COLDWATER FIRE DEPARTMENT FIRE INSPECTION REPORT - duplicate

• Inspection Title

Customer information:

• Name of Business:

• Building Address:
  Address

• Fire Area Square Feet:

• Contact:

• Email Address:

• Emergency Contact:

• Date &Time:

  Date

• Inspector:

PRE-INCIDENT SURVEY :

• Has one been completed on the building?

  Yes

  No

  N/A

FIRE DEPARTMENT ACCESS:

• Knox Box Installed?

  Yes

  No

  N/A

• Knox Box Maintained & Protected?

  Yes

  No

  N/A

• Any Building Access Issues?

  Yes

  No

  N/A

• Water Supply Accessible?

  On Site

  Acceptable Distance

OCCUPANCY INFORMATION:

• What is the occupancy use?

  Select Business Industrial Storage Mercantile Assembly Educational Apartment Hotel Residential Health Care

  • Business
  • Industrial
  • Storage
  • Mercantile
  • Assembly
  • Educational
  • Apartment
  • Hotel
  • Residential
  • Health Care

• Address Posting?

  Not Posted

  Improper Size

  Posted

  Contrasting Issue

• Certificate of Occupancy Issued?

  Yes

  No

  N/A

• How Many Stories Above Grade?

  1

  2

  3

  4

• How Many Stories Below Grade?

  1

  2

  3

  4

• Exterior Construction Type?

  Wood Frame

  Concrete

  Metal

• Roof Construction Type?

  Conventional Wood Truss

  Pre-fab Concrete

  Steel Truss

  Engineered Wood Truss

• Hazardous Materials/Flammable-Combustible Liquids Compliant?

  Yes

  No

  N/A

• Compressed Cylinders Secured & Identified?

  Yes

  No

  N/A

• Fire Protection Systems Existing & Types?

  Select Fire Sprinkler Fire Alarm Commercial Hood System Clean Agent Portable Fire Extinguisher Co2 Dry Chemical Combination N/A

  • Fire Sprinkler
  • Fire Alarm
  • Commercial Hood System
  • Clean Agent
  • Portable Fire Extinguisher
  • Co2
  • Dry Chemical
  • Combination
  • N/A

• Occupant Load Approved?

  Yes

  No

  N/A

EXIT INFORMATION:

• Number of Exits Sufficient?

  Yes

  No

  N/A

• Exit Access or Discharge Issues?

  Select BLOCKED OBSTRUCTED YES NO

  • BLOCKED
  • OBSTRUCTED
  • YES
  • NO

• Exit Door Issues Present?

  Select Blocked Improper Locking Obstructed Faulty Door Improper Hardware Access/Discharge YES NO

  • Blocked
  • Improper Locking
  • Obstructed
  • Faulty Door
  • Improper Hardware
  • Access/Discharge
  • YES
  • NO

• Exit Signage

  Select Sign Needed Sign Needs Repair Sign Location Issue Not Illuminated No Issues

  • Sign Needed
  • Sign Needs Repair
  • Sign Location Issue
  • Not Illuminated
  • No Issues

• Emergency Lighting

  Select Lighting Needed Lighting Needs Repair No Issues

  • Lighting Needed
  • Lighting Needs Repair
  • No Issues

REINSPECTION ITEMS:

ELECTRICAL & HEATING ISSUES:

• Emergency Generator Functional & Tested?

  Yes

  No

  N/A

• Improper Wiring?

  Yes

  No

  N/A

• Improper Use of Extension Cords?

  Yes

  No

  N/A

• Improper Use of Adapters?

  Yes

  No

  N/A

• Panel Needs Attention?

  Yes

  No

  N/A

• Faulty Fixtures?

  Yes

  No

  N/A

• Are Heating Appliances Compliant?

  Yes

  No

  N/A

REINSPECTION ITEMS:

FIRE RATED ASSEMBLIES:

• Listed & Labeled?

  Yes

  No

  N/A

• Improper Rating?

  Safe

  At Risk

  N/A

• Improper Material?

  Yes

  No

  N/A

• Fire Door/Window Inspection Documentation?

  Yes

  No

  N/A

REINSPECTION ITEMS:

INTERIOR FINISH:

• Proper Rating?

  Yes

  No

  N/A

• Compliant?

  Yes

  No

  N/A

REINSPECTION ITEMS:

STORAGE/HOUSEKEEPING:

• Storage Issues?

  Select Accumulations Improper Disposal Hazardous Materials Too High Improperly Stacked Obstructing Sprinklers No Issues

  • Accumulations
  • Improper Disposal
  • Hazardous Materials
  • Too High
  • Improperly Stacked
  • Obstructing Sprinklers
  • No Issues

• Seating Issues?

  Yes

  No

  N/A

• Aisles Maintained & Unobstructed?

  Yes

  No

  N/A

REINSPECTION ITEMS:

FIRE ALARM SYSTEM INFORMATION:

• System Operational?

  Yes

  No

  N/A

• Needs Service?

  Yes

  No

  N/A

• Needs Maintenance?

  Yes

  No

  N/A

• Needs Monitoring?

  Yes

  No

  N/A

• Needs Annual Inspection?

  Yes

  No

  N/A

• Improper Mounting/Type/Devices

  Yes

  No

  N/A

• Detectors or Equipment Required?

  Yes

  No

  N/A

REINSPECTION ITEMS:

FIRE SUPPRESSION & SPRINKLER SYSTEM INFORMATION:

• Commercial Cooking Suppression System Compliant?

  Yes

  No

  N/A

• Commercial Cooking Operations & Hood(s) Compliant?

  Yes

  No

  N/A

• Portable Fire Extinguishers Compliant?

  Yes

  No

  N/A

• Missing Sprinkler Heads?

  Yes

  No

  N/A

• Improper System / Heads?

  Yes

  No

  N/A

• Obstructed?

  Yes

  No

  N/A

• Spare Heads Needed?

  Yes

  No

  N/A

• Are Valves Accessible?

  Yes

  No

  N/A

• Fire Department Connection?

  OBSTRUCTED

  BLOCKED

  COMPLIANT

  N/A

• Repairs or Service Needed?

  Yes

  No

  N/A

• Annual Inspections Needed?

  Yes

  No

  N/A

• Records at Riser?

  Yes

  No

  N/A

REINSPECTION ITEMS:

GENERAL INFORMATION:

• Reinspection Necessary?

  Yes

  No

  N/A

• Re-Inspection Date:

  Date

• Transferring to Building Department BSA?

  Yes

  No

  N/A

• Emailing Report?

  Yes

  No

  N/A

• Additional Comments?

  Yes

  No

  N/A

• REPORT STATUS: