FORM 2/5

for BUSINESS OPERATIONS

1st Inspection Re- Inspection

Number of Applications NOTICE TO

NOTICE TO
Structural CORRECT ABATEMENT
Received for FSIC Issued COMPLY
INSPECTED VIOLATION
BUSINESS
ESTABLISHMENTS Closure Order
(within a month)

Compliant

Compliant

Compliant
Compliant

Compliant
Conpliant
New Renewal

Non-

Non-

Non-

OVERALL NO. OF BUSINESS ESTABLISHMENTS INSPECTED

TOTAL NO. OF NON-COMPLIANT AFTER RE-INSPECTIONS

City/Municipality

Non-Structural (ex. Vehicle used as Rolling Store & etc.)

Closure Order for Failure to Comply the Abatement order

FSIC Issued NOT WITHIN Prescribed Period

FSIC Issued NOT WITHIN Prescribed Period

Total Number of Compliant from Re-Inspection

Total Number of Inspected from 1st Inspection

***FSIC Issued WITHIN Prescribed Period

***FSIC Issued WITHIN Prescribed Period

Total Issued FSIC for Business/ Operation

Issued FSIC for Business Operation

Issued FSIC for Business Operation

Single & Two Family Dwelling Unit

OVERALL NO. OF COMPLIANT

BUSINESS ESTABLISHMENTS
Closure For Failure To Pay Fine
Residential Board and Care

Total Issued Closure Order

Lodging & Rooming House
Detention & Correctional

Issued Abatement Order

TOTAL FSIC Issued
Apartment Buildings

(Total FSIC Issued)

(Total FSIC Issued)

Special Structures
RENEWAL

Issued NTCV
Educational

Health Care

Issued NTC
Dormitories

Mercantile
Assembly
TOTAL

Day Care

Industrial
Business

Storage
NEW

Hote l
AA AB AC A B C D E F G H I J K L
A.1 A.2 A.3 A.4 A.5 A.6 A.7 A.8 A.9 A.10 A.11 A.12 A.13 A.14 A.15 A.16 D.1 D.2 D.3 D.4 D.5 E.1 E.2 F.1 F.2 G.1 G.2 I.1 I.2 I.3

TOTAL 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0
(Past year same month)
Variance

Note: (1) All data under Column (A) pertains only to first inspection, wherein there was an actual inspection conducted. All data for re-inspections shall be Formula(s):
reflected in (2nd) Re-Inspection Column. Likewise, first inspection with violations shall be reflected in (E.1) Those establishment that AC = AA + AB
applied for FSIC for Business Permit during renewal process or B.O.S.S, they shall be reflected in Column (A) if there is actual inspection C=A+B
conducted, usually prior to expiration of FSIC. Example: E.1 = ( C - D ) H = E.2 + F.2 + G.2
(2) Data under (D) pertains to those establishment without violations during first inspection. I.3 = I.1 + I.2
(3) Data under (E.2) ,(F.1), (F.2), (G.1), (G.2), (I.1)and (I.2) pertains only to re-inspections. J = C + E.2 + F.1 + F.2 + G.1 + G.2 + I.1 + I.2
(4) Data under (I.1) pertains to establishments recommended for stoppage/closure for failure to comply the Abatement Order. D.5 = D.1 + D.2 + D.3 + D.4
(5) Data under (I.2) pertains to establishment that is recommended for stoppage of operation/closure for failure to pay fine. K = D.5 + H
**In Case of Mixed Occupancy, the dominant Occupancy will prevail. L = F.1 + G.1 + I.1 + I.2
***FSIC Issued within Prescribed Period: (CITIZEN CHARTER) Where: Column (J) = 1st Inspection + 2nd Inspection
a. FSIC Issued within (1) one day after inspection Column (K) = Issued FSIC from 1st Inspectio + Issued FSIC from 2nd Inspection
b. FSIC Issued within (3) three day3 after inspection
c. FSIC Issued beyond (3) three day3 after inspection

BFP-QSF-FSED-052B Rev. ØØ (07.13.20) Page 2 of 5