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HomeMy WebLinkAbout065-010-006AP 65-01-6 F��j BillupsIRE DAMAGE REPORT) f f f AP 65-01-6 F��j BillupsIRE DAMAGE REPORT) a ;� 9 f*J PRELINED DRAFT PAPER INDICATES AND IS TO BE USED ONLY FOR ALL NEW REGULATORY LANGUAGE. 80321. Complaints and Compliance by operators about the licensing proce the right to bring to the attention of agency any action or behavior by the I :z believes is a wrongful application of enforcement of them. The licensee shz of substantial differences in opinion and any licensing representative about Facilities Act or these regulations. I The Department or licensing agen through and respont to the license � Owner: Address: Tenant: Building Location: Type of Inspection requested: BUTTE COUNTY MPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION' RFPORT' .A. P. Date of- Inspection Inspector. 7-7 1. Pou 5 Ing 2. Financing 3. Change of Occupancy to 4. Other (specify)-- Preseut use, of building: A. Sanitation LBRiri.,IgI 2. I.avaf:ory-., 3. Bathr--ab or shower: 4:, 'Kitchen sink: 5. Hot and cold vater to fixtures: 6. Heating facilities: 7. Natural light and ventilation: 8. Ro mn * and space requ*irements: 9. BedrocAm wind'aw or door for second exit - -. 10. Infestation of Lasects, vermin, or. rode"nts:__ 11. Comect-7 on to sewage. disposal.: 12. Connect'.ion to water supply: '13. Rubbish and garbage facilities: 14. Comrrents: B. Structural 1. P1.ers and footings: 2. Flocr tonstniction: 3. Wall. corstruct loll:___ 4. Ceiling and roof constriction: 5. F :-replaces 6. Ccrments: C. Electrical i. Set -ice: end ground. 2. Receptacles:__ 3. Fusing:___ 4 'Conainnts: D. PljSbink 1. F.Ixt",:reG connec,":M and 2. water heater: 3. Cas 1 cating v ex -1 i" S 4. E. Other 1. M'ain'tenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 6. Comments: — - - F. Commercial Buildings 1, Roof covering: 2. Distance to property lines: — 3. Physically handicapped: 4. Restroom floors and walls: _ 5. Exits: _ 6. Improvements: 7. Zoning:_ 8. Comments: G. Field Problems or Violations 1. Problem or Aolation (give complete description) - 2. What action taken (give complete description) : 3. What action recommended: T% A. Information only - fits. 77 B. Hold for ten(10) days, then write letter. C. Write letter. 77D. Other: -L 0 C*', 1 i G".14 (C C. 01 i r v c P. A.) F-;ESPGNlSE TYPE I A! 4A STOP I > In' ­,RESPOIN'SIBILITY (AT . DiRECT IKV STATUTORY [i FORCSr INGUSTRY r �,�� rri,.:a )t .'4. �—r-' i i� � — `�3 i —_ �-e I �� /J EJ STATE ZDNE ❑ DISTRiCT — j 4- -2, AGRI COUNTY PP. CD �,/OR U.S F.S. INAME LOCAL SNE Fl 6 L.M. Ej # V❑ C -Jon-conlract) -L 0 C*', 1 i G".14 (C C. 01 i r v c P. A.) F-;ESPGNlSE TYPE I A! 4A STOP I > In' ­,RESPOIN'SIBILITY (AT . St—is. in CD0,rect Proleclion Area only, PLAY W/FIRE AIR N MISC E1.1 ANFOUIS N1 "-ter s�ieC'` t�'t"4�l' Y .}$E (Sl;tr;: .n (:CiF Vlrect Prr,?eC:r�n Area only) DiRECT IKV STATUTORY [i FORCSr INGUSTRY PI-431ECTION RESPONSIBILITY WOOD Ej OTHER INDUSTRY-CO)AM M STATE EJ STATE ZDNE ❑ DISTRiCT GRASS j 4- CITY AGRI COUNTY PP. CD �,/OR U.S F.S. LOCAL SNE Fl 6 L.M. Ej V❑ C -Jon-conlract) ❑kP.S. FEDERAL Z014E OTHER FEDERAL ;0 1�,:i I.' ut3 C. 41 P'j r s WSCJOTHER ❑ OTHER'. 00. St—is. in CD0,rect Proleclion Area only, PLAY W/FIRE AIR N MISC E1.1 ANFOUIS N1 "-ter s�ieC'` t�'t"4�l' Y .}$E (Sl;tr;: .n (:CiF Vlrect Prr,?eC:r�n Area only) F Pam N NT-,. FOR,,_ -sr, FIRE DISr., CITY & '8lF-.FL­ rio. ETC. ACRES BURNED (CDF Direct Protecmn-Area only [9 ON ARRIVAL (CDF Direct VEGETA�TIOFI SIZE — C.D.F. D.P.A. VEG. TYPE' � —a [i FORCSr INGUSTRY JTIMBEF P .-Cq- -N P.'EATiC WOOD Ej OTHER INDUSTRY-CO)AM LAND EJ I: C.1 D NON WILDLAND GRASS Ir,f ,j V, AGE Direr, Praleclt:on Area only) AGRI S DAMAGE PP. CD �,/OR YOUNG GROWTH CO. I Goowlh) PHODUCT9 6,000. ;0 1�,:i I.' ut3 C. 41 P'j r s 00. uN r s 00. 00. F Pam N NT-,. FOR,,_ -sr, FIRE DISr., CITY & '8lF-.FL­ rio. ETC. ACRES BURNED (CDF Direct Protecmn-Area only [9 ON ARRIVAL (CDF Direct VEGETA�TIOFI SIZE 8TATUT RESP. — C.D.F. D.P.A. VEG. TYPE' � —a ACRES BURNEO� JTIMBEF J. WOOD LAND BRUSH GRASS B.O.R. AGRI PP. CD TOTAL 8TATUT RESP. C.D.P. .. D.PA' OF ACRES BURNED 111 STATE J. U.S.F.S. B.L.M. B.I.A. B.O.R. OTHER "FED OTHER TOTAL IL ;df&,tion Area only) iER (GO TO QO)) DISTANCE (Origin to head) AC. FEET WEARIER (Est at scene) DIRECTION FROM TEMPERATURE M.P.H. -A t r T 23 N. LOT / /02 AC R 3 A MDB5M O /40 AC AJ e� ©r`iim 20 AC. 4-4-/ 3/ . 14 -GE - SEE 135- 4 - 4 d U1 PGE o /60 AC :0, ` LO BK56 @63.9 I N -W- LOT / LOT 4 0 1 // US4 U //5.03 Ac 40 AC cot I. F4%1 131416 �. 4.96 Ac. P/M5_'•- 13 3 ?d. -'UAC I ;,-.29AC ' 46 735.05 rn r� v R/5 51- 1323.93 I / / f \ � v 1 1 O 40.57dC - n93.61 540.44 4242 7 4 3 F4%1 27 P/M5_'•- 13 3 ?d. -'UAC I ;,-.29AC ' 64.V4 735.05 .� L '���� ` I I�///�( fI v W�iI��I�� / �. / � V �!!� Fl" R E ._�REPORT * III 149 ,. L�CA:TtCiN (COF Direct P.A.) TYPE �"I;��t•ii� I [=JfALSC Ai ARM .�.� STOP '.0 TU t0 , If "QAUS �E (Slarts in COF Direct Protection Area only.) PnofECTION I RESPONSIBILITY CAMPFIRE . (] ARSON (� MISCELLANEOUS STATE v ! tir.L STATE ZONE DISTRICT f STATE RESPONSIBILITY 4- F1 CITY E ei�l LOCAL (Conlract) F] COUNTY 11-1 Oun,tl' LOCAL (Non -contract) U.S-F.S. 0 OTHER INDUSTRY -COMM " Q U 1 It It Y, h?A10OAD 0 kNILDLAND 0 UTILITY, ELECT LOCAL ZONE (% L OCAL (Con:racl) i LOCAL (talon -contract) � N•P,S. t` FEDERAL ZONE L! OTHER FEDERAL ?) J MISC./OTHER D OTHER. "QAUS �E (Slarts in COF Direct Protection Area only.) v » = 1.11311 tTh+IedG �� DEFii�tS n PLAY W/FIRE CAMPFIRE . (] ARSON (� MISCELLANEOUS (j c MOKINCi E(..UIPMEN1 tv LAND .----,!PROPERTY USE (Starts in CDF Direct Protection Area only). r DOt,1EST IC.; E❑ UTILITY, OTHER L) RANCH-FARNI 0 FOREST INDUSTRY 11-1 Oun,tl' 0 RECREATION tD ROAD 0 OTHER INDUSTRY -COMM " Q U 1 It It Y, h?A10OAD 0 kNILDLAND 0 UTILITY, ELECT 0 NON WiLDi_AND t DAMAGE (CDF Direct Protection Area only) t _. _.._�.s...._a.,_. $ DAMAGE I iMBER &/OR YOUNG GROWTH �`diL(�LAaN(.) VEGETAT70N _ i,mber & Young Growth) %GRICULTURAL PRODUCTS ;. xcept Timber & Yowxl Growth) >;rW_LLING NO`, CONTENTS ,1 1UC! 000 $/OR MNTENTS :!i HICLES &. CONTENTS ,)1HF-R _ TOTAL Mut (� Of �- S BURNED (CDF Direct Protection Area only) V�VEG. C.D.F. D.P.A; TYPE ACRES BURNED ' TIMBER WOOD , LAND BRUSH i. GRASS pp! 1� 1 ,GRI. ` ( . PROD TOTAL I STATUT. .... -- ---- GQ.F D.P.A' RESP. OF ACRES BURNED STATE , U.S_F.S B.L.M. i. B.LA.7­7 pp! 1� 1 ( ,B.O.R. ` ( . OTHER ; `'FED OTHER TOTAL ` , f ON ARRIVAL (CDF Direct 0 VEGETATION FIRE t, C SIZE a eektion Area only) DISTANCE (Origin to head) AC. F ' FEET WEATHER (Est.."at seen) WIND DIRECTION FROM �" TEI'APERATUF M.P.H. 7f 10 Over please: } .., • G.D'.F:n 75 0-'1 i6-01'18