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FIRE PREVENTION INSPECTION >i EF~RE I L D
ARTM T
BAKERSFIELD FIRE DEPT.
Prevention Services ~{ ~'
900 Truxtun Ave., Ste. 210 '( { ~~ '
Bakersfield, CA 93301 / ~/ ~~
Tel.: (661) 326-3979 ^ Fax: (661) 2-2171
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DISTRICT BLOCK NO. DATE
FACILITY ADDRESS 1 l ~ O
` CITY, STATE, ZIP
FACILITY NAME NAGE , FA ILI P ONE NO.
BUSINESS OWNER'S NAME AND ADDRESS ~
~ ITY, STATE, ZIP OWNER'S PHONE O.
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i'Q
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS ~ "* CITY, STATE, ZIP, BILLING PHONE NO.
OC T.l: E OCC LOAD i N0. OF FLOORS HIGH RISE B}DG RISER ATE
^ YES ~] NO
CORRECT ALL VIOLATIONS VIOLATION i
REQUIREMENTS
CHECKED BELOW No.
/DRY 1
` Remove and safely dispose of all hazardous refuse and dry vegetation on the above premises (U.F.C.)
COMBUSTIBLE WASTE
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) __________________ 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.)
7 Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each required exit (door/window) to
SIGNSw fire escape. (U.F~.C.) ~
g Provide and maintain appropriate numbers on a contrasting backgro n si a ro treet to indicate the
e correct address of the building. (B. M.C.) (U.F.C.)
g Repair all (cracks/holes/openings) in plaster in (location) ______________________________________. Plastering
FIREDOORSI
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
) - ~ ~ I `-'
closing device
(U
F
C
.
.
.
.
i
EXITS 11 Remove all obstruction from hallways. Maintain all means of egress free of any storage: (U.F.C.) µ
__
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 Violations of Sectiori 7802 U.F.C. or 8.49.040 of the Bakersfield Munici al ode B.M.C.'re ardin fireworks.
OTHER 18
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CUSTOMER: LEGEND:
-- C.F.C. CALIFORNIA FIRE CODE
( ignat e) (Please Print Name Legib Title) U.B.C. UNIFORM BUILDING CODE
~ B.M.C. BAKERSFIELD MUNICIPAL CODE
INSPECTOR: ~ - AP NO.:
~ N.F.P.A. NATIONAL FIRE PROTECTION
(Signature) ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05)