Certificate Of Inspection - Hood Fire Suppression System - Ocean City Fire Marshal
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1TOWN OF OCEAN CITY - OFFICE OF THE FIRE MARSHAL
P.O. Box 158 Ocean City, MD 21843
Phone # 410-289-8780 Fax # 410-289-8767
CERTIFICATE OF INSPECTION
Hood Fire Suppression System
Annual Certificate of Inspection in Accordance with NFPA 96
Non-Annual Certificate of Inspection in Accordance with NFPA 96
Deficiencies:
YES
NO
Protected Property:
Building Name:________________________________
Exact Physical Address:__________________________________________
Contact Person:________________________________
Bill To:_______________________________________________________
Contact Phone #:________________________________
Billing Address: ________________________________________________
Hood Fire Suppression System Testing Company:
Inspector/Technician:___________________________
Company:_______________________________________________
Phone Number:________________________________
Address:________________________________________________
Date System Tested:____________________________
________________________________________________
Hood Fire Suppression System Owner’s Notification:
The owner and/or the owner’s representative of the system was notified on
of all deficiencies?
PRIOR TO TESTING, OCEAN CITY COMMUNICATIONS SHALL BE NOTIFIED!
PHONE # 410-723-6620
(Failure to do so will result in the full provisions of the Town of Ocean City Fire Prevention and Protection Code to be invoked.)
Dispatcher Name/Number:_____________________________
Time:__________________
System Type:
Wet Chemical
Dry Chemical
Other
Deficiencies Identified During Inspection:
System Out of Service/ Impaired
Exhaust System Out of Service
Unprotected Appliance
Missing Filters
Nozzle Blocked / Obstructed
Grease Laden Filters / Hood / Duct Area
Failure of Gas or Electric Shut Off
Agent / Expellant Gas Levels Inadequate
Other: List Below
Comments / Deficiency Description: (Attach an “Additional Information Form” if more room is needed.)
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________
FOR INTERNAL USE ONLY:
Data Entry Date:__________
FM Assigned:__________
Date FM Assigned:__________
Date Inspected/Contacted:__________
No Deficiencies Found
Deficiencies Verified
QV #:__________
Date of Violation:__________
Date of Compliance:__________
**THIS FORM MUST BE SUBMITTED WITHIN 30 DAYS FROM THE DATE OF INSPECTION TO THE OCEAN CITY FIRE
MARSHALS OFFICE **
Rev. 10/7/2008
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