Complete Building Safety Information Checklist for Inspections

BUILDING INFORMATION FORM

• Building’s Name: ___________________________________
• Owner’s Name: ____________________________________
• Address of the building: _____________________________
• Contact Numbers: _________________________________

BUILDING INFORMATION

1. Building Type:

• Commercial
• Residential
• Office
• Shop/Market
• Warehouse
• Factory
• House
• Others: ________________________

2. Ownership:

• Government
• Private
• Mixed

3. Structure:

• Brick masonry
• Concrete
• Covered area: ___________
• No. of floors: _______
• No. of basements: _______

4. Safety and Utilities:

• Has the Earthquake factor been accounted for in the design?
  • Yes / No
• Does your building have basic Electrical Wiring?
  • Yes / No
• Is your building properly Earthed?
  • Yes / No
• Does your building have an Electrical Main cut-off switch?
  • Yes / No
• Does your building have a Gas supply main cut-off valve?
  • Yes / No
• Is your building insured?
  • Yes / No
  • If Yes, Insurance Company Name: _______________________

EMERGENCY ARRANGEMENTS

1. Access to Building:

• Is your building easily accessible for Rescue & Fire vehicles?
  • Yes / No
  • If Yes, describe: ________________________________________
• Width of Access Road to the building: 20 feet

2. Emergency Exit:

• Are there emergency exits provided in the building?
  • Yes / No
  • If Yes, mark the box with ✔:
    • Clearly marked
    • Illuminated (Fluorescent)
    • Number of emergency exits: 04

3. Emergency Staircase:

• Are emergency staircases provided in the building?
  • Yes / No
  • If Yes, mark the box with ✔:
    • Located where exits are visible
    • Obstruction-free
    • Protected by Fire Doors
    • Proper lighting
    • Ventilation system

4. Emergency Evacuation Plan:

• Does your building have an emergency evacuation plan?
  • Yes / No
  • If Yes, mark the box with ✔:
    • Clearly Displayed
    • Layout of the building
    • Emergency Exits Marked
    • Assembly area marked
    • Regular fire emergency evacuation drills carried out

FIRE DETECTION SYSTEMS

1. Fire Alarm System:

• Is your building equipped with a fire alarm system?
  • Yes / No
  • If Yes, mark the appropriate box with ✔:
    • Automatic System
    • Manual System
    • No. of Smoke Detectors: 10
    • No. of Heat Detectors: 05
• Is the system manned at all times?
  • Yes / No
• Location of control panel: Ground Floor, Main Entrance Lobby

2. Sprinkler System:

• Is your building equipped with a fire water sprinkler system?
  • Yes / No
  • If Yes, mark the appropriate box with ✔:
    • Wet System
    • Dry System
• Number of water sprinklers: 25

FIRE FIGHTING ARRANGEMENTS

1. Fire Extinguishers:

• Is your building provided with fire extinguishers?
  • Yes / No
  • If Yes, fill in the following:
    • Extinguisher Type: ABC Dry Powder
    • Quantity: 15

2. Fire Hose Cabinet:

• Are any fire hose cabinets provided in the building?
  • Yes / No
  • If Yes, provide the following details:
    • Number of hose cabinets with fire hose/hose reel: 06

3. Fire Hydrant System:

• Is your building provided with a fire hydrant system?
  • Yes / No
  • If Yes, mark the appropriate box with ✔:
    • Dry Riser System
    • Wet Riser System
    • Hydrant system operational
    • Independent Overhead Water Tank
    • Underground Water Tank
    • Pressure maintained (3–5 bar)
    • Electric Fire Pump
    • Alternate power supply system

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Any Other Relevant Information or Suggestions?

Owner/Manager: _________________________
Signature: ______________________________

FIRE INCIDENT REPORTING FORM

Preliminary Information

Incident Details

• Place of Incident: _____________________________________________
• Building Manager/Owner: __________________________
• Contact No.: _____________________________________
• Caller’s Detail: __________________________________
• Contact No.: _____________________________________

Response Information

• Date: ___________________
• Call Time: _______________
• Response Time: ___________

Fire Incident Details

• Possible Cause of Fire: ______________________________________
• No. of Dead: ______________

Victims and Medical Response

• No. of Victims Shifted to Hospital:
  • Serious: _______
  • Minor: _______
  • Total: _________
• No. of Victims Given First Aid on Spot: _________
• Total No. of Victims: ___________
• Details of Victims:
  • Male: _______
  • Female: _______
  • Children: _______

Emergency Response Vehicles

• Fire Vehicles: ____________________
• Ambulances: _____________________
• Rescue Vehicles: _________________
• Specialized Vehicles: _____________
• Total No. of Vehicles Responded: ___________
• Total No. of Rescuers at Incident: ___________

Special Equipment Used

• Thermal Imaging Camera
• SCBA (Self-Contained Breathing Apparatus)
• Fire Extinguishers
• Foam
• APR (Air-Purifying Respirator)
• Other: ___________________________________

Incident Coverage and Loss Estimation

• Approx. Covered Area:
  • Area (Marla): _______ × No. of Floors: ________
• Approx. Area Affected by Fire:
  • Area (Marla): _______ × No. of Floors: ________
• Estimated Worth of the Building (PKR): ___________________________
• Estimated Loss (PKR): _________________________________________
• Estimated Loss Saved (PKR): ____________________________________

Investigation and Damage Detail

Premises Type:

• Industrial
• Commercial
• Residential

Occupancy:

• Home
• Apartments/Flats
• Hotel/Boarding
• Restaurant
• Warehouse
• Industry/Factory
• Hospital
• Office/Shop
• School/College
• Other: __________________________

Construction Type:

• Brick Masonry
• Wooden Framed
• Concrete
• Steel Framed
• Other: __________________________

Building Design:

• Single Storey
• Multiple Storey
• Basement
• Total No. of Floors: __________
• No. of Basements: ___________

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Cause of Incident (as per Witness):

1. Witness 01:
   • Name: ____________________________
   • Contact: ___________________________
   • Statement: __________________________
2. Witness 02:
   • Name: ____________________________
   • Contact: ___________________________
   • Statement: __________________________
3. Witness 03:
   • Name: ____________________________
   • Contact: ___________________________
   • Statement: __________________________

---

Incident Details:

• Seat/Start of Fire (Location & Floor): ___________________________
• Sequence of Spread of Fire:
  • 1st Spread: ____________________
  • 2nd Spread: ___________________
  • 3rd Spread: ____________________

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Fire Fighting Efforts by Occupants:

---

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Factors Leading to Spread of Fire:

• False Ceiling
• Electrical Appliances
• Woodworks
• Gas Supply Lines
• Furniture
• Carpeting
• Poor Housekeeping
• Hazardous Material
• Other: _________________________
• Storage of Combustible Material
• Fabrics

Implementation Status of Building By-Laws

Access to the Building:

• Clear Access:
  • Yes
  • No
• Fire Alarms Functional:
  • Functional
  • Non-Functional (N.F)
• External Fire Hydrants Functional:
  • Functional
  • Non-Functional (N.F)

Emergency Exits:

• Exit Availability:
  • Locked
  • Clear
• Smoke/Heat Detectors Functional:
  • Functional
  • Non-Functional (N.F)
• Wet/Dry Hydrant System Functional:
  • Functional
  • Non-Functional (N.F)
• Assembly Area Marked:
  • Yes
  • No
• First Aid Kits Available:
  • Yes
  • No

Emergency Staircase:

• Availability:
  • Yes
  • No
• Hose Cabinet Functional:
  • Functional
  • Non-Functional (N.F)
• Water Reservoir/Tank Functional:
  • Functional
  • Non-Functional (N.F)
• Separate Parking Area:
  • Yes
  • No

Emergency Signs and Plans:

• Fire Extinguishers Functional:
  • Functional
  • Non-Functional (N.F)
• Sprinkler System Functional:
  • Functional
  • Non-Functional (N.F)
• Evacuation Plan:
  • Displayed
  • Not Displayed
• Ventilation Ducts:
  • Yes
  • No
• Emergency Lights Functional:
  • Yes
  • No

Building Layout, Approach Area, Fire, and Sector Locations

Building Sketch/Map:

(Attach prints of pictures of the building)
View: ____________________________

Sector Locations

Risk Assessment

• Electricity Control: Yes / No
• Gas Leakage Control: Yes / No
• Basements Control: Yes / No
• Hazardous/Flammable Control: Yes / No
• Lack of Visibility Control: Yes / No
• Falling Objects Control: Yes / No
• Unstable Structure Control: Yes / No
• Debris Control: Yes / No
• Broken/Burnt Stairs Control: Yes / No
• Other Control: Yes / No
  • If Yes, specify: ______________________

Documents Attached:

• Building Sketch/Map
• Statements
• Photographs
• Video
• Others: ____________________________

Resources Deployed

Declaration:

I, __________________ (Name), Rank ______________, hereby verify the above information. I have searched the entire premises for victims and building safety, etc., and certify that the fire search & rescue operation is complete.

 

FIRE SAFETY AUDIT FORM

Premises Information

Premises Information

Basic Details:

• Premises Name: ______________________________________
• Address: ___________________________________________
• Owner’s Name / Focal Person: __________________________
• Contact No.: ________________________________________

Building Area / Age:

• Plot Size: ________ (Marla/Kanal/Sq.ft)
• Total Covered Area: ________ Sq.ft
• Height of Building: ________ ft
• Age of Building: ________ Month / Years

Premises Type:

• Industrial
• Commercial
• Government
• Residential

Occupancy Type:

• Home
• Apartments/Flats
• Hotel/Boarding
• Warehouse
• Industry/Factory
• Hospital
• Office/Shop
• School/College/University
• Plaza
• Restaurant
• Cinema/Auditorium
• Banquet Hall
• Bus Terminal
• Railway Station
• Airport
• Other: _________________________

Ownership Type:

• Government
• Semi-Govt.
• Private
• Other: _________________________
• Leased
• Rented
• Owned

Construction Type:

• Fully Framed
• Semi-Framed
• Steel Framed
• Wooden Framed
• Brick Masonry

Building Design:

• Single Storey
• Multiple Storey
• Basement: [ ] Yes [ ] No
• No. of Floors (Above Ground Level): __________
• No. of Floors (Below Ground Level): __________
• Total No. of Floors: ___________

Occupancy & Storage Details:

No. of Occupants:

• Staff: ________
• Residents: ________
• Visitors: ________
• Others: ________
• Total: _________

Occupant Types:

• Children
• Elderly People
• Handicapped
• Female: _______
• Male: _______
• Other: __________________________

Interior Materials:

• Paint
• Plastic
• Woodworking
• Partition
• False Ceiling
• Wallpaper
• Carpets
• Curtains/Blinds
• Other: ___________________________

Storage Type:

• Electrical Appliances
• Wood
• Petroleum Products
• Paints
• Fabrics
• Hazardous Material
• Medicines
• Paper & Board
• Glass
• Non-Metals
• Explosives
• Refrigerated Items
• Leather
• Chemical/Other: ___________________

Quantity of Material Stored:

• Low Quantity
• Medium Quantity
• Bulk Quantity

General Safety Arrangements

• Loose Electrical Wiring:
  • Yes [ ] No
• Overloaded Socket/Plug:
  • Yes [ ] No
• Damaged/Tapped Wires:
  • Yes [ ] No
• Type of Wiring:
  • Open
  • Underground
  • Both
• Gas Supply Main Cut-off Valve:
  • Yes [ ] No
• Electrical Main Cut-off Switch:
  • Yes [ ] No
• Circuit Breaker for Each Portion:
  • Yes [ ] No
• Alternate Power Supply Available:
  • Yes [ ] No
• Building Material Used:
  • Flameproof
  • Non-Flammable
• Emergency Lighting:
  • Yes [ ] No
• Proper Ventilation Ducts:
  • Yes [ ] No
• Dusting Material Used:
  • Yes [ ] No
• Central Air Conditioning System:
  • Yes [ ] No
  • N/A
• No Smoking Is Followed:
  • Yes [ ] No
• Designated Smoking Area:
  • Yes [ ] No
  • N/A
• Proper Housekeeping Practices:
  • Yes [ ] No
• Waste Removed at All Times:
  • Yes [ ] No
• Building Insured:
  • Yes [ ] No

Emergency Arrangements

• Clear Access to the Building:
  • Yes [ ] No
• Width of Access Road: ___________
• No. of Emergency Exits: ___________
  • Functional
  • Locked
  • Obstruction-Free
  • Clearly Marked
  • Illuminated
• Emergency Staircase:
  • External Staircase
  • Internal Staircase
  • Near Exit
  • Illuminated
  • Obstruction-Free
• Fire Doors Available:
  • Yes [ ] No
  • No. of Fire Doors: ___________
• Emergency Signs:
  • Yes [ ] No
  • Clearly Displayed
  • Illuminated
• Emergency Evacuation Plan:
  • Yes [ ] No
  • Clearly Displayed
  • Building Layout Attached
  • Emergency Exits Marked
  • Assembly Area Marked

Fire Detection Systems

• Fire Detection & Alarm System:
  • Yes
  • No
  • Functional
  • Non-Functional
• Control Panel:
  • Automatic
  • Manual
  • No. of Manual Call Points: ___________
• No. of Smoke Detectors:
  • Functional
  • Non-Functional
• No. of Heat Detectors:
  • Functional
  • Non-Functional

Fire Safety Arrangements

• No. of Portable Fire Extinguishers:
  • Functional
  • Non-Functional
• Fire Extinguisher Types:
  • D.C.P
  • CO2
  • Water
  • Other: ______________________
• Sprinkler System:
  • Yes
  • No
  • Status:
    • Wet System
    • Dry System
    • Functional
    • Non-Functional
• No. of Water Sprinklers: ____________
  • Functional
  • Non-Functional
• No. of Fire Hose Cabinets: ____________
  • Functional
  • Non-Functional

Fire Hydrant System

• Yes
• No
• No. of Fire Hydrants: ___________
• Status:
  • Functional
  • Non-Functional
  • Pressure Maintained (3-5 Bar): [ ] Yes [ ] No
• Fire Hydrant Types:
  • Dry Riser
  • Wet Riser
  • Electric Fire Pump
  • Independent Overhead Water Tank
  • Capacity: ____________
  • Underground Water Tank

Fire Suppression and Response

• No. of Fire Hose Reels: ___________
  • Functional
  • Non-Functional
• Fire Suppression System:
  • Yes
  • No
  • Type: ________________________
  • Functional
  • Non-Functional
• Firefighting Trainings Conducted:
  • Yes
  • No
  • No. of Trained Staff: ____________
  • Type of Training: ___________________

Safety Practices and Evacuation

• Safe Working Practices Followed:
  • Yes
  • No
• Regular Evacuation Drills Conducted:
  • Yes
  • No
  • Record Maintained:
    • Yes
    • No
• Regular Inspection of Firefighting Equipment:
  • Yes
  • No
  • Maintained:
    • Yes
    • No

Local Fire Services Availability

• Availability of Local Fire Service/Team:
  • Yes
  • No
• Nearest Fire Station/Team: _____________________
  • Distance: ___________
• Nearest Lorry Filling Point: ____________________
  • Distance: ___________

Any Other Information / Observations

(25 marks for average remarks/observations)
The information/observations found during the building inspection are attached herewith.

1. ---

2. ---

3. ---

• Risk Level:
  • Low Risk Level
  • Medium Risk Level
  • High Risk Level

(In case of high or medium risk, reasons must be indicated. Immediate steps may be taken to eliminate the risk. The building must not be occupied until the risk is reduced.)

Signatures

• Prepared by:
  Deputy Incharge
  • Signature: _________________________
  • Name: _____________________________
• Verified by:
  Incharge
  • Signature: _________________________
  • Name: _____________________________

Attached prints of pictures of building _____________________________ (View)