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Fire Safety Information Form

Please complete the following for all construction/refurbishment projects, maintenance activities, or any other activities which may impact upon the management of fire risks, prior to work commencing on site.

Health, Safety & Wellbeing will then advise what control measures are required to ensure the work can proceed safely and, if applicable, minimise the likelihood of a false alarm.

This form must be completed and submitted at least 10 days before the start of the work to ensure the control measures can be identified and put in place. If the activity is emergency maintenance, etc. please ring Claire Whittaker or Dave Lamb for further advice.

About the Activity

Activity Details

Provide details of works
Nature of the Activity to be undertaken *
Building and room/s in which activity will take place *
Physical area/extent of activity or work to be undertaken
Project Code (if applicable)
Duration in days *
Start date
End date
Please attach drawings of work area, if relevant
If you need to upload multiple files, please 'zip' them together and upload a single zip file.
Form Completed By * Email * Date

Part A

Impact on Fire Detection and Alarms

Provide detail of risk below:

Dust generated?

Mixing powder materials
Disturbing ceiling tiles or ceiling space
Accessing infrequently used/dusty space

Smoke generated?

If yes, please identify and provide details below.
Welding/brazing/soldering, etc
Using smoke machine/pyrotechnics
Cooking outside kitchen area, etc

Increased fire risk?

If yes please identify and provide details below.
Welding/brazing/soldering, etc
Flammable chemicals or materials
Oxidising agents
Grinding or similar process which could generate sparks
Using pyrotechnics
Cooking outside kitchen area, etc

Other activity not listed above?

Please provide details.

Part B

Impact on Safety Systems

Provide description below:
Restriction to width or obstruction of exits/escape routes
Closure/diversion of an escape route
Removal of doors
Restriction or obstruction of doors
Removal or obstruction of fire extinguishers
Obstruction or temporary decommissioning of fire alarm call points
Obstruction/removal of fire safety signs
Obstruction/removal of emergency lighting
Obstruction or temporary removal of alarm sounder
Breach of building fire integrity or building structure
Work at/around assembly points
Occupants Provide detail of nature of occupants:
Will the area be occupied whilst work is undertaken, i.e. staff/students