Fire Incident Report

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Location

• GPS location
  Address

• Department

• Building/ Floor / Room

Incident

• Type of incident (select all that apply)

  Select Premises evacuation Alarm activation Building/ vehicle fire Obstructed exit routes Extinguisher discharged Building evacuated Other

  • Premises evacuation
  • Alarm activation
  • Building/ vehicle fire
  • Obstructed exit routes
  • Extinguisher discharged
  • Building evacuated
  • Other

• Enter type

• Incident details

• Take photo evidence of incident

  Media

• Problems identified

• List all persons involved in the incident

• Did fire brigade attend?

  Yes

  No

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• Signature

  Sign