Fire Procedures & Pre-fire Plan Survey Template v1

• Job Number

• Title

• Name of Premises

• Address
  Address

• Client / Site

• Trade/Busines

• Conducted on

  Date

• Prepared by

• Routes/Preferred access to site

• Sketch

  Drawing

• Access Codes or Keys

• Adjacent Buildings

Contact Details

• Name

• Job Title

• TEL. NO.

• Mob. No.

• Email Address

Building Details

• Is there Fire Brigade access to the site

  Yes

  No

• Height of building in metres

• No. of floors

• Is there a basement

  Yes

  No

Access to Premises

• Front

• Rear

• Side

Emergency Exits

• Front

• Rear

• Side

Fire Protection

• Fire Panel Location

Repeater Panel Location

• Location

• Hose Reels

  Yes

  No

• Alternative Water Supply

  Yes

  No

• Fire Extinguishers

  Yes

  No

• Smoke Venting Systems

  Yes

  No

• Fixed Firefighting Systems

  Yes

  No

• Foam Inlet

  Yes

  No

• Sprinkler System

  Yes

  No

• Dry Riser

  Yes

  No

• Wet Riser

  Yes

  No

• Firefighting Shafts

  Yes

  No

Staff

• Day

• Min

• Max

• Night

• Min

• Max

• Sleeping

• Min

• Max

Customers/Residents/Students

• Day

• Min

• Max

• Night

• Min

• Max

• Sleeping

• Min

• Max

Visitors

• Day

• Min

• Max

• Night

• Min

• Max

• Sleeping

• Min

• Max

Ambulant/Non-ambulant

• Ambulant

• Non-ambulant

• Is there ELECTRICITY installed

  Yes

  No

• Location

• Type

  Select Main Switch Room Local Consumer Unit Fuse Board Meter Box Switch Room Distributor Box Transformer Hi Voltage Transformer ESB Sub-station

  • Main Switch Room
  • Local Consumer Unit
  • Fuse Board
  • Meter Box
  • Switch Room
  • Distributor Box
  • Transformer
  • Hi Voltage Transformer
  • ESB Sub-station

• Other

• Voltage

  Select 220v 415v Hi Voltage Med Voltage Low Voltage Single Phase 3 Phase

  • 220v
  • 415v
  • Hi Voltage
  • Med Voltage
  • Low Voltage
  • Single Phase
  • 3 Phase

• Other

• Is there NATURAL GAS installed

  Yes

  No

• Location of burner

Location of shut offs

• Is there LPG installed

  Yes

  No

• Location of burner

• Location of tank

• Capacity of tank

Location of shut offs

• Is there OIL installed

  Yes

  No

• Location of burner

• Location of tank

• Capacity of tank

Location of shut offs

Priorities

• Details

• Location

Hazard

• Name

• UN Number

• Quantity

• Location

• Add media

  Media

• Location

• Lock Type

• Add media

  Media

• Location

• Add media

  Media

• Hydrant No.

• Location

• Size of main in mm

• Is it on a ring main

  Yes

  No

• AP No.

• Location

• Areas associated with AP

• Add media

  Media

• Location

• Type

  Select Foam 6L Foam 9L Water 9L CO2 2kg Dry Powder 1kg Dry Powder 2kg Dry Powder 3kg Dry Powder 4kg Dry Powder 6kg Foam 3L CO2 5kg Water 6L Wet Chemical 2L Wet Chemical 6L

  • Foam 6L
  • Foam 9L
  • Water 9L
  • CO2 2kg
  • Dry Powder 1kg
  • Dry Powder 2kg
  • Dry Powder 3kg
  • Dry Powder 4kg
  • Dry Powder 6kg
  • Foam 3L
  • CO2 5kg
  • Water 6L
  • Wet Chemical 2L
  • Wet Chemical 6L

• Add media

  Media

• Other Specify