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Fire Department Pre Plan Template

The Fire Department Pre Plan form serves as an essential tool designed to streamline the collection of critical information about facilities for the fire department's use in case of an emergency. It encompasses a wide range of data, including contact details, occupancy specifics, structural information, access points, water supply, protective measures, and hazardous material details, all aimed at preparing emergency response teams for effective intervention. To ensure the safety and preparedness of your facility, take a moment to fill out the Fire Department Pre Plan form by clicking the button below.

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Table of Contents

When it comes to preparing for emergencies, clarity and preparedness are non-negotiable—especially for fire departments. The Fire Department Pre Plan Form serves as an essential tool in this preparation, encapsulating vital information about facilities within the community it serves. By detailing aspects from general facility details, including name and location, to more specific safety elements like contact information, occupancy details, and structural information, this form lays the groundwork for an effective and swift response in the face of fire emergencies. Furthermore, it delves into fire access points, response staging areas, water supply specifics, and, critically, hazardous materials information, if applicable. Such comprehensive data collection aids fire departments in devising tactical response strategies, ensuring that both firefighters and civilians are afforded the highest degree of protection. The inclusion of diagrams and maps enhances the form’s utility, making it a key resource in emergency preparedness efforts. This document not only streamlines the coordination during an emergency but also underscores the importance of proactive planning in safeguarding communities against the unpredictable nature of fires.

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______________________________ 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

Page 1 of 6

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

Page 4 of 6

Basic Site Plan

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Page 5 of 6

Basic Floor Plan,

____ Floor

 

 

 

 

Make as many copies as necessary

http://www.henrycoema.org/forms/FDPreplanTemplate.pdf

Page 6 of 6

Form Breakdown

Fact Number Fact Detail
1 The form is used by the Fire Department for pre-planning in case of an emergency.
2 It includes sections for facility name and number, which helps in identifying the premises.
3 Diagrams or maps can be attached for detailed layout information.
4 Contact information for up to three contacts is required, including business and emergency phone numbers.
5 Information on the occupancy type (business, industry, single family, multi-family) is collected.
6 It asks for the number of persons (adults, children, elderly, special needs) residing or working at the location.
7 Structural information such as construction class, roof type, and number of stories is required.
8 Details on fire access( main access, roof, attic, basement, and others) are crucial for emergency response planning.
9 Information regarding the water supply, including hydrant locations and volume, is included.
10 The form has a section for detailing hazardous materials present on site, including chemical names and quantities.

Guidelines on Filling in Fire Department Pre Plan

Filling out the Fire Department Pre Plan form is a step to ensure safety and preparedness within your facility. This form helps in documenting essential information that can be crucial during any emergency. The detailed information provided will assist the fire department in understanding the layout, contact points, specific hazards, and protocols related to your facility. Completing the form accurately is vital. Here is a guide to help you through the process, ensuring that all necessary information is clearly and correctly documented:

  1. Start by entering the name of your fire department at the top of the form.
  2. Fill in the "Facility Name" and "Facility Number" fields with the appropriate information.
  3. Under "Diagrams, Maps," provide any available maps or diagrams of your facility that could assist in an emergency.
  4. In the "Contact Information" section, write the facility's address, including city, state, and zip code. Also, provide the manager's name, business phone, and two emergency phone numbers.
  5. For the 2nd and 3rd contact sections, repeat the process used for the manager, including all required phone numbers.
  6. Enter the contact details for the Alarm Company, including the phone number and any relevant notes about the alarm system.
  7. Specify the type of occupancy under "Occupancy," checking the appropriate boxes and filling in details such as the number of apartments, adults, children, elderly, and special needs persons.
  8. Document the locations considered for special needs, assembly points for employees/residents, and evacuation locations.
  9. For "Structure Information," detail the construction class, roof type, number of stories, and the building's dimensions.
  10. Record all relevant access points under "Fire Access Information," including main, secondary, and specific accesses like roof or basement.
  11. Under "Response Information," name the primary and secondary staging areas for emergency response units.
  12. List the water supply information, including hydrant locations, volume, and status.
  13. In the "Protection Information" section, mark whether the facility has sprinkler systems, shut-off valves, and other safety features, including any special notes.
  14. Detail any hazardous materials under "HAZMAT" with their specific locations, quantities, and characteristics.
  15. Attach any additional sheets if the space provided is insufficient for any section of the form.
  16. Finally, ensure a basic site plan of your facility is included on page 5 of the form.

By following these steps, you can complete the Fire Department Pre Plan form comprehensively. This document, once finished, should be kept accessible for emergency services and updated regularly to reflect any changes to the facility or its operations. Remember, the information you provide can significantly impact the effectiveness of emergency response efforts.

Learn More on Fire Department Pre Plan

What is a Fire Department Pre Plan form?

A Fire Department Pre Plan form is a document that provides critical information about a facility or location to the fire department before an emergency occurs. It includes details about the property's layout, contact information, occupancy, structure, access points, water supply, protection systems, and any hazardous materials. This form helps firefighters prepare and respond effectively during emergencies.

Why is it important to complete a Fire Department Pre Plan form?

Completing a Fire Department Pre Plan form is crucial for several reasons:

  • It ensures firefighters have immediate access to essential information, allowing for quicker and safer responses.
  • It helps in planning an effective emergency response strategy, potentially reducing property damage and saving lives.
  • It provides details about hazardous materials on the property, ensuring the safety of emergency responders and the public.
  • It can help in identifying any special needs of occupants, such as individuals with disabilities, ensuring a safer evacuation process.

What information is required on the form?

The Fire Department Pre Plan form requires several pieces of information, including but not limited to:

  1. Facility name and number
  2. Diagrams and maps of the property
  3. Contact information for the manager and other key persons
  4. Details about the occupancy, including the number of residents and any special needs
  5. Structure information, such as construction class and roof type
  6. Access points to the building and emergency exits
  7. Water supply details and the location of hydrants
  8. Information on any fire protection systems installed
  9. Details about any hazardous materials on the premises

Who should fill out this form?

Property managers or owners are typically responsible for filling out the Fire Department Pre Plan form. It’s best completed with the help of building engineers, safety officers, or anyone familiar with the property’s layout and safety features. For facilities that handle hazardous materials, a safety or hazardous materials manager might also need to contribute.

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

The form should be updated:

  • Whenever there are significant changes to the property, such as renovation, expansion, or change in occupancy.
  • When new hazardous materials are introduced or existing ones are removed.
  • After changes to emergency contact information.
  • It’s a good practice to review and update the form annually, even if no significant changes have occurred, to ensure all information remains accurate and up-to-date.

How is the information on the form used by the fire department?

The fire department uses the information on the form to:

  • Develop pre-incident planning strategies that include entry and exit points, water supply locations, and the presence of any hazardous materials.
  • Train firefighters and familiarize them with the layout and specific hazards of the facility.
  • Quickly access contact information for key personnel during an emergency.
  • Ensure a coordinated and efficient response by having access to detailed up-front knowledge about the incident site.

What happens if a facility doesn’t have a completed Fire Department Pre Plan form?

If a facility doesn't have a completed form, it can impair the fire department's ability to effectively respond to an emergency. Without pre-planned information, response times may be slower, and firefighters might face greater risks due to unknown hazards. Facilities without a form might also face legal or insurance implications, depending on local regulations.

Can digital versions of the form be used, or does it have to be paper?

While paper forms are still used, digital versions are increasingly common and encouraged for several reasons:

  • They can be easily updated and shared.
  • They reduce the risk of important documents being lost or damaged.
  • They allow for more detailed information and the inclusion of digital maps and photos.
Always check with the local fire department on their preferred format.

Where can someone get help completing the form?

Help with completing the form can typically be found through:

  • Contacting the local fire department. Many departments have officers dedicated to helping with pre-planning.
  • Seeking assistance from a professional fire safety consultant.
  • For complex facilities, such as those handling hazardous materials, consulting with specialized safety officers may be necessary.

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

The format of the Fire Department Pre Plan form can vary by jurisdiction. However, many follow a similar structure covering contact details, occupancy information, access points, water supply, fire protection systems, and hazardous materials. It's important to use the form provided by the local fire department to ensure all required information is included and formatted correctly.

Common mistakes

Filling out the Fire Department Pre Plan form can sometimes be a complex process, where even minor mistakes can lead to significant misunderstandings or delays in emergency response times. Here are five common mistakes that should be avoided to ensure the form is filled out clearly and effectively:

  1. Not providing detailed diagrams or maps: It's crucial to include accurate and detailed diagrams or maps of the facility. These visuals help emergency responders to quickly understand the layout and navigate efficiently during an emergency.
  2. Incomplete contact information: Failing to provide comprehensive contact information can hinder communication. It's important to list all necessary contacts, including after-hours numbers, to ensure emergency teams can reach someone familiar with the facility at any time.
  3. Omitting details about special needs individuals: Overlooking the specifics about individuals with special needs residing or working in the facility can prevent emergency responders from making the necessary preparations, potentially endangering lives.
  4. Not specifying water supply information: Accurate details about hydrants, including location and volume, are integral for firefighting efforts. Neglecting to provide this information, or providing inaccurate details, could impact the fire department's effectiveness.
  5. Overlooking hazardous materials (HAZMAT) details: The presence of hazardous materials must be clearly indicated, including their quantities and storage locations. Inadequate information could pose additional risks during emergency situations.

Sidestepping these mistakes can vastly improve the utility of the Fire Department Pre Plan form. Doing so ensures a swift and effective emergency response, potentially saving lives and property.

Documents used along the form

When preparing for emergencies, various documents and forms supplement the Fire Department Pre-Plan form to ensure comprehensive planning and response capabilities. These documents help in elaborating on specific details, providing visual aids, and ensuring a more coordinated response during emergencies. Understanding how these documents integrate with the Fire Department Pre-Plan form can facilitate better preparation and quicker emergency response.

  • Emergency Action Plan (EAP): This document outlines the actions employees and occupants should take in response to an emergency. While the Pre-Plan form focuses on providing crucial information to the fire department, the EAP is designed to guide the individuals within the building on evacuation procedures, emergency contacts, and roles and responsibilities.
  • Building Layout Plans: These are detailed drawings showing the layout of the premises, including entry and exit points, interior rooms, and critical infrastructure. They complement the diagrams and maps section of the Pre-Plan form by offering more detailed visual representations that can be crucial for navigating during a fire or other emergencies.
  • Hazardous Material Inventory: Though the Pre-Plan form includes a section for hazardous materials (HAZMAT), a more comprehensive HAZMAT inventory may be needed for facilities with numerous or complex chemical substances. This document provides detailed information about the chemicals, their storage conditions, handling procedures, and potential risks, aiding responders in preparing for specific hazards.
  • Utility Maps: These maps indicate the locations of gas, water, and electrical shutoffs, as well as key infrastructure like fire hydrants. While some of this information is summarized in the Pre-Plan form, detailed utility maps can offer quick visual cues for emergency responders to ensure a rapid and efficient shutdown of utilities if necessary.

Together, these documents create a more complete picture of the facility's preparedness for emergencies, highlighting both the actions needed by occupants and the information necessary for emergency responders. By supplementing the Fire Department Pre-Plan form with these additional resources, facilities can enhance safety and streamline the emergency response process.

Similar forms

  • Emergency Action Plans (EAPs): Similar to the Fire Department Pre Plan, an EAP outlines the steps employees and managers should take in case of an emergency. Both documents focus on ensuring the safety of individuals by providing detailed evacuation procedures, emergency contact information, and assembly locations.

  • Facility Security Plans: These plans share similarities with the Fire Department Pre Plan by detailing specific measures for access control (e.g., main access, secondary access, lock box locations) and identifying critical infrastructure elements like alarm panels. Both aim to safeguard a facility's personnel and assets.

  • Building Evacuation Diagrams: Like the Fire Department Pre Plan, building evacuation diagrams provide layouts of exits, fire extinguisher locations, and assembly points. However, the Pre Plan goes further by including emergency contact information and specific details about the building's construction and water supply.

  • Business Continuity Plans: Business continuity plans ensure that critical business functions can continue during and after a disaster. These plans share goals with the Fire Department Pre Plan by including contact information and details on assembly locations to minimize downtime and protect employees.

  • Hazardous Material (HAZMAT) Response Plans: These plans are closely aligned with the HAZMAT section of the Fire Department Pre Plan. Both documents require the listing of chemical names, locations, quantities, and hazards to prepare and respond effectively to chemical-related emergencies.

  • Occupant Emergency Plans (OEPs): OEPs are designed to protect building occupants during emergencies. Similar to the Fire Department Pre Plan, they include evacuation procedures, emergency contact numbers, and details about the structure to help occupants exit safely and quickly during an incident.

Dos and Don'ts

When completing the Fire Department Pre Plan form, it is important to ensure accuracy and thoroughness to effectively communicate essential details about a facility to first responders. Below are guidelines on what actions to take and avoid during this critical process.

Do:

  1. Provide complete and accurate contact information. Ensure that all phone numbers and addresses are current. This includes emergency and secondary contacts who can be reached if the main contact is not available.
  2. Include detailed diagrams and maps. These are invaluable for understanding the layout of the facility, including entries and exits, which can save lives during an emergency.
  3. Clearly identify special needs. If there are individuals with disabilities or special conditions, make sure their locations and needs are clearly indicated.
  4. Detail all hazardous materials (HAZMAT). Accurate information about the type, quantity, and storage location of hazardous materials is critical for first responders’ safety and emergency planning.
  5. Check and double-check for accuracy. Before submitting, verify that all information is correct, including the spelling of names, addresses, and phone numbers.
  6. Update regularly. Review and update the form periodically, or when any significant change occurs at the facility, to ensure that the information remains current.

Don't:

  • Leave sections blank. If a section does not apply, clearly mark it as "N/A" (not applicable) rather than leaving it empty, to indicate that it was not overlooked.
  • Omit floor plans or building classifications. These are key in helping first responders understand the structure and layout of the building to plan their actions.
  • Underestimate the importance of details. Minor details can be critical in an emergency. For instance, specifying the exact location of gas and water shutoffs can save valuable time.

By following these guidelines, facilities can ensure that their Fire Department Pre Plan forms are comprehensive, clear, and easily understood by first responders, ultimately contributing to the safety and security of both the occupants and the emergency teams.

Misconceptions

Many people hold misconceptions about the Fire Department Pre Plan Form. This document is crucial for emergency preparedness, but misunderstandings can compromise its effectiveness. Let's address some common mistaken beliefs:

  • It's only for large businesses: Small businesses, as well as multi-family residential buildings, can also benefit from having a pre-plan in case of a fire. It helps in ensuring everyone's safety.
  • It's too complicated to fill out: The form is straightforward, asking for essential information about the facility, occupancy, structure, access points, water supply, and hazardous materials. This information is vital for first responders.
  • It's only used for fighting fires: While primarily aimed at fire incidents, the information can be invaluable for other emergencies, such as natural disasters or hazardous material spills.
  • Once completed, no updates are needed: It's important to update the pre-plan regularly, especially after significant changes to the building structure, occupancy, or the addition of hazardous materials.
  • It's the fire department's responsibility to fill it out: While the fire department can provide guidance, the responsibility for providing and updating the information rests with the building owner or manager.
  • Only the fire chief reviews the form: In reality, the form is a critical resource for all responding personnel, providing them with a quick overview of the site, which can be crucial in an emergency.
  • It won't make a difference in emergency response time: Having a pre-plan can significantly expedite the fire department's response by giving them important details about the site before they arrive, potentially saving lives and property.
  • There's no need to include water supply information: Details about hydrants, main sizes, and alternative water supplies are crucial for planning the fire-fighting approach, especially in areas with limited water resources.
  • Alarm and sprinkler system details are unnecessary: These systems are the first line of defense in a fire, and knowing their locations and operational status can be crucial for emergency responders.
  • It's the same as the fire safety plan: While there's some overlap, the pre-plan focuses more on structural and access details, whereas the fire safety plan includes more on evacuation procedures and drills.

Understanding the Fire Department Pre Plan Form's purpose and requirements can greatly enhance emergency preparedness, making it an indispensable tool for safety.

Key takeaways

Filling out and using the Fire Department Pre Plan form is essential for ensuring the safety and preparedness of both first responders and those within a facility. Here are some key takeaways to consider:

  • Complete all sections of the form accurately to provide comprehensive information about the facility, including diagrams and maps, to assist fire department operations.
  • Contact information is critical. List the facility's manager and at least two other contacts with their business and emergency phone numbers to ensure there are multiple points of contact in an emergency.
  • Clearly identify the occupancy type and number of persons within the facility. This includes distinguishing between adults, children, elderly, and special needs individuals, which is vital for evacuation planning.
  • Include detailed structure information such as construction class, roof type, and the building's dimensions. This information helps in assessing the facility's fire risks and structural challenges.
  • Access points to the facility must be clearly marked, including main, secondary, and specific accesses like the roof, attic, basement, and lowest access points, to facilitate quick entry by fire services.
  • Document all fire access information, including locations for lock boxes, alarm panels, and annunciator panels, to enable efficient response to alarms and fire incidents.
  • Response information, including primary and secondary staging areas, should be provided to establish a planned approach for fire services upon their arrival.
  • Water supply information, including the location and status of hydrants and alternative water supplies, is crucial for firefighting operations. Ensure the volume (GPM) and main size are specified for each source.
  • Special protection information, including the presence of sprinklers, gas, electrical, and water shutoffs, and any hazardous materials (HAZMAT), needs to be noted with specific details about location, quantity, and characteristics of chemicals on-site.

By carefully preparing this form, facilities can significantly enhance the effectiveness of fire department response efforts in emergencies, potentially saving lives and minimizing property damage.

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