NAME OF BUSINESS: CONTACT NAME:
TUP APPLICATION AND DOCS ATTACHED:
ADDRESS OF SALE SITE:
FIRE FEES COLLECTED:
INSPECTION SCHEDULED: / / :
PHONE #:
INSPECTION ASSIGNED TO:
PERMIT GENERATED:
ADDTL FIRE INSPECTIONS REQ: Y N
INSPECTION DATE
RE-INSPECTION
REQUIRED
RE-INSPECTION DATE
Initial Inspection Re-Inspection
LIST ITEM NUMBER REQUIRING CORRECTION
USE REVERSE SIDE FOR EXPLANATION OF PROBLEM AREAS
APPROVED
LIST # NOT
APPROVED
APPROVED
LIST # NOT
A
PPROVED
VALID CITY PERMIT DISPLAYED: Permit must be displayed in the holder’s place of business
TYPE OF FIREWORKS: Only Consumer fireworks UN0336, 1.4G permitted
FIRE EXTINGUISHERS: 1. Minimum of 2 (2A minimum), at least one pressurized water type
2. Location of less than 200 Sq. Ft.: minimum of 1 (2A minimum)
3. Maximum travel distance to an extinguisher: 35 feet
4. All in accessible locations
5. Employees trained in extinguisher operation
SITE REQUIREMENTS: 1. Certificate or other evidence verifying tent fabric as fire retardant treated
2. No hay, straw, or shavings unless flame retardant treated
3. 30
area around site clear of dry grass, dry brush, & combustible debris
4. Fireworks not displayed behind glass in direct sunlight
5. Fireworks out of public reach when attendant not on duty
6. No parking within 10’ of sales location
7. No storage trailer within 20’ of sales location
8. 20’ from other building,tents, any combustibles, cooking equipment &
generators/storage fuels
9. 50from gasoline pumps/filling stations,propane tanks, open flame cooking
FIREWORKS DISCHARGE: 1. Fireworks shall not be discharged within 300’
2. At least one sign with 2” letters at each entrance:
“NO FIREWORKS DISCHARGE WITHIN 300 FEET
NO SMOKING SIGNS: 1. At least 1 sign with 2” letters at each entrance: FIREWORKS NO SMOKING”
2. No smoking in or within 25’ of sales area
MEANS OF EGRESS: 1. Minimum of 2 remote means of egress free of obstructions
2. Minimum clear aisle width not less than 48”
3. Tent exit opening not less than 44” in clear width
4. All fireworks not within 2’ of any entrance or exit
EMERGENCY LIGHTING AND EXIT SIGNS: 1. Exit signs to be self-luminous or illuminated (required if
open for business after dark)
2. Emergency lighting required in sales areas of 800 sq. ft
or greater (not required if not open after dusk)
ELECTRICAL EQUIPMENT: 1. Electrical system & equipment isolated from the public
2. All electrical wiring & equipment UL approved, installed and maintained to
prevent electrical hazards (in trenches or protected by approved covers)
3. Branch circuits protected by GFCI (if susceptible to water exposure)
PROHIBITED ACTIVITY/ITEMS: 1. Persons under 16 years prohibited from selling or working unless
under the supervision of another at least 18 years of age
2. Storage & display of pest control devices prohibited
3. Electronic pest control devices prohibited inside sales location
4. Alcoholic beverages prohibited during business hours
5. Proximate & display fireworks not sold with 1.4G fireworks
BUSINESS RESPRESENTATIVE RECEIVING INSPECTION FORM:
PRINT NAME: SIGNATURE: DATE:
INSPECTION CONDUCTED BY:
PRINT NAME:
SIGNATURE: DATE:
CITY OF EL MIRAGE FIRE DEPARTMENT
FIREWORKS SEASONAL RETAILER INSPECTION
13601 N EL MIRAGE RD, EL MIRAGE 623-583-7968
TEMP USE PERMIT NUMBER (ISSUED FROM CITY HALL):