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The Fire Department Pre Plan form serves as a crucial tool for ensuring safety and preparedness in various facilities. This comprehensive document collects essential information about a building, including its layout, contact details, and emergency protocols. Key sections of the form address aspects such as facility identification, contact information for managers and emergency personnel, and specifics about the building's occupancy type and structure. Additionally, the form includes vital fire access information, water supply details, and any hazardous materials present on-site. By providing clear diagrams and maps, the form helps fire departments visualize the premises, facilitating efficient response strategies. Moreover, it outlines critical safety features, such as sprinkler systems and emergency shutoff locations, which are essential during a fire emergency. Overall, the Fire Department Pre Plan form is designed to enhance communication and coordination between facility managers and emergency responders, ultimately aiming to protect lives and property in the event of a fire or other emergencies.

Fire Department Pre Plan Example

______________________________ 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: _______________________________________________________________________

_____________________________________________________________________________

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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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******************************* 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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File Breakdown

Fact Name Description
Purpose The Fire Department Pre Plan form is designed to provide critical information about a facility to aid in emergency response and planning.
Contact Information The form includes sections for multiple contacts, ensuring that emergency responders can reach key personnel quickly.
Occupancy Details It captures important occupancy details such as the number of residents and special needs individuals, which helps in evacuation planning.
Legal Requirement In Indiana, compliance with local fire codes mandates the completion of this form to enhance safety and preparedness in emergency situations.

Guide to Using Fire Department Pre Plan

Completing the Fire Department Pre Plan form is an important step in ensuring safety and preparedness for your facility. This form collects crucial information about your building, its occupants, and emergency contacts. Follow the steps below to fill out the form accurately.

  1. Start with the top section. Fill in the Fire Department name and location, including the city and state.
  2. Enter the Facility Name and Facility Number.
  3. Provide any relevant Diagrams or Maps that may assist in emergency response.
  4. In the Contact Information section, fill in the address, city, state, and zip code.
  5. List the Manager's name and their business and emergency phone numbers.
  6. Include information for a 2nd Contact and a 3rd Contact, along with their respective phone numbers.
  7. Document the Alarm Company name and phone number.
  8. Fill in any Notes that may be important for emergency responders.
  9. In the Occupancy section, indicate the type of business or industry and any relevant notes.
  10. Specify if the facility is Single Family or Multi Family, and provide the number of apartments and total persons (adults, children, elderly, special needs).
  11. Identify the Employee/Resident Assembly Location and any Evacuation Locations.
  12. Note any Transportation Needs.
  13. In the Structure Information section, fill in the construction class, roof type, number of stories, and dimensions.
  14. Document the Building Classification and any Structure Notes.
  15. For Fire Access Information, provide details on main and secondary access points, roof and attic access, and lock box information.
  16. Fill in the Response Information for primary and secondary staging areas.
  17. In the Water Supply Information section, list hydrants and alternative water supplies, including their volume, main size, and status.
  18. Check the boxes for Protection Information such as sprinklers, stand pipes, and shutoff valves, and provide any notes.
  19. In the HAZMAT section, list any hazardous materials present, including chemical names, locations, quantities, and relevant classifications.
  20. If necessary, copy the HAZMAT sheet for additional chemicals.
  21. Finally, ensure all sections are completed and review the form for accuracy.

Get Answers on Fire Department Pre Plan

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

The Fire Department Pre Plan form serves as a crucial tool for emergency responders. It provides essential information about a facility, including its layout, contact details, and specific hazards. This information helps firefighters and other emergency personnel understand the environment they will be working in during an emergency, allowing for quicker and more effective responses.

Who should complete the Fire Department Pre Plan form?

Typically, facility managers or owners are responsible for completing the Fire Department Pre Plan form. It’s important for those who are familiar with the layout and operations of the facility to provide accurate and detailed information. Involving key personnel ensures that all necessary details are captured effectively.

What kind of information is required on the form?

The form requires various types of information, including:

  • Facility name and address
  • Contact information for key personnel
  • Occupancy details, such as the number of residents or employees
  • Structure information, including construction type and access points
  • Water supply details, such as hydrant locations and capacity
  • Any hazardous materials present on-site

Providing this information helps ensure that emergency responders are well-prepared for any situation.

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

It’s advisable to review and update the Fire Department Pre Plan form at least once a year or whenever significant changes occur. Changes might include renovations, alterations in occupancy, or the introduction of new hazardous materials. Keeping this information current helps maintain safety and preparedness.

What are the benefits of having a completed Pre Plan form?

A completed Pre Plan form offers numerous benefits, including:

  1. Improved safety for both occupants and emergency responders.
  2. Faster response times during emergencies.
  3. Better communication between facility management and fire departments.
  4. Enhanced understanding of potential hazards.

These advantages can make a significant difference in emergency situations.

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

Yes, the Fire Department Pre Plan form typically follows a structured format, which includes sections for contact information, occupancy details, structure information, fire access, and more. Using the standard format ensures that all necessary information is captured and makes it easier for emergency responders to find what they need quickly.

What should I do if my facility contains hazardous materials?

If your facility contains hazardous materials, it is crucial to provide detailed information on the Pre Plan form. This includes the type of chemicals, their locations, and any safety measures in place. Clearly indicating this information helps emergency responders take the necessary precautions when responding to incidents involving hazardous materials.

Can I access the Fire Department Pre Plan form online?

Yes, the Fire Department Pre Plan form is often available online through your local fire department's website. Many departments provide downloadable templates that you can fill out and submit. This accessibility makes it easier for facility managers to complete and update the form as needed.

Who should I contact if I have questions about filling out the form?

If you have questions about the Fire Department Pre Plan form, it’s best to contact your local fire department directly. They can provide guidance on how to fill out the form correctly and ensure that you include all necessary information. Engaging with them can also help build a strong relationship between your facility and emergency responders.

Common mistakes

Completing the Fire Department Pre Plan form is a critical step for ensuring safety and preparedness in case of emergencies. However, many individuals make common mistakes that can hinder the effectiveness of this essential document. Recognizing these errors can lead to better planning and improved safety outcomes.

One frequent mistake is incomplete contact information. Failing to provide accurate and comprehensive contact details for the facility manager and key personnel can lead to delays in communication during an emergency. It is vital to ensure that all phone numbers are correct and that alternative contacts are listed. This facilitates swift coordination among emergency responders.

Another common error is neglecting to detail occupancy information. This section should include the number of adults, children, and individuals with special needs present in the facility. Missing this information can complicate evacuation efforts and hinder rescue operations. Accurate occupancy data helps first responders assess potential risks and allocate resources effectively.

Many people also overlook the importance of structure information. Failing to specify construction class, roof type, and other structural details can lead to miscalculations in fire response strategies. First responders rely on this information to understand the building's vulnerabilities and develop an effective approach to firefighting and rescue.

Inadequate documentation of fire access information is another critical mistake. This includes specifying main and secondary access points, as well as roof and attic access. Without clear directions, emergency personnel may waste valuable time searching for entry points, potentially exacerbating the situation. Clarity in this section is essential for efficient response.

Additionally, some individuals provide insufficient details regarding water supply information. It is crucial to include the status, volume, and main size of hydrants and alternative water supplies. Inadequate information can hinder firefighting efforts, especially in large or complex structures where water supply is critical for effective fire suppression.

Lastly, neglecting to document hazardous materials accurately can have severe consequences. This section must include chemical names, quantities, and associated risks. Incomplete or incorrect information can put first responders and occupants at risk. Properly identifying hazardous materials ensures that emergency personnel are prepared for any potential dangers they may encounter.

In conclusion, paying close attention to these common mistakes can significantly enhance the effectiveness of the Fire Department Pre Plan form. Properly completed forms not only aid emergency responders but also contribute to the overall safety of the facility and its occupants.

Documents used along the form

The Fire Department Pre Plan form is an essential document for emergency responders, providing crucial information about a facility's layout, contact details, and emergency procedures. In addition to this form, several other documents are often utilized to ensure a comprehensive understanding of the site and to enhance safety measures. Below is a list of these documents, each serving a specific purpose in the planning and response process.

  • Site Plan: This document provides a detailed layout of the facility, including building dimensions, access points, and the location of key features such as fire hydrants and emergency exits. It helps responders visualize the site and plan their approach during emergencies.
  • Emergency Contact List: This list includes names and phone numbers of key personnel, such as facility managers, safety officers, and emergency contacts. Having this information readily available allows first responders to quickly reach the right individuals for assistance.
  • Hazardous Materials Inventory: This document details any hazardous substances present on the premises, including their quantities and locations. Knowing where hazardous materials are stored is vital for ensuring the safety of both responders and occupants during an emergency.
  • Evacuation Plan: An evacuation plan outlines the procedures for safely exiting the building in the event of an emergency. It typically includes designated escape routes, assembly points, and special considerations for individuals with disabilities or other needs.
  • Fire Safety Inspection Report: This report summarizes the results of recent fire safety inspections, highlighting any violations or areas needing improvement. It helps ensure that the facility complies with fire safety regulations and can guide improvements in safety protocols.

Utilizing these documents alongside the Fire Department Pre Plan form enhances the preparedness of both facility managers and emergency responders. By having a clear understanding of the site and its potential hazards, all parties involved can work together more effectively to ensure safety and minimize risks during emergencies.

Similar forms

The Fire Department Pre Plan form serves as a crucial document for fire safety and emergency response planning. Several other documents share similarities with this form, primarily in their focus on safety, emergency preparedness, and facility management. Below is a list of nine documents that are comparable to the Fire Department Pre Plan form:

  • Emergency Action Plan (EAP): This document outlines procedures for responding to emergencies, including evacuation routes and communication strategies, similar to the Pre Plan's focus on emergency contacts and assembly locations.
  • Hazardous Materials Inventory: Like the Pre Plan, this inventory lists chemicals present in a facility, detailing their locations and potential hazards, which aids in emergency response.
  • Building Evacuation Plan: This plan provides specific evacuation routes and procedures for occupants, paralleling the Pre Plan's emphasis on evacuation locations and assembly points.
  • Fire Safety Plan: This document details fire prevention measures and response strategies, similar to the Pre Plan's focus on fire access and protection information.
  • Site Safety Plan: This plan outlines safety protocols for a facility, including emergency contacts and access points, mirroring aspects found in the Pre Plan.
  • Occupancy Permit Application: This application requires information about building occupancy and safety features, which aligns with the Pre Plan's occupancy details and structure information.
  • Fire Inspection Report: This report documents findings from fire safety inspections, including hazards and compliance issues, similar to the Pre Plan's protective measures and hazards information.
  • Incident Report Form: This form records details of any incidents that occur on-site, including emergency response actions, akin to the Pre Plan's focus on response information.
  • Safety Data Sheets (SDS): These sheets provide detailed information about hazardous materials, including handling and emergency measures, which relates to the HAZMAT section of the Pre Plan.

Dos and Don'ts

When filling out the Fire Department Pre Plan form, it's important to be thorough and accurate. Here are some guidelines to help you through the process:

  • Do provide complete and accurate contact information for all relevant individuals.
  • Do include detailed diagrams and maps of the facility.
  • Do specify the number of persons in the building, including adults, children, and those with special needs.
  • Do note any special hazards, including chemicals and their locations.
  • Do clearly indicate all access points and staging areas for emergency responders.
  • Don't leave any sections blank; incomplete forms can lead to confusion in emergencies.
  • Don't forget to update the form regularly as changes occur in the facility.
  • Don't use abbreviations that may not be universally understood.
  • Don't overlook the importance of documenting evacuation locations.
  • Don't underestimate the need for clear notes regarding any special circumstances or concerns.

By following these do's and don'ts, you can help ensure that the Fire Department has the information it needs to respond effectively in case of an emergency.

Misconceptions

  • Misconception 1: The Fire Department Pre Plan form is only for large facilities.
  • This form is applicable to all types of facilities, regardless of size. Small businesses and residential properties can also benefit from having a pre plan in place.

  • Misconception 2: Completing the form is optional.
  • While not legally required, having a pre plan is highly recommended. It enhances safety and preparedness for emergencies.

  • Misconception 3: The form is only useful for fire departments.
  • Various stakeholders, including facility managers and emergency responders, find the information valuable for planning and response efforts.

  • Misconception 4: The form only needs to be filled out once.
  • Regular updates are necessary. Changes in occupancy, structure, or hazardous materials should prompt a review and revision of the form.

  • Misconception 5: All information on the form is public.
  • While some information may be accessible, sensitive details are typically protected to ensure privacy and security.

  • Misconception 6: The form can be filled out by anyone.
  • It is best completed by someone knowledgeable about the facility's layout and emergency protocols, such as a manager or safety officer.

  • Misconception 7: The form only addresses fire hazards.
  • The pre plan covers various safety concerns, including hazardous materials, evacuation routes, and emergency contact information.

  • Misconception 8: The form is too complicated to complete.
  • While it contains many sections, each part is straightforward. Guidance is often available from local fire departments.

  • Misconception 9: Once submitted, the form is no longer needed.
  • Continuous access to the form is essential. It should be readily available during emergencies and training exercises.

  • Misconception 10: The pre plan is only for fire response.
  • It serves as a comprehensive emergency management tool, aiding in various situations, including medical emergencies and natural disasters.

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 keep in mind:

  • Accuracy is crucial. Ensure all information is filled out correctly, including contact details and facility specifics.
  • Provide clear diagrams and maps. Visual aids help first responders understand the layout and access points of the facility.
  • Include special needs information. Identify any individuals who may require assistance during an evacuation, such as the elderly or those with disabilities.
  • Detail water supply sources. Clearly list hydrants and alternative water supplies, including their status and volume.
  • Regular updates are necessary. Review and update the form periodically to reflect any changes in the facility or its operations.

By following these guidelines, you can help ensure that the Fire Department has the necessary information to respond effectively in an emergency.