR 2 � PAID 11 i EDMONDS FIRE VPT. Name of Company; DBA Anthony's Beach Cafe Edmonds Location 456 Admiral Way In conformity with the terms of Places of Assembly - Occupant Load: 145 the International Fire Code, application is hereby made to -store, use or maintain the following activity, storage or processes: Mailing Address: Anthony's Restaurants P.O. Box 3805 Bellevue WA 98009 EFD UFIR 1611458OB201 (for office use) Your Signature Ao4 Your Name (print) Your Title Please make corrections, attach $40 payable to the City of Edmonds, and mail to: Fire Marshal Department of Fire Prevention 121-5 th Avenue North Edmonds, WA 98020 CITY OF EDMONDS DEPARTMENT OF FIRE PREVENTION PERMIT January 1, 2011 161-145-80B-201 December 31, 2011 Date of Issue UFIR Number Date of Expiration I This PERMIT is issued to: I Anthony's Beach Cafe I I located at: 1456 Admiral Way I Edmonds, WA I To engage in the business, occupation or pr cess of: T- I And shall constitute permission to maintain, store, use or handle materials or to conduct process which produce conditions hazardous to life or property or to install equipment used in connection with such activities as follows: Places of Assembly - Occupant Load: 145 I Allowed Occupant Load: 1 14 Pursuant to the provisions of the International Fire Code, any violation of the Code may be grounds for the revocation of this PERMIT. This permit does not take the place of any license required by law and is not transferable. Any change in the use or occupancy of premises shall require a new permit. FirqParshal,j Debktment of Fire Prevention This Permit Must Be Posted At All Times in The Premises Identified Above City of Edmonds Community Development Code 19.25.020 SNOHOMISH CO. FIRE Serving Brier, Ednionds i Mountlake Terraceand 12425 Meridian Ave S Everett, WA 98208 FIRE PREVENTION INSPECTION REPORT 0 EDMONDS 0 BRIER STR T e Town of Woodway ThwwFireDistrictLorg Phone (425) 551-1200 Fax (425) 551-1272 El WOODWAY [I MOUNTLAKE TERRACE 0 UNINCORPOR ATED r FREQUENCY STATION & SHIFTII� LOCATION: 456 Admiral Way 101 365 1, I BUSINESS NAME: Anthonys Beach Cafe PHONE: 4257714400 SCHEDULED DATE DUE � 08/01/11 MAILING 456 Admiral ft #101 UFIR � 161 8201 ADDRESS: Edmonds 98020 BUSINESS OWNER- "M - ad Anthonys Inc HOME PHONE: 4254550732 ACTIVE 145 EMEhGENCY-1: Olson, Dave HOME PHONE: 4253379298 CURRENT KEY ACCESS-2: HOME PHONE: CITY YES NO BUSINESS El LICENSE PERSON CONTACTED: INITIAL INSPECTION DATE NAME OF INSPECTOR: I I —A ��RE HD 4/11 FE 4j + SYSTEMS: ANNUAL HAZARDS FOUND AND LOCATIONS COMMUNICATIONS j�j�, 1-6 k 0 , 1 2 2 _2a 3 4 4 5 5 6 6 7 7 I AGREE TO CORRECT _��E ABOVE VIOLATION(S) IN THE NEXT 30 DAYS X 1 st REtINSPECTION 2nd RE -INSPECTION FINAL RE -INSPECTION ,_1 EXTENSION VIOLATIONS DATE DUE: DATE DUE: GRANTED TO: DATE DUE: CITED: PERSON PERSON PERSON CONTACTED: CONTACTED: CONTACTED: 1 INSPECTOR: 'INSPECTOR: INSPECTOR: 2 DATE:, DATE: DATE: 3 VIOLATIONS VIOLATIONS PRE -CITATION CITATION ISSUED 1 5 1 15 LETTER SENT NUMBER: 4 I CODE 5 2 6 2 6 D�TE: SECTION: RETURN RECEIPT 3 7 3 7 RECEIVED 6 DISPOSITION: 4 18 4 18 DATE: 7 LETTER NEEDED E] YES [I NO LETTER NEEDED F] YES NO \� I 1 8 FIRE DEPARTMENT COPY 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: Building Owner: COMPLETE Certification Given: RED E] YELLOW E2' WHITE FIRE PROTECTION CONFIDENCE TESTING RANGEHOOD High Pressure Hood Cleaning SYSTEM TEST REPORT Fire Suppression Installation & Service CONFIDENCE TEST 2-REPAIRS 0 1 Fire Extinguisher Sales & Service Range Hood and Fan Service & Repair Filter Sales & Service DATE: City, State, Zip: ygoz)(p Phone Number: Phone Number: Building Owner Address: 9 City, State, Zip: Testers Name (Please Print): & - <2 I'd SFD Certification Number: Scp- ey-Z System Alarm? Yes Q—NoE] Central station monitoring? 'Yes E�--No Monitoring company name: -qp r.11 Control Panel manufacturer: Model Number: Location of Alarm Panel:- j2xitt qw,�t Extinguishing System Manufacturer R A21�0 e System Location / Height of Range hood: IQ�:,p k U.L. 300 System? Yes � I.I.L. 300 Compliant? Yes E] No EEr-Chemical Type: Wet �ry E] I p gpL49 -- - -- - - 4 s ressure -e-i�di(i�t�rin-o-o-e-!��-b-le-r-a-nge? - - - - - Y�s ffr o C[ N 12 year hydro date of cylinder. Is there chemical inside of the cylinder? Yes a- No[j _)yere hand ble ext�ngqijshers p e iceV NA Ybs-(a---No _pRqa_ moperly Wed h CO or nitrogen cartridg - a. Were all cooking surfaces protected? If not, give owner full YesEa- NoE] No visible signs of a system fire or system tampering (if signs check no). Yes No El Check all, piping and conduit: Are all piping and conduit immobilized with Yes Non information. Was operating procedure verbally given to restaurant personnel? Ybsr'q� NoEl properhai�gers and brack6ts? Was UL 300 compliance explained to owner or manager? Yes 1�t- No E] Are all protective covers present on nozzles? Yes L;j- Non Gas shuts down upon system activation? N=A- es[3;-,- 0 1 Are all nozzles checked in the proper�position? Yes[�- Noo Electric power shut's down upon system activation? NA Yes No Does system have adequate volume and/or nozzle coverage? Yes [�J-- No Ran a hood tied to building alarm panel? NAD Yes E�t' Are all ap , pliances,inside of I I he hood protection area? -yes2—,NOF-] Range hood activation signal received at building alarm panel? NA Yes Non Have fuse links been replaced? Yes Non __qla" K extingui sh er pre sent ? Yes Was system operational frorn'terminal link? Grease buildup in group: Was system operational from manual remote? Yes g- Non -0 Light Medium— Heavy, recommend cleaning Date of last cleaning Was systemr.andmicro switch opetatibnal? NA0___Yes_[�j-_ Is system visible and free from obstruction? Yes E;J- No Are cleanin - g intervals within N - FPA standards? Y No-E] V - us Confidence Test Company & Technic fan Is the in spection and service tag omthe cyjinder?_.. Yes L;i No rl A revio A MM1=MMMMM= EMMMMN low ME NON! I mom Proble IF d: (if additional room is needed, please add a sepWate sheet) Joe 5 170� Skue- 0& eA U Customer has declined repairs X Corrections Made: Date Corrected: Corrected By: SFD Certification Number: This certifies that this fire and life safe ed for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code standards. Discrepancies are ing Owner/Responsible Person for corrective action. Signature of Tester: Phone # (206) 726-0940 Testing Agency: 4&-THo6d,a'6d Duct SdML!a� MailingAddress: 610012thAve.S.,Seaftle,WA98108 The owner is to perform af(d 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. If any deficiencies are found, appropriate corrective action shall be taken immediately. intended use. 9. A record of the monthl ins ctions is to be kept reflecting the date inspected, inititals of 3. Insure that all tamper seals are intact and that sy person performing . y s stem is in a ready condition. th in ction ections 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 - `Z FIRE DEPARTMENT COPY R &THood and Duct Services, Inc. 6100 12th Ave. S. Phone (206) 726-0940 Seattle,WA 98108 Fax (206) 767-2607 Occupancy Name: J'I r1',rAQF1V 1. — Occupancy Address: 95-b &�Vil Responsible Person: OAV; off — Building Owner: COMPLETE Certification Given: REDD YELLOW;�J' WHITEE] I FIRE PROTECTION CONFIDENCE TESTING R4NGEHOOD High Pressure Hood Cleaning SYSTEM TEST REPORT Fire Suppression Installation & Service F-CONFIDENCE TESTZI REPAIRSE] Fire Extinguisher Sales & Service Range Hood and Fan Service & Repair Filter Sales & Service D A T E: tyvjl & CityState,Zip: 61m,"44, Z;7�;l Vogo Phone Number: Phone Number: Building Owner Address: City, State, Zip: Testers Name (Please Print): SFD Certification Number: SCP_. -7/10 System Alarm? Ye No F� Central station monitoring? Yes D Nor-] Monitoring company name: zm( �ll 4 4, Control Panel manufacturer: Model Number: Location of Alarm Panel: 17#r yst m S o El Extinguishing System Manufacturer _q 300 System? Yes;n N I.I.L. 300 Compliant? Yes E] NqEfr Chemical Type: Wet��ryF e Location / Height of Range hood: ; I -or- - --- --- s p essure gal inclicatorin operable_rangl0_ --- - -_ -_ -, --- - Yes� N00_1 12 year hydro date of cylinder. it/ il /U Is there chernical inside of the cylinder? Yes,[� No Were -hand p giltable q_4inguishers propejdy serviced?- N�E] Yes Weigh CO2 ornitrogtn_cartric1ge.______ NA Were all cooking surfaces protected? If not, give owner full Yes No No visible signs of a system fire or system tampering (if signs check no). Yesl ' No El information. Was operating verbally to restaurant personnel? S�a_ No C h-ec-k all p__ iping and conduit. Are all piping and conduit immobilized with Yeq,�j No[j procedure given proper hangers and brackets? Was UL300 compliance explained to owner or manager? Yesp�' No F-1 Are all protective covers present on nozzles? Yeso No E] be shuts d NA __p�a_ypon system activation? Ye No Are all nozzles checked in the proper position? _NoQ_ Electric power shuts down upon system activation? NA Yes 2r Non Does system have adequate volume and/or nozzle coverage? Yes NoF_j Range hood tied to building alarm panel? NA Yes No Are all appliances inside of the -hood protection- area?. -_ Yes N - oEj Range hood activatio n signal received at buildi ng alarm panel? NAE] Ye s a Noo Have fuse links been replaced? Yeso- No[] Class K extirl piresent? YesEj-_ No[] Was system operational from terminal link? Yes Grease bl in group: Was system operational from manual remote? Yes No Light ---)L—Heavy, recommend cleaning Was system and micro "i h lional? tc opera NAD Yes ___No[j__ Date of last cleaning Are cleaning intervals within NFPA standards? Ye,�K NoEl Is system visible and free from obstruction? Yes No Is the inspection and service tag on the c ind r? _yj - -er Yes No Previous Confidence Test Company & Techn 0 0 IN - oil 0 EN M = I MOMS= 0 IIIIIIIIHIIIIIIIII ��mmommmommm ommmommmoso on Problems Found: (If addit nal room is needed, please add a separay sheet) Ill Customer has declined repaiu Z l N Corrections Made: Date Corrected: Corrected By: SFD Certif catibn Number: This certifies that this fire #d life safE6 systA)as been properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code standards. Discrepancie We nc a en reported to the building Owner/Responsible Person for corrective action. Signature of Tester: 4L:!C J Phone # (206) 726-0940 Testing Agency: A&T good 6nd`0J'@t ��eQices. Inc. MailingAddress: 6100 12th Ave. S., Seattle, WA98108 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 �ertififpte is in pl a d c ent n r 2. The manual pull stations are unobstructed and in clear view and are labeled for 8. If any deficiencies are toun(Vappropr' n-orrectivre aciion shall betaken immediately. intended use. 9. A record of the nthll ns c i , ns ill to e ke 'reflecting the date inspected, inititals of 3. Insure that all tamper seals are intact and that system is in a ready condition. person performiynh ns y c ctions 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 7 FIRE DEPARTMENT COPY iS CITY OF EDMONt 121 5TH AVENUE N. - EDMONDS, WASHINGTON 98020 (425) 771-0215 FIRE DEPARTMENT 4�' t 8 9 z LOCATION: 456 Admiral Way BUSINESS NAME: Anthonys Beach Cafe MAILING 456 Admiral Wy #10 1 FIRE PREVENTION SAFETY SURVEY 101 PHONE: 4257714400 ADDRESS: Edmonds 98020 BUSINESS OWNER: Mad Anthonys Inc HOMEPHONE: 4254550732 EMERGENCY-1: Olson, Dave HOME PHONE: 4253379298 KEY ACCESS-2: Bergan, Randy HOME PHONE: FREQUENCY I STATION 11 SHIFT 365 '17 C SCHEDULED DATE DUE 1� 08101/10 UFIR 0- 161 8201 AC_nVE 145 INITIAL INSPECTION DATE PERSON CONTACTED: NAME OF INSPECTOR: 4LI, Z-fd)-eiQ FIRE j1b 4/",�JI_300 FEZ,61_0 SYSTEMS.. ) ANNUAL HAZARDS FOUND AND LOCATIONS / COMMUNICATIONS r !i ENTER CODE ONLY ONCE 11� VIOLATION CODE 2 2 ------- 3 3 4 4 5 5 6 6 7 7 8 8 11st RE -INSPECTION DATE DUE: 2nd RE -INSPECTION DATE DUE: EXTENSION GRANTED TO: FINAL RE -INSPECTION DATE DUE: VIOLATIONS CITED: PERSON CONTACTED: PERSON CONTACTED: PERSON CONTACTED: 1 INSPECTOR: INSPECTOR: INSPECTOR: 2 DATE: DATE: 3 VIOLATIONS 1 5 VIOLATIONS 5 _,,.1fr'_'DATE, PRE -CITATION LETTER SENT CITATION ISSUED �'NUMBER: 4 2 6 2 6 'cOp DATE: �SECTION:,. 5 3 7 3 7 RETURN RECEIPT RECEIVED 6 7 4 18 4 .8 DATE: DISPOSITION: 8 �LETTERNIEEDEIJ [] YES NO LETTER NEEDED [-] YES NO FIRE DEPARTMENT COPY . . . . . . COMPLETE Certification Given: RED E] YELLOW[& WHITEE]l FIRE PROTECTION CONFIDENCE TESTING RANGEHOOD R High Pressure Hood Cleaning SYSTEM TEST REPORT C Fire Suppression Installation & Service &THood and Duct Services, Inc. CONFIDENCE TEST Ek REPAIRSE] 4 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: Occupancy Name - Occupancy Address: City, State, Zip: fn—iWWC1Z:1 CK Responsible Person: Phone Numben. Building Owner: Phone Number: Building Owner Address: City, State, Zip: Testers Name (Please Print): SN-1 kQ-A,^ Q�3F%Na-442K SFD Certification Number: SCP_ 1-7*_ SystemAlarm? YesE] NoX Central station monitoring? Yes E] No 09. Monitoring company name: Control Panel manufacturer: Model Number: Location of Alarm Panel: % Extingui - shing System M - anufacture __ r System Size4k--A LI.L.P0 - 0 - Systery?. Yes R&No F r Is ] LI.L. 300 Compliant? Yes No Chemical Type: Wet [KDry Ej Location / Height of Range hood: v:A ; 0 C:� M I Yes No 0 12 year hydro date of cylinder. ko L IS pressure i dicator in op able Lange? _qwug"___ mr Is there chemical inside of the cylinder? Yes A No E] Were hand portable exting4i�khq_rs'pnopj�rty erviced? NA Yes No I 9- Wei h CO2 or nitrogen cartridge. __NAr 11 — ------ Were all cooking surfaces protected? If not, give owner full Yes 5� No E] No visible signs of a system fire or system tampering (if signs check no). Yes F/ NoM information. 'Check all piping and conduit. Are all piping and conduit immobilized with YesF71 NoM Waso erating procedure verb Ily given to restaurant personnel? Yes 2 P a NoM 1 1 proper hiangers and brackets? Was LIL 300 compliance explained to owner or manager? Yes E? No E] Are all protective covers present on nozzles? Yes No Gas shuts down upon system activation?,---------_ e 2 I Are all nozzles checked in the proper position? Yes NoE]___, Electric power shuts down upon system activation? NAE] Yes M _NoE1 No [Z Does system have adequate volume and/or nozzle coverage? Yes [Z No El an�e "06 edfobuilding _aWralpariel? NAj____Yas[_:j__ NoEl-,, Are all -appliances inside of the hood protection area? Yes No 0 Range hood activation signal received at building alarm panel? NA Yes E] No Have fuse links been replaced? Yes No[:] --Class K extinguisher presert? Yes No Was, system oplodional from terminal link? Yesc� -No Grease buLlijup in group: Was system operational from manual remote? Yes No ...... Light MeditLm— Heavy, recommend cleaning W�s system and micro, twitch operational? NA 0__ �(es r-A NqF] ------- Date of last cleanino Is system visible and free from obstruction? Yes 2 ------ No E] Are cleaning intervals within NFPA standards? cWc Yes Nj? is the inWe6tion and'servicLe tag on the c inder?' - Previous Confidence Test Company & Te a Corrections Made: Date Corrected: Corrected By: Customer has declined repairs X SFD Certification Number: This certifies that thi a d lif sa ety system h been properly inspected for reliability to cover the items listed in this report and is consistent with Seattle Fire Department Fire Code s se standards. Discrepa, cries a n b n sported to the building Owner/Responsible Person for corrective action. ave Signature of ester: Phone # (206) 726-0940 Testing Agency: k F t gea46es, Inc. MailingAddress: 610012thAve.S..Seaftle.WA98108 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. If any deficiencies are found, appropriate corrective action shall be taken immediately. intended use. 9. A record of the monthly inspections is to be kept reflectin I spected, inititals of 3. Insure that all tamper seals are intact and that system is in a ready condition. person performing the insvection and anv corre uired. 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