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COIINIY; MID; ISO. ASSMpapYaPEC10R: PHONE: Aevcrwwn..) BLDri: NBR;: USE NLWlE%ISTING: nANSLIYPE: YEAa;. AOOYRS» OCCUP.CLASSI: 2. a: eTOelES: BASEMENT.. COMPLEX COM. TIMECOOE; C NS. ROOMe[ APTS.;: SPRINKLER: eIJAOCATION; a0_ TYPE; dip At(p ,1 lyz I C3 a® 4apaob Laasum Oocupied: fle see Licensed. 3 Y t _1 oriel Line: 2. Appears to Meet - Minimum Requirements: ti\ 3. Y -AppM TOANel Regrdranwft N -0O NotAk*R"Wr N WA- N&Apprkapla. . . . Y N. WA Y N WA .. V N WA ❑ ❑ 1. Kzt 0 S.yF _. ❑ Q' 10..IyddrllLiY6h�! rf Q''❑ a. FD Access ❑ ❑ ❑ a. Allowable quanbdes:� ❑ ❑ ❑ a. Coverage © U" ❑ b. Address visible E3 ❑ Q b. Sloregeddlspensing ❑ ❑ Q b. Controls readily axasabk C. Fire hydranUWater supply U. - .Q ❑ c, Fras of source of ignition U Q Q c. Valves locked open/supervised Q ❑ ❑ d. Combustible Accumulation U U Q d. Ventilation ❑ ❑ ❑ d.. Service Dale: Q ❑. Q e. Gas meteripiping protected ❑ . Q ❑ a. Electrical equipment ❑ U ❑ e. Heads in good condition ❑ U f. FD connections 0 ❑ L. Tank ventinglpfping U ❑ ❑ f. Wrenchlspare heads present ;..❑ ❑ Q g. Marine service.. ❑ U ❑. g•- Automatic monitoring ❑ ❑ Z KIM FaMures ❑'.❑ Q h. Farm tanks ❑ Q t�.Ein_AI�im1166t6nt ❑.. lP roan � ❑ ❑ r e. Numbeofexlts - ❑ U U a Detedore (smokenleap or Q Q b. E%IWsisleNmWdors ❑. U U a. Teak spacing Q Q Q• b. Pull stations m :U. Q c Exit doors �, U ❑ b:. Tank protection Q U Q c._ Service Date: U O Q d. Exit s igns ro U U (a c. Tank support _. ,..' .0 ❑ ❑ d. Teets conducted ❑ Q Q e. Exits signs ❑: U U d. Pipinglconnections Q ❑ a. Automata monitoring (3 Q 0 L Exit condos. Dead ends U ❑ ❑ e. Valves all kinds ❑ ❑ [� Visual A Audible devices Q Q Q' g. Emergency lighting h, Occup. load Q Q Q 1. Maintenance o te- ,.,/ Effigies U. Q Q posted ❑. U ❑ g, Free of source of Ignaion ❑ l.1 1'l. Firms Oroteetlon la" ❑ ❑ 1. Domswing - U 0 ❑ J. Means of escape U Q 7. NWftLdMaehff ❑ Q ❑ a. Standpipes 0 ❑ U k. Stairways ❑ ❑ Q D. Adequate coverage 0'❑ ❑ a. Relief valves.' - ❑ Q ❑ c, Hood system. -:fuel shut off present: ❑ ❑ 3. CoarinPetine: FAaturaa ❑ 13 ❑ D. Shut on valves ❑ ❑ ❑ d. Service Date: Q' U ❑ c. Clearances Q' ❑ ❑ a: Fire/occupancy separations. U m' Q d. Clean ducts & fillers Q ❑. 13. Elaetrleal Q Q b. Rated fire doors ❑' ❑ Fi» Eatiaat i� ❑ ❑ a.. Applianoesdixtures Q Q Q' C. Vertical openings 6.. 0 ❑ ❑ b. Over current protection. U Q U a. Amesslble/suftable location U U. U c.. Kringlconnectan ❑., ❑ !. stunner Q Q Q b. Numberatypa. h ❑ Q d. EYtensloncdrd c. Service. Date:_ Q Q ❑.. e. 3o clear access to panels Q' Q Q a. Ouanlilies/ArrangBment Ef U`U b. Boiler or mechanical "rooms -Q Gl 9. tl6i6[ le fed•!t R ❑ 14.'jb16106Mdi[SMIW. Q jly Z c. Unprotected aaics ✓!" Q Q 9. Unprotected stairways `.Q Q U a. Allowable quantities. _ Q ❑ ❑ a. :Documentation of fireddlls U`Q U : a.: 2'below ceiling(unsprinklared) iQ Q U b. 'Sturegeldispensing Q U ❑ o. Stafftreining E ❑ Cr f. 1S' below sprinkler heads U U Q c, Separation/compbbillty Q ❑ ❑ c. Furniture Q, U g. Aisles Q ❑ Q d Markinglldentification ❑ U Q d. Intederdemrations h. Rubbish. oily Tags, waste material U,QQ a. Compressed gas cylinders -.. U ❑ ❑ a.. lnteriorfinish Remarks: (Alt. methods, Materials& Justification. Include explanation.) Send :Correspondence To: