Fire & Life Safety Inspection - duplicate

Building Information

• Building Civic Address:

• Occupancy Name:

• Occupancy Classifaction:

  Select A1 - Assembly A2 - Assembly A3 - Assembly A4 - Assembly B1 - Care & Detention B2 - Care & Detention C - Residential D - Business & Personal Services E - Mercantile F1 - High Hazard Industrial F2 - Medium Hazard Industrial F3 - Low Hazard Industrial

  • A1 - Assembly
  • A2 - Assembly
  • A3 - Assembly
  • A4 - Assembly
  • B1 - Care & Detention
  • B2 - Care & Detention
  • C - Residential
  • D - Business & Personal Services
  • E - Mercantile
  • F1 - High Hazard Industrial
  • F2 - Medium Hazard Industrial
  • F3 - Low Hazard Industrial

• Building Use:

Inspection Report

• Inspection Report

• Inspector

  Bryan Erwin

  Scott Abrahamson

  Craig Twidale

  John Cassidy

Property Contact Information

• Emergency Property Contact Information

  Change Required

  NO Change Required

• No Change to Property Contact Information

• Change To Property Contact Information

  Select Primary Contact Secondary Contact Owner/Property Manager

  • Primary Contact
  • Secondary Contact
  • Owner/Property Manager

• - Primary Contact Name:

• - Primary Contact Address: (Residence)

• - Primary Contact Telephone Numbers: (Res, Bus, Cel)

• - Secondary Contact Name:

• - Secondary Contact Address: (Residence)

• - Secondary Contact Telephone Numbers: (Res, Bus, Cel)

• - Owner/Property Manager Name:

• - Owner/Property Manager Address: (Residence)

• - Owner/ Property Manager Telephone Numbers: (Res, Bus, Cel)

Building Information

• Building Picture

  Media

• Number of Floors?

  Select 1 2 3 4 5 6 7

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7

• ENSURE BUILDINGS STANDPIPE SYSTEM IS IN GOOD OPERATING CONDITION.

Building Exterior - Life and Fire Safety

• Fire Department Access

  Compliant

  NON-Compliant

  N/A

• - Fire Department Access - Action Required

  Select FDC Fire Lanes Private Fire Hydrants Action Required - See Comments Field

  • FDC
  • Fire Lanes
  • Private Fire Hydrants
  • Action Required - See Comments Field

• - Fire Department Connection - Action Required

• - Fire Lanes - Action Required

• - Private Fire Hydrants - Action Required

• - Action Required - See Comments Field

• Exterior Egress

  Compliant

  NON-Compliant

  N/A

• - Exterior Egress - Action Required

• Exterior Sprinklers

  Compliant

  NON-Compliant

  N/A

• - Exterior Sprinklers - Action Required

• Other Hazards

  Compliant

  NON-Compliant

  N/A

• - Other Hazards - Action Required

Building Interior - Fire & Life Safety

• Emergency Plan / Fire Safety Plan

  Compliant

  NON-Compliant

  N/A

• - Emergency Plan / FSP - Action Required

• Emergency Exits

  Compliant

  NON-Compliant

  N/A

• - Emergency Exit(s) - Action Required

  Select No Storage Permitted No Combustible Materials Displays Permitted Blocked or Obstructed Exit Action Required - See Comments Field

  • No Storage Permitted
  • No Combustible Materials Displays Permitted
  • Blocked or Obstructed Exit
  • Action Required - See Comments Field

• - No Storage Permitted - Action Required

• - No Combustible Material Displays Permitted - Action Required

• - Blocked / Obstructed Exits - Action Required

• - Comments:

• Exit Stairwells

  Compliant

  NON-Compliant

  N/A

• - Exit Stairwell(s) - Action Required

  Select No Storage Permitted No Combustible Materials Displays Permitted Blocked or Obstructed Exit Action Required - See Comments Field

  • No Storage Permitted
  • No Combustible Materials Displays Permitted
  • Blocked or Obstructed Exit
  • Action Required - See Comments Field

• - No Storage Permitted - Action Required

• - No Combustible Material Displays Permitted - Action Required

• - Blocked or Obstructed Exit Stairwell - Action Required

• - Comments:

• Fire Doors

  Compliant

  NON-Compliant

  N/A

• - Fire Door(s) - Action Required

  Select Fire Door Must Close and Latch Securely Fire Door Must Remain Closed Remove Hold Open Device - Fire Door(s) Must Remain Closed No Secondary Locking Devices Permitted on Fire Doors Fire Doors Can Not be Locked Action Required - See Comments Field

  • Fire Door Must Close and Latch Securely
  • Fire Door Must Remain Closed
  • Remove Hold Open Device - Fire Door(s) Must Remain Closed
  • No Secondary Locking Devices Permitted on Fire Doors
  • Fire Doors Can Not be Locked
  • Action Required - See Comments Field

• - Fire Door(s) Must Close and Securely Close - Action Required

• - Fire Door(s) Must Remain Closed - Action Required

• - Hold Open Device - Action Required

• - Secondary Locking Device on Fire Door(s) - Action Required

• - Locked Fire Door(s) - Action Required

• - Comments:

• Storage / Housekeeping

  Compliant

  NON-Compliant

  N/A

• - Storage / Housekeeping - Action Required

• Other Hazards (Electrical, Heating or Ventilation)

  Compliant

  NON-Compliant

  N/A

• - Other Hazard - Action Required

  Select Electrical Heating Ventilation Other Hazard

  • Electrical
  • Heating
  • Ventilation
  • Other Hazard

• - Electrical - Action Required

• - Heating - Action Required

• - Ventilation - Action Required

• - Other Hazard - Action Required

Fire Safety Equipment

• Fire Extinguishers

  Compliant

  NON-Compliant

  N/A

• - Extinguisher - Action Required

  Select Due for Annual Service Fire Extinguisher(s) Requires Mounting Missing Extinguisher - Replace Extinguisher Action Required - See Comments Field

  • Due for Annual Service
  • Fire Extinguisher(s) Requires Mounting
  • Missing Extinguisher - Replace Extinguisher
  • Action Required - See Comments Field

• - Date of Last Annual Service:

  Date

• - Comments:

• - Fire Extinguisher Requires Mounting:

• - Replace Missing Extinguisher(s)

• - Comments:

• Fire Alarm System

  Compliant

  NON-Compliant

  N/A

• - Fire Alarm - Action Required

  Due for Annual Service

  In-Operable Device - Pull Station

  In-Operable Device - Detection Unit

  Service Required - See Comments Field

• - Date of Last Annual Service

  Date

• - Comments:

• - Pull Station - Action Required

• - Detection Unit - Action Required

• - Comments:

• Fire Sprinkler System<br>

  Compliant

  NON-Compliant

  N/A

• - Fire Sprinkler - Action Required

  Due For Annual Service

  Missing or blocked Sprinkler Head

  Painted Sprinkler Head

  Change Temp on Sprinkler Head

  Action Required - See Comments Field

• - Date of Last Annual Service

  Date

• - Comments:

• - Sprinkler head is Damaged, Blocked or Missing.

• - Sprinkler head has overspray/or is painted

• - Sprinkler's fusible link or temperature rating requires action

• - Action Required - See Comments Field

• Emergency Lighting and Exit Signs

  Compliant

  NON-Compliant

  N/A

• - Emergency Lighting and Exit Signs - Action Required

  Select Due For Annual Service Emergency light(s) Requires Service Exit Sign(s) Requires Service Obstructed Exit Sign - Exit Sign Must be Visible Obstructed Emergency Light(s) - Emergency Light Must Illuminate Pathways to Exits Action Required - See Comments Field

  • Due For Annual Service
  • Emergency light(s) Requires Service
  • Exit Sign(s) Requires Service
  • Obstructed Exit Sign - Exit Sign Must be Visible
  • Obstructed Emergency Light(s) - Emergency Light Must Illuminate Pathways to Exits
  • Action Required - See Comments Field

• - Date of Last Annual Inspection

  Date

• - Comments:

• - Emergency Light(s) - Action Required

• - Exit Sign(s) - Action Required

• - Obstructed Exit(s) Signs - Action Required

• - Obstructed Emergency Lighting - Action Required

• - Comments:

Special Hazards

• Flammable /or Combustible Liquids

  Compliant

  NON-Compliant

  N/A

• - Flammable /or Combustible Liquids - Action Required

• Compressed Gases

  Compliant

  NON-Compliant

  N/A

• - Compressed Gases - Action Required

• Other Special Hazards

  Compliant

  NON-Compliant

  N/A

• - Other Special Hazard - Action Required

Commercial Kitchen

• Kitchen Hood Exhaust - Cleaning

  Compliant

  NON-Compliant

  N/A

• Date of Last Cleaning

  Date

• - Kitchen hood Exhaust - Action Required

• Kitchen Fire Suppression System

  Compliant

  NON-Compliant

  N/A

• Date of Last Servicing

  Date

• - Kitchen Fire Suppression System - Action Required

• Other Hazards

  Compliant

  NON-Compliant

  N/A

• - Other Hazards - Action Required

General Remarks:

• Notes

• Additional Photo(s)

  Media

Fire & Life Safety Inspection Results

• Inspection Status

  Compliant

  NON-Compliant

  N/A

• Deficiencies shall be corrected by:

  Date

Items noted on this form have come to the attention of the department during the inspection and are to be considered non-compliant with current life and safety codes and standards. It is the legal responsibility of the owner or occupant to correct the deficiencies noted herein. The Colwood Fire Department shall not be responsible for items noted or not noted within this document or the failure of person or persons to act.

• Inspectors Signature

  Sign

• Owner/Occupier Signature

  Sign

• Request Electronic Copy Emailed to Owner/Occupier

• Emailed Address:

• Request Hard Copy Mailed to Owner/Occupier

• Mailing Address:

• Hard Copy is not required for Owner/Occupier

The Owner, Person, Firm or Corporation having control over any portion of a building that are guilty of infraction of the Fire Prevention Bylaws, Fire Services Act or the British Columbia Fire Code are liable to the penalties and/or conditions defined in those regulations. Info: Tel: 250-478-8321 Fax: 250-478-8032