Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Planned and unplanned fire drills conducted at regular intervals. Date of most recent drill:___________

  • Annual maintenance checks of portable fire extinguishers completed and inspection tags on each extinguisher reflect the date completed.

  • Fire alarms functioning properly and tested annually. Date of most recent test:

  • Electrical closets free of storage

  • Exposure to overhead electrical lines controlled

Signature

  • Any other comments?

  • When completed please provide signature here:

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