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Home My WebLink AboutFAI15-0002 Fire Annual Inspection ArchiveM: -3utte County Fire Department California Department of Forestry and Fire Protection Fire Prevention Bureau 176 Nelson Avenue, Oroville, CA 95965 530-538-7888/530-538-2105(fax) Fire Safety Inspection Business Address: Business Name: 10. Owner/Manager: Bus: Other: Other Contact: Bus: Other: Building Owner: Bus: Other: Address: Fire alarms stem defective Occ. Class: AN INSPECTION OF YOUR FACILITY REVEALED THE FOLLOWING: 1. Fire extinguishers: required, service due 10. Exit(s): obstructed, inadequate 2. Extension cords: Excessive use, defective 11. Exit sign(s): required, illumination, photo luminescent 3. Excessive rubbish, trash, debris 12. Exit sign lights: obstructed, defective 4. Fire alarms stem defective 13. Exit lighting: required, defective 5. Sprinklers stem: service required, defective 14. Heating system: defective appliance, flue combustibles 6. Kitchen hood ext. system: service due 15. Wiring: exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops 16. Address posted and visible from road 8. Smoke detectors: required, defective 17. Other 9. Fire drill log checked Yes ❑ No ❑ 18. Other type of inspection — State below Date: = Discussed with: Signed: (Print) Inspecting Officer: Battalion 1 2 3 4 5 6 7 Station: FPB By order of the Fire Chief: You are hereby notified to correct all violations immediately or show cause why you should not be required to do so. A re -inspection will be conducted on . Willful failure to comply with this notice is a misdemeanor. Violations that are not corrected immediately and/or remain after the re -inspection may be processed as a criminal offense. Thank you for your assistance and cooperation in minimizing the fire and life loss in our community. (H & S sec. 13112) White Copy — Station File Yellow Copy — Re-inspect/business Pink Copy — Business ❑ Check when sent to prevention Fire Prevention Bureau 176 Nelson Avenue Oroville, CA 95965 Telephone 530-538-7888 Fax 530-538-2105 '&�' Butte County Fire Rescue White Copy - Business California Department of Forestry Yellow Copy – Occupancy File and Fire Protection Pink Copy – Station File Facility Inspection Report Occ. Class. - Address: T77-07414 sg\A)4 Business Name: C' -hvnq-r/hAnnngL-r: U ARC i n 4j Bus: Hm: &-7;i-193 n Fax. Assistant Manager: Bus: Hin: Budding Owner: Bus: Address: 7�l �(44P_TZ 57 — 571RUN6_� C-CrY AN UVQVVIrTiniv nF VnITR FACTI.1rV REVEALED THE FOLLOWING: DETAILED EXPLANATION AND CORRtCTIONS: CORRECTED: 1 F64MOVLF StJhG: BOI-7-5 0AI P� C—)Irir D00,12, 6)(1T-S16r45 150'R /LLL4h1/Y/4T/0V I /P- /A1'51r4-LL_ ->fbrA1_5 1141-1- MQV, TL) XeWeIAI L'1/VLLC XC;V uW'<Ilvcj� - 1. Fire Extinguishers: Required, service due /0• /A/:S 7-13- L L- 10. Exit(s) obstructed, inadequate 2. Extension cords: Excess use, defective 11. Exit sign(s) required, illumination 3. Excessive rubbish, trash, debris 12. Exit sign lights need replacing 4. Fire alarm system defective 13. Exit lighting: Required, defective 5. Sprinkler system: Service required, defective 14. Smoke detectors: Required, defective 6. Kitchen hood extinguishing system service due H 15. Wiring: Exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops Discussed with: (Print) MA1ZCJ 14 ANARYVI Heating system: Defective appliance, flue combustibles Battalion,"I 2 3 8. Knox Box keys #"-16 17. Address posted and visible from road 9. Fire Drill Witnessed Yes 0 No N 1 8. 18. M, Mer DETAILED EXPLANATION AND CORRtCTIONS: CORRECTED: 1 F64MOVLF StJhG: BOI-7-5 0AI P� C—)Irir D00,12, 6)(1T-S16r45 150'R /LLL4h1/Y/4T/0V I /P- /A1'51r4-LL_ ->fbrA1_5 1141-1- MQV, TL) XeWeIAI L'1/VLLC XC;V uW'<Ilvcj� - RU�51AIU_->S /-/0LjP,5 it -,41-4- 0)(17-5(A1o7-)1ejT04r=0 /0• /A/:S 7-13- L L- C_ /44fQb W4/ZjF Ar P 644e– C—)( T_ ate: /17/0 4 Discussed with: (Print) MA1ZCJ 14 ANARYVI Signed: Battalion,"I 2 3 4 5 6 7 1 Station: -9 7RL,)PJ& Cl --v FPB Jwslplct ng Offwer., FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOPERATION WITH CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DA TE Fire,Prevention Bureau ,176 Ne',Llbn Avenue Oroville, CA 95965 Telephone 530-538-7888 Fax 530-538-2105 Address: � Owner/Manager: ,144 Assistant Manager: Building Owner: ... Butte County Fire Rescue California Department of Forestry and Fire Protection Facility Inspection Report White Copy - Business Yellow Copy — Occupancy File Pink Copy — Station File Occ. Class. Business Name: �1, -,A Bus: Hill: d Bus: Hm: Bus: Hm: Fax: Address: 1 17 PP) (�, , s AN TNCPFCTinN nF YOUR FACILITY REVEALED THE FOLLOWING: 1. Fire Extinguishers: Required, service due Signed: 10. Exit(s) obstructed, inadequate 2. Extension cords: Excess use, defective 11. Exit sign(s) required, illumination 3. Excessive rubbish, trash, debris �' 12. Exit sign lights need replacing 4. Fire alarm system defective f 13. Exit lighting: Required, defective 5. Sprinkler system: Service required, defective p 14. Smoke detectors: Required, defective 61 6. Kitchen hood extinguishing system service due t/ 15. Wiring: Exposed, damaged connectors, etc. 7. Fire walls, ceilings, fire doors, draft stops v% 16. Heating system: Defective appliance, flue combustibles 8. Knox Box keys p 17. Address posted and visible from road ti 9. Fire Drill Witnessed Yes ❑ No ❑ 18. Other DETAILED EXPLANATION AND CORRECTIONS: C014RL(1 ED: Date: Discussed with: Signed: (Print) Inspecting Officer: Battalion "1 , 2 3 4 5 6 7 Station: FPB - FIRE PREVENTION SAVES LIVES, PROPERTY, AND BUSINESS. YOUR COOPERATION WITH CORRECTING THE ABOVE LISTED ITEMS IS APPRECIATED. RE -INSPECTION DATE: ,S'- /S- 63 I� PRE-ENGINEERED SYSTEM INSPECTION REPORT QUARTERLY ❑ ANNUALLY BUSINESS / A/ �ti ^ ____ 1�1- SEMI-ANNUALLY ❑ NEW INSTALLATION I i CU r�� 11-7v,vV / i 4' INSPECTION NO. INVOICE NO. / G�� j ADDRESS CITY STATE ZIP CODE MANAGER/OWNER PH NE SYSTEM LOCATION AREA TYPE SYSTEM AMT. MODEL NO. CYLINDER SIZE METHOD OF ACTUATION AMT. DEGREE OF ACTUATION SYSTEM INSTALLED AS PER PLATE NO. PAGE LB. I� / �_ )c I D G o:�, LAST DATE OF HYDROSTATIC TEST LAST DATE OF RECHARGE CYLINDER SERIAL NO. FUEL SHUT OFF U A SIZE ELECTRIC SIZE L FL (� SHOW APPLIANCES AND LOCATION OF SURFACE NOZZLES --L-RESTAURANTElMARINE El INDUSTRIAL i j 1-/ 0 C) a 0 _ ........................................................................................ A (/ ") � e 1. IS SYSTEM MOUNTING BRACKET IN ACCESSIBLE LOCATION AND SOUNDLY MOUNTED? .......................................... 2. IS PIPING TIGHT, SECURED AND CHECKED FOR BLOCKAGE?...................................................................... 3. ARE GREASE TIGHTS INSTALLED AT ALL HOOD PENETRATIONS?.................................................................. 4. IF MULTIPLE SYSTEMS, DID ALL SYSTEMS OPERATE SATISFACTORY?.............................................................. 5. IS SYSTEM PROPERLY INSTALLED FOR AREA(S) TO BE PROTECTED?............................................................... 6. ARE ALL NOZZLES PROPER TYPE AND SIZE?....................................................................................... 7. IS MANUAL PULL OPERATIONAL AND IN PROPER LOCATION?...................................................................... 8. ARE FUSIBLE LINKS, H.A.D.S OF PROPER TEMPERATURE RATING?................................................................. 9. WERE FUSIBLE LINKS REPLACED ON SEMI-ANNUAL INSPECTION?................................................................. 10. IS AUTOMATIC DETECTION OPERATIONAL?........................................................................................ 11. DID FUEL SHUT OFF PROPERLY?................................................................................................... 12. DID ELECTRIC SHUTOFFS/ALARMS OPERATE?..................................................................................... 13. ARE BURSTING DISC AND CHEMICAL IN GOOD CONDITION?....................................................................... 14. IS CARTRIDGE WITHIN THE REQUIRED WEIGHT?................................................................................... 15. ARE NOZZLES CLEAN AND CAPS/SEALS PROPERLY INSTALLED?................................................................... 16. IS CYLINDER PRESSURE IN OPERATIONAL RANGE?......................................... ....................................... 17. ARE FILTERS CLEAN?.............................................................................................. 18. ARE ALL SAFETY PINS REMOVED, CARTRIDGES RE -INSTALLED AND SYSTEM REPLACED IN NORMAL OPERATION CONDITION? ... 19. HAVE PERSONS WORKING IN SYSTEM AREA BEEN INSTRUCTED AS HOW TO OPERATE SYSTEMS BY MANUAL METHODS? ......... 20. WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE PRESENTLY ADOPTED EDITIONS OF NFPA 17,17A AND 96? .............................................. ........................... 21. WAS THE SYSTEM TAGGED IN ACCORDANCE WITH RULE 4A-21.240? ("NO" ANSWER MUST BE EXPLAINED IN THE COMMENTS SECTION OF THIS REPORT.)........................................................................ . . . ................. 22. WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE MANUFACTURER'S MANUAL AND THE MANUFACTURER'S SPECIFICATIONS?......................................................................................... 23. DOES SYSTEM COMPLY WITH UL300? ..................... ....... . UQ Ale Z P ?OG L o �� /r l% ' UNDERSIGNED, CERTIFY THAT I PEFISbNALLY INSP CTED THE ABOVE PREMISES AND FOUND CONDITIONS AS ;E TECHN IAN DATETIME CUSTOMER 81�NA r OFFICE COPY NO C_ �is� Master PRE-ENGINEERED SYS fEM INSPECTION REPORT ElQUARTERLY ElANNUALLY EMI -ANNUALLY P ElNEW INSTALLATION INSPECTION NO. INVOICE NO, r!� 7G f L�; / U9INES;S, ` P, Ir,- f DaRESS - ('/ ; CITY ;.:- �� ;. c 1 STATE cs ZIP CODE s L/ ,"' 1,A„ ANAGER/OWNER PHONE S STEM LOCATION AREA TYPE SYSTEM AMT. MODEL NO. DER,$IZli y, METHOD OF ACTUATIO W AMT. / DEGRSy OF A'CTU TION SYSTEM INSTALLED AS PER PLATE NO. PAGE Tl LAS DATE OF HYDROSTATIC TEST LAST DATE OF RECHARGE CYLINDER SERIAL NO. FUEL SHJI�OFF SIZE ELECTRIC SIZE �� SHOW APPLIANCES AND LOCATION OF bURFA�CE NOZZLES rr `�-PFESTAURANT ❑ MARINE ❑ INDUSTRIAL F-1 1 17 ..........................L ........................................... ...... I .......... 1. IS SYSTEM MOUNTING BRACKET IN ACCESSIBLE LOCATION AND SOUNDLY MOUNTED? .......................................... 2. IS PIPING TIGHT, SECURED AND CHECKED FOR BLOCKAGE?...................................................................... 3. ARE GREASE TIGHTS INSTALLED AT ALL HOOD PENETRATIONS?.................................................................. 4. IF MULTIPLE SYSTEMS, DID ALL SYSTEMS OPERATE SATISFACTORY?.............................................................. 5. IS SYSTEM PROPERLY INSTALLED FOR AREA(S) TO BE PROTECTED?............................................................... 6. ARE ALL NOZZLES PROPER TYPE AND SIZE?....................................................................................... 7. IS MANUAL PULL OPERATIONAL AND IN PROPER LOCATION?...................................................................... 8. ARE FUSIBLE LINKS, H.A.D.S OF PROPER TEMPERATURE RATING?................................................................. P. WERE FUSIBLE LINKS REPLACED ON SEMI-ANNUAL INSPECTION?................................................................. 10. IS AUTOMATIC DETECTION OPERATIONAL?........................................................................................ 1 DID FUEL SHUT OFF PROPERLY?................................................................................................... 1 DID ELECTRIC SHUTOFFS/ALARMS OPERATE?..................................................................................... 1 ARE BURSTING DISC AND CHEMICAL IN GOOD CONDITION?....................................................................... 1 IS CARTRIDGE WITHIN THE REQUIRED WEIGHT?................................................................................... 1 ARE NOZZLES CLEAN AND CAPS/SEALS PROPERLY INSTALLED?................................................................... 1 IS CYLINDER PRESSURE IN OPERATIONAL RANGE?............................................................................ I ... 1 ARE FILTERS CLEAN?.............................................................................................................. . 1 ARE ALL SAFETY PINS REMOVED, CARTRIDGES RE -INSTALLED AND SYSTEM REPLACED IN NORMAL OPERATION CONDITION? ... 1 HAVE PERSONS WORKING IN SYSTEM AREA BEEN INSTRUCTED AS HOW TO OPERATE SYSTEMS BY MANUAL METHODS? ......... 2 WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE PRESENTLY ADOPTED EDITIONS OF NFPA 17,17A AND 96?......................................................................... 2 . WAS THE SYSTEM TAGGED IN ACCORDANCE WITH RULE 4A-21.240? ("NO" ANSWER MUST BE EXPLAINED IN THE COMMENTS SECTION OF THIS REPORT.)........................................................................................... 2 . WERE THE INSPECTION AND MAINTENANCE PERFORMED IN ACCORDANCE WITH THE MANUFACTURER'S MANUAL AND THE MANUFACTURER'S SPECIFICATIONS?......................................................................................... 23. DOES SYSTEM COMPLY WITH UL300?.................................................................................. IETS A TI” I, THEI UNDERSIGNED, CERTIFY.THAT I PERSONALLY INSPECTED THE ABOVE PREMISES AND FOUND CONDITIONS AS NOTED. SERVI E TECHNICIAN -- _ D(TE /j TIME - CIjSTOMER SIGNATURE ^OAT�jE7/AZ FL 1041 1/77 ! f..