FIRE WATCH VICTORIA
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INSPECTION DETAILS & SPECIFICATIONS
1
1. PURPOSE OF VISIT
INSPECTION
CONSULTATION
QUOTATION
TEST & TAG EXTINGUISHERS
FIRE TEST EQUIPMENT
ELECTRICAL TEST
SAFETY SWITCH (RCD) TEST
EMERGENCY LIGHT TEST
FIRST AID KIT MAINTENANCE
DOORWAY ACCESS
ADDITIONAL
TYPE OF PROPERTY
RESIDENTIAL
COMMERCIAL
ADDITIONAL
LOCATION IN VICTORIA
NORTH
SOUTH
EAST
WEST
2.
2. TIME & DAY ON-SITE
TIME OF THE DAY
7:00AM
7:30AM
8:00AM
8:30AM
9:00AM
9:30AM
10:00AM
10:30AM
11:00AM
11:30AM
12:00PM
12:30PM
1:00PM
1:30PM
2:00PM
3:00PM
3:30PM
4:00PM
4:30PM
5:00PM
5:30PM
6:00PM
6:30PM
7:00PM
DAY OF THE WEEK*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
DAY OF THE MONTH*
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
21st
22nd
23rd
24th
25th
26th
27th
28th
29th
30th
31st
MONTH OF THE YEAR*
January
February
March
April
May
June
July
August
September
October
November
December
ALTERNATIVE TIME ON-SITE
ANY FURTHER COMMENTS?
SEND CONFIRMATION BY;*
Email
Text-SMS
3.
Option 1
Option 2
3. ADDRESS OF PREMISE/ON-SITE
BUILDING FLOOR APARTMENT UNIT
STREET NUMBER*
STREET NAME*
STREET TYPE*
Road
Street
Arcade
Avenue
Boulevard
Circle
Circuit
Close
Court
Crescent
Drive
Esplanade
Freeway
Gardens
Glen
Grove
Heights
Highway
Hill
Key
Lane
Loop
Mall
Mews
Parade
Place
Rise
Road
Square
Street
Terrace
Track
Trail
Walk
Way
SUBURB*
POST CODE*
FURTHER INFORMATION
SUBMIT ADDITIONAL ADDRESS
CONTACT PERSON WHEN ON-SITE*
PROPERTY ACCESS DETAILS
4.
4. CONTACT DETAILS
NAME*
EMAIL ADDRESS*
MOBILE NUMBER
5.
5. EXTINGUISHERS
EXTINGUISHER ONE 1.
PHOTO FRONT WIDE LENSE
PHOTO FRONT CLOSE LENSE
TAG PHOTO 1
BOTTLE MAINTENANCE
DUST BOTTLE
DUST HAND GRIP AND HOSE
REPLACE BROKEN TIE
DATE STAMPED ON BOTTOM BAND
YEAR FIVE EXPIRE DATE
EXTINGUISHER TWO 2.
PHOTO FRONT WIDE LENSE 2
PHOTO FRONT CLOSE LENSE 2
DUST AND CLEAN 2
BOTTLE
HAND GRIP AND HOSE
DATE STAMPED ON BOTTOM BAND 2
YEAR FIVE EXPIRE DATE 2
EXTINGUISHER THREE 3
TAG PHOTO 2
PHOTO FRONT WIDE LENSE 3
PHOTO FRONT CLOSE LENSE 3
TAG PHOTO 3
DUST AND CLEAN 3
BOTTLE
HAND GRIP AND HOSE
DATE STAMPED ON BOTTOM BAND 3
YEAR FIVE EXPIRE DATE 3
EXTINGUISHER FOUR 4
PHOTO FRONT WIDE LENSE 4
PHOTO FRONT CLOSE LENSE 4
TAG PHOTO 4
DUST AND CLEAN 4
BOTTLE
HAND GRIP AND HOSE
DATE STAMPED ON BOTTOM BAND 4
YEAR FIVE EXPIRE DATE 4
6.
6. LIGHTING
LOCATE ELECTRICAL BOX
YES
NO
FIND LIGHTING SWITCH
YES
NO
SWITCH OFF LIGHTING SWITCH
YES
NO
ARE CEILING LIGHTS ILLUMINATING?
YES
NO
SET STOP WATCH FOR ONE HOUR FACING CEILING LIGHTS
7.
7. KEEP CLEAR DOORWAYS
LOCATE FIRE ESCAPE DOORS
HOW MANY DOORWAYS
DOORWAY ONE 1.
IS IT CLEAR OF OBSTRUCTIONS TO 1.5M?
YES
NO
CAN YOU GET MANAGEMENT TO CLEAR SPACE?
YES
NO
DOORWAY TWO 2.
IS IT CLEAR OF OBSTRUCTIONS TO 1.5M? 1
YES
NO
CAN YOU GET MANAGEMENT TO CLEAR SPACE? 1
YES
NO
DOORWAY THREE 3.
IS IT CLEAR OF OBSTRUCTIONS TO 1.5M? 2
YES
NO
CAN YOU GET MANAGEMENT TO CLEAR SPACE? 2
YES
NO
DOORWAY FOUR 4.
IS IT CLEAR OF OBSTRUCTIONS TO 1.5M? 3
YES
NO
CAN YOU GET MANAGEMENT TO CLEAR SPACE? 3
YES
NO
8.
8. FIRE BLANKET
HOW MANY BLANKETS ON PREMISE
ANY OBSTRUCTIONS?
YES
NO
TAG
CLEAN
YES
NO
TAKE PHOTO
PAYMENT RECEIPT
YES
NO
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INSPECTION DETAILS & SPECIFICATIONS
1
1. PURPOSE OF VISIT
INSPECTION
CONSULTATION
QUOTATION
TEST & TAG EXTINGUISHERS
FIRE TEST EQUIPMENT
ELECTRICAL TEST
SAFETY SWITCH (RCD) TEST
EMERGENCY LIGHT TEST
FIRST AID KIT MAINTENANCE
DOORWAY ACCESS
ADDITIONAL
TYPE OF PROPERTY
RESIDENTIAL
COMMERCIAL
ADDITIONAL
LOCATION IN VICTORIA
NORTH
SOUTH
EAST
WEST
2.
2. TIME & DAY ON-SITE
TIME OF THE DAY
7:00AM
7:30AM
8:00AM
8:30AM
9:00AM
9:30AM
10:00AM
10:30AM
11:00AM
11:30AM
12:00PM
12:30PM
1:00PM
1:30PM
2:00PM
3:00PM
3:30PM
4:00PM
4:30PM
5:00PM
5:30PM
6:00PM
6:30PM
7:00PM
DAY OF THE WEEK*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
DAY OF THE MONTH*
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
13th
14th
15th
16th
17th
18th
19th
20th
21st
22nd
23rd
24th
25th
26th
27th
28th
29th
30th
31st
MONTH OF THE YEAR*
January
February
March
April
May
June
July
August
September
October
November
December
ALTERNATIVE TIME ON-SITE
ANY FURTHER COMMENTS?
SEND CONFIRMATION BY;*
Email
Text-SMS
3.
3. ADDRESS OF PREMISE/ON-SITE
BUILDING FLOOR APARTMENT UNIT
STREET NUMBER*
STREET NAME*
STREET TYPE*
Road
Street
Arcade
Avenue
Boulevard
Circle
Circuit
Close
Court
Crescent
Drive
Esplanade
Freeway
Gardens
Glen
Grove
Heights
Highway
Hill
Key
Lane
Loop
Mall
Mews
Parade
Place
Rise
Road
Square
Street
Terrace
Track
Trail
Walk
Way
SUBURB*
POST CODE*
FURTHER INFORMATION
SUBMIT ADDITIONAL ADDRESS
CONTACT PERSON WHEN ON-SITE*
PROPERTY ACCESS DETAILS
4.
4. CONTACT DETAILS
NAME*
EMAIL ADDRESS*
MOBILE NUMBER
5.
5. EXTINGUISHERS
EXTINGUISHER ONE 1.
PHOTO FRONT WIDE LENSE
PHOTO FRONT CLOSE LENSE
TAG PHOTO 1
BOTTLE MAINTENANCE
DUST BOTTLE
DUST HAND GRIP AND HOSE
REPLACE BROKEN TIE
DATE STAMPED ON BOTTOM BAND
YEAR FIVE EXPIRE DATE
EXTINGUISHER TWO 2.
PHOTO FRONT WIDE LENSE 2
PHOTO FRONT CLOSE LENSE 2
DUST AND CLEAN 2
BOTTLE
HAND GRIP AND HOSE
DATE STAMPED ON BOTTOM BAND 2
YEAR FIVE EXPIRE DATE 2
EXTINGUISHER THREE 3
TAG PHOTO 2
PHOTO FRONT WIDE LENSE 3
PHOTO FRONT CLOSE LENSE 3
TAG PHOTO 3
DUST AND CLEAN 3
BOTTLE
HAND GRIP AND HOSE
DATE STAMPED ON BOTTOM BAND 3
YEAR FIVE EXPIRE DATE 3
EXTINGUISHER FOUR 4
PHOTO FRONT WIDE LENSE 4
PHOTO FRONT CLOSE LENSE 4
TAG PHOTO 4
DUST AND CLEAN 4
BOTTLE
HAND GRIP AND HOSE
DATE STAMPED ON BOTTOM BAND 4
YEAR FIVE EXPIRE DATE 4
6.
6. LIGHTING
LOCATE ELECTRICAL BOX
YES
NO
FIND LIGHTING SWITCH
YES
NO
SWITCH OFF LIGHTING SWITCH
YES
NO
ARE CEILING LIGHTS ILLUMINATING?
YES
NO
SET STOP WATCH FOR ONE HOUR FACING CEILING LIGHTS
7.
7. KEEP CLEAR DOORWAYS
LOCATE FIRE ESCAPE DOORS
HOW MANY DOORWAYS
DOORWAY ONE 1.
IS IT CLEAR OF OBSTRUCTIONS TO 1.5M?
YES
NO
CAN YOU GET MANAGEMENT TO CLEAR SPACE?
YES
NO
DOORWAY TWO 2.
IS IT CLEAR OF OBSTRUCTIONS TO 1.5M? 1
YES
NO
CAN YOU GET MANAGEMENT TO CLEAR SPACE? 1
YES
NO
DOORWAY THREE 3.
IS IT CLEAR OF OBSTRUCTIONS TO 1.5M? 2
YES
NO
CAN YOU GET MANAGEMENT TO CLEAR SPACE? 2
YES
NO
DOORWAY FOUR 4.
IS IT CLEAR OF OBSTRUCTIONS TO 1.5M? 3
YES
NO
CAN YOU GET MANAGEMENT TO CLEAR SPACE? 3
YES
NO
8.
8. FIRE BLANKET
HOW MANY BLANKETS ON PREMISE
ANY OBSTRUCTIONS?
YES
NO
TAG
CLEAN
YES
NO
TAKE PHOTO
PAYMENT RECEIPT
YES
NO
0%
Some required fields are missing. Please review the form and submit again.
*er:
SEND
