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(620) 231-4100
Fire Pre-Plan Form
Home
> Fire Pre-Plan Form
Fire Pre-Plan Form
Step
1
of
3
33%
PRE-PLAN
Contact Info
Business Name:
Occupancy Type:
Address:
*
Street Address
Phone:
Emergency Contacts:
Name:
Title:
Phone:
Name:
Title:
Phone:
Fire Protection
Detectors:
Smoke
Heat
Sprinker:
Full
Partial
Sprinkler:
Knox Box:
Knox Box
Riser:
Riser
Ann. Panel:
Ann. Panel
Standpipe
Standpipe
FDC:
FDC
Alarm Panel:
Alarm Panel
Specialized Extinguishing System:
Specialized Extinguishing System:
Hydrant Locations:
Building Access
Building Access:
Stairways:
Stairways
Elevators
Elevators
Roof Access
Roof Access
Basement:
Full
Partial
Basement Access:
Attic:
Attic Access:
Building Construction
Width:
Length:
Stories:
Type:
Roof Structure:
Roof Hazards:
Roof Hazards:
Parapet Wall:
Height:
Other:
Utilities Location
Gas:
Electric:
Water:
Other:
Notes:
Created by:
Revision Date:
MM slash DD slash YYYY
Staffing:
Hazmat Specialist On-site:
Name
First
Last
Phone
Staffing:
Dayshift:
NIghtshift:
SDS Location:
Evacuation Plan:
Hazmats On-Site
Hazmat:
Normal Quantity
Location:
Hazards:
Hazmat:
Normal Quantity
Location:
Hazards:
Hazmat:
Normal Quantity
Location:
Hazards:
Hazmat:
Normal Quantity
Location:
Hazards:
Hazmat:
Normal Quantity
Location:
Hazards:
Plan of Attack:
Initial Isolation Zone:
Level of Evacuation Required:
Extinguishment Procedures:
Containment Procedures:
PPE Required:
Decon Procedures:
External Resources Required:
Notes:
Created by:
Revision Date
MM slash DD slash YYYY
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