Title Page
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Occupancy Name
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Physical building address
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Main Phone Number
Pre Plan Information
- Key Holders
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Name
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Phone Number
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E-Mail
Building Construction
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Building Construction Type
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Stories above ground?
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Does this structure have a basement?
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Building Length (ft)
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Building Width (ft)
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Building Size (Sq.Ft)
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Are there stairs in the building?
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Location
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Is there an elevator in the building?
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Location
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Are there any fire walls in the building?
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Location
Occupancy
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Occupancy Type
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Special Evacuation Needs
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Primary Hours of Operation
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Typical Daytime Occupancy
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Typical Nighttime Occupancy
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Are there exposures to be considered
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What are the exposures and their locations
Access
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Is there a Knox box?
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Location
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Is there a main access point?
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Location
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Any concerns gaining access
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Explain Concerns
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Are there additional access points?
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Explain locations
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Is there exterior roof access?
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Location
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Is there interior roof access?
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Location
Utilities
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Is there electrical service present?
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Disconnect Location
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Natural Gas Present
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Valve Location
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Propane Present
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Tank Location
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Municipal Water Present
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Shut Off Location
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Is there a generator present?
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Generator location?
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Solar Power Present
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Disconnect Location
Fire Protection
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Fire Alarm System
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Panel Location
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Sprinkler System
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Main Control Location
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Fire Department Connection
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Location
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Fire Pump
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Location
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Fire Protection System
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Type of Fire Protection System
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Type Description
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Special Extinguishing Agent
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Type
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Amount
Water Supply
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Water Supply
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Closest Fill Site
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Backup Fill Site
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Hydrant Location
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Needed Fire Flow 25% Involved (gpm)
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(Length x Width) / 3 x number of floors = Fire Flow. Fire Flow x.25 gets 25% needed
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Needed Fire Flow 50% Involved (gpm)
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(Length x Width) / 3 x number of floors = Fire Flow. Fire Flow x.5 gets 25% needed
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Needed Fire Flow 75% Involved (gpm)
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(Length x Width) / 3 x number of floors = Fire Flow. Fire Flow x.75 gets 25% needed
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Needed Fire Flow 100% Involved (gpm)
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(Length x Width) / 3 x number of floors = Fire Flow
Hazardous Materials Present
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Hazardous Materials Present
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Chemical Name / UN
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Water Reactive
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Amount
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Location
MABAS
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MABAS Card
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Will equipment staging be needed?
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Staging locations
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Special Call
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Resource
NOTES
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Additional Notes