What is your Fire Warden area?

Fire Extinguishers

Fire Escape Routes

Fire Safety Notices and Signs

Fire Exits

Electrical Equipment

Heating Equipment

General Housekeeping

Signed: (Fire Warden) *.............................................................Date: ............................

Signed: (Safety Manager) *........................................................ Date: ........................... Fire Wardens & ASMs should keep a copy of this form for their records. The Fire Warden should forward the completed form, signed* and dated* to the appropriate Area Safety Manager. The ASM should forward the completed copy to the SHE office and action remedial measures where necessary. *When submitting an electronic copy of this form, insertion of the Fire Warden’s / Area Safety Manager’s name with the appropriate date will constitute an authorisation signature.

Comments: (please use this space to support any of your answers)

Please add any photo evidence to support your answers here.

Are extinguishers in labelled locations?

Are emergency exit routes clearly signposted?