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FIRE PREVENTION INSPECTION
Tel.: (661) 326-3979 ^ Fax: (661) 852-2171
DISTRICT BLOCK NO. DATE ~~ ~ r
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FACILITY ADDRESS ~ ~~
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CITY, STATE, ZIPS ~
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FACILITY NAME
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MANAGER'S NAME
BUSINESS OWNER'S NAME AND ADDRESS CITY, STATE, ZIP OWNER'S PHONE NO.
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 VIOUITION REQUIREMENTS
CHECKED BELOW No.
TIB
CO
E W
STE /DRY 1 Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.)
MBUS
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A
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.)
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) __,~__ approved (type & size) _,_~___G ~qs~ _ portable fire extinguisher to be
immediately accessible for use In (area) __~~-/ .G s~_____________ (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.)
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/holes/openings) in plaster in (location) ___________ ____________________. Plastering
FIRE DOORS/
F
RATIONS shall return the surface to its original fire resistive condition. (U.B.C.)~ ' '
~ `'
IRE SEPA
10 Remove/repair (item & location) ____________________ __________________________. _ _ Self-closing
~
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doors shall be designed to close by gravity, or by the action of a mechanical device, or by an
p
~smoke and
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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 13 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 ions of Section 7802 U.F.C. or 8.49.040 of th Bakersfield Munici al Code B.M.C. re ardin fireworks.
OTHER 1 ~ G ~ ~ ~ s ( J ~ G °'` /T D O ~ H ~ S ((/ .S c.+.-•
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CIJS-COMER: LEGEND:
C.F.C. CALIFORNIA FIRE CODE
Signature) (Please Print Name Legibly, Title) U.B.C. UNIFORM BUILDING CODE
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INSPECTOR: ~~ 4~~'/~- I ~'' .~ AP NO.:~~E~ H B.M.C. BAKERSFIELD MUNICIPAL CODE
N.F.P.A. NATIONAL FIRE PROTECTION
(Signature) ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
BAKERSFIELD FIRE DEPT.
a B R 3 F 1 o Prevention Services //~
F111PE 900 Truxtun Ave., Ste. 210 ~j~ 1 ~:'
ARTM T Bakersfield CA 93301 1
White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05)