Fillable Printable Fire Risk Assessment Template
Fillable Printable Fire Risk Assessment Template
Fire Risk Assessment Template
Issued: 19/06/2013 1 686 - v1.1
FIRE RISK ASSESSMENT – Self Assessment
Important! This fire risk assessment form is to be filled in by the responsible person within a business or organisation. As this is a free download for
the use of end users, this form must not be used by professional fire risk assessors. This form, while provided free of charge by Safelincs, has NOT
BEEN completed by Safelincs! This fire risk assessment form helps to address the majority of fire safety considerations stated in the official fire risk
assessment guides related to the Regulatory Reform (Fire Safety) Order 2005. However, before filling in this form you must nevertheless read the
relevant fire risk assessment guide(s). This assessment form must be used in conjunction with the official fire risk assessment guide(s)!
There might be fire safety risks not addressed in this form. These risks must be assessed and recorded on separate sheets which must be
attached to this form.
If the building is materially altered or the occupancy changes the fire risk assessment must be updated.
Responsible Person
Name of Premises or
Company
Address
Post Code Telephone N
o
Name of Assessor(s)
Signature of Assessor(s)
Date of Assessment
Date of Review with
Responsible Person
Building
Property Use
N
o
of floors
N
o
of floors below
ground
Approx area in m
2
of footprint
of building
Age of building
Brief details of construction
Building Occupants
Occupancy Profile:
Maximum Number of persons, in the
most highly occupied compartment
Weekdays Weekends
Are people sleeping in premises?
If so, how many
Description of Occupants:
Predominant Type
Atypically mobile for this type of occupancy
Average mobility for this type of occupancy
Untypically vulnerable for this type of occupancy
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Building Plan
Insert plan of your building here or if you do not possess one, use this space to draw your building floor
plan (this does not have to be to scale). Further guidance can be found in Part 1 Section 4.1 of the
appropriate guide. Mark on all fire precautions equipment e.g. Fire doors, Extinguishers, Emergency
lighting, Fire alarm and any fire detection.
KEY
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FIRE HAZARDS AND THEIR ELIMINATION OR CONTROL
1. SOURCES OF FUEL
1.1 Are there any highly flammable substances in the premises. E.g.
paints, thinners, flammable gases etc, flammable chemicals,
plastics, rubber, foams – polystyrene / polyethylene?
Yes
No
Control Measures
Replace them with safer alternatives
Remove or significantly reduce any highly flammable substances
Keep them in fire resisting stores
Separate them from heat sources by use of fire resisting construction
Keep minimum quantity in workroom
Ensure all containers are kept closed when not in use
Other (state here):
1.2 Are flammable liquids or gases used or stored in areas without
adequate ventilation?
Yes
No
Control Measures
Improve ventilation
Other (state here):
1.3 Are there quantities of combustible material stored, on display, or in
use in the premises. E.g. Paper, cardboard, packaging, fabrics,
wood?
Yes
No
Control Measures
Replace stocks of combustible materials with non-combustibles
Reduce stocks of readily combustible materials to a minimum
Separate such materials from heat sources or by fire resisting construction
Other (state here):
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1.4 Are quantities of combustible waste allowed to accumulate in the
premises such as Paper, cardboard, wood shavings, dust?
Yes
No
Control Measures
Improve the arrangements for the disposal of waste and rubbish
Improve the general housekeeping
Ensure staff are aware of the standard of housekeeping required
Give specific additional training to the staff responsible
Other (state here):
1.5 Does the premises contain foam filled furniture which is not
combustion modified (see label) or is worn to the point that it exposes the
foam interior?
Yes
No
Control Measures
Replace or repair
Other (state here):
1.6 Are areas of walls or ceilings covered with combustible linings?
such as walls covered with carpet tiles, ceilings covered
with polystyrene tiles.
Do notice boards have large amounts of loose paper on them?
Yes
No
Control Measures
Remove
Reduce
Treat with fire resisting solution
Cover
Replace large notice boards with small
Other (state here)
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1.7 Are combustible seasonal or promotional decorations, artificial foliage or
plants used to decorate the premises?
Yes
No
Control Measures
Remove
Treat with fire retardant spray/liquid
Introduce real plants
Replace with non combustible plants
Other (state here):
1.8 Are there additional sources of oxygen stored or used, such as
oxidising chemicals, oxygen cylinders or piped systems?
Yes
No
Control Measures
Move oxidising material away from any heat or flammable materials
Control use and storage of oxygen and chemicals
Remove sources of ignition
Other (state here):
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Note any significant findings from section 1:
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2. SOURCES OF IGNITION
2.1 Does the work activity involve hot work processes such as welding or flame
cutting, hot surfaces, sparks? Are hazards introduced by outside contractors
and building works?
Yes
No
Control Measures
Replace with a cold system
Implement a hot work permit system
Minimise the amount of combustible materials on the work area
Arrange so that hot metal and sparks are safely contained
Eliminate hot surfaces/sparks
Ensure satisfactory control over works carried out by outside contractors
Impose fire safety conditions on outside contractors
Other (state here)
2.2 Does the work activity involve processes such as incinerating or
Cooking?
Yes
No
Control Measures
Ensure that cookers, incinerators, etc. are used in accordance with
manufacturer instructions.
Ensure they are cleaned regularly including surfaces, ducts or flues
Ensure food cooking is not left unattended
Give additional specific training to staff responsible
Ensure correct type of extinguisher if deep fat fryers are used
Other (state here)
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2.3 Are heating appliances portable or of a radiant or open flame type?
Yes
No
Control Measures
Replace equipment with fixed convector heaters
Ensure that gas or oil burning equipment is used in accordance with
manufacturers instructions
Ensure that all heaters are adequately guarded
Ensure all portable heaters are stable and void of flammable materials
Other (state here)
2.4 Is smoking permitted?
Yes
No
Control Measures
Implement a smoking policy which provides for a safe smoking area and
prohibition elsewhere
Ensure suitable arrangement for informing visitors
Enforce the prohibition of matches and lighters in high-risk
Other (state here)
2.5 Are there light fittings near combustible materials?
Yes
No
Control Measures
Remove combustible materials
Replace tungsten/halogen bulbs with fluorescent tubes in areas where there
is a possibility that combustible materials may be ignited
Other (state here)
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2.6 Is electrical equipment and wiring: Faulty, damaged or not used in
accordance with the Manufacturers Recommendations?
Yes
No
Control Measures
Repair or replace faulty or damaged equipment
Portable Appliance Testing carried out
Fixed installations periodically inspected and tested
Suitable policy regarding the use of personal electrical appliances
Ensure all fuses are the correct rating
Other (state here)
2.7 Are inspection lamps or extension leads used?
Yes
No
Control Measures
Ensure extension leads are fully uncoiled
Limit extension leads and adaptors
Ensure extension leads are not overloaded
Suitable guards are covering inspection lamps
Ensure flexible power cables are kept as short as possible and safely routed
Other (state here)
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2.8 Is Arson a potential problem?
Yes
No
Control Measures
Improve security measures e.g. lighting, cameras
Remove combustible storage / waste bins from perimeter of building
Ensure combustible storage is contained with lid secure
Install anti-arson letterboxes
Train occupants about handling of arson
Ensure that occupants are aware of the alternative exits
Other (state here)
2.9 Is lightning a potential problem?
Yes
No
Control Measures
Install lightning protection system
Extend fire detection to cover roof void
Incorporate measures in your emergency plan
Other (state here)
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Note any significant findings from section 2:
