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Date Inspected: ___/___/___ Inspected By: _________________
OUTSIDE THE HOUSE
Is area around the house' clear of accumulated combustibles?
Are long grass, weeds & brush cut back at least 50 feet from house?
Is chimney in good repair and properly installed with a cap?
Is the roof clear of debris?
Are fuel tanks & piping properly installed & in good repair?
Are fuel tanks securely mounted on proper stands?
Are doors clear & can they be opened easily in case of fire?
Are steps and landings in good repair?
Is back porch clear of accumulated combustibles?
BASEMENT OR UTILITY ROOM
Is the basement free of garbage, accumulated combustibles, old paint and flammable liquid containers?
Is the firrnace or wood stove in good repair, operating satisfactorily and safely installed?
Are the smoke pipes clean, in good repair and 18 inches from walls or ceilings that will burn?
Are ashes from furnace deposited in metal containers?
Are stairs on top and below free from rubbish & other materials?
KITCHEN
Is the kitchen free of unnecessary accumulated combustibles?
Is the stove in good repair, properly installed & suitably protected from floors & walls?
Is the chimney in good repair, properly installed and clean?
Are the smoke pipes properly installed and 18 inches from walls or ceilings that will burn?
Are ashes from the stove placed in a metal container outside the building?
Are visible electric outlets and switches in good condition and trouble free?
Are the correct size of fuses or breakers used in electric panel?
Are appliance cords in good condition?
Are extension cords okay and not fastened to walls, hung over pipes or run under carpets?
Is the door to outside clear of obstructions & easy to get out of in case of fire?
Is the kitchen free of flammable liquids (gasoline, kerosene, etc.)?
Is the wood stove area clear of combustible objects?
LIVING ROOM
Is the living room free of accumulated combustibles?
Are visible electric outlets and switches in good condition?
Are lamps or heater cords in good condition?
Are extension cords in OK & not fastened to walls, hung over pipes and run under carpets?
Is fireplace equipped with a metal screen?
Is space heater properly installed, free of trouble, clean, with sufficient clearances.
Are smoke pipes properly installed 18 inches from walls or ceilings, that will burn?
Are ashes from the stove placed in a metal container outside the building?
Is door to outside clear and easy to get out of in case of fire?
Are ashes from the stove placed in a metal container outside the building?
BEDROOMS, STAIRS, STORAGE
Are stairs free of storage or other material both on top and underneath?
Are extension cords okay and not fastened to
walls, hung over pipes or run under carpets?
Are windows free and easy to get out of in case of fire??.
Are these areas free of flammable liquids?
BATHROOM
Is bathroom clear of accumulated combustibles and flammable liquids?
Are visible electrical outlets and switches in good condition and trouble free?
FIRE PROTECTION
Is the fire extinguisher in good condition, fully charged and in its proper place?
Does the occupant know how to use the fire extinguish?
Does the occupant know to call the fire department in case of fire?
Fire Department phone number is: 911
Does the occupant know what to do in case of fire (how to get out, etc.)?
Do the smoke alarms work and are they in the proper location?
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