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Tool 2 – FIRE PREVENTION INSPECTION FORM
TOOL 2
FIRE PREVENTION INSPECTION FORM
Facility: ____________________________________________ Month of: ___________________________________
1. Weekly Fire Protection Control Valve Inspection
(1. OS&Y, 2. PIV, 3. WPIW, 4. IBV)
Open (Y) (N) / Locked (Y) (N)
| _PRIVATE __ Valve # |
Valve Type |
Week 1 |
Week 2 |
Week 3 |
Week 4 |
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1 |
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2 |
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3 |
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4 |
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5 |
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6 |
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7 |
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8 |
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9 |
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10 |
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| Any valve closures: | ( ) Yes | ( ) No |
| Red tag alert procedure used: | ( ) Yes | ( ) No |
2. Monthly Testing/Inspection
| Sprinkler water flow alarm testing | Date of Test: _____________________ |
| Operate satisfactory: | ( ) Yes ( ) No |
3. Fire Extinguishers
| All charged: | ( ) Yes ( ) No | Accessible: ( ) Yes ( ) No |
| Locations marked: | ( ) Yes ( ) No | Additional Needed: ( ) Yes ( ) No |
Sample Fire Prevention Inspection Form (continued)
4. Storages
| Solvents/Flammables Amount: ______ | No. of Totes/Barrels | |
| Oil storage: | Orderly: ( ) Yes ( ) No | Spills: ( ) Yes ( ) No |
| Pallet storage: | Does storage exceed 6 ft.? | ( ) Yes ( ) No |
| Material storage: | Storage in designated area? | ( ) Yes ( ) No |
| Storage height: ____ | Satisfactory: | ( ) Yes ( ) No |
5. General Order and Neatness
| Waste paper area: | ( ) Yes ( ) No |
| Compactor area clean : | ( ) Yes ( ) No |
| Compacted material picked up regularly: | ( ) Yes ( ) No |
6. Cutting and Welding
| Any cutting or welding operations since last inspection: | ( ) Yes ( ) No |
| Cutting and welding permits used: | ( ) Yes ( ) No |
7. Smoking
| Designated smoking area provided: | ( ) Yes ( ) No |
| Any evidence of smoking outside designated area: | ( ) Yes ( ) No |
8. Division Emergency Organization (DEO)
| Roster posted and current: | ( ) Yes ( ) No |
General Comments:
Inspector: Date:
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