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2016 Generator Inspection Report <br /> • <br /> Date of Inspection: 4/21/2017 <br /> Name of Facility: Everett Rehab Facility Licensed As: 0 Boarding Home <br /> 1919 112th St SW I] Nursing Home <br /> Everett WA 98024 0 Hospital <br /> City State Zip 0 Retirement Facility <br /> Other 0 <br /> Administrator: Barry Telephone: 0 <br /> Inspecting Firm: D Square Energy LLC Telephone: (800) 820-0162 <br /> 201 W. North Bend Way <br /> North Bend WA 98045 Elec. Lic. No. DSQUASE903MF <br /> City State Zip <br /> Technician: Barry Palmer Cont. Lic. No. DSQUASE895DQ <br /> Generator Manufacturer: Generac Fuel Type: DIESEL <br /> Engine Brand: HINO Hour Meter: 441.70 KW: 100 RPM: 1860 <br /> 1. Transfer Test - Seconds until unit starts after power failure? 1 <br /> 2. Transfer Switches-Seconds until transfer to gen after power failure? 4 <br /> 3. Volts: Loaded 208.00 Unloaded 208.00 <br /> 4. Hertz: Loaded 59.9 Unloaded 61 <br /> 5. Amps: Phase A 90 Phase B 105 Phase C 85 <br /> 6. Battery voltage while cranking: 24.1 Volts DC <br /> 7. Generator run light on? CI Yes 0 No 0 N/A <br /> 8. Generator stops when power restored? ES Yes 0 No Time: 15 Minutes <br /> 9. Does primary and/or backup fuel supply come from on-site source and have <br /> a minimum two hour fuel supply in accordance to WAC 212-321 El Yes 0 No <br /> 10. Fuel Supply: Primary DIESEL Backup <br /> 11. Does automatic transfer to on-site fuel supply work properly? 0 Yes 0 No ❑x N/A <br /> 12. Coolant: El Full 0 Low Protected to -34 0 N/A <br /> 13. Does all required Fire and Life Safety Equipment operate on the generator? <br /> A) Illumination - Means of Egress ❑x Yes 0 No <br /> B) Exit Signs I] Yes 0 No <br /> C) Fire Alarm and Alerting Systems I] Yes ❑ No <br /> D) Communication Systems - Telephone, etc. I] Yes 0 No <br /> E) Large Assembly Rooms .. CI Yes 0 No <br /> F) Generator Set Locations I] Yes 0 No <br /> G) Elevator Cab lighting and Controls 10 Yes 0 No <br /> 14. Is any non-emergency equipment connected to the generator? 0 Yes I] No <br /> If yes, list: <br /> 15. Are Emergency Panel(s)and circuits clearly identified? Yes 0 No <br /> 16. Does connected load exceed generator capacity? 0 Yes 0 No <br /> 17. Deficiencies Found: <br /> 18. Corrections Made: <br /> Corrected By: Date Corrected: <br /> This is to certify that the Emergency Generator System has been properly inspected for reliability covering all the items on this form. <br /> 0 Barry Palmer <br /> Signature of Facility Owner/Representative Signature of Generator Firm Representative <br />