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FIRE PREVENTION INSPECTION >i EF~RE I L D
- ARTM T
BAKERSFIELD FIRE DEPT. `~ v
Prevention Services
900 Truxtun Ave:, Ste. 210 ~ I
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Bakersfield, CA 93301
Tel.•r(661) 326-3979 ^ Fax: (661) 85 2171 j
DISTRICT - BLOCK NO. DATE ~ EE '' t•~~-
FACILITY ADDRESS ~ ~~ % / CITY, STATE, ZIP ~
F Y NA ~ :MANAGER'S NAME FACILITY PHONE NO.
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USINESS 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 VIOLATION REQUIREMENTS
CHECKED BELOW No. - -
COMBUSTIBLE WASTE / DRY 1
I 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 fittin bustible waste and rubbish pendirig its
/ ' safe disposal. (U.F.C'.)
' COMBUSTIBLE STORAGE ~ Relocate combustible storage _~: e_at-least-3"feet clearance-aroun` otor fuse box/ a door (N. E.C.) (U.F.C.)
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~ Relocate fire extin s) so that they will be in a conspicuous location, hanging on bracRets with the top to the
v ~ extinguisher ~. or han 5 feet above the floor. (N.F.P.A.~No. 10 ~~
EXTINGUISHERS !
5 Provi Y ~
wand inst (amount) ____ approved (type & size) ~ _~'~.__ A __ portable ire extinguisher to be
- - ----
j im diately a essible for use in (area) _ __. ,,,, ,( /1 /-~;~_ (U.F1~C.)
6 Re-charge all fire extinguishers.~~ re e~tiriguishers shkall°tie serviced at least once a ch year, andlor after each use,
I by a person having a valid Iicens~~or~ertiEica~e (U.F.C.)
SIGNS fj 1 I Provide~_an~ m intain~:EXIT" sign(s) wi tters 5 or more inches in heighi overreach required exit (door/window) to.
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I Provide\a d maintain~,,pproprltate numbers on a contrasting background and visible from the street to indicate the
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Litding. B.M.C.) (U.F.C.) ~~
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Repair a!I (c aciis/ oles0/openings) in plaster in (loeatlon)
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. Plastering
' FIRE DOORS _
FIRE SEPA TIONS ~ ___
________________ _____
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shall return the su face to its original fire~strve.conditio ."(U.B.C.)
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~ Removelrepair~ (item & ~odatlon)
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%"~ /'~ Self.-"closing
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doors shall~b~detsigned to4close by g~.vify, or He action-of~rriecrariical!d~ice,'oyby;.an'app~o"ved•smoke and
~ heat sensit~~dewce.~y~Self-closing-d v o tt" ft ~ apable of prevent_in.g the operation of the
~ closing device. (~UtiF_~C.) ~/ - ~ •~,o ) ~ f /•`~ '';~^
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EXITS Remove all obstruction fro Iways. Maintain aYl means'of egres
.free of'a
y storage. (U. F. C.)
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~ Provide-a~contr g colored and permanently i ~talled'electric
liglit over or near requiretl exit(location)•
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•-"~'=~______________________ to clear) indicate:it;as,an exit. (U•,F.C:) ,; '. = - ~~~;~
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STORAGE -j3 ~ _
Remove all storage and/or other obstructions from fire escape landingsland stairways stair shafts. (Fire
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j escapeslstair shafts are to be maintained free fo>~obstructiortsat all times.) (U!.,F;C.,) `.
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! 14 Extension cords shall not be used in lieu of~er)nan~nt~approvecl wiring^ Install additional approved electrical outlets
ELECTRICAL APPLIANCES where needed. (N.E.C.) (U.F.C.) t ~~ i
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15 I Remove multiple"attachment cords from sped Clio electric
l-convemence
outlet (one plug per outlet) (N.E.C.) (U.F.C.)
OUTDOOR BURNING
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'. Violation of:Secfion 1102 dealin with recrea°t onal fires,or o en burnin - U.F.C.
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FIREWORKS 17 Violations-~
•Secfion 7802 U.F.C. or 8. 9.
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Munici aI Code B.M.C. ,re a~din fireworks.
OTHER------~-- __ _ 18 ! 'Y~h!-. "l:'7 ~~ N.[ ,n t~~P ~ i'
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v v Si riature ~ ~j ' ~ ~ Please Print Name Le ibl Tltle CALIFORNIA FIRE CODE
U.B.C. UNIFORM BUILDING CODE
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INSPECTOR: 1'.~. L't'~~~ /i~.f •~~_--~ AP NO.: /~ ~ B.M.C. BAKERSFIELD MUNICIPAL CODE
N.F.P.A. NATIONAL FIRE PROTECTION
' (Signatu"re) ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
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White -Customer/Original Yellow -Station Copy Pink -Prevention Services
FD 2022 (Rev. 09/05)
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FIRE P~RfVE-NTION INSPECTION F,RE
ARTM T
BAKERSFIELD FIRE DEPT.
Prevention Services .:- ~~ -
900 Truxtun Ave., Ste. 210 ~~
Bakersfield, CA 93301
Tel.: (661) 326-3979 ^ "Fax: (661) 852-2171
DISTRICT BLOCK NO. DATE {~,,,, ~ ~ /'~ y'
1 EE ~~ (~ ~=-'.
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FACILITY ADDRESS '~ j ~ ~t~r r - ;~ CITY, STATE, ZIP
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FACILITY NAME - ~
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t (l A1A~A ~ R;S,tNAME~)_
' FACILITY PHONE~N0. ~ .
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BUSINESS
OWNER'S NAME AND ADDRESS ~ ~ CI~Y, STATE, ZIP OWNER'S PHONE NO.
BILL TO: (If DIFFERENT FROM ABOVE) NAME, ADDRESS CITY, STATE, 21P, BILLING PHONE NO.
OCQTYPE OCC
LOAD NO. OF FLOORS RISER.DATE
HIGH RISE BLDG ,
~~ ,
~ ~ ~ }
^ YES ^, NO )`, f ~ ~~';
CORRECT ALL VIOLATIONS VIOLATION a ~ ~ WI ~ REQUIREMENTS ~
CHECKED BELOW xo.
COMBUSTIBLE WASTE 1 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 moto a bo
/fire
door (N. E.C.) (U.F.C.)
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Relocate fire extinguisher(s) so that they will be in a conspicuous location, hang n ~ pr~C~ts with the top to the
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extinguisher not more than 5 feet above the floor. (N.F:P.A. No. 10)
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EXTINGUISHERS 5 Provide and install (amount) _____ approved (type 8 size) __________________ portable fire extingui ~be
immediately accessible for use in (area) ___________~ ________________ (U.F.C.)
6 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.) t
7 ~ Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each requiretl exit (door/window) to
SIGNS • I fire escape. (U. F. C.)
8 i 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 (crackslholes/openings) in plaster in (location) _______ ______________________________. Plastering
FIREDOORSI
FIRE SEPARATIONS I shalt return the surface to its original fire resistive condition. (U.B.C.)
I
10 Remove/re air item & location
____________. Self-closing
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I 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 shalt have no attachments capable of preventing the operation of the
closing device. (U. F. C.) ~ ~
EXITS ~ ' 11 I 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)
i ______________________________ 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 b'e maintained free from obstructions at all times.) (U.F.C.)
14
Il 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.)
oUTDOORBURNING 16 I Violation of~Section 1>102 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 a
,fireworks.
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~~ LEGEND:
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' I(SlgnatUfe) (Please Pnnt Name Legibly, Title) C.F.C. CALIFORNIA FIRE CODE
U.B.C. UNIFORM BUILDING CODE
-i'"f ~
~ B.M.C. BAKERSFIELD MUNICIPAL CODE
+.~,~ •~~{ ~~
INSPECTOR: ~~ y~~; ~
t"`"" AP NO.: ;,' ` ,'~ N.F.P.A. NATIONAL FIRE PROTECTION
(SlgnatUfl?) ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
rtcr-i~<v
White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05)
. ~ .- C -., r... - - ~ ~' Sr -- ... .-
FIRE PREVENTION INSPECTION
B E R S F I D
P/RE
Ali<TM T
1
BAKERSFIELD FIRE DEPT.
Prevention Services - - C
900 Truxtun Ave., Ste. 210 ~/~
Bakersfield, CA 93301 1
Tel.: (661) 326-3979 ^ Fax: (661) 852- 1
DISTRICT BLOCK NO. DATE /~~/~~ EE l} ~ (Ja
7
FACILITY ADDRESS /~~D ; ~ ~ CITY, STATE, ZIP ~ /1/ ~
J`
FACILITY NAME ~ ~
i tl/ 7 FACILITY PHONE NO.
MANAGER'S NAME
BUSINESS OWNER'S NAME AND ADDRE 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 VIOLATION
CHECKED BELOW No. REQUIREMENTS
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 I 3 Relocate combustible storage to provide at least 3 feet clearance around motor fuse box/fire door (N. E. C.) (U.F.C.)
I 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
I Provide and install (amount) _____ approved (type & siz _________________ portable fire extinguisher to be I
immediately accessible for use in (area) _____________ _ _ (U.F.C.)
g Re-charge all fire extinguishers. Fire extinguishers shall be serviced at le t c ear, and/or after each use,
by a person having a valid license or certificate. (U.F.C.)
SIGNS 7 Provide and maintain "EXIT" sign(s) with letters 5 or more inches in height over each required exit {doorlwirSdow) to ~
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.)
FIREDOORSI
FIRE SEPARATIONS g Repair all (cracks/holes/openings) in plaster in (location) ______________________________________. Plastering
~ 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. Seif-closing doors shall have no attachments capable of preventing the operation of the
closing device. (U.F.C.)
EXITS 11 j 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) I
_____________________________ 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.)
ELECTRICAL APPLIANCES t4 Extension cords shall not be used in lieu of permanent approved wiring. Install additional approved electrical outlets
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 1g - ja ~~.
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CUSTOMER:
(Signature)-= (Please Print Name Legibly, Title)
__-- //
INSPECTOR: 1~7.G1~1 AP NO.: ~
~(SI~Ure) LEGEND:
C.F:C. CALIFORNIA FIRE CODE
U.B.C. UNIFORM BUILDING CODE
B.M.C. BAKERSFIELD MUNICIPAL CODE
N.F.P.A. NATIONAL FIRE PROTECTION
ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
KBF-7320
White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05)
0212612007 10:24 3250528 TURNINGPDINTREENTRY PAGE 02/02
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