Information
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Name of Occupant
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Inspection Date
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File No.
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Inspection No.
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Location
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Phone Number
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Building Complex (where applicable)
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Name of Contact Person
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Contact Telephone
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Inspected by
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Means of egress are unobstructed.
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Exit doors are equipped with approved exit hardware and open freely.
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All exit lights are visible and illuminated.
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Emergency lights work properly
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A Fire Emergency Plan is posted, where required.
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Fire drills are held regularly, where required
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Date of last fire drill
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Drill #
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Openings in fire separations are protected with acceptable closures and openings are repaired to maintain fire separations.
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Doors in fire separations are kept closed.
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Building occupancy limits are posted, where required.
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Standing Space
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Space with fixed seats
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Space with non-fixed seats
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Space with non-fixed seats & tables
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Other
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Fire protection records are satisfactory.
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Exhaust systems appear to be free of lint and / or grease.
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Special extinguishing systems have been inspected. (semi-annual)
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Date of last inspection
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Types
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The building is adequately provided with fire extinguishers.
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Fire extinguishers are properly tagged and serviced. (annual)
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Date of inspection
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Standpipe systems appear in good condition.
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Fire Department Connections appear in good condition.
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Private hydrants have been inspected. (semi-annual)
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Date of inspection
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Sprinkler systems have been tested (annual)
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Type of sprinkler system
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Date of last inspection
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Sprinkler control valves are easily accessible and locked open or electronically monitored.
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Sprinkler heads are free from dirt, grease, paint, etc.
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Fire alarm systems have been tested (annual)
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Local Alarm
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Monitored
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Monitored by
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Date of last inspection
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Combustibles are stored in a safe manner.
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Hazardous goods are processed, handled and stored safely.
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List amounts where appropriate
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Flammable and combustible liquids are stored, handled and used in an approved manner.
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List and amounts
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Compressed gas cylinders are stored in a safe manner.
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Fuel inventory records are complete.
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The heating appliances appear to be clean and in good repair.
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Electrical extension cords are used in an acceptable manner.
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Telephone emergency number is posted.
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Building address is visible.
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Key lock box has required keys.
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Additional Information / Further Requirements
Signatures
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This inspection assumes no responsibility for the facility. The owner or his authorized agent shall be responsible for carrying out the provisions of the Alberta Fire Code.
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Signature of Occupant
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Signature of Inspector
