Your Full Name (required)
Which Call Point was used for the evacuation? 123
Is the glass intact? YesNo
Time taken to evacuate all persons
How many people evacuated?
Is the Fire Call Point visible and easy to access? YesNo
Is the Fire Call Point in good condition with no damage? YesNo
Did all people make a safe and prompt evacuation? YesNo
Is the Fire Call point button easy to activate without resistance? YesNo
Can the alarm be heard in all areas? YesNo
Is the alarm immediate on pressing the button? YesNo
Is the alarm clear? YesNo
If no to any questions explain below or if you have any additional comments or safety concerns? If you are not completing this form at the time of evacuation enter the date & time of evactuation below.
This form will be stamped with the date and time at time of submission and will be stored on our secure servers for the purpose of traceability with regards to Fire Safety Compliance. (Fire Reform Order 2005)
By clicking submit, I confirm and acknowledge, I understand the legal importance of recording accurate information required for Fire Safety compliance purposes, and the submission of incorrect, false information could increase the risk of serious injury and could lead to disciplinary actions as appropriate.
By clicking submit. I have confirmed the details entered above are correct at the time of inspection.
Submitted forms are automatically sent to The Factory Managers for actioning.
