Title Page
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Document No.
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Conducted on
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Location
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Evacuation Start Time:
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Evacuation End Time:
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Total time for evacuation process including accountability:
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Was the building completely evacuated?
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Was the evacuation alarm heard in every area of the building?
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Are the fire lanes clear and accessible to the fire department?
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Did all employees meet at their designated meeting point?
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Have procedures for the handicapped been addressed?
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Did all equipment (doors, alarms, pull stations, exit signs, etc.) function properly?
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Problem or Issue Noted:
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Additional Comments/Requirements:
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FIRE ALARM CAME IN TO GATES FIRE DISTRICT HQ IN HOW MANY MINUTES?
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NUMBER OF PEOPLE EVACUATING?
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Building Representative:
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Gates Fire District Evaluator:
