HomeMy WebLinkAboutSpecial Inspection Miscellaneous 1987-10-12
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ATTACHMENT F
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CITY OF SPRINGFIEL~
i AMBULANCE VEHICLE INSPECTION REPonT
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VEHICLE HOUSIlIG ANa CRE':I OUARTEitS STMIOAROS
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AMSULANCE CC~1P ANY:
DATE: 10-12-87
Business Name:
Springfield Fire & Life Safety
Phone:
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Mailing Add~ess: 225 N. 5th Street
(Street/Apt.d)
Sprin9fieid, OR
(Cit$/State/lip)
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97477
I. VEH!C!..lO HOUSr~IG:
726-3737
726-3737
(Phone)
Any ambulance service licensed with the City of Springfield is required to house
1tj amb~lance vehicles in a heated and sec~~e c~rage. Please cc~olete the
1nfor:::ation in sec":.ions A~0 and indic;lte cc~pi janc~ wfth the requirement
by filling out section E (OECISIC:I).
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A. LOCAnml OF GARAGE:
(,,~S\ rYJ~ ~.I-:f
(Street);'pt.,,)
. S'>lA~i1i '.U n/\
(Clty/StQte/ .~)
B. NU~SER OF AMP1ILA.NCE VE,.,!CllO$ HOUSECl AT THIS lOCAnC:I:
C. IDENTITY OF .AMS~" AIlCE VEHICllOS HOUSECl AT THIS lCCATiml:
1. MAKE/MODEL/YEAR OF VEHICLE: 1985 Ford Fraun - Type III
lICENSE PLATE NUMSEit:
E158258
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Z. MAKE/MODEL/YEAR OF VEHICLE:
LICENSE PLATE NU:1BER:
3. MAKE/MODEL/YEAR OF VEHICLE:
LICENSE PLATE NUMBER:
3/86.
726-3744
(Phone)
Page 1 of 3
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e . C!TV OF S~~I'NGF I ELOe
AMBULANCE VEHICLE INSPECTION REPORT
DATE: IO!I~\'61
AMBULANCE COMPANY:
4. MAKE/MODEL/YEAR OF VEHICLE:
lICENSE PLATE NUI'lBER:
S. MAKE/MODEL/YEAR OF VEHICLE:
lICENSE PLATE NU:'lBE~:
C. CD~1PLIA/ICE:
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VEHICLE HOUSIIIG
1. Are the amouianc2 venlcles housea
in a heatad garage?
2. Are the amouianc2 venic:es nausea
in a secure garage?
D. DEC!SIml:
D
D
[g]
Acceptable.
YES
v"
V'
NO
CC:':MENT
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Acceptable. with minor discrepancies to be corrected and
Inspected by this date:
Not acceptable. with discrepancies to be corrected and
Inspected by this date: J07:J.:J/'Xi
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AODrrrm/AL COMMENTS:
1(p~_" ~-t~ Mn--;:t;;-A"L. ~ "",,,._d -1 ri JL.
}j~1() 0_"".k\~
Person\9onOucting the Inspection
3/86
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Date of Inspection
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Page Z of 3 ..
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.. CITY OF SPRINGFIELD.
, AMBULANCE VEHICLE INSPECTION iMPORT
CATE:
AMBULANCE COMPANY:
II. CR~~ QUARTERS STANDARDS:
"
Any ambulance service licensed by the :City of Springfield is required to pro-
vide crew quarters that conform to the standards set forth in the current
Uniform Building Code for residential occupancies (c'r/en ings). Please
complete the information in section A and indic3te complianc~ with the
requirement by filling out section B (DECISION). Please attach copies
of any inspection forms used by the Building Division to determine com-
pliance.
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A. lOCA nD:1 OF CRE'," OUARTE;tS:
(Street/Apt.;;)
(City/State/Zip)
B. DECISION:
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Acceptable.
(Phone)
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Acceptable, with minor discrepancies to. be corrected and
inspected by this date:
Not acc;otable, with discrepancies to be corrected and
inspected by this date: ICi/3ol'l;l
,
ADDITIONAL CC~MENTS:
..R~.~""..e In r'~--J. ~..J:w.~ r -1 .
~ J~u QA~_ "'"^. ,2<w-.A ~ I_"'~ ,.ill '-
A:lg"iru,;J vul~ ...:.1P ~D Is """.Nu.T~h<l..::'i
.f'r.7.., -t-J-h._ (~' 'V1 l' J j IY).%' rl... ,.rrntd. )
I - Va i""'O /
;{?~ ~:MAU
Pe'rson Cor.::Juc"tlng the'lnspectlon
J(')/t,g.,./fl
Oat~ or Inspection
3/86
Page 3 of 3
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CITY OF SPRINGFIELD
AMBULANCE VEHICLE INSPECTION REPORT
DATE:
AMBULANCE COMPANY:
4. MAKE/MODEL/YEAR OF VEHICLE:
LICENSE PLATE NU:'lBE~:
5. MAKE/MODEL/YEAR OF VEHICLE:
LICENSE PLATE NW'1BE~:
C. CO:1PLINICE:
/
-;.
VEHICLE HOUSnlG
YES
NO
CC;.lMENT
1. Are the amouiance venicles housea
in a heated garage?
.;---
ELc"-f ;:v'At:E
A'':;'''I~
2. Are the amouiance venicies nousea
in a secure garage?
..--
o.
DEe! S ION:
D
~
o
Acceptable.
Acceptable, with minor discrepancies to be corrected and
inspected by this date: s~r '?/:I, !.9..f+:,C;
Not acceptable. with discrepancies to be corrected and
inspected by this date:
ADDITIONAL COMMENTS:
~i:ipLAi'lh /iFf'.- I ~~J7tt'/ k ~T'V;ruP+ ~J13<?//1>t?
--1t!J.kI...! J'lP:Y'" 1<"" JI(J.A-A.''A/>7~ .AVo .r:)(JlIV/A~ IAJ~a'JF
JJh'rJ 77"'f!.. -n n,l ") .
JJ~./~/f7N.
Person Conaucd n'9' the Inspect 1 on
1/2. <7 ~.s-
Datef of {n~pectlon
2/85
Page 2 of 3.
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~. CITY OF SPRINGFIELD ~
AMBULANCE VEHICLE INSPECTION REPORT
DATE:
AMBULANCE COMPANY:
II. CRE',~ QUARTERS STANDARDS;
Any ambulance service licensed by the :City of Springfield is required to pro-
vide crew quarters that conform to the standards set forth in the current
Uniform Building Code for residential occupancies (dwellings). Please
complete the information in section A and indicate compliance with the
requirement by filling out section B (DECISION). Please attach copies
of any inspection forms used by the Building Division to determine com-
pliance.
<.
A.
LOCA nml OF CREH QUARTERS:
(Street/Apt.#)
(City/State/Zip)
(Phone)
B. DECISION:
~
D
D
Acceptable.
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 CO~MENTS:
. /w.~;;'p,--,
Person Conducting the Inspection
1/.7.1/t;5
Dat~ of l'nspection
2/85
Page 3 of 3
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..... CITY OF SPRINGFIELD ~
AMBULANCE VEHICLE INSPECTION REPORT
DATE:
AMBULANCE COMPANY:
II. eRE'''! OUARTERS STANDARDS:
Any ambulance service licensed by the :City of Springfield is required to pro-
vide crew quarters that conform to the standards set forth in the current
Uniform Building Code for residential occupancies (d.tlellings). Please
complete the information in section A and indicate 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.
lOCA TIml OF CRE','/ OUARTERS:
(Street/Apt.lI)
(City/State/Zip)
(Phone)
B. DECISION:
f2r
o
D
Acceptable.
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:
/~/:h~
Person Conducting the Inspection
11:.1' /~ '"
Dat~of inspection
2/85
Page 3 of 3
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ATTACHMENT F
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~4d
CITY OF SPRINGFIELD
AMBUl.ANC~ VEHICLE INSPECTION REPORT
VEH!CLE HOUSIIiG AND CRE':1 OUARTERS ST,\NOAROS
DATE:
A:~CUlJl/1C~ Cc:~oPIY:
8u~ir.ess Name:~nrinafield Deot of Fire & Life Safety
Phone: 726-3737
Mailing Add~ess: 225 North 5th Street
(St~eet/';p:;.it)
/
Springfield. OR 97477
(C;tj/Stat2/lip)
726-3737
(Phone)
1. VE:!IC,-E HO!JSr:IG:
Any ambulance service licensed with the City of Springfield is required to house
1t= arn=~lance vehi:1es in a he~:2~ and .sec~~e garage. Please c=~oleta t~e
1nfor:::a-:~on in sec-:icns A-Q anc inc~::.!t~ cc~piian:.:~ wft:-: t.he requirer.1en~
by flllin; out section E (CE::S:C~).
A. LC(:..~iIC~l CF G;"KAG~:
fi853 Main Street
(St.~eet./';p...ii')
Sorinafield. OR 97478
(City/State/lip)
726-3737
lPhone)
8. ~<U:~~E2 OF ;.~eUL~NC~ VE"!CL~S HO!JS::D AT THIS LOC,\TIC:I:
C. ID::NTITY OF .AMeUlJI:~CE VEHICLES HOUSED AT THIS LOCATiO:!:
1. MAKE/~ODEL/YEAR OF VEHICLE: 1985 Braun #849
LICENSE PLATE NUMBER: E158258
2. MAKE/~ODEL/YS;R OF VEHICLE:
LICENSE PLATE NU:1SER:
3. MAKE/PoOOEL/YEAR OF VEHICLE:
LICENSE PLATE NU~BER:
3/86
, Page 1 of 3
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CITY OF SPRINGFIELD
A.'1BULANCE VEHICLE INSPECTION REPORT
DATE:
A~BULANCE COMPANY:
Springfield Department of Fire & Life Safety.
4. MAKE/;~O[)EUYEAR OF VEHICLE:
LICE:NSE PLATE NU1.:BE:t:
S. MAKE/l~OOEUYEAR OF VEHICLE:
LICENSE: PLATE NU:'lBE~:
C. CC:1PLINiCE::
/' :
VE:iICLE HOUS I1:G
YES
NO
CC:':.'1ENT
1. Are the d~o~janc~ venlcles nausea
in a heateQ garage?
~
eJ.-fi;:::(.' ~
f/G?f,~ .
2. Are the amouianC2 venicles nousec
in a secure garage? ~
D. DEC!SIC:I:
8'
D
o
Acceptable.
Acceotable, with minor discrepancies to be corrected and
inspected by this date:
. Not acceptable, with 'discrepancies' .to be corrected and
inspected by this date:
ADDITIO:IAL CC:~.'o1;:NTS:
J, Wd)7) ~s~ WIJ.JMiV~ -MG 'l>F[f'i?/~rJl~
-./21) ""(1'11;, ~LtM (fI-~VJ/~ AD/) TlJV1AnrJ.
TJH=.y SJfflul.1\ 111;:; /fJ1?lalrl#i'3'I (~n<.Jil.u/ 1'- T fJA./~ "l T /.W
h1~TJ{'_ )~~ ~Ql/.A"f e4)...
JJ. /J1/l1)(1./E./.J, J11roqlt::t:tJt..,J it "~
Person ConJu~tlng the Ins~ectlon
3/:J...b/~td
Date of Inspectlon
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3/86
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Page 2 0'( 3
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AMBULANCE COMPANY:
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CITY OF SPRINGFIELD ..
A.'o1BULANCE VEHICLE INSPECTION REPORT- ,':.: .'
DATE:
. .. ':~~~~\::;..~;. ~'~~-;~~~~,~;~.7. .;,~
Springfield Department of Fire. & Life Safety
I I. eRE',,' QUARTERS STAUOARDS:
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 (c.....ellings). Please
complete the information in section A and indicaee compliance with the
requirement by filling out section B (OECISIDU). Please attach copies
of any inspection forms used by the Building ~ivision to determine com-
pliance.
/'
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LOCA TIO~1 OF CRE':! QU;'RERS:
A.
(Street/Ap,..i')
(Ci,Y/Sta,e/Zip)
B. DEC!SIO~I:
~
o
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Acceptable.
(Phone)
Acceptable, with minor discrepancies to be corrected and
inspected by this date:
Not acceotable, with discrepancies to be corrected and
inspected by this date:
ADDITIONAL CC~MENTS:
-1). H1~MG/..J,II1..~JM. S/I;fu)
Person COC~uctlng tne Ins~ec,ion
3/86
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Date or InspectIon
/'
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