Title Page

  • Site conducted

  • Conducted on

  • Prepared by

  • Location
  • Activity / item / area/ project

  • Persons at risk

  • Total number of people at risk

Sources of Ignition

  • Naked flames/ incineration

  • Electrical, gas, oil fired heaters

  • Hot processes, welding, cutting, grinding

  • Cooking equipment

  • Hot surfaces e.g. lighting

  • Arson

  • Faulty / misused equipment / poor maintenance

  • Reactive chemicals

Sources of Fuel

  • Combustible construction materials - walls, floors, doors, hoarding, roofs

  • Flammable liquids / solvents

  • Plastics / rubber

  • Waste materials

  • Flammable gases

  • Textiles / clothing

  • Combustible storage materials

  • Packaging materials

Sources Of Oxygen

  • Natural ventilation through doors / windows

  • Air conditioning

  • Oxidising chemicals

  • Oxygen cylinders

  • Other sources

  • Work is outside

How are hazards controlled?

Fire Fighting Equipment – State type needed, numbers and location

  • Fire extinguishers

  • Water hoses

  • Sprinklers

  • Fire blanket

Fire Detection and Warning System - including numbers and location

  • Smoke / heat detectors

  • Fire alarms

  • Other warning system

Competent Persons / Training requirements

  • Site Responsible person

  • Marshall’s / wardens

  • Training of staff

  • Instruction of visitors / contractors

Fire Procedures for the site

  • Fire action notices

  • Escape route signs

  • Fire fighting equipment signs

  • Raising of alarm

  • Instructions

  • Protecting others form fire risk Clients. Customers. Members of the Public Other workers Trespassers

  • Permits to work (including hot work)

  • Isolation procedures (electric, equipment)

  • No smoking policy

  • Emergency contacts

  • Control of risks to other locations

Escape Routes (refer to site plan where required)

  • Layout

  • Escape stairs / steps

  • Safe muster points

  • Automatically shutting doors

  • Lighting

  • Sufficient number of escape routes

  • Refuges

Maintenance and Testing Procedures (during works)

  • Extinguishers

  • Heat / smoke detection

  • Alarms (e.g. weekly)

  • Lighting (including emergency)

  • Electrics

  • Machinery / equipment

  • Securing gas cylinders

  • Fire doors and closures

  • Daily checks

  • Signs

  • Alarm system

Housekeeping / Storage / Waste

  • Flammable liquids/ gases

  • Materials

  • Waste

Additional Control Measures

  • undefined

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.