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oo o Home has smoke alarms on every (City of El Paso)

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U.S.A. forms for City of El Paso

BROWSE CITY OF EL PASO (TX) FORMS

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oo o Home has smoke alarms on every level.
oo o Home has a smoke alarm in every bedroom.
oo o Smoke alarms are located outside each separate sleeping area.
oo o Smoke alarms are located at least 10 feet from a stationary or fixed cooking appliance.
oo o All smoke alarms are working.
oo o Family has a home fire escape plan.
oo o Family practices the home fire escape plan at least twice a year.
oo o The home has occupant(s) that require assistance to escape. Occupants discuss
escape planning and occupant requirements in case of a fire or emergency escape.
oo o House number is visible from the street.
oo o Windows used for escape open easily — not blocked by furniture, security bars or
nailed/painted shut.
oo o Security bars, if present, have a functioning quick release-device.
oo o Home has a home fire sprinkler system.
oo o Home has a carbon monoxide alarm outside each separate sleeping area.
oo o Home has a carbon monoxide alarm on every level.
oo o Carbon monoxide alarms are working.
oo o Emergency phone numbers are displayed in a visible location.
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oo o Smokers smoke outside the home.
oo o Large ashtrays are provided outside for smokers.
oo o Matches and lighters are stored in a secure cabinet.
oo o Lit candles are not left unattended.
oo o Medicines, poisons, cleaning supplies and other chemicals are stored safely.
oo o The home does not have excess storage of clothes, magazines, newspapers and other
items that can burn or can block your way out in an emergency.
oo o Hot water heater is set at no higher than 120 Fahrenheit.
oo o Nothing that can burn is stored inside the water heater closet.
oo o Things that can burn are at least 3 feet from the furnace.
oo o The furnace is inspected and cleaned annually.
oo o Things that can burn are kept at least 18 inches from any portable heating device.
oo o Clothes dryer lint filter and vent pipes are clean.
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oo o Things that can burn are removed from the stovetop.
oo o Small appliances are unplugged when not in use.
oo o Adult stays in the kitchen when stovetop is in use.
oo o The stove is not used to heat the house.
Like us on Facebook @ www.facebook.com/ElPasoFire
Follow us on Twitter @EPTXFire
EPFD • 416 N. Stanton, El Paso Tx, 79901 485-5699 www.elpasotexas.gov/fire
Like us on Facebook @ www.facebook.com/ElPasoFire
Follow us on Twitter @EPTXFire
EPFD • 416 N. Stanton, El Paso Tx, 79901 485-5699 www.elpasotexas.gov/fire
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oo o Fireplace has proper screen and hearth.
oo o Things that can burn are at least 3 feet from space heaters and fireplaces.
oo o Chimney is inspected annually and cleaned as needed.
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oo o There is a solid door between garage and residence.
oo o Gas powered equipment is stored in an outside shed or garage, separate from the home.
oo o Gasoline is stored in an approved safety container in an outside shed or garage, separate
from the home.
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oo o Outside electrical receptacles are GFCI and they are in good working condition.
oo o There is no rubbish, trash, brush or tree trimmings accumulation on the property.
oo o Barbecue grill is only used outdoors.
oo o Swimming pool or hot tub is enclosed by a four-sided fence and locked gate.

oo o Kitchen and bathrooms have GFCI outlets on countertop surfaces within 6 feet of running
water outlets and they are working properly.
oo o All receptacle and switch cover plates are installed and in good condition.
oo o Receptacles have been tested and are in good working condition — no evidence of arcing
or overheating.
oo o Switches are in good condition — no evidence of arcing or overheating.
oo o Extension cords and cables are not used as fixed wiring, run through holes in walls,
ceiling or floor, run through doorways or windows or under carpets or attached to building
surfaces.
oo o If there are young children in the home, the home has tamper-resistant outlets.
oo o Panel board and distribution equipment is accessible for inspection and in good condition
(no evidence of overheating, corrosion or other damage).
+%!2%!-26%13(%&.++.6)-'#.-31.+04%23).-2 (Your address is only used to document which homes in our community
have had surveys done. We will not identify families and will not contact you unless you request it.)
1. Address and Zip Code: ___________________________________________________________
2. Number of Residents in the Home:_________ Number under age 5 _____ Number over age 65 _____
3. Type of Residence: _____ Single-Family _____ Multiple-Family (Duplex, Quadraplex) ____ Apartment
4. Rent _____ or Own _____
5. Phone #: ___________________ (please provide this information if you would like us to contact you)
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oo o Home has smoke alarms on every (City of El Paso)

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Completed 13 February 2021

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