SOP 511.09-att-2: Institutional Fire Incident Report

Division:
Facilities
Effective Date:
September 23, 2020
Reference Code:
IVN06-0001
Topic Area:
511 Policy-Fire Services
PowerDMS:
View on PowerDMS
Length:
153 words

Summary

This form is used to report all fires occurring at GDC facilities to the GDC Fire Services office within 24 hours of the incident, as required by Georgia Safety Fire Commissioner regulations. The report collects critical information about the fire including location, extent of damage, injuries or deaths, known and probable causes, and responding fire department details. Suspected incendiary fires must be reported immediately.

Key Topics

  • fire incident report
  • fire reporting
  • institutional fire
  • fire damage
  • fire investigation
  • incendiary fire
  • fire safety
  • life safety
  • facility fires
  • fire documentation

Full Text

SOP 511.09
Attachment 2

9/23/20

GDC Fire Services and Life Safety

300 Patrol Rd.
P. O. Box 1529
Forsyth, GA 31029

INSTITUTIONAL FIRE INCIDENT REPORT

In accordance with the Rules and Regulations of the Georgia Safety Fire Commissioner
Chapter 120-3-6, Paragraph 120-3-6-.03 every fire must be reported to the GDC Fire Services
office within twenty-four (24) hours of the incident. This form shall enable you to report and
to provide the necessary details of the incident. Report suspected incendiary fires
immediately.

Name of Facility:

Address: City: ________________

Number of Stories: Number of Patients: ________

Date of Fire: Time of Fire: _______

Location of Fire in Building: _____________________________________

Extent of Damage to affected area:

|Name|Sex|DOB|Extent of Injury|
|---|---|---|---|
|1.||||
|2.||||
|3.||||
|4.||||
|5.||||

Injuries and/or Deaths
Known Cause of Fire:

Probable Cause of Fire:

Name of Fire Department Responding:

Signature of Administrator: _______________________ Date: __________________

Retention Schedule: Upon completion, this form shall be retained by the Chief of Security for two (2) years .

Attachments (2)

  1. Emergency Response Plan Fire Safety Checklist (263 words)
  2. Institutional Fire Incident Report (153 words)
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