HomeMy WebLinkAboutSpecial Inspection Miscellaneous 1991-6-5
rl~.
... ....
ATTACHMENT' F
SPRINQF1ELD
.
.
CITY OF SPRINGFIELD
AM!3ULANCE VEHICLE INSPECTION REPORT
VEHICLE HOUSING AND CRE',l OUARTEilS STMIOMOS
AMBULANCe: CO~1PANY:
DATE: June 5. 1991
Business Name:~ingfield Fire & Life Safety
Phone: 726-3737
'.
Mailing Add.ess: 225 North 5th Street
(St:reet/Apt.#)
Springfield, OR 97477
(CIty/State/Zip)
(Phone) .
1. VE~IC!.E HOUSING:
Any ambulance service licensed with the City of Springfield is required to house
its ambulance vehicles in a heate~ and secu.e gJr~ge_ Please cc:olete the
infor:ation in sec<:,ions A-Q and indicate cC::lpiiancc wHh the requiremen-:.
by f111ing ou: sec<:,1on E (DECISIO~). .
A. LOCAiTml OF GAII/,Ge:
-
6853 Main Street
(Street/ Apt.if)
Spririgfiel,l, OR 97478
(City/State/lip)
726-3737
(Phone)
B.
NU:~BE:t OF AM8UI,\NCE VE:-!!CLES HOUSE;) AT THIS LOCATIC:l:
c.
IDEHTITY OF AMIIULAtlCE VEHICLES HOUSC:O AT THIS LOCATiON:
.,...,- ~...- - . ..,.-. " ,-.
1.:"MAKE/MODEUYEAR OF VEHICLE:
'~LICENSE PLATE NUMBER: -
2.-MAKE/MODEUyEAR OF VEHICLE:
-LICENSE PLATE NUI1BER:
3. MAKE/MODEL/yEAR OF VEHICLE:
LICENSE PLATE NUMBER:
..~'---
3/86.
"'- - - .. - ~ .,
1- _,
. CITY OF SPRINGFIEL~
AMBULANCE VEHICLE INSPECno"'REPORT
DATE:
.
AMBULANCE COMPANY:
4. MAKE/MOOEL/YEAR OF VEHICLE:
LICENSE PLATE NW1BER:
5. MAKE/MODEL/YEAR OF VEHICLE:
LICENSE PLATE NUMBER:
C. CO:1PLIANCE:
VE:iICLE HOUSING
1. Are the amouiance venicles housea
in a heated garage?
2. Are the amouiance venic:es ncusec
in a secure garage?
D. DEC!SION:
o
o
o
Acceptable.
YES
NO
CO:I,MENT
Acceptable, with minor discrepancies to be corrected and
inspected by this date:
Not acceptable, with discrepancies to be corrected and
inspected by this date:
-
ADDITIONAL COMMENTS:
. - --- ---- ...-. ~
.~/~~~
.per!O~~ti~ (he Inspection
"J /01;
~ -,S -'1/
Date of Inspection
. . CITY OF SPRINGFIELD t
AMBULANCE VEHICLE INSPECTION PORT
. DATE:
AMBULANCE COMPANY:
II. CR~~ OUARTERS STANDARDS:
Any ambulance service licen~ed by the :City of Springfield is required to pro-
vide crew quarters that conform to the standard~ set forth in the current
Uniform Building Code for residential occupancies (d',/en ings). Please
complete the information in section A and indicJte compliance with the
requirement by filling out sectioh B (DECISION). Please attach copies
of any inspection forms used by the Building Division to determine com-
pliance.
-
-
A. LDCATIml OF CR~..1 OUARTE:tS:
(Street/Apt.it)
(City/State/Zip)
(Phone)
B. DECISION:
o
o
o
Acceptable.
Acceptable, with minor discrepancies to be corrected and
inspected by this date:
Not acceptable, with disc~epancies to be cor~ected and
inspected by this date:
ADDITIONAL COMMENTS:
~//~~
Persori Conducting the Inspection
1:.-5'-7'1
Date-of Inspection
.., 1f'"J~