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


  • Any other comments?

  • When completed please provide signature here:

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.