Title Page
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Please forward complete report form to the Office of Health, Safety & Environment department
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Drill Time
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Type of Drill
- Fire Mock
- Hazardous Chemical Release Mock
- Other
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Drill Location
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Scenario of special circumstances
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List all participating departments
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Observer report completed by
Observe's Responsibility for the drill
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To identify the weakness whether all the employee are aware in case of fire occurred.
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Was alarm heard throughout the building?
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were all alarm devices operating correctly?
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list location where alarm is not operating
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Did all occupant evacuate the building?
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Note room numbers/work area that not evacuate
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Did occupants assemble in designated areas?
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Please rate the overall effectiveness of the drill
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Speed of Evacuation
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Effectiveness of Procedures
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Communication during Drill
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Total time required to evacuate building:
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Additional Comments
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Alarm system reset by
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Time 'All Clear' given
Mock Drill Evidences
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Mock drill Media