Forms • Edmond, OK • CivicEngage

If you are a business within the Edmond city limits that is considered a low-hazard occupancy, you can complete the following online self-inspection form, This program is part of our partnership with the business community in fire and life safety. The goal of this program is to facilitate annual fire and life safety inspections that keep fire loss costs to a minimum without disrupting your business with on-site inspections.

Even though your business may be classified as low-hazard, it is important that we provide you with the appropriate information regarding International Fire Code and Safety issues. The Edmond Fire Department wants to make sure all businesses meet a reasonable level of fire and life safety standards for the benefit of the entire community.

This annual self-inspection program helps make you aware of fire and life safety issues and helps you develop a proactive attitude towards fire safety.

Please note: It is very important that you read through the entire form and make sure you are able to mark each question with a complete or N/A . Complete the form only if you are able to mark complete or N/A on every applicable section.

Note: required fields are marked with an asterisk (*).

Contact Information

Business Name*

Address Line 1*

Address Line 2

City*

State*

Zip*

Business Phone*

Email Address*

Primary Contact Name*

Primary Contact Phone*

Emergency Contact 1 Name*

Emergency Contact 1 Phone*

Emergency Contact 2 Name*

Emergency Contact 2 Phone*

Access & Premises

Property address is marked in large numbers and is clearly visible from the street.

Complete

N/A

Fire lanes are properly marked and are unobstructed.

Complete

N/A

Areas outside and around the building free of weeds, debris and trash.

Complete

N/A

Fire Hydrants are clear of vegetation, debris, etc. for a minimum of 5 feet.

Complete

N/A

Egress(Exiting)

Exit signs are provided and are in working order if provided with illumination

Complete

N/A

If the main exit door is provided with key-locking hardware, as allowed by code, the following signage must be posted on the door "THIS DOOR MUST REMAIN UNLOCKED WHEN BUILDING IS OCCUPIED" Secondary exits are operable from the inside without the use of a key or any special knowledge or effort

Complete

N/A

Exit (s) and exit pathway (s) clear of obstructions

Complete

N/A

Emergency lighting is maintained and in operable condition

Complete

N/A

Electrical

All electrical outlets, switches and junction boxes are closed or covered

Complete

N/A

Circuit breakers/fuses are labeled so as to identify the area protected

Complete

N/A

Electrical panel(s) must remain clear of obstructions a minimum of 30 inches

Complete

N/A

Extension cords are utilized for temporary use only

Complete

N/A

All multiple Outlet Power strips are UL listed and equipped with a built-in circuit breaker, which is plugged directly into a permanently installed receptacle

Complete

N/A

Fire Alarm/Fire Sprinkler System

The Fire Alarm / Fire Sprinkler system (s) have been inspected within the last 12 months.

Complete

N/A

Fire Extinguishers/Suppression Systems

The Commercial Cooking Fire Suppression System has been inspected within the last 6 months.

Complete

N/A

Fire extinguishers are clearly marked and accessible

Complete

N/A

All extinguisher(s) have been serviced / tagged by a fire extinguisher company within the last twelve months

Complete

N/A

Storage of Compressed Gas Cylinders

Compressed gas cylinders (Co2, helium, etc) are properly secured

Complete

N/A

Storage of Combustibles

Boiler rooms, mechanical rooms and electrical rooms are clear of any combustible materials

Complete

N/A

Combustible materials are stored properly, away from any heat source

Complete

N/A

Agreement

I have completed this form with accurate information to the best of my knowledge.

Type I AGREE in the box if you agree with the terms stated above.*

* indicates required fields.

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