Fire Risk Assessment - tsas

• Conducted on

  Date

• Prepared by

• Location
  Address

• Signature

  Sign

Fire Risk Assessment , space by space.

Add new space.

• Space

• Description.

• Orientation photos.

  Media

• Room size L x W

• Source of combustible materials

  Select Furnishings Stationary Packaging (paper/card) Wood Flammable Liquids Pallets Other

  • Furnishings
  • Stationary
  • Packaging (paper/card)
  • Wood
  • Flammable Liquids
  • Pallets
  • Other

• Source of ignition.

  Select Office Equipment Kitchen appliances Welding Grinding Soldering Stud welding Naked flames Electrical Equipment Forklift Trucks Other hot work Other

  • Office Equipment
  • Kitchen appliances
  • Welding
  • Grinding
  • Soldering
  • Stud welding
  • Naked flames
  • Electrical Equipment
  • Forklift Trucks
  • Other hot work
  • Other

• Occupants

  Select Adults Supervised children Unsupervised children Elderly Disabled

  • Adults
  • Supervised children
  • Unsupervised children
  • Elderly
  • Disabled

• Describe special arrangements for evacuation of disabled persons.

• Number of occupants

  Select Transitory 1-5 6-10 11-30 30-100 100+

  • Transitory
  • 1-5
  • 6-10
  • 11-30
  • 30-100
  • 100+

• Means of raising alarm

  Select Call point in room Call point adjacent Automatic Fire Detector in room Automatic Fire Detector adjacent Other

  • Call point in room
  • Call point adjacent
  • Automatic Fire Detector in room
  • Automatic Fire Detector adjacent
  • Other

• Means of fighting fire?

  Select Sprinklers Fire extinguishers - in room Fire extinguishers - adjacent Fire Blanket Suppression System Other

  • Sprinklers
  • Fire extinguishers - in room
  • Fire extinguishers - adjacent
  • Fire Blanket
  • Suppression System
  • Other

• Type of extinguishers

  Select CO2 x 2kg CO2 x 5kg Foam 6L Foam 9L Water 6L Water 9L Powder 6kg Powder 9kg Chemical

  • CO2 x 2kg
  • CO2 x 5kg
  • Foam 6L
  • Foam 9L
  • Water 6L
  • Water 9L
  • Powder 6kg
  • Powder 9kg
  • Chemical

• Are emergency lighting arrangements adequate?

  YES

  NO

  N/A

• Are fire doors fitted to room and appropriate?

  YES

  NO

  N/A

• Are escape routes adequate?

  YES

  NO

  N/A

• Number of emergency escape routes available from exit door?

• Maximum distance to final escape point (m)?

• Is the room a ‘room within a room’?

  Select Room in a Room Room directly connected to passage Room directly connected externally

  • Room in a Room
  • Room directly connected to passage
  • Room directly connected externally

• Describe arrangement and additional measures for safety.

• Other Comments for this room

• Is this room SAFE to occupy?

  YES

  NO

  N/A

Fire extinguisher record.

• Date of last service inspection.

  Date

• Fire extinguisher service company.

Fire extinguisher location.


• Location

• Type

  Select CO2 x 2kg CO2 x 5kg Foam 6L Foam 9L Water 6L Water 9L Powder 6kg Powder 9kg Chemical

  • CO2 x 2kg
  • CO2 x 5kg
  • Foam 6L
  • Foam 9L
  • Water 6L
  • Water 9L
  • Powder 6kg
  • Powder 9kg
  • Chemical

• In date?<br>

  Off

  On

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• Date inspected?

  Date

• In good condition?

  Off

  On

• Describe concern.

Fire Call Points

CP Location


• Reference Number

• Location

Fire Extinguishers

• Service Company

• Reference Picture(s)

  Media

• Date of inspection

  Date

• Comments

Portable Appliance Testing

• Service Company

• Reference Picture(s)

  Media

• Date of last inspection

  Date

• Comments

Fire Alarm Maintenance

• Has the fire alarm system been inspected in the last 12 months

  Yes

  No

  N/A

• Inspection Company

• Reference Picture

  Media

• Date of last service

  Date

• Comments

Emergency Lighting Maintenance

• Has the emergency lighting system been inspected in the last 12 months

  Yes

  No

  N/A

• Inspection Company

• Reference Picture

  Media

• Date of last inspection

  Date

• Comments

Gas System Maintenance and Service

• Has the gas system been inspected in the last 12 months

  Yes

  No

  N/A

• Inspection Company

• Reference Picture

  Media

• Date of last service

  Date

• Comments

Electrical Fixed Wiring Inspection (5 years)

• Has the facility electrical fixed wiring been inspected in the last 5 years

  Yes

  No

  N/A

• Inspection Company

• Reference Picture

  Media

• Date of last inspection

  Date