Truro Township Fire Department Fire Safety Inspection

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Contacts

• Property Representative (Name, Phone #, Email )

• Property Owner (Name, Phone #, Email )

• Emergency Contact 1 (Name, Phone # )

• Emergency Contact 2 (Name, Phone # )

Preplan

• Preplan Drawing (OverHead)

  Drawing

• Preplan Photos A,B,C,D sides

  Media

Building Pre-plan Information

• Knox Box (if yes enter location)

  Yes

  No

  N/A

• Annunciator Panel (if yes enter location)

  Yes

  No

  N/A

• FDC (if yes enter location)

  Yes

  No

  N/A

• Gas Service (if yes enter location)

  Yes

  No

  N/A

• Electric Service Location

• Special Hazards ( if yes list hazards)

  Yes

  No

  N/A

• Number of Stories Above Grade

  1

  2

  3

  4

• Number of Stories Below Grade

  0

  1

  2

  3

  4

• Construction Type

  Select Fire-Resistive Noncombustible Ordinary Heavy Timber Wood Frame

  • Fire-Resistive
  • Noncombustible
  • Ordinary
  • Heavy Timber
  • Wood Frame

• Sprinkler System installed?

  Yes

  No

  N/A

• Occupancy Group

  Select A - Assembly B - Business E - Educational F - Factory/Industrial H - High Hazard I - Institutional M - Mercantile R - Residential S - Storage U - Miscellaneuos

  • A - Assembly
  • B - Business
  • E - Educational
  • F - Factory/Industrial
  • H - High Hazard
  • I - Institutional
  • M - Mercantile
  • R - Residential
  • S - Storage
  • U - Miscellaneuos

• Occupancy Group Comments

• Pictures

  Media

General

• Valid Occupancy Permit

  Yes

  No

  N/A

• Occupancy Posted

  Yes

  No

  N/A

• Were alterations or renovations made since last inspection?

  Yes

  No

  N/A

• Were violations corrected at the time of inspection?

  Yes

  No

  N/A

• Is a follow-up inspection required?

  Yes

  No

  N/A

• # of days until follow up inspection?

• Were violations corrected at the time of re-inspection?

  Yes

  No

  N/A

Exits, Doors, Egress, Signs and Lighting

• Is Emergency Egress adequate for capacity

  Yes

  No

  N/A

• Are Fire Doors functioning properly?

  Yes

  No

  N/A

• Are the Exit Doors Locked?

  Yes

  No

  N/A

• Are the Exit Doors Blocked?

  Yes

  No

  N/A

• Are all exits visible, free from obstruction & ready for immediate use?

  Yes

  No

  N/A

• Are all exits & egress adequately lit?

  Yes

  No

  N/A

• Are Egress Pathways Clear & Unobstructed?

  Yes

  No

  N/A

• Is Emergency Lighting adequate, unobstructed & properly tested & maintained? (tested monthly)

  Yes

  No

  N/A

• Are doors equipped only with approved hold-open & self-closing devices?

  Yes

  No

  N/A

• Are Exits marked properly & exit signs unobstructed & properly maintained?

  Yes

  No

  N/A

• Violation Pictures

  Media

Fire Protection

• Is the sprinkler system maintained, tested & documented properly?

  Yes

  No

  N/A

• Are sprinkler heads unobstructed & free of debris?

  Yes

  No

  N/A

• Are the sprinkler riser & FDC free of obstructions?

  Yes

  No

  N/A

• Is the FDC properly marked & protective covers in place?

  Yes

  No

  N/A

• Sprinkler cabinet: spare heads & wrench present?

  Yes

  No

  N/A

• Is the fire alarm system maintained & inspected as per NFPA 72?

  Yes

  No

  N/A

• Is there a manual alarm system?

  Yes

  No

  N/A

• Are pull stations present, working & properly maintained?

  Yes

  No

  N/A

• Is the fire alarm system monitored? (required on group homes > 6 & daycares > 50)

  Yes

  No

  N/A

• Monitoring Company & Phone #?

• Detector Type

  Select Smoke Smoke & CO CO only Rate of Rise Heat Smoke & Heat Not Present

  • Smoke
  • Smoke & CO
  • CO only
  • Rate of Rise
  • Heat
  • Smoke & Heat
  • Not Present

• What type of alarm signals are present?

  Audible

  Visual

  Audible & Visual

• Are fire extinguishers correct for the application, unobstructed maintained as per NFPA 10?

  Yes

  No

  N/A

• Are fire extinguishers properly identified & hung on the wall?

  Yes

  No

  N/A

• Are walls & ceilings maintained in tact?

  Yes

  No

  N/A

• Violation Pictures

  Media

Housekeeping & Storage

• Is inside storage maintained in a safe manner; 24" below ceiling in non-sprinklered buildings, 18" below ceiling in sprinklered buildings?

  Yes

  No

  N/A

• Is the flammable/combustible liquid storage within code?

  Yes

  No

  N/A

• Are compressed gases stored & secured properly?

  Yes

  No

  N/A

• Is mechanical room free from combustible storage & a minimum 36" clearance maintained between heating equipment & storage?

  Yes

  No

  N/A

• Are utilities in good working order? (HVAC, Water, Electrical)

  Yes

  No

  N/A

• Are good housekeeping practices followed?

  Yes

  No

  N/A

• Does the building require any maintenance?

  Yes

  No

  N/A

• Are ceiling tiles in place?

  Yes

  No

  N/A

• Are balconies free from open-flame grills?

  Yes

  No

  N/A

• Violation Pictures

  Media

Laundry Rooms

• Are clothes dryers free from lint accumulations?

  Yes

  No

  N/A

• Fire extinguisher present?

  Yes

  No

  N/A

• Is the dryer properly vented?

  Yes

  No

  N/A

Kitchens

• Is the kitchen cooking area protected by a hood system?

  Yes

  No

  N/A

• Are all gas appliances properly protected by hood system?

  Yes

  No

  N/A

• Does the hood system need to be serviced? (require service every 6 months)

  Yes

  No

  N/A

• Is hood pull station properly identified and unobstructed?

  Yes

  No

  N/A

• Does the hood system need to be cleaned?

  Yes

  No

  N/A

• The hood system was last cleaned?

  Date

• The hood system was last serviced?

  Date

• Are hood filters in place and properly fitted?

  Yes

  No

  N/A

• Violation Pictures

  Media

Electrical

• Is the area around electrical panels clear? (minimum clearance shall be 30"W x 76"H x 36"D)

  Yes

  No

  N/A

• Are there extension cords being used as permanent wiring?

  Yes

  No

  N/A

• Are there electrical hazards present? (open boxes, exposed wiring, open breakers)

  Yes

  No

  N/A

• Are outlets, switches, junctions boxes or panel boxes missing covers?

  Yes

  No

  N/A

• Are electric meters and panels properly labeled as to area serviced?

  Yes

  No

  N/A

• Violation Pictures

  Media

School & Daycare Only

• Number of Fire Exits?

  Select 1 2 3 4 5 6 7 8 9 10 or more

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10 or more

• Are fire doors self-closing?

  Yes

  No

  N/A

• Are the fire doors latching?

  Yes

  No

  N/A

• Are exit enclosures & egress free of storage?

  Yes

  No

  N/A

• Is emergency lighting present & working?

  Yes

  No

  N/A

• Is emergency lighting tested monthly?

  Yes

  No

  N/A

• Is there a written emergency plan?

  Yes

  No

  N/A

• Are evacuation plans properly posted?

  Yes

  No

  N/A

• Are fire drills conducted monthly

  Yes

  No

  N/A

• Number of fire drills conducted per year?

  Select 1 2 3 4 5 6 7 8 9 10 11 12 or more

  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12 or more

• Are tornado drills conducted?

  Yes

  No

  N/A

• Is clothing stored in corridors?

  Yes

  No

  N/A

• Are artworks & teaching materials on walls <20% of wall area?

  Yes

  No

  N/A

• Violation Pictures

  Media

Residential Facilities Only

• Occupancy Type:

  Group Home

  Foster Home < 5

  Residential Daycare < 5

• Structure Type:

  Single Family

  Two Family

  Apartment

  Group Home

• Ad there UL approved smoke detectors on each level & in each sleeping area?

  Yes

  No

  N/A

• Is a fire extinguisher present in the cooking area? (minimum 2A-10BC)

  Yes

  No

  N/A

• Is the basement approved as an occupiable space? (must have 2 ways out)

  Yes

  No

  N/A

• Is the calendar of of fire drills approved?

  Yes

  No

  N/A

• Is the evacuation plan approved?

  Yes

  No

  N/A

• Is the facility reasonably free from hazards at the time of inspection?

  Yes

  No

  N/A

• Is the facility approved?

  Yes

  No

  N/A

• Violation Pictures

  Media

Violations

• Violations Found (Number Violations)

• Recommended Corrections ( Number corrections to correlate with violation)

• Violation Pictures

  Media

• Violations to be corrected by:

  Date

• Facility Represenative

  Sign

• Inspector

  Sign

• For questions about this inspection please contact the Truro Township Fire Department Fire Prevention Bureau at (614) 729-1920.