Area Inspection Checklist - Fire - New Form

Area Inspection Checklist - Fire v.1.1

(SECTION II ARTICLE 6 - Palo Verde Safety Manual)

DATE INSPECTED:  11/14/2015

Reviewed by Area Owner

Click here to sign this section

Area:   Area Description: e.g. Building "B" Second Floor Right

SUMMARY COMPLETED BY  

Enter Userid:     Department:

  Get User
 [e.g. Z06838]

Name: Phone Number:

AREA OWNER or AREA OWNER DESIGNEE  

Enter Userid:     Name:

  Get User
 [e.g. Z06838]

NOTE: When the form is submitted, the area owner will receive an email to digitally sign this form.
 

ITEM AREA INSPECTION CRITERIA         01DP-0IS18 Area Inspections SAT NI UNSAT COTS N/A

Is the portable fire extinguisher mounted, accessible, and not

1
blocked (extinguishers in cabinet DO NOT need to be mounted)?
Is fire extinguisher fully charged (arrow in or around the green
area) and in working condition? Arrow can be slightly off green
2
and still be within acceptable range; the gauge on a FE is not
calibrated.
Are fire extinguishers and hose reels free from obstructions or
3
blockage (a total of approximately 3 feet wide area around)?

Are all exit signs legible and in good condition, working properly,
4
and illuminated? (Self-illuminating exit signs are acceptable)

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Area Inspection Checklist - Fire - New Form

5 Are all doors leading to outside recognized as an exit?

6 Are any exit route(s)/doors, blocked, locked, or obstructed?

Is the evacuation route clear and free from any obstruction that
7
would hinder employees from exiting quickly?
LEGEND
SAT - Satisfactory, no deficiencies identified
N/A - Not Applicable (does not pertain to the Area being inspected)
NI - Needs Improvement (few or minor deficiencies)
COTS - Corrected On The Spot (deficiency corrected on the spot by the Area Owner or Inspection
Team)
PVAR TO BE WRITTEN WHEN:
UNSAT - Unsatisfactory (many or major deficiencies)

INSPECTION TEAM

Printed/Typed Name (or Enter Names separated with semicolons.)

 
Insert item

INSPECTION SUMMARY/COMMENTS
Area:  Area Description:

Short Description (one sentence) of Deficient Conditions by Item Number

(NI, UNSAT - include Station Corrective Action Document Numbers)

AED INSPECTION
Location:
Unit Serial No:

Primary Probe Expires:

Spare Probe Expires:
Battery Installation Date:
Insert item

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Area Inspection Checklist - Fire - New Form

CR#:  
Short Description:

Insert item

Maximo No:

Maximo Description:

 
Insert item

 
SUBMIT
  CLOSE FORM

NOTE: Make sure you SUBMIT the form. Closing the form will not save the data.
 

 
 

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