APPENDIX “A”
Anywhere Fire Services
SUMMARY SUBMISSION
Re: Review No. FM-______- Inspection Order concerning premises located at ______Street,______ON.
Date: ______
My name is ______and I am a Fire Prevention Officer with the ______Fire Service. Under the Authority of the Fire Protection and Prevention Act (section 11), I am designated as an Assistant to the Fire Marshal.
On ______, 20___ I attended ______Street,______ON; which is:
(Inspector to enter building description, type of occupancy, operating name etc as applicable)
and conducted a Fire Safety Inspection under the authority of the Fire Protection and Prevention Act, 1997, Section 19 (2), for the purposes of assessing fire safety.
Also in attendance with me was ______who under the Authority of the______is designated as an ______.
I began the fire safety inspection of the building by making observations, documenting them with photos, and then recording the appropriate notes after exiting and as soon as reasonably practicable.
I observed, documented and noted the building to be a:(Insert summary here)
(**Inspector to provide more information/description, bldg. height, size, construction type, current operations, # of occupants, use of bldg., description of where certain occupancies or suites/ rooms are located.
Reference and include any additional appendices you wish to submit that reference relevant supporting documents, labelled pictures and correspondence as applicable to support the FSI Order.
It should provide a clear description of the building, the chronological history of events to date as applicable and clearly summarize what the fire safety issues are. Please see the following paragraphs which are meant as an example only.
E.g.“The building is a single storey commercial building of combustible construction operating as a commercial business with regular hours of commerce and employees; Commercial use and business activities are consisting of, but not limited to, cooking operationsthat produce smoke and grease laden vapours and processes of food to be sold to the public.
The day of the fire safety inspection I observed, documented and noted commercial cooking equipment in operation consisting of deep fat fryers, a grill, as well as multiple fridges containing food materials and canned drinks, counters with sinks, and combustible package materials typically used for food production and retailing.
In addition I observed, documented and noted the following contraventions of the Fire Code O.Reg. 213/07 as amended: (See attached Appendix B, photo log)
1)Damages to the existing fire separation on the interior of the occupancy. (Various methods of construction and combustible materials used to build around and extend previous mobile trailer.)
2)The single existing portable fire extinguisher had no maintenance record available and no indication it had been inspected in conformance with NFPA 10, "Portable fire Extinguishers".
3)Hood, ducts, filters, and exhaust ventilation systems with the accumulation of combustible deposits.
4)Internal Hood joints, seams and penetrations of the hood had openings and lacked a liquid tight weld to make grease tight.
5)Electrical installations that pose a risk of fire because of inadequacy or want of repair of the installation and their wiring.
6)Evidence of accumulation of combustible deposits due to lack of exhaust ventilation systems installed in conformance with NFPA 96, "Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations" on screen window, interior walls, wiring, exhaust system duct work to exterior of building, fan blades.
7)Commercial cooking equipment installed with the lack of fire protection systems installed in conformance with NFPA 96, "Standard for Ventilation Control and Fire Protection of Commercial Cooking Operations".
On ______a Fire Safety Inspection Order was served by ______to ______identifying all observed contraventions of the Fire Code O.Reg. 213/07as amended.
If you require further information or wish to review please contact:
(Insert all applicable CONTACT Information):
SIGNED: ______Date:______, 20___
(Inspector Name/Title Printed)
______
Page 1 of 2