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-~ - 5416 CALIFORNIA AVENUE -
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~/ ~ ~ EAKERSFIELD FIRE DEPT.
Prevention Services
FIRE PREVENTION INSPECT N e EFiRE t L D 900 Truxtun Ave., Ste. 210
~RTM T Bakersfield, CA 93301
Tel.: (661) 326-3979 ^ Fax: (661) 852-2171
DISTRICT BLOCK NO. DATE ,t^~~ ~~ EE ~el~~
FACILITY ADDRESS ( r f CITY, STATE, 21PfJ ~,,, r /~ ,/
FACILITY NAME ~p "j" A/ ,s7 r ~ r~ /~ y~ ~
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,f MANAGER'S NAME F CILITY PH NE NO.
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BUSINESS OWNER'S
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A CITY, STATE, ZIP S P
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 Ho.
Y 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.)
COMBUSTIBLE WASTE /DR
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 floor. (N.F.P.A. No. 10)
EXTINGUISHERS 5 Provide and install (amount) ~~[jproved (type & size) ______________ portable fire extinguisher to be
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immediately accessible for us a __________________________ (U.F.C.)
6 Re-charge all fire extinguishers. Fire extingu s r~h~~ serviced at least once each year, andlor after each use,
by a person having a valid license or certificate. ( F
7 Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each required exit (door/window) to
SIGNS 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/holeslopenings) in plaster in (location) _______ _______________________. Plastering
FIRE DOORS/
IR
PARATI
NS shall return the surface to its original fire resistive condition. (U.B.C.)
F
E SE
O
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 Viola
tions of Section 7802 U.F.C. or 8.49.040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks.
OTHER 18 /J
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CUSTOMER: ~ - LEGEND:
`(Signature) (Please Print Name Legibly, Title) C.F.C. CALIFORNIA FIRE CODE
U.B.C. UNIFORM BUILDING CODE
yr r/! B.M.C. BAKERSFIELD MUNICIPAL CODE
INSPECTOR: 0 f/t2;~.ry~ ~'~ri.~'7.A,. AP NO.: `~'" N.F.P.A. NATIONAL FIRE PROTECTION
(Signature) ~ ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
White -Customer/Original Yetfow -Station Copy Pink -Prevention Services FD 2022 (RBV. 09/05)