Get Fire Department Pre Plan Form

Get Fire Department Pre Plan Form

The Fire Department Pre Plan form is a crucial document that helps emergency responders prepare for incidents at specific facilities. By gathering essential information such as contact details, occupancy types, and water supply resources, this form ensures that firefighters can respond effectively and safely. To contribute to the safety of your facility, please fill out the form by clicking the button below.

Structure

The Fire Department Pre Plan form serves as a vital tool for emergency responders, providing essential information about a facility before an incident occurs. This comprehensive document includes details such as the facility's name, location, and contact information for key personnel, ensuring that first responders can reach the right individuals quickly. It contains diagrams and maps that illustrate important structural features and access points, which are crucial during emergencies. Additionally, the form outlines occupancy details, including the number of residents and any special needs individuals, helping responders prepare for evacuation and care during a crisis. Information about the building's construction, fire access routes, and water supply sources is also included, allowing for effective planning and response strategies. Furthermore, the form addresses protection measures in place, such as sprinklers and emergency shutoffs, and identifies hazardous materials that may be present on-site. By gathering all this information, the Fire Department Pre Plan form enhances safety and efficiency in emergency situations, ultimately protecting lives and property.

Fire Department Pre Plan Preview

______________________________ Fire Department

_____________________________________________

__________________, IN ______________

Facility Name:______________________________________ Facility Number: _________

Diagrams, Maps: _______________________________________________________________

******************************* Contact Information *******************************

Address: ______________________________ City: _____________ State: ___ Zip: ________

Manager:

_______________________

Business Phone:

(___) ____-_______

Emergency Phone (1): (___) ____-_______

Emergency Phone (2): (___) ____-_______

2nd Contact:

_______________________

Business Phone:

(___) ____-_______

Emergency Phone (1): (___) ____-_______

Emergency Phone (2): (___) ____-_______

3rd Contact:

_______________________

Business Phone:

(___) ____-_______

Emergency Phone (1): (___) ____-_______

Emergency Phone (2): (___) ____-_______

Alarm Company: ___________________________ Phone: (____) ____-______

Notes: _______________________________________________________________________

_____________________________________________________________________________

******************************* Occupancy ***************************************

Business: ___

Industry: ___

Notes: __________________________________________

Single Family: ___

Multi Family: ___

# Apartments: ___

Number of Persons:

 

 

 

 

 

Adults:_____

 

Children: _____

Elderly: _____

Special Needs Persons: _____

Notes: __________________________________________

Special Needs Locations:

______________________________________________________

Employee/Resident Assembly Location:

__________________________________________

Evacuation Location (1):

______________________________________________________

Evacuation Location (2):

______________________________________________________

Transportation Needs:

 

______________________________________________________

________________________________________________________________________

Notes: ________________________________________________________________________

________________________________________________________________________

******************************* Structure Information *****************************

Construction Class:

____________

Roof Type:

__________________

Number of Stories:

____________

Roof Covering:

__________________

Length, Width, Height:

____________

Building Classification: _________________

Structure Notes: ________________________________________________________________

______________________________________________________________________________

http://www.henrycoema.org/forms/FDPreplanTemplate.pdf

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******************************* Fire Access Information ***************************

Main Access:

____________________________________________________________

Secondary Access:

____________________________________________________________

Roof Access:

____________________________________________________________

Attic Access:

____________________________________________________________

Basement:

____________________________________________________________

Lowest Access:

____________________________________________________________

Lock Box:

____________________________________________________________

Alarm Panel:

____________________________________________________________

Annunciator Panel:

____________________________________________________________

Notes: _______________________________________________________________________

_____________________________________________________________________________

******************************* Response Information ******************************

Primary Staging:

____________________________________________________________

Secondary Staging:

____________________________________________________________

******************************* Water Supply Information**************************

Hydrant-1 ______________________________________________________________

Volume (GPM)

________

Main Size:

_____

Status: ______________

Notes: _______________________________________________________________________

_____________________________________________________________________________

Hydrant-2 ______________________________________________________________

Volume (GPM)

________

Main Size:

_____

Status: ______________

Notes: _______________________________________________________________________

_____________________________________________________________________________

Hydrant-3 ______________________________________________________________

Volume (GPM) ________ Main Size: _____ Status: ______________

Notes: _______________________________________________________________________

_____________________________________________________________________________

http://www.henrycoema.org/forms/FDPreplanTemplate.pdf

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Alt Supply-1: ______________________________________________________________

Volume (GPM) ________ Main Size: _____ Status: ______________

Notes: _______________________________________________________________________

_____________________________________________________________________________

Alt Supply-2 ______________________________________________________________

Volume (GPM) ________ Main Size: _____ Status: ______________

Notes: _______________________________________________________________________

_____________________________________________________________________________

******************************* Protection Information *****************************

 

Yes/No

Special Notes

Sprinklers:

_____

_______________________________________________

Spare Heads:

_____

_______________________________________________

FD Connection:

_____

_______________________________________________

Stand Pipe:

_____

_______________________________________________

Gas Shutoff:

_____

_______________________________________________

Electrical Shutoff:

_____

_______________________________________________

Water Shutoff:

_____

_______________________________________________

Notes: _______________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

http://www.henrycoema.org/forms/FDPreplanTemplate.pdf

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******************************* HAZMAT ****************************************

Chemical Name:

___________________________________________________________

Location:

 

___________________________________________________________

Quantity:

_____________ Gallons/Pounds

 

Flammable:

____

Toxic: ____

Corrosive: ____

Oxidizer: ____

UN #: _____

Guide # _____

 

 

NFPA 704:

Fire __ Health __ Reactivity __ Special _________

Chemical Name:

___________________________________________________________

Location:

 

___________________________________________________________

Quantity:

_____________ Gallons/Pounds

 

Flammable:

____

Toxic: ____

Corrosive: ____

Oxidizer: ____

UN #: _____

Guide # _____

 

 

NFPA 704:

Fire __ Health __ Reactivity __ Special _________

Chemical Name:

___________________________________________________________

Location:

 

___________________________________________________________

Quantity:

_____________ Gallons/Pounds

 

Flammable:

____

Toxic: ____

Corrosive: ____

Oxidizer: ____

UN #: _____

Guide # _____

 

 

NFPA 704:

Fire __ Health __ Reactivity __ Special _________

Chemical Name:

___________________________________________________________

Location:

 

___________________________________________________________

Quantity:

_____________ Gallons/Pounds

 

Flammable:

____

Toxic: ____

Corrosive: ____

Oxidizer: ____

UN #: _____

Guide # _____

 

 

NFPA 704:

Fire __ Health __ Reactivity __ Special _________

Copy this sheet and attach as many as necessary

http://www.henrycoema.org/forms/FDPreplanTemplate.pdf

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Basic Site Plan

http://www.henrycoema.org/forms/FDPreplanTemplate.pdf

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Basic Floor Plan,

____ Floor

 

 

 

 

Make as many copies as necessary

http://www.henrycoema.org/forms/FDPreplanTemplate.pdf

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Document Data

Fact Name Description
Purpose The Fire Department Pre Plan form is designed to gather essential information about a facility to assist in emergency response planning.
Contact Information The form requires detailed contact information for key personnel, including managers and emergency contacts, to ensure quick communication during emergencies.
Occupancy Details Occupancy information, such as the number of residents and special needs individuals, is collected to facilitate effective evacuation and rescue operations.
Governing Laws In Indiana, the use of this form is governed by local fire codes and regulations, ensuring compliance with state safety standards.

How to Use Fire Department Pre Plan

Filling out the Fire Department Pre Plan form is an important step in ensuring safety and preparedness in case of emergencies. This form collects essential information about a facility, including contact details, occupancy, structure information, and water supply. Completing it thoroughly helps first responders effectively plan for emergencies.

  1. Begin by entering the Fire Department name and the location details, including city and state.
  2. Fill in the Facility Name and Facility Number.
  3. Provide any relevant Diagrams or Maps that may assist in understanding the layout of the facility.
  4. In the Contact Information section, fill out the address, city, state, and zip code of the facility.
  5. Enter the names and phone numbers for the Manager, Emergency Contacts, and the Alarm Company.
  6. Indicate the type of Occupancy by checking the appropriate boxes for business, industry, single-family, or multi-family.
  7. Provide details about the number of persons in the facility, categorizing them into adults, children, elderly, and special needs persons.
  8. List the Employee/Resident Assembly Location and any Evacuation Locations.
  9. Complete the Structure Information section, including construction class, roof type, number of stories, and building dimensions.
  10. Detail the Fire Access Information, including main and secondary access points, as well as any attic or basement access.
  11. Fill out the Response Information, specifying primary and secondary staging areas.
  12. In the Water Supply Information section, provide details about hydrants and alternative water supplies, including volume and status.
  13. Indicate the presence of any Protection Information such as sprinklers, standpipes, and shutoff valves.
  14. Document any HAZMAT materials, including chemical names, locations, quantities, and hazard classifications.
  15. If necessary, copy the HAZMAT sheet for additional entries and attach them to the form.

Key Facts about Fire Department Pre Plan

What is the purpose of the Fire Department Pre Plan form?

The Fire Department Pre Plan form is designed to provide essential information about a facility to local fire departments. This information helps first responders understand the layout, hazards, and emergency protocols of a building before an incident occurs. By having this information readily available, firefighters can respond more effectively and safely during emergencies.

Who should fill out the Fire Department Pre Plan form?

The form should be completed by the facility manager or a designated representative who is familiar with the building and its operations. This person should have knowledge of the facility's layout, emergency contacts, and any hazardous materials present. It is crucial that the information is accurate and up-to-date to ensure the safety of both the occupants and the first responders.

What types of information are required on the form?

The form requires various details, including the facility name, contact information, occupancy type, structure information, fire access points, water supply details, and any hazardous materials present. Additionally, it asks for information about emergency contacts and evacuation procedures. All of this information is vital for effective emergency planning and response.

How often should the Fire Department Pre Plan form be updated?

The form should be reviewed and updated at least annually or whenever there are significant changes to the facility. Changes may include renovations, alterations in occupancy, or updates in hazardous materials. Regular updates ensure that the fire department has the most current information, which is critical during an emergency response.

What happens to the completed Fire Department Pre Plan form?

Once completed, the form should be submitted to the local fire department. They will keep it on file for reference during emergencies. It is also advisable for the facility to maintain a copy of the form on-site, easily accessible to staff and emergency responders. This practice can enhance safety and preparedness in case of an emergency.

Is there a specific format for submitting the Fire Department Pre Plan form?

The form is typically available in a printable format, allowing for handwritten entries. Some fire departments may also accept electronic submissions. It is important to check with your local fire department for their preferred submission method. Regardless of the format, ensure that all sections are filled out completely to provide comprehensive information.

Common mistakes

Filling out the Fire Department Pre Plan form is crucial for ensuring safety and effective emergency response. However, many individuals make common mistakes that can hinder the process. One frequent error is leaving out essential contact information. This includes not only the primary contact but also secondary contacts. Missing phone numbers can lead to delays during emergencies, making it vital to double-check that all contact fields are filled accurately.

Another mistake often made is neglecting to provide detailed occupancy information. The form asks for the number of adults, children, and individuals with special needs. Omitting this data can lead to confusion during an emergency, as first responders may not have a clear understanding of how many people are present in the facility. This information is crucial for effective evacuation and rescue operations.

Many people also overlook the importance of accurately describing the structure and its features. For instance, failing to indicate the number of stories or the type of roof can complicate firefighting efforts. Firefighters rely on this information to plan their approach and ensure they have the right equipment on hand. Always take the time to fill out these sections thoroughly.

In addition, some individuals forget to include detailed water supply information. The form requests specifics about hydrants and alternative water supplies, including their status and volume. If this information is missing, it can slow down firefighting efforts, as responders may need to search for water sources during a critical time.

Another common pitfall is not updating the form regularly. Facilities often change over time, whether through renovations or changes in occupancy. If the form is not kept current, it can lead to outdated information being used in an emergency, which can have serious consequences.

Lastly, people sometimes fail to provide notes or additional details that could be helpful for first responders. This might include information about hazardous materials on-site or specific evacuation routes. These notes can be lifesaving, so it’s essential to utilize the space provided for any additional context that could assist emergency personnel.

Documents used along the form

The Fire Department Pre Plan form serves as a crucial document for ensuring safety and preparedness in various facilities. Alongside this form, several other documents are often utilized to provide comprehensive information about a location. Each of these documents plays a specific role in enhancing the effectiveness of fire response and safety protocols.

  • Site Plan: This document provides a detailed layout of the facility, indicating important features such as exits, fire hydrants, and access points. It helps firefighters quickly understand the layout of the building during an emergency.
  • Hazardous Materials Inventory: This inventory lists all hazardous materials present on the premises, including their locations and quantities. Knowing the types and amounts of hazardous substances allows firefighters to prepare adequately for potential risks during a fire response.
  • Emergency Contact List: This list includes contact information for key personnel, such as managers and emergency coordinators. Having quick access to these contacts ensures that firefighters can communicate effectively and gather necessary information during an incident.
  • Evacuation Plan: This document outlines the procedures for evacuating occupants in the event of a fire. It specifies routes, assembly points, and roles for staff, ensuring a coordinated and efficient evacuation process.

Utilizing these documents in conjunction with the Fire Department Pre Plan form creates a comprehensive safety framework. Together, they enhance preparedness and response capabilities, ultimately contributing to the safety of occupants and first responders alike.

Similar forms

The Fire Department Pre Plan form serves a critical role in ensuring safety and preparedness. It shares similarities with several other important documents. Here are four documents that are similar and how they relate:

  • Emergency Response Plan: Like the Fire Department Pre Plan, this document outlines procedures for responding to emergencies. It includes contact information and specific actions to take in various scenarios, ensuring that all personnel are prepared for incidents.
  • Building Evacuation Plan: This document details evacuation routes and assembly points, much like the evacuation locations listed in the Pre Plan. Both documents aim to facilitate safe and efficient evacuations during emergencies.
  • Hazardous Materials Inventory: Similar to the HAZMAT section of the Pre Plan, this inventory lists chemicals and their locations within a facility. It ensures that first responders are aware of potential hazards when responding to an incident.
  • Site Safety Plan: This plan outlines safety protocols and emergency contacts, paralleling the information provided in the Pre Plan. Both documents are essential for maintaining safety standards and ensuring that all personnel understand the risks associated with their environment.

Dos and Don'ts

When filling out the Fire Department Pre Plan form, it is important to be thorough and accurate. Here are some guidelines to follow:

  • Do provide complete contact information for all relevant parties.
  • Do include accurate details about the facility's structure and occupancy.
  • Do clearly indicate any special needs or vulnerable populations within the facility.
  • Do specify all access points and water supply information.
  • Don't leave any sections blank; every part of the form is important.
  • Don't use abbreviations that may not be understood by emergency responders.
  • Don't forget to update the form regularly, especially after any changes to the facility.
  • Don't hesitate to ask for assistance if you are unsure about any part of the form.

Misconceptions

Misconceptions about the Fire Department Pre Plan form can lead to misunderstandings regarding its purpose and importance. Here are eight common misconceptions, along with clarifications to help foster a better understanding.

  • It is only for large facilities. Many believe that only large buildings require a Pre Plan form. In reality, all facilities, regardless of size, can benefit from having a plan in place to ensure safety and preparedness.
  • It is a one-time requirement. Some people think that once the form is filled out, it does not need to be updated. However, changes in occupancy, structure, or hazards necessitate regular updates to keep the information current and relevant.
  • Only the fire department needs it. A misconception exists that only firefighters utilize the Pre Plan form. In truth, it serves as a vital resource for facility managers, emergency responders, and safety personnel, promoting a coordinated response during emergencies.
  • It is too complicated to fill out. Many feel overwhelmed by the form’s details. While it may seem extensive, the information is crucial for safety. Assistance is often available from local fire departments to help complete the form accurately.
  • It only addresses fire-related issues. Some individuals think the Pre Plan form solely focuses on fire hazards. In fact, it encompasses various safety concerns, including hazardous materials, evacuation routes, and special needs considerations.
  • It is not legally required. There is a belief that completing the Pre Plan form is optional. In many jurisdictions, it is a requirement, especially for businesses, to ensure compliance with safety regulations and to protect lives.
  • It is not necessary for residential properties. Some assume that only commercial properties need a Pre Plan. However, residential properties, especially those with special needs residents, can greatly benefit from having a plan in place for emergencies.
  • Once submitted, it is out of sight, out of mind. Many think that after submitting the form, it will not be revisited. In reality, ongoing communication with the fire department is encouraged to ensure that the plan remains effective and relevant.

Understanding these misconceptions can help foster a culture of safety and preparedness in the community. By recognizing the value of the Fire Department Pre Plan form, individuals and organizations can take proactive steps to protect themselves and others in the event of an emergency.

Key takeaways

Filling out the Fire Department Pre Plan form is essential for ensuring safety and preparedness in case of emergencies. Here are key takeaways to consider:

  • Accurate Information: Ensure that all contact information is current and correct. This includes business and emergency phone numbers for key personnel.
  • Facility Details: Clearly specify the facility name and number, along with its address and occupancy type. This helps responders identify the location quickly.
  • Occupancy Information: Document the number of occupants, including adults, children, elderly, and those with special needs. This information is crucial for evacuation planning.
  • Evacuation Routes: Identify and clearly mark primary and secondary evacuation locations. This aids in swift and safe exits during emergencies.
  • Access Points: Include details about main and secondary access points to the building. Also, specify roof, attic, and basement access for firefighters.
  • Water Supply: List hydrants and alternative water supplies, including their volume and status. This information is vital for firefighting efforts.
  • Protection Systems: Indicate the presence of fire protection systems, such as sprinklers and standpipes. Note any shutoff valves for gas and electricity.
  • Hazardous Materials: Identify any hazardous materials on-site, including their locations and quantities. This is crucial for the safety of responders and occupants.

Completing this form thoroughly enhances the safety of both the facility and the community. Regular updates and reviews of the information are also recommended to maintain its accuracy.