Fire Department Pre Plan Template

Fire Department Pre Plan Template

The Fire Department Pre Plan form is a crucial document that provides essential information about a facility to assist firefighters during emergencies. This form includes details on facility layout, contact information, occupancy, structure specifications, and hazardous materials present. Ensure your safety and preparedness by filling out the form; click the button below to get started.

Table of Contents

The Fire Department Pre Plan form serves as a crucial tool for emergency responders, ensuring they have vital information at their fingertips when responding to incidents at various facilities. This comprehensive document captures essential details about the facility, including its name, location, and contact information for key personnel. It also includes diagrams and maps that illustrate the layout of the property, which can significantly aid in navigation during emergencies. The form outlines occupancy types, detailing the number of residents and any special needs individuals, along with designated assembly and evacuation locations. Furthermore, it provides critical structural information, such as the building's construction class, roof type, and dimensions, which help firefighters assess potential hazards. Fire access points and water supply details are also meticulously recorded, ensuring that first responders can quickly locate hydrants and alternative water sources. Protection features like sprinklers and gas shutoff valves are noted, along with any hazardous materials present on-site, including their quantities and associated risks. By consolidating this information, the Fire Department Pre Plan form enhances preparedness and response efficiency, ultimately contributing to the safety of both responders and the community.

Fire Department Pre Plan Sample

______________________________ 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: ________________________________________________________________

______________________________________________________________________________

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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: _______________________________________________________________________

_____________________________________________________________________________

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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: _______________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

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Page 3 of 6

******************************* 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

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Basic Floor Plan,

____ Floor

 

 

 

 

Make as many copies as necessary

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Document Attributes

Fact Name Description
Purpose The Fire Department Pre Plan form is designed to provide critical information about a facility to assist firefighters during emergencies.
Facility Identification Each form includes essential details such as the facility name and number, ensuring accurate identification during a response.
Contact Information Multiple contact points, including business and emergency phone numbers, are recorded to facilitate communication.
Occupancy Details The form captures occupancy specifics, including the number of adults, children, and special needs persons present in the facility.
Evacuation Plans Designated evacuation locations are specified to guide occupants safely out of the building in an emergency.
Water Supply Information Details about hydrants and alternative water supply sources, including flow rates and status, are crucial for firefighting efforts.
Protection Systems The form assesses existing fire protection systems, such as sprinklers and standpipes, to determine readiness.
HAZMAT Reporting Hazardous materials on-site must be documented, including their quantities and classifications, to ensure safe handling by responders.
Legal Compliance In Indiana, the use of such pre-plan forms is often guided by local fire codes and regulations, ensuring compliance with safety standards.
Regular Updates Facilities are encouraged to review and update their pre-plan forms regularly to reflect any changes in occupancy or structure.

Fire Department Pre Plan: Usage Instruction

Completing the Fire Department Pre Plan form is essential for ensuring safety and preparedness in emergency situations. Follow these steps carefully to fill out the form accurately.

  1. Start by entering the Fire Department name and location in the top section of the form.
  2. Fill in the Facility Name and Facility Number in the designated spaces.
  3. Provide any necessary Diagrams or Maps related to the facility.
  4. In the Contact Information section, fill out the address, city, state, and zip code.
  5. List the Manager's name and include both business and emergency phone numbers.
  6. For the 2nd Contact and 3rd Contact, repeat the process of entering names and phone numbers.
  7. Enter the name and phone number of the Alarm Company.
  8. Make notes in the Notes section as needed.
  9. In the Occupancy section, indicate the type of business or industry.
  10. Specify if the facility is Single Family or Multi Family and provide the number of apartments.
  11. List the number of adults, children, elderly, and special needs persons present in the facility.
  12. Identify the Employee/Resident Assembly Location and any Evacuation Locations.
  13. Note any Transportation Needs for evacuation.
  14. In the Structure Information section, provide details about the construction class, roof type, and number of stories.
  15. Fill in the dimensions of the building and any relevant structure notes.
  16. For Fire Access Information, indicate the main and secondary access points, roof access, and any lock boxes.
  17. In the Response Information section, specify the primary and secondary staging areas.
  18. Detail the Water Supply Information, including hydrants and alternative supplies, noting their volume, main size, and status.
  19. In the Protection Information section, indicate whether sprinklers, stand pipes, and shutoffs are present.
  20. Provide information about any hazardous materials under the HAZMAT section, including chemical names, locations, and quantities.
  21. If needed, attach additional sheets for more hazardous materials.
  22. Finally, review the entire form for accuracy before submission.

Frequently Asked Questions

  1. 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 help fire responders during emergencies. It includes details such as contact information, building structure, fire access points, and any hazardous materials present. This information ensures that firefighters can respond quickly and effectively to any incidents at the location.

  2. Who should fill out the Fire Department Pre Plan form?

    The form should be completed by the facility manager or a designated representative. It is important that the person filling out the form has a thorough understanding of the facility's layout, emergency procedures, and any special needs of the occupants. Accurate information is crucial for the safety of both the responders and the individuals in the building.

  3. What information is required on the form?

    The form requires various types of information, including:

    • Facility name and number
    • Contact details for the manager and emergency contacts
    • Occupancy details, such as the number of residents and any special needs
    • Structure information, including construction type and access points
    • Water supply details, such as hydrant locations and capacities
    • Hazardous materials present on-site

    Completing all sections of the form ensures that emergency responders have a comprehensive understanding of the facility.

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

    The form should be reviewed and updated regularly, especially when there are significant changes to the facility. Changes may include renovations, alterations in occupancy, or updates to hazardous materials. It is a good practice to review the form at least once a year or whenever there are major changes to ensure that the information remains accurate and useful for emergency responders.

Common mistakes

Completing the Fire Department Pre Plan form accurately is crucial for ensuring safety and effective response during emergencies. However, several common mistakes can hinder this process. Understanding these errors can help individuals provide the necessary information correctly.

One frequent mistake is leaving sections blank. Each part of the form serves a purpose, and missing information can lead to confusion during an emergency. For example, failing to fill in the Facility Name or Facility Number can prevent first responders from identifying the location quickly.

Another common error is providing outdated contact information. It is essential to ensure that all phone numbers, especially emergency contacts, are current. If a manager or contact has changed, the form should reflect this to avoid delays in communication.

People often overlook the importance of detailed notes. Providing additional context about the facility, such as unique hazards or special needs populations, can be invaluable. Insufficient notes can lead to misunderstandings during an emergency response.

Inaccurate occupancy information is also a significant issue. Individuals may not correctly report the number of occupants, including adults, children, and those with special needs. This information is vital for emergency responders to assess the situation effectively.

Another mistake involves incomplete water supply information. Each hydrant's status, volume, and size must be documented accurately. If this data is incorrect or missing, it can severely impact firefighting efforts.

Many people also fail to include the necessary details about fire protection systems. Information about sprinklers, standpipes, and shutoff valves should be included to provide a comprehensive understanding of the facility's safety measures.

Neglecting to indicate hazardous materials is another critical error. If chemicals are present, their names, quantities, and classifications must be documented. This information is essential for ensuring the safety of first responders and the surrounding community.

Lastly, not reviewing the completed form before submission can lead to overlooked errors. A final check can help catch mistakes and ensure all information is accurate and complete. Taking the time to verify details can make a significant difference in emergency situations.

Documents used along the form

The Fire Department Pre Plan form is an essential document for ensuring safety and preparedness in case of emergencies. Along with this form, several other documents are often used to provide comprehensive information about a facility and its emergency response procedures. Here are some of the key documents that complement the Pre Plan form:

  • Site Plan: This document includes a detailed layout of the facility, showing important features such as entrances, exits, and hazardous areas. It helps emergency responders understand the layout of the property quickly.
  • Emergency Contact List: This list contains names and phone numbers of key personnel who can be contacted during an emergency. It ensures that responders can reach the right people without delay.
  • Fire Safety Inspection Report: This report outlines the results of fire safety inspections conducted at the facility. It highlights any violations or necessary improvements, helping to maintain compliance with safety regulations.
  • Hazardous Materials Inventory: This document details any hazardous materials present on-site, including their quantities and locations. It is crucial for informing responders about potential risks during an emergency.
  • Evacuation Plan: This plan provides clear instructions on how to evacuate the building safely. It includes designated evacuation routes and assembly points for occupants, ensuring everyone knows what to do in an emergency.

These documents work together with the Fire Department Pre Plan form to create a well-rounded emergency response strategy. Having all this information readily available can make a significant difference in ensuring safety and efficiency during emergencies.

Similar forms

The Fire Department Pre Plan form serves a critical role in emergency preparedness by providing essential information about a facility. Several other documents share similarities with this form in terms of purpose and content. Below is a list of five such documents:

  • Emergency Action Plan (EAP): An Emergency Action Plan outlines procedures for responding to various emergencies, including fires. Like the Pre Plan form, it includes contact information, evacuation routes, and special considerations for individuals with disabilities or other needs.
  • Fire Safety Plan: This document details the strategies and procedures for fire prevention and response within a facility. Similar to the Pre Plan, it contains information about fire hazards, alarm systems, and evacuation plans, ensuring that all staff are aware of their roles during an emergency.
  • Building Evacuation Plan: A Building Evacuation Plan provides a clear layout of exit routes and assembly points for occupants during an emergency. This document, like the Pre Plan, emphasizes the importance of accessibility and includes information about the number of occupants and any special needs.
  • Hazardous Materials Inventory: This inventory lists all hazardous materials present in a facility, including their locations and safety information. Similar to the Pre Plan, it highlights critical details about chemical storage and potential risks, which are vital for emergency responders.
  • Site Safety Plan: A Site Safety Plan outlines safety protocols and emergency procedures specific to a worksite. It shares similarities with the Pre Plan by addressing potential hazards, emergency contacts, and evacuation procedures tailored to the unique aspects of the site.

Dos and Don'ts

When filling out the Fire Department Pre Plan form, attention to detail is crucial. Here are some important dos and don'ts to consider:

  • Do ensure all contact information is accurate and up to date.
  • Do provide clear diagrams and maps of the facility layout.
  • Do include the number of persons present, specifying adults, children, elderly, and special needs individuals.
  • Do specify the main and secondary access points for emergency responders.
  • Do indicate the locations of fire hydrants and their status.
  • Don't leave any sections blank; incomplete forms can delay response times.
  • Don't underestimate the importance of noting special hazards, such as chemicals on site.
  • Don't forget to update the form regularly, especially after any significant changes to the facility.
  • Don't use vague terms; be specific in your descriptions to avoid confusion.
  • Don't neglect to include evacuation routes and assembly locations for employees and residents.

By following these guidelines, you can help ensure that your Fire Department Pre Plan form is both effective and useful in the event of an emergency.

Misconceptions

  • Misconception 1: The Pre Plan form is only necessary for large facilities.
  • Many believe that only large buildings require a Pre Plan. In reality, every facility, regardless of size, benefits from having a detailed plan. Small businesses or residential areas can present unique challenges during emergencies.

  • Misconception 2: The information on the form is only relevant to the fire department.
  • While the fire department uses this information, it is also crucial for facility managers, employees, and emergency responders. Having accurate details can save lives and improve response times.

  • Misconception 3: Once submitted, the Pre Plan does not need to be updated.
  • Many assume that the Pre Plan is a one-time task. However, facilities change over time. Regular updates are essential to ensure that the information remains accurate and useful.

  • Misconception 4: The Pre Plan form is too complicated to fill out.
  • Some people find the form intimidating. In truth, it is designed to be straightforward. Each section addresses specific needs, making it easier to gather necessary information systematically.

  • Misconception 5: Only the owner of the facility can fill out the form.
  • While the owner may have the most comprehensive knowledge, employees or managers can also contribute valuable information. Collaboration can enhance the accuracy of the Pre Plan.

  • Misconception 6: The Pre Plan is only for fire emergencies.
  • Although it is primarily focused on fire safety, the Pre Plan can also address other emergencies, such as hazardous materials incidents or natural disasters. A well-rounded plan prepares for various scenarios.

  • Misconception 7: The Pre Plan does not require diagrams or maps.
  • Visual aids like diagrams and maps are vital components of the Pre Plan. They help responders understand the layout of the facility, including access points and evacuation routes.

  • Misconception 8: Submitting the Pre Plan is the end of the process.
  • Many believe that once the form is submitted, their responsibilities end. In reality, ongoing communication with the fire department and regular drills are necessary to ensure everyone is prepared in case 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 some key takeaways to consider:

  • Complete all sections: Ensure that every part of the form is filled out accurately. Missing information can hinder emergency response.
  • Provide clear contact details: List all relevant contacts, including managers and emergency contacts. This information is vital for quick communication during an incident.
  • Include occupancy details: Specify the type of occupancy and the number of people present. This helps responders understand the potential risks involved.
  • Document structure information: Note construction class, roof type, and building dimensions. This data assists firefighters in assessing the building's vulnerabilities.
  • Identify access points: Clearly indicate main and secondary access routes. This information can save valuable time during an emergency response.
  • Detail water supply sources: List hydrants and alternative water supplies, including their status and capacity. Knowing where water sources are located is critical for firefighting efforts.
  • Report hazardous materials: If applicable, include details about hazardous substances present on-site. This information is crucial for ensuring the safety of responders and the community.

By following these guidelines, you can enhance the effectiveness of the Fire Department Pre Plan form and contribute to a safer environment.