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-UNIFIED `?ROGRAM INSPECTION CHECKLIST;
SECTION 1: Business Plan and Inventory Program 'T
•
BAKERSFIELD FIRE DEPT
Prevention Services
~«~ 900 Truxtun Ave., Suite 210
~w>rn r Bakersfield, CA 93301
Tel.: (661) 326-3979
Fax: (661) 872-2171
FACILITY NAME
~ ~ NSPECTION DATE
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N-oSJ INSPECTION TIME
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ADDRESS
~~ot (+-.iT~ L~ ) HONE NO.
83'7- 7~3Z O OF EMPLOYEES
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FACILITY CONTACT
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' USINESS ID NUMBER
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Section 1: Business Plan and Inventory Program
ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V ~ C=Compliance OPERATION
V=Violation COMMENTS
__ __
LK ^ APPROPRIATE PERMIT ON HAND
^ BUSIn@SS PLAN CONTACT INFORMATION ACCURATE
I>~ ^ VISIBLE ADDRESS
^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS
Cry ^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
L~f ^ PROPER SEGREGATION OF MATERIAL
LR~ ^ VERIFICATION OF MSDS AVAILABILITY
CtY ^ VERIFICATION OF HAZ MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND
PROCEDURES
C-'~ ^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
^ FIRE PROTECTION
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE? lld'YES ^ NO
EXPLAIN: ~+`~g~T~L. 61c. _ Z~ 0 Cj~'L --- -
TIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 328-3979
Inspector (Please Print) Fire Prevention / 1B1 In /Shift of SitelStation ff
White -Prevention Services Yellow -Station Copy Pink -Business Copy FD2049 (Rav. 02/05)
` Prevention Services
UN1FfED PROGRAM INSPECTION CHECKLIST >3 F R s F , . „ 90o Truxtun Ave., suite 210
_.-~_.: ~.: m_ _ Fief Bakersfield, CA 93301
SECTION 1: Business Plan and Inventory Program aRrM t Tel.: (661) 326-3979
F (661) 872 2171 -
ax: -
FACILITY NAME _
- - - INS
PE
CTION DATE INSPECTION TIME
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ADDRESS
~S c> > ~C~1 t~ r `T~ L ~. PHONE NO.
Z~3 ~- NO OF EMPLOYEES
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FACILITY CONTACT
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~ c BUSINESS ID NUMBER
15-021- (per
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Section 1: Business Plan and Inventory Program ~~~~ -
^ ROUTINE ^ COMBINED ^ JOINT AGENCY ^ MULTI-AGENCY ^ COMPLAINT ^ RE-INSPECTION
C V (c=Compliance` OPERATION
V=Violation J COMMENTS
,,/
i~
^ APPROPRIATE PERMIT ON HAND '
/
~ld~ ^ BUSIneSS PLAN CONTACT INFORMATION ACCURATE ENT~D ~ ~ c ~
^ VISIBLE ADDRESS
^ CORRECT OCCUPANCY
^ VERIFICATION OF INVENTORY MATERIALS
^ VERIFICATION OF QUANTITIES
^ VERIFICATION OF LOCATION
^ .PROPER SEGREGATION OF MATERIAL.
~^ VERIFICATION OF MSDS AVAILABILITY
^ VERIFICATION OF HAZ MAT TRAINING
^ VERIFICATION OF ABATEMENT SUPPLIES AND PROCEDURES
~^ EMERGENCY PROCEDURES ADEQUATE
^ CONTAINERS PROPERLY LABELED
^ HOUSEKEEPING
~,
^ FIRE PROTECTION
^ SITE DIAGRAM ADEQUATE & ON HAND
ANY HAZARDOUS WASTE ON SITE?
EXPLAIN:
QUESTIONS REGARDING THIS INSPECTION? PLEASE CALL US AT (661) 326-3979
Inspector (Please Print) Fire Prevention / 1' In /Shift of Site/Station # Business Site /Responsible Party (Please Print)
DYES ^ NO
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White -Prevention Services Yellow -Station Copy Pink -Business Copy. FD 2155 (Rev. 09/05
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BAKERSFIELD FIRE DEPT.
~- ~- ~-g- " ' D Preveatioa Services •
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ARf/ 900 Trtaxtun Ave., Ste.-.210 .. ~Gf/-,~~~j~ ~•
Bakersfield, 'CA 93301 tf'
Tel.: {661) 326-3979 X Fax: (661.) 852-2171
OCCUPANCY. DISTRICT BLOCK NO. DATE }~ ~i!
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TO (~'' TtTLE ' FIRM OR DBA ~ ' ,
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COMPANY ADDRESS (CITY, STATE, ZIP) ~ .y ~
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CORRECT ALL VIOLATIONS vro~arroN t~ ~~ REQUIREMENTS
CHECKED BELOW No.
LE WAS
E /DRY
OMB 1 Remove and safely dispose of-all hazardous refuse and dry vegetation on the above premises (U.F,C.)
USTIB
T
C
VEGETATION 2 Provide non-combustible containers with tight fitting lids for the storage of coinbusttble waste and rubbish pending ifs
- safe disposal. (U.F.C.)
COMBUSTBLE srORAGE. 3 Relocate combustible storage to provide at least 3 feet.ciearance arourid motor fuse box/fire door (N.E.C.) (U.F.CJ
' q hanging on brackets with the top to the
Relocate fire extinguisher(s) so'thaC
they will be in a conspicuous location
;,; .
,
extinguisher not more than 5 feet above the floor. (N.F.P.A. No. •10)
ExIINGUISHERS - 5 ~~ Provide and install (amount) _____ approved (type 8 size) ___~___~_______ porttable fire extinguisher to be
•
immediately ;accessible for, use in (area) _,-,__________~_~__~____~ (U.F.G:)
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
SIGN$ fire escape. (U.F.G.)
g . Provide a•nd 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 ali (cracks/holes/openings) in plaster in (location) r~___,___________~_______________. Plastering
FJREDOORS/ .
RE S
AT
O shall return the surface to its original fire resistive condition. (U.B.C.)
Fl
EPAR
I
NS
. ~ • 10 . Removelrepair (item & location) _ _ _ _ _ ____ ____ _ __ ___ __________~_. Self-closing
, doors shall be designed.to close by gravity, or by the action of a mechanicaldevice, 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
~ 1.1 Remove all obstruction from hallways. Maintain all means of egress free of any storage. (U. F.C.)
.
y _
• 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.IF.C:)
" '14 Extension cords shall riot be used in lieu of permanent approved wiring.' Install additional approved electrical outlets
ELECTRICALAPPLUWCES where needed. (N.E.C.j (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. bufnin 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 - 18 •
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Q ,zON (DATE)
AN INSPECTION WILL BE MADE, IF NO COMPLIANCE HAS BEEN MADE, ADDRIONAI: pEpsaN CEM110 Np7N;E OF v~q.~7pN
REGULATORY ACTKNJ MAY BE INITIATED.
{
ENF T WI L E ENT BY C RTI AIL P DIN A N DATE "~--'' TARE
AFTER VIOLATIONS ARE CORRECTED, RETURN THIS araROEROP THE CIE aH~ t)ATE COMPLkTEO~
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NOTICE BY MAIL OR IN PERSON TO:
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f9AKERSFIELD FIRE DEPT. a~sPECroRSIONATURE alaPECroR SwNATURE
• OFFICE OF PREVENTION SERVICES
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` 800 TRUXTUN AVE.; SUITE 210' us.c. uNroRrl euILOINO Done '
BAKERSF
IELD; CA 83301' aM.c. ._ aNKERSF~~ n MuNNXPAL CoOE .
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. N.FPA .NATIONAL FUtE PROTEC710N ASSOCY1710N
. . N.E.C. 'NATIONAL ELECTRIC OOOE ~ ' •
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BAKERSFIELD FIRE DEPT.
Prevention Services ~';
FIRE PREVENTION INSPECTION a EF-RE t D 900 Truxtun Ave., Ste. 210 '
ARTM T Bakersfield, CA 93301
Tel.: (661) 326-3979 ^ Fax: (661) 852-2171
DISTRICT BLOCK NO... DATE ~ , O r
b EE _.,..~
.
FACILITY ADDRESS ~~ \ l ,~~~
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CITY STAT ,ZIP
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FACILITY NAME
~^ MANAGER'S NAME FACILITY PHONE O.
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BUSINESS OWNER'S NAME ANb ADDRESS CITY, STATE, ZIP N R'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 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 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
FIREDOORSI
FIRE SEPARATIONS shall return the surface to its original fire resistive condi ' .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 y 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 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 V
io
lations of Section 7802 U.F.C. or 8.49.040 of the Bakersfield Munici al Code B.M.C. re ardin fireworks.
OTHER 18 o
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CUSTOMER: LEGEND:
~ C.F.C. CALIFORNIA FIRE CODE
(Signature) (Please Print Name Legibly, Title) U.B.C. UNIFORM BUILDING CODE
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INSPECTOR: f i~~~%Z. ~. t `~ 1 .- AP NO.'!~ ~ B.M.C. BAKERSFIELD MUNICIPAL CODE
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)