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~Q~~~n p~,~~ CITY OF BAKERSFIELD F1RE DEPARTMENT
OFFICE OF ENVIRUNNiF,NTA1. SERVICES
UNIFIED PROGRAM INSPECTION CHECKLIST
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FACILITY NAME~`~ ~ c2C-.~ INSPECTION DATE _
ADDRESS- ~Ur ~G!/;~/~Nj~4 PHONE NO.
FACILITY CONTACT BUSINESS ID NO. _ _ 15-210- 'Z~
INSPECTION TIME NUMBER OF EMPLOYEES
Section 1: Business Plan and Inventory Program
^ Routine ^ Combined ^ Joint Agency ^Mu1ti-Agency [,] Complaint ^ Re-inspection
OPERATION C V COMMENTS
Appropriate permit on hand
Business plan contact information accurate
Visible address
Correct occupancy
Verification of inventory materials
Verification of quantities
Verification of location
Proper segregation of material
Verification of MSDS availability
Verification of Haz Mat training
Verification of abatement supplies and procedures
Emergency procedures adequate
Containers properly labeled
Housekeeping
Fire Protection
Site Diagram Adequate & On Nand
C=Compliance V=Violation
Any hazardous waste on site?: ^ Yes ^ No
Explain:
Questions regarding this inspection'' Please call us at (661) 326-3979
White -Env. Svcs. Yellow -Station Copy Pink -Business Copy
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Business Site Responsible Party
Inspector:-
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- BAKERSFIELD FIRE DEPT.
Prevention Services ~ r
FIRE PREVENTION INSPECTION >, EP~IPE r D 900 Truxtun Ave., Ste. 210 l
- ABTM ~ Bakersfield, CA 93301
y Tel.: (661) 326-3979 ^ Fax: (661) 852-2171
DISTRICT BLOCK NO. DATE ~~ EE ~
FACILITY ADDRESS ^'7~jf ~ ~~ r
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FACILITY NAME
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MANAGER'S NAMF~'t ~
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BUSINESS OWNER'S NAME AND ADDRESS ,,,,. 7 ^-- OWNER'S PHONE NO.
CITY, STATE; ZIP
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO.
OCC TYPE OCC LOAD NO. OF FLOORS HIGH RISE BLDG RISER DATE
^ YES ^ NO
CORRECT ALL VIOLATIONS VIOLATION REQUIREMENTS
CHECKED BELOW No.
COMBUSTIBLE WASTE /DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.)
VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of combustible waste and rubbish pending its
safe disposal. (U.F.C.)
coMBUSTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse box/fire door (N.E.C.) (U.F.C.)
q Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanging on brackets with the top to the
extinguisher not more than 5 feet above the floor. (N.F.P.A. No. 10)
EXTINGUISHERS 5 Provide and install (amount) _____ approved (type & size) _________________ portable fire extinguisher to be
immediately accessible for use in (area) ____________________________ (U.F.C.)
g Re-charge all fire extinguishers. Fire extinguishers shall be serviced at least once each year, and/or after each use,
by a person having a valid license or certificate. (U.F.C.)
SIGNS 7 Provide and maintain "EXIT" sign(s) with letters 5 or more inche~~~~i hI1~J~~eatlh ~grn~go~cit (door/window) to
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fire escape. (U.F.C.)
g Provide and maintain appropriate numbers on a contrasting background and visible from the street to indicate the
correct address of the building. (B.M.C.) (U.F.C.)
g Repair all (cracks/holes/openings) in plaster in (location) _____________________________________. Plastering
FIRE DOORS/
FIRE SEPARATIONS shall return the surface to its original fire resistive condition. (U.B.C.) -
10 Remove/repair (item & location) _________________________________________________________. Self-closing
doors shall be designed to close by gravity, or by the action of a mechanical device, or by an approved smoke and
heat sensitive device. Self-closing doors shall have no attachments capable of preventing the operation of the
closing device. (U.F.C.)
EXITS 11 Remove all obstruction from hallways. Maintain all means of egress free of any storage. (U.F.C.)
12 Provide a contrasting colored and permanently installed electric light over or near required exit (location)
_____________________________ to clearly indicate it as an exit. (U.F.C.)
STORAGE 1g Remove all storage and/or other obstructions from fire escape landings and stairways stair shafts. (Fire
escapes/stair shafts are to be maintained free from obstructions at all times.) (U.F.C.)
14 Extension cords shall not be used in lieu of permanent approved wiring. Install additional approved electrical outlets
ELECTRICAL APPLIANCES where needed. (N.E.C.) (U.F.C.)
'" 15 Remove multiple attachment cords from specific electrical convenience outlet (one plug per outlet) (N. E.C.) (U.F.C.)
OUTDOOR BURNING 16 Violation of Section 1102 dealin with recreational fires or o en burnin U.F.C.
FIREWORKS 17 Violations of Section 780
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U.F.C. or 8.49
040 of the
Bak
ersfield Munici al Code B.M.C. re ardin fireworks.
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CUSTOMER: LEGEND:
C.F.C. CALIFORNIA FIRE CODE
(Signature) (Please Print Name Legibly, Title) U.B.C. UNIFORM BUILDING CODE
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INSPECTOR: L,.~ G~~-'"""- AP NO.:~~ '~'~ B.M.C. BAKERSFIELD MUNICIPAL CODE
N.F.P.A. NATIONAL FIRE PROTECTION
($IgnatUfe) ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
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FIRE PREVENTION INSPECTION
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BAKERSFIELD FIRE DEPT.
e ,? R s P t L D Prevention Services I_
FARE 900 Truxtun Ave., Ste. 210 ~ ~ t(J
ARTM T Bakersfield, CA 93301
Tel.: (661) 326-3979 ^ Fax: (661) 852-2171
DISTRICT BLOCK NO. DATE ~ " ~ c
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FACILITY ADDRESS -~^~
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BUSINESS OWNER'S NAME AND ADDRESS OWNER'S PHONE NO.
CITY, STATE, ZIP
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO.
OCC TYPE OCC LOAD NO. OF FLOORS HIGH RISE BLDG RISE DAT
^ YES ^ NO
CORRECT ALL VIOLATIONS vio~~rioN REQUIREMENTS
CHECKED BELOW No.
COMBUSTIBLE WASTE /DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.)
VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of combustible waste and rubbish pending its
safe disposal. (U.F.C.)
COMBUSTIBLE STORAGE 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse boxlfire door (N.E.C.) (U.F.C.)
4 Relocate fire extinguisher(s) so that they will be in a conspicuous location, hanging on brackets with the top to the
extinguisher not more than 5 feet above the fltior.~ (N.F'.R.A. No. 110) ~ ,' r: '.
EXTINGUISHERS 5 Provide and install (amount) _____ approved (type & size)t_~_ r~!tl! f ~ _____ portable fire extinguisher to tie ` -
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immediately accessible for use in (area) _ .. (U.F.C.) t, '
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Re-charge all fire extinguishers. Fire'extiriguishers shall be serviced at leasi~once"~`ACh year, anti/or after,e,ach use,
by a person having a valid license or certificater~'(U.F.~C:-) .~;,;,,:-1--"° ~ /(~,/~ ,r;`
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Provide°and~maintain "E~X6T="sign(•s•)'with~lettersLS or mor~e~i ches fn ,height over each required exit (door%w,ndow
SIGNS l'~', ~, ,
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fire escape. (U.F.C.) l~
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Provide and maintain appropriate numbers on a contrasting background and visible from the street to i dicate the
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- correct address of the building. (B. M.C.) (U.F.C.) ~ ~''` ~
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Repair all (cracks/holes/openings) in plaster in (location)~__ /~ ______ . i _!.t ~ ~~_______ _ .' Plastering
FIRE DOORS/
FIRE SEPARATIONS
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doors shall be designed to close by gravity, or by the~btion of ai mechaniba'I device or by an approved smoke and +
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attachments cap
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EXIT 11 Remove all obstruction from hallways. Maintainrall means~of_ g~ess~free of any storage: (U.F.C.) {'~ ~ ,• y
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Provide a contrasting colored and permanently.-installed electtic,l~ght over or near~~equired exit-(.location) ,%r ~~t
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STORAGE 13 ~~
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Remove al{ storage andlor other obstructions from fir`s escape~andings and stairways stair s gifts. (Fire
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Extension cords shall not be used in lieu of. permanent approved wiring
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ELECTRICAL APPLIANCES /
where needed. (N.E.C.) (U.F.C.) '- ~,.. - .1 - ~
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15 Remove multiple attachmentycords';frbm~sp cific e_lectricaf convenierice~'ouUet (onerpfug pere.o~tlet~) (N:E.C.;) (U.F.C.~--
OUTDOOR BURNING 16 ViOlatlOn of S2Cti0n 1102 d~eali N%Ith recreational fireslor,o en burnin U:F6C~ l`
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FIREWORKS 17 _
Violations of Section 7802,~~U.F:C. or .040 of the Bakersfield Munici al~Code B.M.C. t. re ardin fireworks.
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CUSTOMER: . - - ~~ `LEGEND:
C.F.C. CALIFORNIA FIRE CODE
(Signature) (Please Print Name Legibly, Title) U.B.C. UNIFORM BUILDING CODE
INSPECTOR: ~-~~&~..1 -^ " AP N0.~8±4? ~'~ B.M.C. BAKERSFIELD MUNICIPAL CODE
N.F.P.A. NATIONAL FIRE PROTECTION
(Signature ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
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White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05)