HomeMy WebLinkAbout1022 17 STREET (2)SELF - CERTIFICATION CHECKLIST
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BAKERSFIELD FIRE DEPT.
Prevention Services
2101 H Street
Bakersfield, CA 93301
Tel.: (661) 326 -3979
Fax: (661) 852 -2171
FACILITY NAME:
ELF - CERTIFICATION DATE:
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SITE ADDRESS:
ZIP CODE
HONE NUMBER:
MAILING ADDRESS: ZIP CODE
FAX NUMBER:
SA
ME
6�t 325 -9163
DO NOT DISCARD — FAILURE TO RETURN WILL RESULT IN FIRE DEPARTMENT INSPECTION
INSTRUCTIONS:
Please verify and check each item as appropriate. Include comments on each line or at the bottom as necessary.
When completed, make a second copy for your records and mail the original to the address above. Failure to return will result In inspection.
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OPERATION
COMMENTS
❑
Spent fluorescent tubes saved in a suitable container and recycling.'
Name:
(If you rely on an outside agency for the recycling, please Indicate the name, address, and phone number of the
agency that removes your tubes.)
Phone No.:
Address:
❑
Waste batteries saved in suitable container for recycling.'
❑
Discarded electronic devices saved for recycling.'
❑
Discarded items containing Mercury saved for recycling.'
❑
Discarded non -empty aerosol spray cans saved for recycling.'
'. ❑
Current annually serviced "ABC Type" fire extinguisher every 75 feet of travel.
❑
Extension Cords (longer than 6 feet) shall not be used in place of permanent
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approved wide .
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❑
All exits indicated by exit signs, not more than 100 feet apart, if occupant load
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is 100 or more.
15
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Minimum of 30 inches of clearance in front of electrical panels.
- ❑
Cover plates installed on all electrical outlets, switches, and junction boxes (no
exposed wiring).
❑
Flammable and combustible material stored properly and not adjacent to a
source of ignition (check hot water heater and furnace area).
❑ �k
Do you use or store any hazardous materials on site?
❑ Sr
Does your building have a monitored fire alarm system?
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Does your building have a fire suppression (sprinkler) system?
'Recycle at the Kem County Special Waste Facility, 4951 Standard Street, Bakersfield, CA 93308. Phone: (661) 862 -8922
COMMENTS:
QUESTIONS REGARDING THIS CHECKLIST? PLEASE CALL US AT (661) 326.3979 //Rn /MM /GRgT /oN Sti/e d I C!_= S /NC
Signature Business Site / Responsible Party (Please Print)
I IIIIII II FD 2155b (Rev. 09/06)
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