MCFRS Station Safety Inspection Form

Name*

First NameLast Name

Email*

Please Select Your Station:*

Smoke detectors operable?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Heat detectors Operable?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

CO detectors in sleeping quarters, checked and operable?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Are all plymovents functional?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Generator Operable?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Exits – doors operable, properly marked, clear egress, stairs clear?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Fire extinguishers – mounted, and have current inspection dates?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Fire alarm test records available?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Electronic MSDS records up to date?*

YesNoRepeat ViolationNot Applicable

Click HERE to update MSDS database

Please indicate the location and specific violation.*

Kitchen hood/duct system in date?*

YesNoRepeat ViolationNot Applicable

Next Service Date:*

Date

Please indicate the location and specific violation.*

Hazardous/Flammable Material - Insure all materials are properly stored*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Hazardous/Flammable Material - No smoking signs posted around flammable/combustible liquids*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Hazardous/Flammable Material - Emergency shut-offs to fuel pumps operable and identified*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Waste receptacles provided and clean?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Adequate lighting throughout the station?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Outlet covers and switch plates in place?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Ground fault circuits operable?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Flexible cords/cables on reels/hangers?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Is the station free of any tripping hazards?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Machine guarding in place?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Adequate HVAC exhaust ventilation, free of obstruction?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Potable water?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

General housekeeping in all locations:*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Do overhead door safety devices such as electric eyes and return strips function?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Is bio-waste safely stored, removed & properly destroyed on an acceptable time schedule?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Fire sprinkler system - secured in open position; proper pressure settings; heads free from obstructions - test records available?*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

SCBA - Spare cylinders stored securely*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

SCBA - Air compressor logs for maintenance and operation present and up to date*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

SCBA - Cascade cylinders secure*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

SCBA - Air quality certificate posted (for cascade)*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

SCBA - Cylinder blast protection provided and operable*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Station has no other observations of note – (include storage areas/out buildings)*

YesNoRepeat ViolationNot Applicable

Please indicate the location and specific violation.*

Are there any potential mold issues/concerns in any place throughout the station?*

No potential issues notedYES there is potentially mold

**PLEASE contact SA700 to have them come out and inspect the potential mold issue/concern. They can be reached on the SA700 cell phone at (240)-243-7870**

MOLD PROCESS

Please indicate the issues/concerns and the location.*

Any other concerns/issues, please address them here:

*Click HERE to submit a Facility Defect*