Town of Gates Fire Safety Inspection Report

• Document No.

• Business Name

• Address & Phone Number

• Conducted on

  Date

• Prepared by

• Personnel

Contact/Building Rep name-Email(for report) and phone number

• Emergency contacts and cell #'s

Construction Type

• Type I

  Type II

  Type III

  Type IV

  Type v

Occupancy Class

• Select Assembly Business Educational Factory High Hazard Institutional Mercantile Residential Storage Utility or Other

  • Assembly
  • Business
  • Educational
  • Factory
  • High Hazard
  • Institutional
  • Mercantile
  • Residential
  • Storage
  • Utility or Other

Emergency and Exit lighting

• Emergency Lighting operational?

  Yes

  No

  N/A

• Annual testing of the emergency lighting completed and documented?

  Yes

  No

  N/A

• Exit Signs illuminated and visible

  Yes

  No

  N/A

Means of Egress

• No combustible storage in exit ways

  Yes

  No

  N/A

• Exit ways unobstructed

  Yes

  No

  N/A

• Aisle width compliant?

  Yes

  No

  N/A

• Exterior exits accessible ?

  Yes

  No

  N/A

• Door hardware compliant

  Yes

  No

  N/A

• Exits free from snow and ice buildup

  Yes

  No

  N/A

• Exit ways properly lit?

  Yes

  No

  N/A

• Exit doors easily opened from inside and self close and latch

  Yes

  No

  N/A

• Fire door tags in place on door and door frame and legible

  Yes

  No

  N/A

Electrical Systems

• Extension Cords temporary use only

  Yes

  No

  N/A

• Exposed wiring prohibited

  Yes

  No

  N/A

• Open junction boxes prohibited

  Yes

  No

  N/A

• No Wiring and equipment unsecured

  Yes

  No

  N/A

• Main shut offs not accessible, 36" in front of panels and shut offs required

  Yes

  No

  N/A

Heating systems

• Heat producing device/appliance not defective

  Yes

  No

  N/A

• Air supply for combustion and ventilation sufficient

  Yes

  No

  N/A

• Safety devices in place and operable

  Yes

  No

  N/A

• Combustibles not within 18" of heat producing appliances/devices

  Yes

  No

  N/A

Fire Safety Safeguards

• Interior combustible waste not excessive

  Yes

  No

  N/A

• Location of dumpsters in proximity to the building

  Yes

  No

  N/A

• Exit ways free from combustible waste?

  Yes

  No

  N/A

Fire Protection Equipment

• Fire hydrants have a 3' clearance

  Yes

  No

  N/A

• Private Hydrant Inspection report

  Yes

  No

  N/A

• Sprinkler Systems<br>

  Yes

  No

  N/A

• Inspection reports available and done in required time frame

  Yes

  No

  N/A

• Storage at least 18" below sprinkler heads

  Yes

  No

  N/A

• Sprinkler heads free of dust loading and debris

  Yes

  No

  N/A

• Sprinkler valves and riser accessible?

  Yes

  No

  N/A

• Adequate number of spare heads and a wrench in box?

  Yes

  No

  N/A

• Fire department connection visible and not blocked by vegetation or other objects

  Yes

  No

  N/A

• FDC caps in place

  Yes

  No

  N/A

• Kitchen suppression systems

  Yes

  No

  N/A

• Semi-annual inspection done

  Yes

  No

  N/A

• Hood, filters and surrounding areas free of grease buildup

  Yes

  No

  N/A

• Class "K" extinguisher available

  Yes

  No

  N/A

• Fire Alarm System

  Yes

  No

  N/A

• Annual inspection report available and no deficiencies noted

  Yes

  No

  N/A

• All devices in place and free from obstructions

  Yes

  No

  N/A

• Portable Fire Extinguishers

  Yes

  No

  N/A

• Annual inspection complete and extinguisher tagged

  Yes

  No

  N/A

• Extinguisher sealed and in proper pressure range

  Yes

  No

  N/A

• Extinguishers visible and not obstructed

  Yes

  No

  N/A

• Extinguishers are the proper type for hazards present

  Yes

  No

  N/A

• Fire pumps

  Yes

  No

  N/A

• Test paperwork available

  Yes

  No

  N/A

• Is the pump room free from storage?

  Yes

  No

  N/A

• No signs of fluid leaks or other deficiencies during a visual inspection

  Yes

  No

  N/A

Hazardous Materials

• Compressed gas tanks stored properly and secured to protect them from tipping over

  Yes

  No

  N/A

• Stored in approved containers or cabinets

  Yes

  No

  N/A

• MSDS paperwork up to date and available

  Yes

  No

  N/A

• Tier 2 reporting done to county. If not have them contact Dave Richards at 585-753-3813 or drichards@monroecounty.gov

  Yes

  No

  N/A

General Concerns

• Building address visible and no less than 4" in height

  Yes

  No

  N/A

• Fire doors blocked or obstructed

  Yes

  No

  N/A

• Repair openings in fire walls and separations

  Yes

  No

  N/A

• Maintain storage at least 2' below the ceiling

  Yes

  No

  N/A

• Combustible storage in boiler, mechanical or elevator rooms prohibited

  Yes

  No

  N/A

• Fire apparatus roads obstructed

  Yes

  No

  N/A

• Fire Lane obstructed

  Yes

  No

  N/A

• Combustible storage under staiways

  Yes

  No

  N/A

Violations to be corrected by

• Select date

  Date

• Building representative

  Sign

• Inspector

  Sign

• Pictures if any

  Media

Additional notes