HomeMy WebLinkAboutMiscellaneous Miscellaneous 1986-8-26
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ATTACHMENT F
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SPRINGFIELD
CITY OF SPRINGFIELD
AMBUL\NCE VEHICLE INSPECTION REPORT
VEHICLE HOUSING AND CRE':l OUARTERS STPIOAROS
DATE: g - 26 -~
Business Name: SPRINGFIELD DEPT OF FIRE'& LIFE SAFETY Phone: 726-3737
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Mailing Add~ess: 225 NORTH 5TH STREET
(Streel:/Apt.#)
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SPRINGFIELD, OR 97477
(City/State/lip)
726-3737
(Phone)
I. VEH!C!..E HOUS!~IG:
Any ambulance service licensed with the City of Springfield is required to house
1t~ amo~lance vehicles in a heated and sec~~e garage. Please cc~oiete t~e
1nfor~a:.ion in sec~icns A-Q and in"dic:!t.c cc~pi ianc~ .,.,ft.h the requiremeo-:.
by filling out section E (DECISION). .
A. LOCA7TO~1 OF GARAGE:
~~~AIN STREET
(Street/Apt.#)
SPRINGFIELD, OR 97478
(City/State/lip)
726-3737
(Phone)
B. NU~~~E" OF A~eUL'!'NCE VEHICLES HOUSED 'AT TH,S lOCc\TTC~I:
C. IDENTITY OF AMBULAI:CE VEHICLES HOUSE;) AT nns LCCATTml: .
1. MAKE/MODEl/YEAR OF VEHICLE:
LICElISE PLATE NUMSER:
2. MAKE/MODEL/YEAR OF VEHICLE:
LICENSE PLATE NU:1SER:
3. MAKE/MODEL/YEAR OF VEHICLE:
LICENSE PLATE NUM8ER:
3/86
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CITY OF SPRINGFIELD
AMBULANCE VEHICLE INSPECTION REPORT
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DATE:-.B-2~ -~
AMBULANCE CCMPANY:
SPRINGFIELD DEPARTMENT OF FIRE & LIFE SAFETY
4. MAKE/I~ODEUYEAR OF VEHICLE:
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· LICENSE PLATE NUI.leER:
S. MAKE1MOOEUYEAR OF VEHICLE:
LICENSE PLATE NW.1BER:
C. COMPLIANCE:.
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VEHICLE HOUSING
YES
NO
CC:':MENT
1. Are the amouianc~ venicles nausea
1n a heat~d garage?
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dAS YA-eE IfStIr71JCS
2. Are the amouiance venic:es nausea
1n a secure garage?
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D. DECISION:
~ Acc~ptable.
Acceptable. with minor discrepancies to be corrected and
Inspected by thi s date: .
D
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Not acceptable. with discrepancies to be corrected and
Inspected by this date:
ADDITIONAL CO:~r"ENTS:
rflK:M~
Person Concuctlng tne Inspection
3/86
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Date of Inspection
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CITY OF SPRINGFIELD
~~8ULANCE VEHICLE INSPECTION REPORT
DATE: ~-;2./11?-€3~
AMBULANCE COMPANY:
SPRINGFIELD DEPARTMENT OF FIRE & LIFE SAFETY
11. eRE'.. QUARERS ST A:WARDS;
Any ambulance service licensed by the :City of Springfield is required to pro-
vide crew qu~rters that conform to the standards set forth in the current
Uniform Building Code for residential occupan.c;es (c'tiel1ings). Please
complete the information in section A and indicate ccmpliance with the
requirement by filling out section B (DECISIO~). Ple~se attach copies
of any inspection forms used by the Building Division to determine com-
pliance.
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A. lOCA TIC:l OF CRE','I OUARiE;lS;
(Street/Apt.;;')
(City/State/lip)
(Phone)
B. DEC!SrO:-l:
~ Acceptable.
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Acceptable. with minor discrepancies to be corrected and
inspected by this date:
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Not acce~table. with disc~epancies to be corrected and
inspected by this date:
ADOITImlAL CC:~MENTS:
/~~ 0:?4IM _
~~~u~~~qne 1'iispection
fb-2c" ~
Date or Inspection
3/86
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