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r;---,---=r-�-� j � <br /> COMPLETE IF STFUCTUpE FIRE i • � � FU•7C <br /> i�X[D PqOiEflfY TYPE TE�R CO;ISf HqG4I � <br /> 5 3 � GNOd110 FLOOR AqEA COYSiFVC710;1 iYp[ —� <br /> / � .� � � GCCIIP,1ryiLOqO <br /> I 2 FA � �y <br /> �'O57 RCCE;If IfISPECIION ,� �' �� �� 16 �� � '22 EE ' ' ' <br /> REPONiflO. Atp;�iH OpY YEAR � I��: <br /> COOE VIOI4TION NOTEDf COIA?Ilc.y_:i3fnlryCOr .� <br /> (CHECK IF YES)_ (CII(CN IF Y[S) <br /> Od2'iA[IES TO F(RE NESCUE CH 29 3l ]3 75 _�s__g; -7a 39 <br /> - ( ECN 90%ES)__-- -- --- �0 ' <br /> �' <br /> ••� N'I;i00WlES5 SiAT10I1ppY STEEI S0.SH <br /> BG�•,pIrIG �� / ,3 INSOFFIUENT E%ITS OUSiR�:ilOt1 �ry <br /> <t EGFESS �5 FLAMNqplf I� CGFE55 <br /> I1NPF:TECTF9 VEFTIC,I p�qMMpBLE <br /> OPEtlrIC=�_ 47 M1�TTEp'ALS LA�OENING OTHER BESCUE <br /> . UBSTAClES TO FIFE FIGHiIHG(CNECK BO%ES) �9 OOSiA��ES � 19 OBSLACLES __ <br /> IAC;:OF ACCE55 WINOOWlE55 WALlS LRCK OF VEHTS OR <br /> 51 52 OIFFlCO:{ TO VEHT AAEAS BEYON�pEALH EXLESSIyE HEIGI:i 1 <br /> 5] OF NOSE S7AfhMS S� <br /> INSL'fFIpENi r <br /> . C'1:O:F5 56 COMiEHiS ' ' <br /> EXTENT OF OA1dACE � 51 OTMER FIRE FIGHTIHC OBSTAClES ' . • � <br /> lr.:.2 LAMAGE • � <br /> . � SMONE AHD WATER O�MAGE <br /> LOST TIME OF BUSIME55 N0,DATS <br /> . . T� .j <br /> sn � . - -Ta . .. . . . I <br /> COM1iF Ll7E IF THERE WERE FIRE PROTECTION FACILITIFS Ea <br /> 6I E' <br /> WATER SUPP�y;TYPE ' � ' ' <br /> S � Z FL1UW MAIN T(6NK CAPFILITYI <br /> 1 2 ' F.,� �0 II J1!': 15 16 I 371_'1"-�L <br /> SPdIN1(LERS:TYPE <br /> . IIUMBER f10.OPFHEO EFFELiIVEHE55 . <br /> FBAA <br /> STAIiD71PE5:7YPE i2 23 25 26 za ' eenc I--- <br /> NUMBER NO.USED EFFELTWEHFSS ---j= <br /> ' FBBA � ' <br /> � POPTABLE EXTIiiGUISN:pS:TYPE 30 � 3I 3? � 3] 3/ R9E3 <br /> � NGM1iGER N0.USED EfFECTIVENE55 <br /> � • fOCp <br /> PRIVATE BN!CqOE:TYPE �5 37 '3 �� �Z �eCB <br /> � SIIE H0.USEU EfPECiIYENE55 �-- <br /> P90A • r <br /> SPECIAI WAiER SOIIRCE:iYPE �� t5 �� �6 50 fiEO��_ <br /> 10�CALLOHS1 300 GAI,�OHS USEO EFFECTIVENESS <br /> � .TBE1 52 53 I�L" 5� bZ � <br /> SPECINL N�SAftO pP.OTECTIp11;TYPE .1.'.ER _ <br /> EFfECTIVEME55 � �' <br /> . . � � ' fBGA . . . . � <br /> SIGNR�I�C OR NAqMIRG SYSTEM;TTPE fi� A3�a <br /> I . ' . .... .. , _ EFFECTIVEHESS ._ [� <br /> FBHA <br /> 'ifATCH�JAN: �— 66 • - . . . . . � � . - P.6Y.q�_ <br /> ([BECK IF TES) E�t4CT1YENE55 , OTNEq IIRE PROTECTIOM �°= <br /> � � . fBfA FAqLIiIES �ECTIYEMESS . <br /> 68 ' - PBFA (CNECN IF YE� FBU <br /> � 69 ]� ' ' _-6BIA .,, <br /> COMPLEfE FOR ALL INCIDENTS - ' <br /> REMARAS: Fi�/i/- A%'i',�:'-��.t: i'v �f.{�C T7�J•CTF_,? ini /,—.•-� . . . • <br /> f�nr�Sf-. .�i�lc� L��'.-S i�l,-i-�r. S?�1G'�o TH.e�j �c/T <br /> T('�RCt ad T , �'��^'�YT/ii� O/t .�i�.Ri vp�. ��'�'�L' /�{r:��..F. �r-Cr•:/!_. <br /> . t � /•�v[CTi-, rf•i`7/�?sl i <br /> �.. .[.J' Tl; r�C tf tP0 r=�'�Z 1'�d i�T �C.�iS-i'2 Yi4'r'/T� <br /> ^ ;�3f2/�C/`:S. EN6��yr� GTC, /�/d �t.G<eyN.i�7T, CRtfl'E.. Ll�Y/YNJeUr/ A-T T/f�s T:�s� <br /> V-'� 'Thr S /7 S /� '�-t PSt <br /> � lHrlit/f� <AyTA,i rti',�'S'i'lr FifcTaRT Tu JF�2 � ,r.� <br /> � tfUtISP i11.:��ufT C-�tTT�_'C �1/� r=i2C OA E; /`^/�'• /f•. <br /> OFfICCq IH CHRq�E; <br /> ' �/, <br /> • r r a :� c z .zr_7 'r <br /> ' ' PREYANEO BY: � . � OqTE: — I':� . <br /> . i <br /> 1APPROVEO Bl': DAiE: ' <br /> NG1E;PO'+IilONS]-9 Of CpCH CANO MUSi �q�N TIIE IIICIUfNi A110 SIIYPLEMEMTAL MIIMfiEB9. <br /> . ._� <br />