Evacuation Report

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Name of Venue / Building

• Esplanade Lagoon Management

• Esplanade Lagoon

• Muddy's

• Skateplaza

• BGVC

• Barlow Park

• Date of evacuation

  Date

• Time taken to Evacuate

  Under 5 min

  Under 10 min

  Under 15 min

  Under 30 min

• Cause of evacuation

  fire

  bomb threat

  personal threat

  false alarm

  drill

• Did Qld Fire Services Attend

  yes

  no

• If yes what time did they arrive

  Date

Systems

• Tick the the following systems that operated

  Select emergency signals sprinkler system fire alarm system public address system radio network visual indicators A/C Shutdown fire authority automatically notified

  • emergency signals
  • sprinkler system
  • fire alarm system
  • public address system
  • radio network
  • visual indicators
  • A/C Shutdown
  • fire authority automatically notified

• Other comments/specifics

Warden debrief on movement of persons

Casualties

Other comments

• Add signature

  Sign

• Select date

  Date