Fillable ED FIRE SAFETY DIRECTOR FORM APPOINT (District of North Vancouver)

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ED FIRE SAFETY DIRECTOR FORM APPOINT (District of North Vancouver)

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DISTRICT OF NORTH VANCOUVER FIRE & RESCUE SERVICES
1110 Lynn Valley Road, North Vancouver V7J 1Z9
T: 604-980-7575 | F: 604-988-5249
E: firesafetyplans@dnv.org
4196761
APPOINT
ED FIRE SAFETY DIRECTOR FORM
BUILDING NAME:
ADDRESS:
FIRE SAFETY DIRECTOR:
PHONE:
FIRE SAFETY PLAN PRODUCED BY:
COMPANY NAME:
PHONE #:
FAX:
IT IS THE RESPONSIBILITY OF THE OWNER, AGENT OR MANAGER OF THE PREMISES HEREIN NAMED TO ENSURE THE
SAFETY OF THE OCCUPANTS AS LAID DOWN IN DIVISION C, PART 2, SENTENCE 2.2.1.1.(1) OF THE 2018 BRITISH COLUMBIA
FIRE CODE. FURTHERMORE, DIVISION B, PART 2, SENTENCE 2.8.2.1.(1) STATES SUPERVISOR STAFF SHALL BE TRAINED IN
FIRE EMERGENCY PROCEDURES DESCRIBED IN THE FIRE SAFETY PLAN BEFORE THEY ARE GIVEN ANY RESPONSIBILITY
FOR THE FIRE SAFETY. FIRE SAFETY SUPERVISORY STAFF SHALL BE TRAINED IN THE FOLLOWING:
EVACUA
TION PROCEDURES EXPLAINED
YES
NO
ELEVATOR PROCEDURES EXPLAINED
YES
NO
VOICE
COMMUNICATION PROCEDURES EXPLAINED
YES
NO
LOCA
TION OF FIRE EXTINGUISHERS
YES
NO
FIRE E
XTINGUISHER INSPECTION PROCEDURES
YES
NO
LOCAT
ION OF FIRE ALARM PANEL
YES
NO
HOW T
O RESET A FIRE ALARM PANEL
YES
NO
EMERG
ENCY LIGHTING TESTING PROCEDURES
YES
NO
EMER
GENCY GENERATOR OPERATION
N/A
YES
NO
LOCATION OF HAZARDOUS MATERIALS
N/A
YES
NO
PROCEDURES FOR KITCHEN SYSTEM
N/A
YES
NO
SPRINKLER SYSTEM LOCATION
N/A
YES
NO
SPRINKLER INSPECTION PROCEDURES
N/A
YES
NO
STANDPIPE LOCATION
N/A
YES
NO
FIRE PUMP INSPECTION PROCEDURES
N/A
YES
NO
MAINTENA
NCE STAFF: EQUIPMENT SHUT DOWN PROCEDURES
YES
NO
KITCHEN STAFF: EQUIPMENT SHUT DOWN PROCEDURES
YES
NO
CLEANING RE
QUIREMENTS (HOODS, ETC.)
YES
NO
I HEREBY CONFIRM THAT THE ABOVE INFORMATION HAS BEEN EXPLAINED AND IS UNDERSTOOD:
SIGNATURE:
DATE:
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ED FIRE SAFETY DIRECTOR FORM APPOINT (District of North Vancouver)

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Completed 3 April 2021

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