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West River Head Start

FIRE PREVENTION INSPECTION


Occupant:_________________________________________________ Occupancy – A B E F H I M R S U
Address:____________________________________­­­­­_____________________________________________
Owner or Manager: ______________________________________Phone:____________________________
A Fire Prevention Inspection has been made of your business; as a result of this inspection, we list the following conditions in violation of our Codes. Failure to make correction(s) could result in legal action.
The following list pertains to Fire Prevention and Life Safety:
1. Exits ____________________ 8. Flammables______________ 14. Housekeeping______________

2. Exit Lights________________ 9. Halls, Aisles______________ 15. Detectors__________________

3. Stand Pipes ______________ 10. Storage__________________ 16. Alarms____________________

4. Fire Doors________________ 11. Electrical_________________ 17. Emergency Lights___________

5. Smoke Doors _____________ 12. Heating__________________ 18. Training___________________

6. Fire Escapes______________ 13. Sprinklers________________ 19. Other_____________________

7. Fire Extinguishers__________ WP _______ ABC _______ BC _______ CO2_______ Auto _______
Recommendations and Comments:

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________

________________________________________________________________________________


Fire Inspector: ____________________________________________________________________
Received by:____________________________________________________ Date:___________


Service to our community through fire prevention and life safety.

Revised 2/1/06


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