CITY FIRE MARSHAL                                                                 CITY OF ANDREWS

INSPECTION REPORT                                                                 111 Logsdon

Date  _________________                                                              Andrews, TX 79714

Time _________________                                                               Phone 915-523-4820

Firm _______________________________________     Occupancy Classification ___________________

Address ____________________________________     Phone No. _______________________________

Person Contacted ____________________________      Title ____________________________________

Business Owner _____________________________       Phone No. _______________________________

Address ______________________________________________________________________________

TYPE INSPECTION:

ڤ Semi-Annual         ڤ Annual              ڤ New Business      ڤ Safety Complaint            ڤ Other _____________

AREA AROUND BUILDING:

ڤ Fire Lanes/Fire Zones        ڤ Address      ڤ Outside Storage       ڤ Grass/Weeds        ڤ Trash/Rubbish

HOUSEKEEPING:

ڤ Accumulated Trash/Rubbish                    ڤ Interior Decorations                                ڤ Open Flame Devices

ڤ Storage of Merchandise                           ڤ Grease Accumulation                              ڤ Compressed Gas Cylinders

ڤ Flammable Liquid – Storage/Use              ڤ Lint/Dust Accumulation                           ڤ Other _____________

ڤ Explosive Agents/Chemicals                    ڤ Gas Connections/Appliances                    ڤ Other _____________

MAINTENANCE OF EXIT WAYS:

ڤ Exit Obstruction/Locked       ڤ Exit Hardware                  ڤ Posted Occupancy Load       ڤ 2 Exits Required

ڤ Exit Sign Illumination            ڤ Exit Doors/Aisle Width      ڤ Landing Identification           ڤ Other _____________

ڤ Emergency Lighting              ڤ Improper Signing               ڤ Exit Corridors                       ڤ Other _____________

ELECTRICAL:

ڤ Use of Extension Cords                           ڤ Possible NEC Violations, Condition          ڤ Meter Loop

ڤ Breakers Unlabeled                                   to be referred to Electrical Inspector          ڤ Main Disconnect

ڤ Exposed Wiring/Service                           ڤ Panel Access Blocked                             ڤ Other _____________

FIRE PROTECTION – System/Appliances:

ڤ Portable Fire Extinguishers                      ڤ Sprinkler System                                     ڤ Yard Hydrants/Pumps/Valves

ڤ Hood – Fixed System                              ڤ Fire Alarm System                                  ڤ Hose Cabinets

ڤ State Certification Tags                           ڤ Smoke/Heat Detectors                            ڤ Other _____________

ڤ Fire Extinguisher Location Signs               ڤ Standpipe System                                    ڤ Other _____________

Fire Ext. Service Co. ______________________________  Date Last Inspection ____________________

Sprinkler System Service Co. ______________________________________________________________

                                                        (Name)                             (Address)                                (Phone)

SPECIAL HAZARDS – Permits Required: _________________________________________________

You are hereby requested to correct the above conditions on or before the re-inspection date. Failure to comply may render you liable to penalties provided by law.