Form 12-A 
FIXED WET CHEMICAL EXTINGUISHING SYSTEMS
General Information
Date
Location
Inspector
System
System designation
System manufacturer
Date installed
Service contractor
Type of extinguishing agent
Potassium carbonate
Combination potassium carbonate/potassium acetate
Sodium acetate
Wet chemical cylinder
Normal pressure:
psi (bar)
Manufacturer’s minimum pressure:
Normal weight:
psi (bar)
lbs (kg)
Manufacturer’s minimum weight:
Equipment protected
lbs (kg)
Deep fat fryer
Upright broiler(s)
Grill(s)
Griddle(s)
Charbroiler(s)
Range top(s)
Expellant gas cartridge—any provided?
If yes, normal weight (if carbon dioxide):
Connected to fire alarm system?
Automatic shutdown of cooking equipment?
If yes, is it:
Comments
Yes
No
lbs (kg)
Yes
No
Yes
No
Gas
Electric
Other