Pre-Fire Inspection Audit Worksheet Pre-Fire Inspection Audit Worksheet InstructionsPlease review each question and check “Yes or No”. If a question does not apply, check “NA. “ A “No” answer will indicate a condition requiring attention. Space has been provided at the bottom of this form to comment on any action being taken to correct condition. Please ensure the business name is identical to the submitted “New Business Registration Form”. If you have any questions, feel free to contact the Fire Inspector at 231-733-8890.Business Name*Business Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Business Phone*HousekeepingAre spaces, including under stairways and around heating devices kept free of accumulated combustibles?* Yes No N/A Are ashtrays emptied into non-combustible containers daily?* Yes No N/A Is the outside dumpster kept at least 5 feet away from combustible walls, windows and doors, and is the lid kept closed?* Yes No N/A Are flammable and combustible liquids like gasoline, oil, etc stored in approved containers and do not exceed a total of 10 gallons?* Yes No N/A ExitsAre exit ways and doors easily recognizable, unobstructed and unlocked during business hours?* Yes No N/A Are all illuminated exit signs and/or emergency lighting systems working properly?* Yes No N/A Are all automatic closing doors kept unblocked and working properly? Do they close and latch?* Yes No N/A ElectricalElectrical panel has a minimum of 30” clearance, all circuits are labeled, and breakers are free from tape or other devices that keep breakers from operating?* Yes No N/A Are all electrical covers for outlets, switches and junction boxes in place?* Yes No N/A Are all electrical devices properly grounded?* Yes No N/A If multi-outlet adapters are used, does the adapter have its own fuse or breaker?* Yes No N/A Extension cords are used as temporary wiring only, not in place of permanent wiring and only used for one portable appliance?* Yes No N/A HeatingIs your heating equipment in good working order and free of lint and dust accumulation?* Yes No N/A Are portable heaters equipped with automatic safety shut-off devices?* Yes No N/A If you have a boiler, has it been inspected within the last year, and is the current boiler inspection posted?* Yes No N/A Fire ProtectionAre fire extinguishers properly mounted, accessible, and inspected by a certified company within the last year?* Yes No N/A Are employees familiar with the use of portable fire extinguishers?* Yes No N/A Do all apartment units have smoke detection? Are they checked periodically?* Yes No N/A Cooking ventilation hood fire suppression system has been inspected and tagged by a certified company within the last six months?* Yes No N/A Inspected Date:* MM slash DD slash YYYY Inspected by:*Does your commercial kitchen contain a class K fire extinguisher?* Yes No N/A MiscellaneousAll holes in walls and ceilings are patched; ceiling tiles are in place and in good condition?* Yes No N/A All compressed gas cylinders are secured to prevent falling?* Yes No N/A Is the gas meter, regulator, or exposed piping protected from vehicular traffic?* Yes No N/A Is address visible, legible, of a contrasting color, and permanently posted on building?* Yes No N/A Does your business contain a Fire Department Access Entry Key Box? If not, contact the Fire Department for Keybox Order Form. Home businesses are exempt.* Yes No N/A Your Name* First Middle Last Date* MM slash DD slash YYYY CommentsNameThis field is for validation purposes and should be left unchanged.
