• Document No.

  • Inspection Numbers are to be entered in the following format with all digits resetting each day and new days beginning with 001: YYYY-MM-DD-###
    Example: The third inspection conducted on December 8, 2015 would be 2015-12-08-003

  • Location
  • Provide Building Name, Municipal Address, Department, All Room #s.

  • Conducted on

  • Date and Time will be automatically generated by the program according to the date and time set by the iPad by selecting today then save under the green date tab on the right.

  • Conducted By

  • Please select the primary inspector for the report.

  • Department Members Present During Inspection

  • Please enter the names and positions of all department/workgroup members present during the inspection.

Extension Cords

  • Are there any extensions cords in use as permanent fixtures?

  • How many cords are present in the Department/workgroup?

  • Extension Cord as Permanent Fixture Violation
  • Room number or area
  • Photograph each cord in the department individually.

  • Are there any extension cords that are rated for outdoor use only?

  • How many cords are present in the Department/workgroup?

  • Outdoor Use Only Extension Cord Violation
  • Room number or area
  • Photograph each cord in the department individually.

  • Are there any extension cords that currently present a tripping hazard?

  • How many cords are present in the Department/workgroup?

  • Outdoor Use Only Extension Cord Violation
  • Room number or area
  • Photograph each cord in the department individually.

  • Unplug and remove all offending cords that will not immediately impact projects or research. Example remove all that are not attached to research refrigerators or other research equipment that is currently running.

  • Please enter the locations of all extension cords that were immediately unplugged and removed during the inspection.

Power Bars

  • Are there any appliances plugged into power bars?

  • How many appliances are plugged into power bars?

  • Appliances Plugged Into Power Bars Violation
  • Room number or area
  • Photograph each occurrence in the department individually.

  • Are there any power bars that appear to be overloaded or plugged into another power bar(octopus style setup)?

  • How many overloaded or octopus setup power bars are there in the department/workgroup?

  • Overloaded or Octopus Style Power Bar Violation
  • Room number or area
  • Photograph each occurrence in the department individually.

  • Are there any power bars that currently present a tripping hazard?

  • How many cords are present in the Department/workgroup?

  • Power Bar Tripping Hazard Violation
  • Room number or area
  • Photograph each cord in the department individually.

  • Unplug and remove all offending cords that will not immediately impact projects or research. Example remove all that are not attached to research refrigerators or other research equipment that is currently running.

  • Please enter the locations of all power bars and appliances that were immediately unplugged and removed during the inspection.

Space Heaters

  • Are there any space heaters present in the department?

  • How many space heaters are present in the department?

  • Space Heater Violation
  • Room number or area
  • Photograph each occurrence in the department individually.

  • Unplug and remove all offending space heaters in the department. Instruct anyone present to take home personal space heaters.

  • Please enter the locations of all space heaters that were immediately unplugged and removed during the inspection.

Fire Alarm Systems

  • Are there any Fire Alarm Pull Stations present in the department that are obstructed?

  • How many obstructed Pull Stations are present?

  • Pull Station Violation
  • Room number or area
  • Photograph each obstructed Pull Station in the department individually.

  • Are there any Smoke or Heat Detectors present in the department that are obstructed?

  • How many obstructed Smoke and Heat Detectors are present?

  • Smoke and Heat Detector Violation
  • Room number or area
  • Photograph each occurrence in the department individually.

  • Are there any Sprinkler heads present in the department that are obstructed?

  • How many obstructed Sprinkler Heads are present?

  • Sprinkler Head Violation
  • Room number or area
  • Photograph each occurrence in the department individually.

  • Move or Remove obstructions to All Fire Alarm System components. These are major Fire Code Violations and must be dealt with immediately during the inspection. No Exceptions!

  • Please enter the locations of all obstructions that were immediately removed during the inspection.

Fire Extinguishers

  • Are there any Fire Extinguishers present in the department that are obstructed?

  • How many obstructed Fire Extinguishers are present?

  • Fire Extinguisher Obstruction Violation
  • Room number or area
  • Photograph each obstructed Fire Extinguisher in the department individually.

  • Move or Remove obstructions to Fire Extinguishers. This is a major Fire Code Violation and must be dealt with immediately during the inspection. No Exceptions!

  • Please enter the locations of all space heaters that were immediately unplugged and removed during the inspection.

  • Are there any Fire Extinguishers present in the department that are out of date for being inspected either monthly or annually?

  • How many obstructed Fire Extinguishers are present that are out of date for inspection?

  • Fire Extinguisher Inspection Violation
  • Room number or area
  • Photograph each out of date Fire Extinguisher in the department individually. Ensure that the University ID tag number is visible in the picture along with the inspection tag.

  • Move or Remove obstructions to Fire Extinguishers. This is a major Fire Code Violation and must be dealt with immediately during the inspection. No Exceptions!

  • Please enter the locations of all obstructions that were immediately removed during the inspection.

Hazardous Goods

  • Are there any improperly stored Hazardous Goods present in the department?

  • How many improperly Hazardous Goods are present in the department?

  • What type of Hazardous Goods are being improperly stored?

  • Please provide more information on the "other" Hazardous Good.

  • Improper Storage of Hazardous Goods Violation
  • Room number or area
  • Photograph each area containing improperly stored hazardous goods in the department individually.

  • Please copy all Deans, Directors and Department Heads responsible for this area on this report. Financial support for the continued storage of these goods may be necessary.

Means of Egress

  • Are there any Hallways, Corridors, Fire Exits, Stairwells present in the department that are obstructed?

  • How many obstructed Areas are present?

  • Means of Egress Obstruction Violation
  • Room number or area
  • Photograph each obstructed Fire Extinguisher in the department individually.

  • Are there any Fire Exit Doors present in the department that are locked or sealed from the inside?

  • How many locked or sealed Fire Exit Doors are present in the department?

  • Fire Exit Door Violation
  • Room number or area
  • Photograph each locked or sealed Fire Exit in the department individually.

  • Please advise Physical Plant Immediately about these issues. These are major Fire Code Violations and need to be resolved ASAP!

  • Move or Remove obstructions to Fire Exits. This is a major Fire Code Violation and must be dealt with immediately during the inspection. No Exceptions!

  • Please enter the locations of all obstructions that were immediately removed during the inspection.

Fire Load

  • Are there any Excessive Fire Loads present in the department?

  • How many Areas with Excessive Fire Loads are present in the department?

  • Fire Load Violation
  • Room number or area
  • Photograph each Area with an Excessive Fire Load in the department individually.

  • Please have the department remove any small fire loads. Larger Fire loads may require Physical Plant to remove items. Please copy the Deans, Directors, or Department Heads on this report so that they can arrange for requisitions if needed.

  • Please include any small Fire Loads removed during the inspection.

Other Issues

  • Are there any other issues that should be addressed that were not in the previous sections?

  • Please describe any issues and provide details as to the nature of the issue

  • Photograph each issue individually.

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