Republic of the Philippines

Department of the Interior and Local Government

Bureau of Fire Protection
(Region)
(District/Province Office)
(Station)
(Station Address)
(Telephone No./Email Address)

INSPECTION ORDER _____________________

NUMBER: __________________ DATE
(Pre-numbered)

TO :

PROCEED :

PURPOSE :

DURATION :

REMARKS OR :
ADDITIONAL
INSTRUCTION/S

RECOMMEND APPROVAL: APPROVED:

_________________________________ _______________________________
Chief, Fire Safety Enforcement Section CITY / MUNICIPAL FIRE MARSHAL

-------------------------------------------------------------------------------------------------------- -----------------------------------

ACKNOWLEDGEMENT
This is to acknowledge that permission was granted to the above-named Fire Safety
Inspector/s accompanied by authorized representative to conduct Fire Safety Inspection within the
premises in accordance with law.

_________________________________________________ _____________________
Signature over Printed Name/Authorized Representative Date/Time

PAALALA: “MAHIGPIT NA IPINAGBABAWAL NG PAMUNUAN NG BUREAU OF FIRE PROTECTION SA MGA KAWANI NITO
ANG MAGBENTA O MAGREKOMENDA NG ANUMANG BRAND NG FIRE EXTINGUISHER”

“FIRE SAFETY IS OUR MAIN CONCERN”

DISTRIBUTION:
Original (Applicant/Owner’s Copy)
Duplicate (BFP Copy)

BFP-QSF-FSED-009 Rev. 01 (07.05.19)