HS09 - Fire Evacuation Report

• Document Number

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

Fire Drill Checklist

• *Prior to Fire Drill, Site Manager is to coordinate plan with Compliance Manager and the Alarm Company are aware.

• Facility:

• Time Drill Began:

  Date

• Time Building Cleared:

  Date

• Time Ended:

  Date

• Facility Evacuated to (Meeting Location):

• Place YES or NO answers in spaces provided

Evacuation Team Personnel

• Was the Fire alarm heard in all areas?

  Yes

  No

• Team members reported to designated meeting area?

  Yes

  No

• Team members carried out assigned Duties? (Facility search and Head count)

  Yes

  No

Evacuation

• Were corridors and exits found clear? (no obstructions)

  Yes

  No

• Did the evacuation proceed in an orderly manner?

  Yes

  No

• Did the evacuation happen in a timely manner?

  Yes

  No

• Were all doors closed but not locked on the way out of the building?

  Yes

  No

Remarks and Recommendations

• Explain all “NO” answers and make additional comments or problems encountered

• Signature:

  Sign