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Date: ________________
I. GENERAL INFORMATION
III. SECTIONAL OCCUPANCY (Note: Indicate specific usage of each floor, section or rooms)
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IV. EXIT DETAILS
Occupant Load: ________________________________ Egress Capacity______________________________________
(Requirement: 9.3 square meters per person)
Capacity of Horizontal Exit (Corridor/Hallway):_____ ( Requirement:100 persons per unit of exit width per min)
Capacity of Exit Stair:__________________________ (Requirement: 60 persons per unit of exit width per min)
No. of Exits ____________________ Remote?[ ] Yes [ ] No
Minimum Requirement: No. of Exits: Two (2) units per floor
Location of Exits _______________________________________________________________________________
Maximum Travel Distance Requirement from Farthest Room: 61 m without AFSS & 915m with AFSS
Any Enclosure Provided? [ ] Yes[ ] No Min of 2-hr fire rating- 4-storey or more, Min of 1 hr fire rating- less than 4-storey
MEANS OF EGRESS
Readily accessible? [ ] Yes [ ] No Obstructed? [ ] Yes [ ] No
Travel distance within limits? [ ] Yes [ ] No Dead-ends within limits ? [ ] Yes [ ] No
Adequate illumination [ ] Yes [ ] No Proper rating of illumination? [ ] Yes [ ] No
Panic hardware operational? [ ] Yes [ ] No Door swing in the direction of exit? [ ] Yes [ ] No
Doors open easily? [ ] Yes [ ] No Self-closure operational? [ ] Yes [ ] No
Bldg w/ Mezzanine? [ ] Yes [ ] No Mezzanine with proper exits? [ ] Yes [ ] No
Corridors & aisles of sufficient size? [ ] Yes [ ] No
A. VERTICAL EXITS
C. HORIZONTAL EXITS
Width of door/s ______________________ Construction________________________ With vision panel [ ] Yes [ ] No
Door swing in the direction of egress travel? [ ] Yes [ ] No With Self-closing device? [ ] Yes [ ] No
Width of corridors or hallways _______________________________Construction _______________________________
Corridor walls extended from slab to slab? [ ] Yes [ ] No Properly illuminated? [ ] Yes [ ] No
Exit readily visible? [ ] Yes [ ] No Clear and unobstructed? [ ] Yes [ ] No
Properly marked w/ illuminated exit sign? [ ] Yes [ ] No With illuminated directional sign? [ ] Yes [ ] No
Properly located? [ ] Yes [ ] No
D. RAMPS
Provided? [ ] Yes [ ] No Type: [ ] Interior [ ] Exterior Width _______________
Railings provided? [ ] Yes [ ] No Height from the floor ______________(Requirement: 91 cm)
Any enclosure provided? [ ] Yes [ ] No Construction________________________________________________
Are fire doors provided? [ ] Yes [ ] No Width ____________________ Fire door construction______________
Door equipped w/ Self-closing device? [ ] Yes [ ] No Door with proper rating? [ ] Yes [ ] No
Door provided w/ vision panel? [ ] Yes [ ] No If Yes, made of _____________________________________________
Door swing in the direction of exit travel (when required)? [ ] Yes [ ] No
Any obstruction? ________________________________ Termination/Discharge of exit _________________________
E. AREA OF SAFE REFUGE
Provided? [ ] Yes [ ] No Type: [ ] Interior [ ] Exterior Location _________________________________
Any enclosure provided ? [ ] Yes [ ] No Construction________________________________________________
Are fire door provided? [ ] Yes [ ] No Width _______________ Fire door construction___________________
Door equipped w/ self-closing device? [ ] Yes [ ] No Door with proper rating? [ ] Yes [ ] No
Door provided w/ vision panel? [ ] Yes [ ] No If Yes, made of ________________________________
Door swing in the direction of exit travel? [ ] Yes [ ] No
B. EXIT SIGNS
Exit Signs Illuminated? [ ] Yes [ ] No Location _________________________________________________
Source of Power [ ] AC/DC [ ] Others____________________________________ Readily visible? [ ] Yes [ ] No
Minimum Letter Size _______________________ Min. Requirement: Height of 11.5 cm & width of 19.0 mm
Exit Route Plan posted on: Lobby/Hallways? [ ] Yes [ ] No Rooms? [ ] Yes [ ] No
Directional Exit Signs? [ ] Yes [ ] No Location_____________________________________________________
C. WARNING/SAFETY SIGNS
[ ] No Smoking [ ] Dead-end [ ] Elevator Sign [ ] Keep Door Closed
Others, specify _____________________________________________________________________________________
B. ALARM SYSTEM
Fire Alarm Provided? [ ] Yes [ ] No Type: [ ] Manual [ ] Automatic Centralized? [ ] Yes [ ] No
Location of Central Control __________________________________________________________________________
No. of Bells per Floor __________ Location__________________________________________________________
Coverage: [ ] Building [ ] Air Handling Unit [ ] Portion, specify__________ Monitored? [ ] Yes [ ] No
Type of Initiation Device? [ ] Smoke [ ] Heat [ ] Manual [ ] Water Flow [ ] Others ____________________________
No. of Pull Stations per Floor______Max.. Horizontal Distance Bet. Pull Stations: 61.0 m
Smoke Detectors? [ ] Yes [ ] No No. of Units per Room _______________ Integrated? [ ] Yes [ ] No
Heat Detectors? [ ] Yes [ ] No No. of Units per Room _______________ Integrated? [ ] Yes [ ] No
Power Source of Detectors [ ] AC/DC [ ] Others___________ Total Detectors per Floor ________________________
Date Last Tested ____________________________________________________________________________________
C. STANDPIPE SYSTEM
Type: [ ] Wet [ ] Dry Tank Capacity ____________________Location _______________________________
Siamese Intake Provided? [ ] Yes [ ] No Location _________________________________________________
Size ________________ No. of Units ___________________________ Accessible? [ ] Yes [ ] No
Fire Hose Cabinets Provided? [ ] Yes [ ] No With Complete accessories [ ] Yes [ ] No
Location ___________________________
No. of Units per Floor ____________ Size of Hose ___________________ Length of Hose _______________________
(Note: Min Required Size of Riser & Distribution Pipe: 2 inch and 1 inch in diameter, respectively
Type of Nozzle ____________________________Date Last Tested __________________________________________
Fire Lane Provided: [ ] Yes [ ] No Location of nearest Fire Hydrant ______________________________
D. Electrical System
Is there any electrical hazard? [ ] Yes [ ] No Specify location_______________________________________
E. Mechanical System
Is there any mechanical hazard? [ ] Yes [ ] No Specify location ______________________________________
No. of elevators provided ____________________
Firemans elevator provided? [ ] Yes [ ] No Firemans key/switch provided? [ ] Yes [ ]No
XI. RECOMMENDATIONS
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ACKNOWLEDGED BY:
____________________________________________ ____________________________________________
Signature over Printed Name of Owner/Representative Fire Safety Inspector/s
Date & Time______________________
__________________________________________
Team Leader
__________________________________________
CHIEF, FIRE SAFETY ENFORCEMENT SECTION
APPROVED/DISAPPROVED:
____________________________________
Original (BFP copy)
Duplicate(BO or BPLO, as the case maybe) City/Municipal Fire Marshal
Triplicate (Applicant/Owners Copy)