Information
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Occupant
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Location
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Phone Number
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Emergency Contact Name
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Emergency Contact Number
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Classification
- Assembly
- Business
- Educational
- Hazardous
- Factory
- Institutional
- Mercantile
- Residential
- Storage
- Utility
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Type
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District
- 1
- 2
- 3
- 4
- 5
- 6
- ETJ
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Conducted on
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Document No.
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Inspector:
Fire Inspection
Hazard Type
Heating
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1. Combustibles too near heater
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2. Improper portable heater
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3. Improper Ventilation
Grills
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4. Improper storage
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5. Operating too close to combustibles
Exits
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6. Exits blocked
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7. Storage in exit access
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8. Improper fire exit
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9. Improper locking mechanism
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10. Emergency exit signs / lighting
Electrical
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11. Defective fixture
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12. Defective wiring
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13. Misuse of extension cords
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14. Clearance of electrical equipment
Miscellaneous
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15. Rubbish and trash
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16. Improper storage of flammable liquids
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17. Fire extinguishers
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18. Auto hood system
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19. Sprinkler system
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20. Fire alarm system
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21. Other
Remarks
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Owner / Employee Signature