Fault Reporting
Name Of Building
Address of Building
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2. Name and contact details of responsible person
*
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address of Responsible Person
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
3. What type of equipment does the fault relate to?
*
Automatic door release mechanisms
Evacuation alert systems
Fire detection and alarm systems
Lifts for use by firefighters or Evacuation lifts
Rising mains
Smoke control systems
Suppression systems
4. What is the Nature of the Fault?
*
5. What area(s) of the building are affected by the fault?
*
6.What is the estimated timescale for rectification of the fault?
*
7. Did the fault necessitate a temporary change in evacuation strategy from stay put to simultaneous?
*
Yes
No
The building already has a simultaneous evacuation policy
8. Have any additional measures being implemented to mitigate against the fault?
*
Yes
No
9. If yes, provide details on additional measures.
10. Name and contact details of person completing form
*
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Address of person completing form
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please verify that you are human
*
Submit
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