You are on page 1of 2

Corvine Chemicals & Pharmaceuticals Ltd.

OBSERVATIONS OF MOCK DRILL


(In the case of Fire)
Date:……………….

1. Fire detected at (site)


………………………………..Time…………………………

2. Fire alarm rang on (time)


……………………………………………………………

3. Personal responded on (time)…..…………….. at………………………………….

4. Head Counting was (Number & OK)……………………………………………….

a. If not OK, missing person (No)……………………………………………….

b. Where they were………………………………………………………………..

c. Reason for late…………………………………………………………………..

5. Fire extinguisher used (numbers)……………………Type……………………..


….

6. Type of Fire………………………………………………………………………....

7. Effected
Area………………………………………………………………………..

8. Chairman informed by (name)………………………………on………………..….

9. Fire brigade informed by (name)……………………………


on……………………

10. Fire extinguished at……………………………..by………………………………..

11. Damage occurred by


fire…………………………………………………………….

12. Co-ordinator remarks (good / satisfactory)


………………………………………….

13. Corrective action required…………..………………………………………………

Signature of the supervisor.

F/09. Rev-00
Corvine Chemicals & Pharmaceuticals Ltd.

Prepared by: Approved by:

F/09. Rev-00

You might also like