Information

  • Conducted on

  • Occupancy Name:

  • Location
  • Inspector :

  • Occupancy Phone Numbers

Fire Alarm System

  • Test Records of fire alarm system are on-site.

  • Add media

  • Fire Alarm is operating at all times.

  • Add media

Sprinkler System

  • Water connections are in working condition.

  • Add media

  • Head clearance is maintained.

  • Add media

  • Alarm valves are in working condition.

  • Add media

  • Sprinkler system test and maintenance records are on-site.

  • Add media

  • Dry chemical extinguishing system test and maintenance records are on-site.

  • Add media

  • Exhaust hood system maintained.

  • Add media

Fire Extinguishers

  • Test records of fire extinguishers are on-site.

  • Add media

  • Identification of fire extinguishers is posted.

  • Add media

  • Fire extinguishers are properly installed.

  • Add media

  • Fire extinguishers are easily accessible.

  • Add media

  • Fire extinguishers on-site are of proper size (2A:20BC 5 lbs).

  • Add media

Exits

  • Fire escapes are properly maintained.

  • Add media

  • Exits are free from obstructions.

  • Add media

  • Exit signs are illuminated.

  • Add media

  • Corridors and exits are properly lit.

  • Add media

  • Doors are operable without special knowledge.

  • Add media

  • Emergency lights are working.

  • Add media

  • Egress doors have exit signs.

  • Add media

Electric

  • Non-fused, multi-plug adapter(s) are not present.

  • Add media

  • Extension cords are not being used in place of permanent wiring.

  • Add media

  • Extension cords are shielded from damage.

  • Add media

  • Alterations have not been made to electrical panel.

  • Add media

  • Covers are placed over junction box(s).

  • Add media

  • Electrical splices are in junction box(s).

  • Add media

Fire Barriers

  • Fire walls have no holes.

  • Add media

  • There is no opening in ceiling.

  • Add media

  • Fire doors are in working condition.

  • Add media

  • Fire doors have been tested.

  • Add media

Storage

  • Storage is kept 24” from hot water heater and furnace.

  • Add media

  • No combustible decorative materials are on-site.

  • Add media

  • Housekeeping is properly maintained.

  • Add media

  • Flammable liquids are properly stored.

  • Add media

  • Storage is kept 30” from electric panel

  • Add media

Building

  • Correct keys are in Knox Box.

  • Add media

  • Building has address numbers.

  • Add media

  • Building has Knox Box.

  • Add media

  • Other Comments

  • Signature of person granting permission to inspect and date:

  • Signature of inspector and date:

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.