Self Inspection Form Page 3
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5IFC/NFPA
Y/N/NA
EXPLAIN
Storage
Height of stored items at least 18” below sprinkler heads
315.2.1
Stored items at least 24” below ceiling
315.2.1
315.2.3
Combustibles not stored near heat
304.3.1
Materials susceptible to spontaneous ignition, such as oily rags, shall be
stored in a listed disposal container
3404.3.4.4
Flammable safe storage cabinet present, needed? (yes/no)
3404.3.4.4
Storage of the less than 10 gal. shall be in approved containers
3404.3.4.4
Storage in excess of 10 gal. shall be in a approved liquid storage cabinet
3003.5.3
Compressed gas cylinders chained & upright, protective caps in place
310
No smoking signs/hazard signs posted & enforced where appropriate
304.3.3
Dumpsters (larger than 1.5 cu. yds.) shall not be placed within 5 feet of
combustible walls, openings or roof eave lines
104
Unsafe of dangerous conditions present?
Any storage of lawn mowers, snow blowers, etc… in the building
34
34
Are there any NFPA 704 placards on the building
315.2
Storage of combustibles shall be neat and orderly
310
Proper receptacles provided for smoking material
Electrical
605.5
Unsafe use of extension cords
605.6
Damaged, open splices, or modified electrical wiring present-all wiring
605.1
needs to be covered to prevent accidental shock.
605.6
Approved covers on all electrical boxes & switches
Clear access to panel – at least 36 “
605.3
605.3.1
Electrical panel properly labeled
605.4
Use of non-approved multi-plug adapters
NEC
Properly rated fuses in panel
605.3.1
Electrical & Mechanical Rooms need to be identified
Notes/Comments
904.11.6.3
Hood & Duct System clean
NFPA 96
NFPA 96
Fusible links replaced semi-annually
904.11
Current Inspection Tag
NFPA 96
901.6.2
Kitchen suppression system inspected & tested (every 6 mos.)
904.11.6.4
CONFIDENTIAL
3 of 5
6/1/2015
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