OF F IC E OF INSURANC E AND SAF ETY F IRE C OMMISSIONER
Ralph T. Hudgens, Commissioner
2 MLK, JR . DR ., 612 W EST TO W ER , ATLANTA, GA 30334 W W W .GAINSUR ANCE.O R G
FORM FM298
SAFETY FIRE INSPECTION REPORT File No. 016-BUS-001
Building No. #108A
Nam e of Building WILDLIFE PAVILION
Nam e of Facility GEORGIA SOUTHERN UNIVERISTY
Com pany Nam e
Se rial No.
O wne r MR HANK HUCKBY
Addre ss P.O BOX 8072-01
Addre ss
C ity STATESBORO
State GA
Zip 30460
UNIVERSITY SYSTEM OF GEORGIA A P rovinc e/ U.S.A A C ountry
270 WASHINGTON STREET State GA
City ATLANTA
Zip 30334
Physical Location 244 FORREST DRIVE
O wne r's Phone # (404) 656-2022
Facility Phone #
Em ail :
[email protected]
(912) 478-5234
Type of Inspection Follow-up
2nd time
Special Request
Consultation
Standard Used 2000 LSC
Select or type...
Existing
A dmin. Information C .P.No Date Issue d # of curre nt violations 0
Fe e
C.O .No. 85131S
Date Issue d 09/29/1999
# violations last inspe ction 2
Description Of Facility Type O ccupancy PAS-public assembly Construction Type
Sprinkler
V (0,0,0) / VB
None
Variance
Last inspe ction by BRYANT
Date last inspe cte d 12/01/2011
O ccupant Load 160
#of be ds
Sq.Ft.are a 2,542
#of storie s 1 Basement No
Deficiency Type
Compliance
Deficiency Type
Compliance
Y es Y es 1.Num be r of e x its 8. De te ction, alarm , com m unication syste m s Y es Y es 2.Me ans of e gre ss of approve d type 9. Ex tinguishm e nt syste m s Y es Y es 3.Trave l distance s to e x ists 10.Construction type re quire m e nts Y es Y es 4.Ex it signs 11.Com partm e ntation re quire m e nts Y es Y es 5.Em e rge ncy lighting 12.Ele ctrical syste m N/A Y es 6.Ve rtical ope nings prote ction 13.HVAC syste m Y es Y es 7.Inte rior finish 14.O the r A ccompanied by: This ack nowle dge s the owne rship of this facility is as state d above ; and this ack nowle dge s that an e x it inte rvie w was give n; that I unde rstand the te rm s and conditions of the NO TICE be low; and that I have /have not re ce ive d a copy of this re port. Name/Signature
Title
ROBERT SEEL
GSU FIRE MARSHAL
Date
01/03/2013
This ack nowle dge s that I accom panie d the Fire Safe ty Com pliance O ffice r m ak ing this re port. Name/Signature
Title
ROBERT SEEL
GSU FIRE MARSHAL
Date
01/03/2013
Notice: All de ficie ncie s and/or violations note d above and on the attache d page s shall be corre cte d im m e diate ly in orde r for this facility to com ply with O .C.G.A. Title 25, Chapte r 2. This re port shall be re turne d to the Safe ty Fire Division O ffice within 30 days indicating the de ficie ncie s and/or violations note d have be e n corre cte d by initialing and dating e ach ite m . If all ite m s are not corre cte d, a plan of corre ction shall be attache d and subm itte d to this office within 30 days stating what corre ctive m e asure s will be tak e n with the e stim ate d date of com ple tion. Failure to corre ct the note d de ficie ncie s and/or violation is violation of Ge orgia Safe ty Fire Law. Follow-up inspection fees of $150 or $220 will be charged and due payable in advance for second, third, and subsequent inspections as specified in Code Section 25-2-4.1. No visual violations we re note d.
R e com m e nd issuance of Ce rtificate of O ccupancy
R e com m e nd issuance of te m porary Ce rtificate of O ccupancy for
A follow-up inspe ction is sche dule d to be conducte d in
days
approx im ate ly
days
C opy of re port le ft: Yes Review Supervisor Signature
Title
Date
Name/Signature
KEITH BRYANT
Title
FSCO
Date
01/03/2013
OF F IC E OF INSURANC E AND SAF ETY F IRE C OMMISSIONER
Ralph T. Hudgens, Commissioner
2 MLK, JR. DR., 612 WEST TOWER, A TLA NTA , GA 30334 WWW.GA INSURA NCE.ORG SAFETY FIRE INSPECTION REPORT File Num be r 016-BUS-001
Item #
Reference
Building Num be r #108A
Se rial Num be r
Comments
Type Def Select or type...
ALL PREVIOUS VIOLATIONS HAVE BEEN CORRECTED.
FORM SFD376
