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Imo', .r -. - - ~.. ~ ~..~. ~ :_Tl_ ,.. .._ __- .:.-.. .. - .>'-.. .. .. - --.., , a ~ ~ .. ~~ z ~~ a~ .,~~ ~. ~IR~~ PREVENTION INSPECTION >I EF/RE I D ~RSr r BAKERSFIELD FIRE DEPT. Prevention Services. 900 Truxtun Ave., Ste. 210 Bakersfield, CA 93301 Tel.: (661) 326-3979 ^ F (661) 852-21 1 ~d-~e_~ ~~a~~ DISTRICT BLOCK NO. DATE ~ _ ` ~ 1 EE FACILITY ADDRESS A n /~ l/©S V CITY, STATE, ZIP ~~ /•'y /_ V W ~~ FACILITY NAME FACILITY P ENE NO. MANAGER'S NAME BUSINESS OWNER'S NAME AND DRESS OWNER'S PHONE NO. CITY, S(ATG (lP .+... / BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, ZIP, BILLING PHONE NO. I v OCCr P OCC ~LOA~ D I NO. OF FLOORS HIGH RISE BLDG RISE/R DATE i ~-!- , O YES O / CORRECT ALL VIOLATIONS VIOLATION REQUIREMENTS CHECKED BELOW t. No. COMBUSTIBLE WASTE I 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.) 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 81 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 certifilcate. (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/ 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 ;oY . heat sensitive device. Self-closing doors shall have no attachments capable of preventing the operation of the ~~I, 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 colds 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 7802 U.F.C. or 8.49.040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks. OTHER 16 I L7'~ ~..((/~ ~ CUSTOMER: ~: LEGEND: ~ C.F.C. CALIFORNIA FIRE CODE ' (51 ature (Please Print Name Legibly, Title) U.B.C. UNIFORM BUILDING'CODE ~ B.M.C. BAKERSFIELD MUNICIPAL CODE "'-- INSPECTOR: ,(A. AP NO.: ' N.F.P.A. NATIONAL FIRE PROTECTION ( Ign Ure ASSOCIATION N.E.C. ~ NATIONAL ELECTRIC CODE l~6F/J<U White -Customer/Original Yellow -Station Copy Pink ='Prevention Services ~ FD 2022 (Rev. 09/05) _ ___ __ !~ -r .,. 1' STATE of Cw~~i1N1A FIF'c aAFETY INSPECTION REQUEST STi;. 850 (REV. 1P81) See lnstructlons on reverse. AGENCY CONTACTS NAME TELEPHONE NUMBER REQUEST DATE PROGRAM COMMUNITY CARE LICENSING 559 243-4584 2-7-06 109 EVALUATOR'S NAME REQUESTING AGENCY FACILITf NUMBER REQUEST COOE MIKE BUSSEY 153807994 3A RESPONSE REQUIRED coDEs ~ 1. ORIGINAL A. FIRE CLEARANCE LICENSING ~ TATE DEPT. OF SOCIAL SERVICES 2. RENEWAL 8. LIFE SAFETY AGENCY NA~AEAND COMMUNITY CARE LICENSING 3. CAPACITY CHANGE ADDRESS 770 E. SHAW, SUITE 300 4. OWNERSHIP CHANGE FRESNO, CA 93710 5. ADDRESS CHANGE 6. NAME CHANGE 7. OTHER AMBULATORY NONAMBULATORY BEDRIDDEN TOTAL CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIOUS CAPACITY CAPACITY PREVIDUS CAPACITY 14 $ 14 FACILITY NAME LICENSE GATEGrGRY ERRECALDE, AMY FCC FAMILY CHILD CARE STREET ADDRESS (Aefwl Location) NUMBER OF BUILDINGS 4020 COLUMBUS 1 CITY RESTRAINT BAKERSFIELD 93306 FACIUTY CONTACT PERSON'S NAME HOURS AMY ERRECALDE 661 871-6792 DAYTIME SPECIAL coNOmoNS - ~~ ~~ - zll ~' ~ "~~e'fa>B~~GONIPLETED BY.INSPECTINQ AUTHORI;'TY , ~ ~ ~~ ~ ~ ~ ~ CLEARANCe/,p~NML CODE ~/ i BAKERSFIELD FIRE DEPT ~ coDEs . FIRE g00 TRUXTON AVE. #210 AUTHORfTY 1:y„~IRECLEARANCEGRANTED NAi~AEAND BAKERSFIELD, CA 93301 2. FIRE CLEARANCE DENIED ADDRESS A. EXITS B. CONSTRUCTION C. FIRE ALARM RISPECTOR'S NAME (Typal a PrNfrd) fr"-" -t11 ~ ! ! ~ `(~, i ! ~r. >~f G.t'1__ TELEPHONE NUMBER ~ r% ~ I ~ . )~<~~, ` ~ , j ~' CFlRS NUMBER 7 IC.~ ~'7 OCCUPANCY CLASfi .~ ~ ~„ D. SPRINKLERS E. HOUSEKEEPING F. SPECIALHATARD 9VSPECT1oN DA~~TE/ INSPECTORSNA E ypW or ~ f G. OTHER ExPLAIN DENIAL OR IJST SPECIAL aTtoNs