fire badgeFire Service Emergency Cover (FSEC) Other Building Site Assessment Form
 
Q1
 
Q1a
 
Q2 Is the premise multi-occupied?
 
 
Q3
 
Q4
 
Q5
 
Q6
 
Occupancy Type
 
Q7 Under which category does your premise fall? Please tick accordingly:
 
 
Q8
 
Q9 What is the total floor area in sqm including all floors if multi occupied? Please tick accordingly:
 
 
Occupancy Profile
 
If the premise is multi-storey please indicate the numbers of people occupying the highest location within the building during specific periods of the day:
 
Q10 Weekdays:
00:00 to 04:00
1 - 50
 
50 - 100
 
100 - 150
 
150 -200
  04:00 to 08:00      
  08:00 to 12:00      
  12:00 to 16:00      
  16:00 to 20:00      
  20:00 to 24:00      
 
Q11 Weekends:
00:00 to 04:00
1 - 50
 
50 - 100
 
100 - 150
 
150 - 200
  04:00 to 08:00      
  08:00 to 12:00      
  12:00 to 16:00      
  16:00 to 20:00      
  20:00 to 24:00      
 
Description of Occupants
 
Q12 Would the typical occupant of the premise be considered mobile?
 
 
Q13 Are there disabled persons located within the premise?
 
 
Q14 If yes, are there procedures in place to aid their evacuation in the event of a fire?
 
 
Sole Supplier in UK
 
Q15 Does your business provide a unique service or product not available anywhere else in the UK?
 
 
 
Exceptional Value
 
Q16 Does the premise being assessed have a building value or re-stock value of £100,000,000 or more? An example may be the value of rebuilding & re-stocking a large shopping precinct.
 
 
Community Loss
 
 
Q17 In the event of a fire at this premise would the loss of the premise have a significant impact on the local community? For example, if the business was a large employer, such a loss could make a large number of people, around 100 or more, unemployed and also impact on other businesses in the area?
 
 
Property Loss
 
Q18 In the event of a fire developing within the premise without any fire fighting prevention of any kind please indicate if the fire would be:
 
 
Q19 Please indicate if, in the event of a large fire without any fire fighting prevention of any kind, are there other buildings nearby that could potentially be affected by a large fire?
 
 
Environmental Risk
 
Q20 In the event of a fire does the premise hold any materials on site that may be of significant impact on the environment or to the local community if not contained?
 
 
 
Building Construction
 
Q21 Are there any construction materials in the building that may assist the spread of a fire? Please tick accordingly:
 
 
 
Fire Fighter Hazard
 
Q22 In the event of a fire, are there any factors the Fire & Rescue Service may need to be aware of?
 
 
 
Fire Warning & Management Procedures
 
Q23 Does the premise being assessed have a fire warning system of any kind?
 
 
Q24 If yes, is the system automatic (smoke detectors)
 
 
Q25 If automatic, is the alarm system linked to a receiving station?
 
 
Q26 Is the system audible?
 
 
Q27 Is the system visible (warning lights)?
 
 
Q28 Does the premise have fire management procedures in place?
 
 
Sprinklers
 
Q29 Is there a sprinkler system installed in the premise and maintained in working order?
 
 
Q30 If yes, how much of the building is covered by the sprinkler system?
 
 
Thank you on behalf of Warwickshire Fire & Rescue Services for taking the time to fill in this form.
 

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