Date of Inspection (DD/MM/YYYY):
Time of Inspection:
AM
PM
Sprinkler Inspection Test:
Dartmouth College
Test Date (DD/MM/YYYY):
Sprinkler Inspection:
Dartmouth College
Inspection Date (DD/MM/YYYY):
Sprinkler System Condition:
Pass
Fail
Comments:
Fire Extinguisher Inspection:
Dartmouth College
Inspection Date (DD/MM/YYYY):
Emergency Lighting Status:
Pass
Fail
Comments:
Exit Sign Status:
Pass
Fail
Comments:
Means of Egress Status (Stairwells, Hallways, Fire Escapes, etc.):
Pass
Fail
Comments:
Fines:
Pass
Fail
Comments:
Overall Comments:
ALL WORK REQUIRED ABOVE MUST BE COMPLETED WITHIN 2 WEEKS OF THE RECEIPT OF THIS REPORT TO AVOID A $200 PER WEEK FINE.
Inspection completed by:
Report Submission
Please click on the "Submit Report" button to send the report. You will be redirected to a webpage confirming that you have successfully submitted the GLOS Fire, Health and Safety Inspection. If you are not redirected, the form was not successfully submitted.
Last Updated: 7/25/18
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