Title Page
-
Document No.
-
Conducted on
-
Audit Title
-
Report prepared for
-
For the attention of
-
Site
-
Location
-
Prepared by
PASSIVE FIRE
- FIRE RATED AREA IDENTIFIED
-
LOCATION
-
COMPARTMENT COMPRISES OF?
- WALLS
- FLOOR
- CEILING
- FIRE DOORS
- ENTIRE ROOM
- ABOVE CEILING
- UNDER FLOOR
- SINGLE WALL
- STAIR WELL
- ACCESS HATCHES
- FIRE SHUTTERS
- DAMPERS
-
HAVE DRAWINGS INDICATING FIRE RATED AREAS BEEN PROVIDED?
-
TOTAL NUMBER OF PENETRATIONS ?
- NIL
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 20 +
-
TYPE OF PENETRATIONS PRESENT?
- N/A
- CABLE THROUGH FLOOR
- CABLE THROUGH WALL
- CABLE THROUGH CEILING
- UNSEALED CABLE TRAY
- PIPE THROUGH FLOOR
- PIPE THROUGH WALL
- PIPE THROUGH CEILING
- DAMAGED WALL/ FLOOR/ CEILING
- UNSEALED HOLE
- UNSEALED CRACK
-
ARE ANY PENETRATIONS UNSEALED OR ARE THERE ANY OTHER DEFECTS PRESENT?
-
DEFECT PHOTOS
-
IS THIS CONSIDERED AN OLD OR NEW PENETRATION ?
- N/A
- OLD PENTRATION
- NEW PENTRATION
- UNKNOWN
- NEW ITEM THROUGH OLD PENTRATION
- NEW DAMAGE WITHIN FIRE RATED AREA
- NEW HOLE
-
ACTION TO RECTIFY?
- N/A
- ADD FIRE RATED PILLOWS
- ADD FIRE RATED SEALANT
- ADD INTRUMESCENT SPRAY
- ADD INTRUMESCENT SEAL
- ADD PIPE COLLAR
- REPAIR/ REPLACE DOOR SEAL
- REPAIR/REPLACE FIRE RATED DOOR FRAME
- REPAIR REPLACE FIRE RATED ACCESS PANEL
- NEW FIRE RATED CLADDING
- BUILDING REPAIR
- OTHER, SEE COMMENTS
-
EQUIPMENT REQUIRED TO ACCESS ISSUE IDENTIFIED?
- N/A
- SHORT STEPS
- 1.8 Steps
- 3 .0 STEPS
- SCISSOR LIFT
- BOOM LIFT
- EASY, FLOOR LEVEL
- EASY, SHOULDER HEIGHT OR BELOW
- SCAFFOLD
-
COMMENTS
-
COMPLIANT?
SIGNED
-
AUDITOR SIGNATURE
-
CLIENT SIGNATURE
