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BAKERSFIELD FIRE DEPT. $~~
Prevention- Services ,/ / ~~
900 Tnixturi .Ave:., Ste.. 210 7~ 1/
Bakersfield, CA 93301
Tel.: (661) 326-3979 ^ Fax: (66 852=2171
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FACILITY ADDRESS ' r" ,~, • CITY, STATE, ZIP
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FACILITY NAME p° ~
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' MANAGER'S NAME ~ FACIL'ITY PHONE~NO: ,~ (";i
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BUSINESS OWNER'S NAME AND ADDRESS,r"'~ "~"~!"'
I ti CITI', 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
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CORRECT ALL VIOLATIONS vio~~rioN REQUIREMENTS .
CHECKED BELOW ao.
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.) -
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 8 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 mo h i l~i~t ~veQe fired exit (door/window) to
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SIGNS fire escape. (U.F.C.) v
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.) ~ ~~
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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 fi•om~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 11.02 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
ireworks.
OTHER 18 "f
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CUSTOMER: ~/ ~ u-I/-/t~• I 1. LEGEND: . `
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` (Signature) r° (Please Print Name Legibly, Tltle) C.F.C: CALIFORNIA FIRE CODE.
U.B.C.. UNIFORM BUILDING CODE
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+ B'.M.C. BAKERSFIELD, MUNICIPAL CODE
INSPECTOR: '~
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A -" N.F.P:A. NATIONAL FIRE PROTECTION
" (Signature) '' a ASSOCIATION
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N.E.C. NATIONAL ELECTRIC CODE
ON INSPECTION
~o V ..~._ ..~._ - 4 ...~_ o r n m~l Yellow-Station Co Pink-Prevention Services
~~~~ ~ ~.{'~h~~~~e' ; ay ~ FD 2022 (Rev. 09/05) .