Republic of the Philippines

Department of the Interior and Local Government

Bureau of Fire Protection
Regional Office VIII
Northern Leyte Provincial Office
Mahaplag Fire Station
Independence St. Poblacion Mahaplag, Leyte
Cellphone Number: 09470608806/ 09069281531

INSPECTION ORDER
NUMBER: 2022 – 01 – 21 DATE
(Pre-numbered)

TO : SFO1 Juaren L Lause

PROCEED : John Paul & Rachel Bakeshop

Add: Brgy. Union, Mahaplag, Leyte
Owner: Gracilda O. Orano
PURPOSE :
To Conduct fire Safety Inspection of said Establishment &
implement the provision of R.A. 9514 & other pertinent laws,
rules, regulations & other pertinent ordinance.

DURATION : After Completion

REMARKS OR : Coordinate with the owner/occupants & observe proper

ADDITIONAL norms of conduct while in the performance of duty
INSTRUCTION/S

RECOMMEND APPROVAL: APPROVED:

SFO1 Juaren L Lause SFO4 Rex B Lagunzad

Chief, Fire Safety Enforcement Section MUNICIPAL FIRE MARSHAL

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ACKNOWLEDGEMENT
This is to acknowledge that permission was granted to the above-named Fire Safety
Inspector/s accompanied by authorized representative to conduct Fire Safety Inspection within the
premises in accordance with law.

_________________________________________________ _____________________
Signature over Printed Name/Authorized Representative Date/Time

PAALALA: “MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF FIRE PROTECTION SA MGA KAWANI NITO
ANG MAGBENTA O MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER”

“FIRE SAFETY IS OUR MAIN CONCERN”

DISTRIBUTION:
Original (Applicant/Owner’s Copy)
Duplicate (BFP Copy)

BFP-QSF-FSED-009 Rev. 01 (07.05.19)