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FIRE PREVENTION INSPECTION '' a EP,RE I
D ARTM T
BAKERSFIELD FIRE DEPT.
Prevention Services ~~
900 Truxtun Ave., Ste. 210 ~~
Bakersfield, CA 93301
Tel.: (661) 326-3979 ^ Fax: (661) 852-2171
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DISTRICT
~ BLOCK NO. DATE _ ~/ 1 _ U /
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FACILITY ADDRESS t / ~~/~ -~ /~/ ~~~ ~- ~~~~
1 ( CITY, TATE, ZIP (:,/~ 2D
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FACILITY NAME i - ' `
,/7; C ~ ~ / Q FA~ILI,TY~P-HyONE.NO. ''''7~
--t-AGER'S NAME
BUSINESS OWNER'S NAME AND ADDRESS CITY, STATE, ZIP / -r OWNER'S PHONE NO.
BILL TO: (IF DIFFERENT FROM ABOVE) NAME, ADDRESS
n CITY, STATE, ZIP, BILLING PHONE NO.
OCC ~T`YPE
~ OCC LOAD NO. OF FLOORS
~ HIGH RISE BLDG RISER DATE
c8 ^ YES NO
CORRECT ALL VIOLATIONS VIOLATION REQUIREMENTS ~
CHECKED BELOW no.
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 & 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
SIGNS fire escape. (U.F.C.) ~
g Provide and maintain appropriate numbers on a contrasting b o d a i reef 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 shall return the surface to its original fire resistive condition. (U.B.C.)
10 Remove/repair (item 8 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 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 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 1102 dealin with recreational fires or o en burnin U.F.C.
FIREWORKS 17 Violations of Section 7802 U.F.C.. or 8x49.040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks.
OTHER 1g ~ ~ /' ~~
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CUSTOMER: =-~=~~1~I;~ r) !, ~'!' ~~
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"~~'Slgnatllre~ j •~ (Please Print Name Legibly,~itle)
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~ C.F.C. CALIFORNIA FIRE CODE
U.B.C. UNIFORM BUILDING CODE
B.M.C. BAKERSFIELD MUNICIPAL CODE
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INSPECTOR: .C
r N.F.P.A. NATIONAL FIRE PROTECTION
`~ (Signature) ASSOCIATION
N.E.C. NATIONAL ELECTRIC CODE
K6F-7320
White -Customer/Original Yellow -Station Copy Pink -Prevention Services FD 2022 (Rev. 09/05)
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INSPECTIONS ~~~s
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FIRE CLEARANCE ~'~
BAKERSFIELD FIRE DEPT. '
Prevention Services
1600 Truxtun Ave., Suite 401
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
Page 1 of 1
1.''FIRE AUTHQRITY;_NAME
Fire Authority Name: Phone No.
Bakersfield Fire Dept. -Prevention Services (661) 326-3979
Address: City State Zip
1600 Truxtun Avenue, Suite 401 Bakersfield CA 93301
11. INSPEGTOR.INFORMATION
Fire Inspector's Name:
-~~~~ ~ ` Phonne No. j 'CFIR'S No.
~.~J ~ ~V~~ ~ I ~ ~C~~ 15005
Signat ank of i ector granting clearance:
Inspection Date: ,11, 6
"cZ.V
"Fire Departments number assigned by California Fire Incident Reporting System (CFIRS)
FD 2038 (Rev. 09/05)
The site below was inspected this date for compliance with local requirements, and is hereby granted a
fire clearance to operate an outpatient alcohol and/or other drug treatment program at:
~Itl~7~"~C~~®~~ "`;
FIRE CLEARANCE
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ARr~r r
BAY{ERSFYELD FY1ZE DEPT. '
Prevention Services
1600 Truxtun Ave., Suite 401
Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 852-2171
Page 1 of 1
L FIRE AUTHORITY NAME
Fire Authority Name: Phone No.
Bakersfield Fire Dept. -Prevention Services (661) 326-3979
Address: City State Zip
1600 Truxtun Avenue, Suite 401 Bakersfield CA 93301
II. INSPECTOR INFORMATION
Fire Inspector's Name:
---c)~,~ Phone No. *CF1R'S No.
~ r ~_ ~ ~ i / _ ~~c~ 15005
~O
Signat ank of I ector granting clearance:
Inspection Date: ~ O
~~~
*Fire Department's number assigned by California Fire Incident Reporting System (CFIRS)
The site below was inspected this date for compliance with local requirements, and is hereby granted a
iFire clearance to operate an outpatient alcohol and/or other drug treatment program at:
' IIL _PROGRAM`INFORMATION
Name of Program Phone No. t ~
i n ~ .S °~ ~ ~ ` r ~ `l'V ~'a~ ~ LEI °7' ~7`7
Full Address (Including Suite #): .City State Zip
l [~ ~Q ~ ~ ~~ ~~~ Bakersfield CA ~ ~~ ~\
FD 2038 (Rev. 09/05)