OAKVILLE FIRE DEPARTMENT
ADDRESS: ______________________________________

DATE: ____________________________

Is there presently a fire safety plan approved:           YES NO

Does the plan contain all of the following:

#     Item                                             Yes No   N/A

    1 Title page
      a) address
      b) building name
      c) date prepared
      d) who the plan was prepared by

    2 Table of contents

    3 Human Resources Audit Information:
      a) owner information
      b) management information
      c) list of key contact persons

    4 Building Audit Information:
      a) number of storeys
      b) type of construction
      c) type of occupancy
      d) number of units
      e) fire department access, firefighter windows
      f) elevators
      g) has elevators been modified
      h) natural gas shut off
      i) year of construction
      j) does retrofit apply
      k) occupant load
#     Item                                                          Yes No   N/A

    5 Safety Equipment Audit Information:
      a) fire alarm system & type
      b) reset procedures for the fire alarm system
      c) post reset procedures adjacent the fire alarm panel
      d) fire alarm system not reset until directed by fire dept.
      e) sprinkler systems & types
      f) standpipe system
      h) fire pump(s) & types
      i) monitoring company information
      j) hallway fire doors (smoke control & separations)
      k) emergency lighting & types
      l) exit locations
      m) fire extinguishers & types
      n) emergency generator
      o) siamemse connection(s)
      p) fire hydrants
      q) kitchen suppression system & type (kit. sys.)
      r) operating instructions provided for kit. sys.
      s) operating kit. sys. before using portable extinguisher
      t) other fixed suppression systems
      u) operating instructions for elevators
      v) resetting procedures for elevators
      w) operating instructions for voice communication sys.

    6 Emergency Procedures:
      a) procedures for occupants if fire alarm sounds
      b) procedures for supervisory staff if fire alarm sounds
      c) procedures for occupants if discovery of fire
      d) procedures for supervisory staff if discovery of fire

    7 Posting Emergency Procedures:
      a) procedures posted above each manual pull station
      b) posted in each elevator lobby
#     Item                                                      Yes No   N/A

    8 Stay Or Go Policy:
      a) residential occupancies only

    9 Owner Responsibility:
      a) fire safety plan has been kept current
      b) changes have been submitted to fire for review
      c) fire safety plan has been reviewed by owner annually
      d) supervisory staff have been appointed
      e) training has been provided on the fire safety plan

10 Supervisory Staff:
   a) supervisory staff have been appointed
   b) supervisory staff have been trained
   c) training records have been kept on file
   d) procedures for training supervisory staff
   e) topics for training:
      battery changing for tow motors
      storage & handling of compressed gases
      storage & handling of flammable/combustible liquids
      hot work permits
      fire code Div.B 4.4,,
      resetting of the fire alarm system

11 Fire Drills:
   a) procedures for conducting fire drills
   b) monitoring contacted before & after the drill
   c) contact OFD dispatch before & after (905 637 8253)
   d) drills will be documented
   e) copy of post evacuation feedback form provided
   f) identify outside designated evacuation assembly area
   g) frequency of drill(s)
       daycare & group B - monthly
       schools - 3 times per each spring/fall semesters
       hi-rise buildings - every 3 months
# Item                                                         Yes No   N/A
 11 Fire Drills (con't):
       laboratories - every 6 months
       all other buildings - annually

12 Fire Prevention Information:
   a) electrical information
   b) storage information
   c) general hazard information

13 Fire Extinguishment/Portable Fire Extinguisher(s):
   a) operating instructions (PASS method)
   b) classes of fires
   c) when to extinguish a fire
   d) call 911 before using an extinguisher
   e) training

14 Hazardous Material Information/Procedures:
   a) no smoking policy (or smoking areas provided)
   b) smoking area on floor plans
   c) smoking area on site plan
   d) flammable/combustible liquid spill procedure

15 Maintenance Of Fire & Life Safety Equipment:
   a) test records kept on site for a minimum of two years
   b) test records kept for intervals greater then two years
   c) fire alarm verification report on site (Nov. 2007)
   d) definition of check, test, inspect
   e) owner responsible for completion of maintenance
   f) welding equipment information
   g) fire alarm system information
   h) voice communication system information
   i) sprinkler system information
   j) hood, duct, filter information
   k) water supply information
   l) fire door and separation information
   m) emergency lighting information
# Item                                                         Yes No   N/A
 15 Maintenance Of Fire & Life Safety Equipment (con't):
    n) emergency power supply information
    o) monitoring information
    p) fire damper and fire stop flap information
    q) chimney, flue, flue pipe information
    r) HVAC information
    s) portable fire extinguisher information
    t) hydrant information
    u) fire door and separation information
    v) kitchen suppression system information
    w) firefighter elevator information
    x) smoke control measure information

16 Alternative Measures:
   a) system shut-down information
   b) installing/posting notices to occupants
   c) monitoring company contacted
   d) fire department contacted (less than 24 hrs)
   e) fire department notified in writing (more than 24 hrs)
   f) fire watch completed every 1/2 hour (minimum)
   g) fire watch documented
   h) what equipment will be provided during the fire watch

17 Special Procedures For High Buildings:
   a) elevator recall
   b) voice communication system operation
   c) evacuation procedures (fire floor, one above/below)
   d) smoke control measures
       smoke shafts
       elevator pressurization
   e) elevator operation
   f) stay or go policy (residential occupancy only)
   g) evacuation of persons requiring assistance
# Item                                                     Yes No   N/A
 17 Special Procedures For High Buildings (con't):
    h) procedure to facilitate fire department access
    i) procedure to identify fire location to fire dept.
    j) operation of other life safety systems

18 Site Plan Drawing:
   a) fire route
   b) fire hydrant(s)
   c) main entrance
   d) fire department connections
   e) all buildings/structures
   f) gas shut off (if not on floor plan)
   g) street name
   h) north arrow
   i) storage sites/locations
   j) hazardous area(s)
   k) smoking area
   l) designated assembly areas

19 Floor Plan Drawings:
   a) all floors
   b) exits
   c) roof plan
   d) electrical room(s)
   e) mechanical room(s)
   f) sprinkler control room
   g) fire alarm control room
   h) manual pull station
   i) smoke control measures
   j) fire extinguishers
   k) emergency generator(s)
   l) sprinkler control valves
   m) standpipe control valves
   n) standpipe cabinets
   o) water shut off
   p) gas shut off
# Item                                                        Yes No   N/A
 19 Floor Plan Drawings (con't):
    q) kitchen suppression system
    r) other special extinguishing systems
    s) stairwell identification
    t) smoking areas

20 Radio Active Materials:
   a) location & identification of storage
   b) location & identification of use area(s)
   c) methods to control a fire emergency
   d) recover of material
   e) contact list for assistance (experts/companies)
   f) location of radiation survey instruments
   g) contact list for advice on safety

21 Ontario Fire Code Division B Part 4:
   a) labs required to submit a fire safety plan
   b) personnel protection equipment (PPE) provided
   c) PPE location shown on floor plans
   d) site plan showing location of piping/transfer system
   e) floor plan showing location of piping/transfer system
   f) site plan showing valves for fire protection systems
   g) floor plan showing valves for fire protection systems
   h) floor plan showing emergency shut off valve(s)
   i) site plan showing emergency shut off valve(s)
   j) spill control measures
       operating procedures to prevent spills/leaks
       control of ignition
       spill containment & clean up (dikes, sand)
       personnel protective equipment
       handling & disposal of waste
       notification of affected agencies
       notification of management
       preventive maintenance program
       training new staff (within 3 months of being hired)
# Item                                                      Yes No    N/A
 21 Ontario Fire Code Division B Part 4 (con't):
        training existing staff every six months
    k) list of all flammable/combustible liquids on site
    l) floor plan showing location of flam./comb. Liquid

22 Hotels:
   a) building audit has been completed by owner
   b) building audit is on site
   c) training of staff
   d) records of training
   e) fire drill records kept on site

23 Institutional Buildings:
   a) staffing levels meet OFM guideline 01-98
   b) procedures for horizontal evacuation
   c) procedures for vertical evacuation
   d) evacuation techniques provided
      proper lifts
      carry/drag persons
      area of refuge
   e )site plan showing designated assembly area(s)

24 General Requirements:
   a) approved alternative solutions kept on site
   b) fire department key vault provided
   c) key vault shown on site/floor plan
   d) fire safety plan lock box provided
   e) fire safety plan lock box shown on site/floor plan

25 Notes:
   a) fire safety plan to be kept on site in an approved location
   b) fire department will not accept sample plans as a submission
   c) two copies of the draft plan must be submitted for review
   d) The attached fire safety plan summary sheet must be completed

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