Fire Evacuation Exercise (6 month)

• Site conducted

  Select

• Is this is scheduled fire evacuation drill?

  Yes

  No

  N/A

• Conducted on

  Date

Statutory six monthly full evacuation drill

• Village Name

  Select Avon Park Blagdon Castle Cedars Charters Debden Grange Elmbridge Gittersham Hill Park Gradwell Park Lime Tree Mayford Grange Moat Park Park Place Roseland Parc Thamesfield The Priory Chester West Byfleet Other

  • Avon Park
  • Blagdon
  • Castle
  • Cedars
  • Charters
  • Debden Grange
  • Elmbridge
  • Gittersham Hill Park
  • Gradwell Park
  • Lime Tree
  • Mayford Grange
  • Moat Park
  • Park Place
  • Roseland Parc
  • Thamesfield
  • The Priory
  • Chester
  • West Byfleet
  • Other
• Site Address:
  Address

• Date and Time of Exercise:

  Date

• Is the Fire Detection and Alarm System operating with no isolations or faults indicating?<br>

  Yes

  No

• Have any faults or isolations been reported to the relevant site contact?

  Yes

  No

  N/A

• Has verbal approval been given by the site contact to activate the Emergency Warning System?

  Yes

  No

  N/A

• Has the fire brigade and Alarm company been informed of the test?

  Yes

  No

  N/A

• Has The fire alarm panel been taken off-line?

  Yes

  No

  N/A

• Start Time of Evac:

• End Time of Evac:

• Notes on Exercise:

• Muster Point easily identified?

  Yes

  No

  N/A

• Fire Doors Closed?

  Pass

  Fail

  N/A

• Windows Closed?

  Pass

  Fail

  N/A

• Office secured?

  Pass

  Fail

  N/A

• Toilets cleared?

  Yes

  No

  N/A

• Fire Marshalls identified?

  Yes

  No

  N/A

• Kitchen appliances turned off?

  Yes

  No

  N/A

• Equipment left safely?

  Yes

  No

  N/A

• Number of residents leaving premises

• Front door secured to prevent access?

  Yes

  No

  N/A

• Total evac time (mins)

• Notes for De-Brief:

• Head count at roll call

• Persons missing at roll call

• Persons late at roll call

• Building Representative Name and Signature verifying Warning System returned to normal operation:

  Sign

• Name of person conduction evacuation

• Signature

  Sign

• Date of next planned fire drill