Title Page
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Business Name
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Location
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Date of Inspection
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Inspector
Plans / Drawings
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Verify approved plans / drawings are on-site or are available to the contractor.
Visual Inspection
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Door swings in the direction of egress.
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Emergency lighting is provided at all egress doors.
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“Push to Exit” button is installed, readily visible / accessible, and labeled.
Operational Test
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Door releases upon fire alarm activation.
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Door releases upon loss of power to the lock or locking mechanism.
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Door releases upon pressing of “Push to Exit” button.
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Door releases upon pressing override switch, if applicable.
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Door releases upon activation of motion sensor.
Delayed Egress
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Door is labeled “PUSH UNTIL ALARM SOUNDS - DOOR CAN BE OPENED IN 15 SECONDS”
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An irreversible process after release device is pressed for 1 second and door unlocks within 15 seconds (manual reset).
Inspection Status
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Inspection Status
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Next Inspection
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Owner / Representative
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Phone #
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Email Address