• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Location
  • Personnel

  • Building name:


  • Building or Facility is free from debris and litter.

  • Refuse is picked-up at frequent intervals. There is no absence of excess refuse.

  • Trash chute doors operate freely mad positively latch on their own.

  • Wall sections and doors have less than 20% of surfaces covered with flammable materials.

Fire Protection Equipment

  • Fire are located off of the floor in a designated a marked area and are unobstructed.

  • Smoke and/or Heat detectors are undamaged and are absent of paint, debris, and hanging items

  • Sprinkler heads are undamaged and are free of paint, debris and hanging items.

  • Sprinkler heads have at least 16" of clearance between obstructions and 24" from the ceiling.

  • Fire alarm panel is locked.

  • Fire pump has a current inspection tag. List the date.

  • Sprinkler system riser has current inspection tag. List the date.

  • Sprinkler system riser has hydrostatic test data located on a placard near the riser.

  • Fire alarm signaling components are in working order

  • Fire Department Connections (FDC's) are unobstructed and easily accessible.

  • Sprinkler system risers are unobstructed and easily accessible.

  • Post Indicator Valves (PIV's) are locked and in the open position.

General Fire Safety

  • Heating equipment has at least 36" clearance between the equipment and any stored items

  • Gasoline, kerosine or propane are not stored inside the structure.

  • Corrosive or flammable chemicals are located in approved containers or cabinets.

  • Gas cylinders are anchored or secured.

  • Ceiling tiles are present and unbroken.

  • Ceilings are free from debris and hanging items.

  • Penetrations in the fire walls are sealed with fire caulk or other approved means.

  • Dryer vents are free from debris and lint.

Exit Ways and Doors

  • Corridors, stairways and stairwells are free from obstruction and storage.

  • Exit signs are lit.

  • Fire doors close completely and latch positively on their own.

  • Doors are not propped open at unattended offices or rooms.

  • Exit doors can be opened without special knowledge, effort, key or unapproved device.

  • Exits are unobstructed and the width if the doors is maintained along and throughout the path of egress.

  • Clear space of at least 10' is maintained outside of exit doors.

Exit Signs and Lighting

  • Exit signs are visible.

  • Exit signs are not damaged and in working order.

  • Doors that could be confused as an exit are marked "Not an exit".

  • Lighting fixtures are in good working order and there is adequate lighting to find the way out of public areas.


  • Electrical service equipment has at least 36" of clearance between equipment and any stored items.

  • Extension cords are not being used unless for temporary use.

  • Unapproved multi plug adapters are not being used.

  • Electrical outlets and junction boxes are equipped with approved covers.

  • Spliced or cut wires are capped/covered with an approved box.

  • Electrical boxes are not missing knock out covers.

Emergency Planning

  • Fire evacuation floor plans and tornado shelter plans are posted on each floor.

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.