HomeMy WebLinkAboutMiscellaneous Miscellaneous 1987-11-23
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ATTACHMEN'fF
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'CITY OF SPRINGFIELD
AMBULANCE VEHICLE INSPECTION REPORT
VEHICLE HOUSING AND CRE'..I QUARTERS STMIOARDS
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DATE: 11-23-87
AMBULANCE Cm1PANY:
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Business Name: Springf:l.eid Fire and Lite' Safety '.' ""Phone: 726-3737
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-"'-;il1ng Addre'~~~~-iiSN~rili 5th Street ... .'
(Street/Apt.lI)
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Springfield OR 97477
(Clty/State/Zip)
726-3737
. (Phone)
_--.~~I.. .:'~:~~:~~=,:;~~~: ,~:~" C;,,' ,;- S;~'~~"~~'d to h,"',
. .. ...... its ambulance vehicles in a heated and secure OJro1ge. Please cc::;olete the
· _~L..~,::::..:..infor::;ation in sections A-a and indicJte ccmpliance wft.h the requirement
:- ,"::..' by filling out sec-:.ion E (DECrSrO:I). ..... ..,
A.
LOCAnON OF GARAGE:
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(Street/Apt.;;) r~~
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lPhone)
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B. NU~9E~ OF AMBULA.NCE VE.;!ClES HOUSED Ai THIS lOCATIC~I:
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C. IDENTITY OF AMBULAtlCE VEHICLES HOUSED AT THIS LOCATION:
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1. MAKE/MODEL/YEAR OF VEHICLE: /9R7
. LICENSE PLATE NUMBER: F /t/9tJtJ?
,_2. MAKE/MODEL/YEAR OF VEHICLE:
,.dlICENSE PLATE NUI1BER:
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__3.MAKElMOOELlYEAR OF VEHICLE:
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LICENSE PLATE NUMBER:
3/86\
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.' CITY OF SPRINGFIELD t
AMBULANCE VEHICLE INSPECTION PORT
DATE:'///;.J/I?
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AMBULANCE COMPANY:
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4. MAKE/MODEl/YEAR OF VEHICLE:
LICENSE PLATE NW1BER:
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S. MAKE/MOOElIYEAR OF VEHICLE:
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LICENSE ,PLATE NUMBER; .",- .. ,
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C. CO:1PLIANCE: _ ______
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VEHICLE HOUSING
YES
NO
CCl1,,"lENT
1. Are the amouiance venicles housea
'fn a heated garage~
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(W >>VI I'~l
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2. .Are the amouiance venicies nousea
fn a secure garage?
D. DEC!SION:
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Accept.able.
Acceptable, with minor discrepancies to be corrected and
fnspected by this date:
Not acceptable, with discrepancies to be corrected and
fnspected by this date:
ADDITIONAL COMMENTS:
P"~~~ -(,;,?~:~-
11/2-1 h7 ?
Dateiof Inspection
3/86
Pace 2 of 3
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.. CITY DF SPRINGFIELD a
~BULANCE VEHICLE INSPECTION R~RT
DATE:
AMBULANCE COMPANY:
Any ambulance service licensed by the :City of Springfield is required to pro-,
vide crew quarters that conform to the standardi set forth in the current
Uniform Building Code for residential occuparu:ies (d'tlel-l ings). 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-
pl lance.
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II. CR~~ QUARTERS STANDARDS:
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A. LQCA TIml QF CREH QUARTERS:
(Street1Apt.l:)
(City/State/Zip)
(Phone)
B. DECISION:
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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:-lMENTS:
Pm4//~~
Petson Cor.ducting the Inspection
Dat~7br~Ztion
3/86
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