Fillable Apartment Fire Safety and Evacuation Plan (City of Colorado Springs)

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Apartment Fire Safety and Evacuation Plan (City of Colorado Springs)

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U.S.A. forms for City of Colorado Springs

BROWSE CITY OF COLORADO SPRINGS (CO) FORMS

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Apartment Fire Safety and Evacuation Plan
Directions:
-Fill out form on computer and print. Do not print the form first.
-Ensure form is accurate and complete.
-Items in red boxes are required.
-All basic text has been provided. Communities just fill out empty fields as applicable.
-Submit to the Division of the Fire Marshal via
E-mail to fireevacplan@springsgov.com
or
Fax to 719-385-7334 or
By hand to 375 Printers Parkway, Colorado Springs, CO 80910
Distribution: All plans accepted by the fire department must be provided to all residents of the community and/or all new residents upon
move in. It is recommended that all adult residents sign a form that indicates the resident has received, read and understands the plan.
Such forms must be kept on file in the office for future reference or the duration of each resident.
Plan Maintenance: Plans must be initially reviewed by the fire department. The community must review the plan annually. Major revisions
to the plans must be submitted to the fire department for review and acceptance. Minor revisions such as personnel changes or contact
information changes do not review fire department re-review.
GENERAL INFORMATION
Apartment Community Name
Community Main Address
Community Main Phone #
Community Main Fax #
Community E-mail
AFTER HOURS EMERGENCY CONTACT INFORMATION
Emergency Contact Name
Emergency Contact Title
Emergency Contact Phone #
Emergency Contact E-Mail
Emergency Contact 2 Name
Emergency Contact 2 Title
Emergency Contact 2 Phone #
Emergency Contact 2 E-mail
PERSON RESPONSIBLE FOR PLAN CONTENTS
Name
Title
Phone #
E-mail
SECTION 1 - Fire/Emergency Reporting and Occupant Notification
Upon discovery of a fire or other emergency, dial 9-1-1 immediately.
If facility is provided with manual pull stations, activate pull station. (SEE SECTION 7 FOR ADDITIONAL)
Notify other residents (yelling and pounding on doors) of emergency if safe to do so.
SECTION 2 - Evacuation and Accountability
Evacuate the structure via primary or secondary escape routes as shown on the floor plan(s).
Close doors upon exiting.
Do NOT use elevators (if present) during the evacuation.
If exiting through smoke, stay low and crawl if necessary to the nearest exit.
Regroup at the designated meeting point(s) as shown on the site plan.
Dial 9-1-1.
Notify building management (if on scene) as well as emergency responders of any missing persons and last known locations.
Do not regroup in fire lanes or around fire hydrants.
Do not reenter the building unless cleared by the fire department.
If unable to exit building:
Dial 9-1-1 and report your exact location
Seal room(s) by closing doors, windows and vents
Move to a window, open window (only in room you are in) and signal for help
Make yourself visible by waiving a flashlight or some other bright object
Loudly call out to bystanders or firefighters upon their arrival
SECTION 3 - Emergency Response and Crowd Management
The community has residents that are considered non-ambulatory (unable to evacuate without assistance). The list of non-ambulatory
residents and their locations is kept on file at (provide specific location): (if none indicate such)
Notify fire department of any such residents that are unaccounted for.
SECTION 4 - Occupancy Hazards
The following is a list of major fire hazards associated with the normal use and occupancy of the premises including maintenance and
housekeeping procedures: (if none indicate such)
The following personnel (include contact numbers) are responsible for maintenance, housekeeping and controlling fuel hazard
sources: (if none indicate such)
The following personnel (include contact numbers) are responsible for maintenance of systems and equipment installed to prevent or
control fires (note this may be a fire protection contractor): (if none indicate such)
SECTION 5 - Floor Plans
Floor plans for each apartment type as well as each floor in each building are found at the end of this document. Floor plans show the
following information (check all that apply): (See also Section 12)
Locations of all exits, stairs and exit corridors
Primary and secondary evacuation routes from each apartment
Accessible egress routes and all areas of refuge
Exterior areas for assisted rescue
Locations of all manual pull fire alarm boxes (pull stations)
Locations of all fire extinguishers
Locations of all hose valve/standpipes
Locations of all fire alarm annunciator and control panels
SECTION 6 - Site Plans
A site plan for the layout of the site is found at the end of this document. The site plan shows the following information (check all that
apply): (See also Section 12)
Building footprint(s) and all exits from each building
Evacuee assembly point(s)
Fire hydrants
Fire department connections
Fire lanes
SECTION 7 - Fire Alarm Pull Stations
Check box is none are located on site.
Pull stations should be activated in the event of a fire.
Call 9-1-1 in addition to activating the pull station.
In the event of a fire, activate the pull stations by the following method:
Pull stations are located in the following locations:
If applicable, the consequences for damaging, vandalizing or tampering with a pull station is:
SECTION 8 - Smoke Alarms
Check box if none are located on site.
Smoke alarms provide early detection of smoke and signal a warning to exit the building.
Smoke alarms are located in the following locations in each unit:
and located in the following locations throughout the building: (hallways, mechanical rooms, etc)
If applicable, the consequences for damaging, vandalizing or deactivating a smoke alarm are:
The following is responsible for monthly testing of smoke alarms:
The following is responsible for changing smoke alarm batteries annually:
Keep free of dust by vacuuming smoke alarms regularly.
Never paint a smoke alarm.
Replace any smoke alarm older than 10 years.
SECTION 9 - Fire Sprinklers
Check box if none are located on site.
Fire sprinklers are a life saving device. They will slow the spread of fire and give residents time to evacuate.
DO NOT paint, tamper with or hang items from fire sprinklers.
Fire sprinklers are in the following locations within each unit:
and in the following locations within each building: (hallways, mechanical rooms, etc)
If applicable, the consequences for damaging, vandalizing or tampering a fire sprinkler is:
SECTION 10 - Fire Extinguishers
Check box if none are located on site.
Fire extinguishers are for putting out a fire.
To use a fire extinguisher, use P.A.S.S. (Pull, Aim, Squeeze, Sweep).
Only use fire extinguishers if you know how to operate it.
Only attempt to extinguish small fires no larger than an office trash can.
Make sure you can exit safely if the fire is not extinguished.
Never turn back to fire when using a fire extinguisher.
Fire extinguishers are in the following locations within each unit:
and in the following locations within each building: (hallways, mechanical rooms, etc)
If applicable, the consequences for discharge, vandalizing or theft a fire extinguisher is:
SECTION 11 - Exit Signage
Check box if none are located on site.
Exit signs denote the closest way out of a building and must be visible from any direction of travel.
Exit signs are in the following locations within each building:
SECTION 12 - SAMPLE APARTMENT EGRESS AND SITE PLANS
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Apartment Fire Safety and Evacuation Plan (City of Colorado Springs)

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Completed 12 February 2021

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