City of Alexander Business Fire Prevention Code Inspection

• Site conducted

  Select

• Business/ Tenant Name:

• Location
  Address

• Phone Number:

• Type of Inspection:

  Initial

  Annual

  Re-Inspection

  Special

• Alexander Business License Profit/ Non profit

  Yes

  No

• Alexander Business Licence No.:

• undefined

• Conducted on:

  Date

Exits

• All exits and properly identified and working in accordance with state, county, and city codes and ordinances?

  Safe

  Unsafe

  N/A

• Violation:

  Select Locked exit Obstructed exit Exit not properly marked No exit lighting Exit requires panic bar No fire evacuation plan, or plan not posted Exit door swings in wrong direction

  • Locked exit
  • Obstructed exit
  • Exit not properly marked
  • No exit lighting
  • Exit requires panic bar
  • No fire evacuation plan, or plan not posted
  • Exit door swings in wrong direction

• Location/ description:

• Picture of violation:

  Media

Smoke Alarm

• Yes

  No

  N/A

Extinguishers

• All extinguishers working and tag in accordance with state, county, and city codes and ordinances?

  Safe

  Unsafe

  N/A

• Violation:

  Select Inadequate number of extinguishers Inspection tags out of date Extinguisher not accessible Improper installation of extinguisher

  • Inadequate number of extinguishers
  • Inspection tags out of date
  • Extinguisher not accessible
  • Improper installation of extinguisher

• Location/ description:

• Picture of violation:

  Media

Housekeeping

• Housekeeping prevents high fire load conditions?

  Safe

  Unsafe

  N/A

• Violation:

  Select Areas cluttered Combustibles not properly stored Inadequate waste containers Combustibles stored under stairwells Vent-A-Hood needs cleaning Cooking area needs cleaning Missing or damaged ceiling tiles Means of egress not cleared

  • Areas cluttered
  • Combustibles not properly stored
  • Inadequate waste containers
  • Combustibles stored under stairwells
  • Vent-A-Hood needs cleaning
  • Cooking area needs cleaning
  • Missing or damaged ceiling tiles
  • Means of egress not cleared

• Location/ description:

• Picture of violation:

  Media

Sprinkler/ Suppression Alarm System

• Sprinkler/ suppression systems working in accordance with state, county, and city codes and ordinances?

  Safe

  Unsafe

  N/A

• Violation:

  Select Sprinkler or alarm system inspection out of date Heads obstructed Heads painted Needs service Vent-A-Hood supression systemp inspection out of date Vent-A-Hood suppression system not working properly No accompanying monitored fire alarm system Suppression system is inadequate for intended task

  • Sprinkler or alarm system inspection out of date
  • Heads obstructed
  • Heads painted
  • Needs service
  • Vent-A-Hood supression systemp inspection out of date
  • Vent-A-Hood suppression system not working properly
  • No accompanying monitored fire alarm system
  • Suppression system is inadequate for intended task

• Location/ description:

• Picture of violation:

  Media

Smoking

• Smoking in areas in accordance with state, county, and city codes and ordinances?

  Safe

  Unsafe

  N/A

• Violation:

  Smoking in restricted areas

• Location/ description:

• Picture of violation:

  Media

Hazardous Materials

• All hazardous materials stored according to federal, state, county, and city laws, codes, and ordinances?

  Safe

  Unsafe

  N/A

• Violation:

  Select Hazardous materials improperly stored Excessive amount of hazardous materials for storage system used Excessive quantity of hazardous material in use Improper use of hazardous materials Hazardous materials not properly marked No MSDS book on site

  • Hazardous materials improperly stored
  • Excessive amount of hazardous materials for storage system used
  • Excessive quantity of hazardous material in use
  • Improper use of hazardous materials
  • Hazardous materials not properly marked
  • No MSDS book on site

• Location/ description:

• Picture of violation:

  Media

HVAC System

• HVAC system working in accordance with state, county, and city codes and ordinances?

  Safe

  Unsafe

  N/A

• Violation:

  Select Gas odor Vent needs repair Combustibles stored near heater Vent system needs cleaning

  • Gas odor
  • Vent needs repair
  • Combustibles stored near heater
  • Vent system needs cleaning

• Location/ description:

• Picture of violation:

  Media

Electrical

• Electrical system working in accordance with state, county, and city codes and ordinances?

  Safe

  Unsafe

  N/A

• Violation:

  Select Wiring in general disrepair Electrical box not secured Non-grounded extension cord in use Missing covers at junction boxes, wall fixtures Extension cords are not to be used as permanent wiring 90 minute emergency lighting missing or not functioning properly Not in compliance with 3' clearance around electrical panels

  • Wiring in general disrepair
  • Electrical box not secured
  • Non-grounded extension cord in use
  • Missing covers at junction boxes, wall fixtures
  • Extension cords are not to be used as permanent wiring
  • 90 minute emergency lighting missing or not functioning properly
  • Not in compliance with 3' clearance around electrical panels

• Location/ description:

• Picture of violation:

  Media

Service Stations

• Service station operating in accordance with state, county, and city codes and ordinances?

  Safe

  Unsafe

  N/A

• Violation:

  Select Inadequate "No Smoking" signs Improper or no emergency shutoff switch No HAZMAT spill kit on hand for spills less than 5 gallons

  • Inadequate "No Smoking" signs
  • Improper or no emergency shutoff switch
  • No HAZMAT spill kit on hand for spills less than 5 gallons

• Location/ description:

• Picture of violation:

  Media

Address Numbers

• Address marking numbers in accordance with state, county, and city codes and ordinances?

  Safe

  Unsafe

  N/A

• Violation:

  Select Numbers smaller than 6 inches Numbers can not be seen from the street Numbers do not contrast the building

  • Numbers smaller than 6 inches
  • Numbers can not be seen from the street
  • Numbers do not contrast the building

• Location/ description:

• Picture of violation:

  Media

Miscellaneous

• Are there violations that are not specifically listed above?

  Yes

  No

• Violation:

• Location of violation:

• Picture of violation:

  Media

Summary

• Inspection results:

  Select Conditions are safe and in accordance with Federal, State, County, and City Fire Prevention codes and ordinances Conditions are not in accordance with Federal, State, County, and City Fire Prevention codes and ordinances, but does not warrant shutting down the business while violations are fixed Conditions are not in accordance with Federal, State, County, and City Fire Prevention codes and ordinances, and conditions warrant shutting business down due to extreme life safety issues

  • Conditions are safe and in accordance with Federal, State, County, and City Fire Prevention codes and ordinances
  • Conditions are not in accordance with Federal, State, County, and City Fire Prevention codes and ordinances, but does not warrant shutting down the business while violations are fixed
  • Conditions are not in accordance with Federal, State, County, and City Fire Prevention codes and ordinances, and conditions warrant shutting business down due to extreme life safety issues

• You will be re-inspected on:

  Date

• E-mail inspection should be sent to:

• Inspector:

  Sign

• Business representative:

  Sign