Form 9-2012 - Confidence Test Report - Seattle Fire Department Page 2
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1
2
3
4This is a Federal Building
The items on the checklists below shall be inspected and tested. This list may not constitute all of the required
inspecting and testing of the fire and life safety system. Refer to the 2009 Seattle Fire Code (SFC) Sec. 202, 602,
609, 904.11-904.11.6.3; SFC Administrative Rule 9.02.09; and 2002 NFPA 17, 2002 NFPA 17A, and
2008 NFPA 96 for inspecting and testing requirements.
P
-T
C
RE
EST
HECKS
1. The Fire Alarm was put into test mode and/or other precautions were taken
N/A
Yes
No
to avoid preventable alarms.
2. This is the only Range Hood Fire Suppression system at this address.
Yes
No
If “No” provide the unique ID number. (See SFC Ad Rule 9.02.09) _________
Yes
No
3. The suppression system meets the UL300 standard.
(Note to System Owners: Non UL300 systems are no longer UL listed for commercial
range hood fire suppression. All non UL300 systems must be upgraded or replaced to
meet the UL300 standard.)
A
C
, N
,
P
PPLIANCE
OVERAGE
OZZLES
AND
IPING
4. All cooking appliances that can produce grease laden vapors are completely under the range
Yes
No
hood.
5. All cooking appliances have the required number and type of nozzles to provide adequate
Yes
No
fire protection.
Yes
No
6. All nozzles are properly positioned.
Yes
No
7. All piping and conduit are immobilized with proper hangers and brackets.
S
C
YSTEM
ONTROLS
Yes
No
8. All system controls and components are accessible and free from obstructions.
Yes
No
9. The system is operational from the terminal link (last fusible link)
Yes
No
10. The fusible links were replaced.
Yes
No
11. The manual (remote) pull is configured correctly and is operational.
Yes
No
12. The operation of the fusible link line is not impaired by grease.
13. The micro switch that controls the gas and/or electrical power to the appliances functions
Yes
No
properly.
N/A
Yes
No
14. The gas shuts down upon system activation.
N/A
Yes
No
15. The appliance electrical shutdown device functions properly.
C
E
A
YLINDERS AND
XTINGUISHING
GENT
16. The extinguishing agent in the cylinders conforms to the manufacturer’s requirements for this
Yes
No
system.
17. The system has adequate supply of extinguishing agent as required to meet the demand for
Yes
No
complete coverage of the cooking
appliances.
18. The cylinders are filled with the correct volume of extinguishing agent.
Yes
No
Required volume ________lbs. or __________gals.
Yes
No
19. The cylinder gauge is in the operational range.
20. The CO2 or Nitrogen cylinder is fully charged.
Yes
No
Design weight _____ lb.
Actual Weight _____lb.
21. The hydrostatic testing of the agent cylinder(s) is up-to-date.
Yes
No
Date for next hydrostatic test ______________________
Range Hood System
9-2012 Ver.1.3
Page 2 of 4
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