Fire Protection UW Impairment Fire Watch Form

Overview
When a required fire protection system is out of service, the building must either be evacuated or an approved person shall be conducting a fire watch.
1. An approved person must be trained on the use of a fire extinguisher.
2. An approved person must have the means of notifying the fire department if deemed necessary.
3. An approved person’s only task is to monitor and patrol the areas where a fire protection system is out of service.
The fire watch shall include all areas where a fire protection system has been disabled, and shall continue until the system has been returned to service.
Project Information
Name of Person Doing Fire Watch:*
First Last
Phone Number of Person Doing Fire Watch:*
Email of Person Doing Fire Watch:*
Date of Fire Watch:*
MM slash DD slash YYYY
Project Name:*
Project Number:
Work Order Number:
Search for a Building*
Room Number(s)/Area(s) For Fire Watch:*
Impairment Repair Performed By:*
- UW Employee
- Contractor
Employee/Contractor Name:*
Contractor Company Name/Physical Plant Work Unit:*
Supervisor/Foreman Name:*
Supervisor/Foreman Phone Number:
Fire Watch Information
Time the Fire Watch was started:

: Hours

Minutes

AM/PM
Time the Fire Watch was completed:

: Hours

Minutes

AM/PM
Notes For The Fire Watch:
I hereby certify that the information provided on this form is accurately described and correct.
By submitting this form you will receive an email containing the information listed above. Would you like to send this information to additional email addresses?*
- Yes
- No
Additional Email #1
Additional Email #2
Additional Email #3
Additional Email #4
Additional Email #5
Signature of Person Completing Form:*
Name
This field is for validation purposes and should be left unchanged.

Fire Protection UW Impairment Fire Watch Form

Overview

Project Information

Fire Watch Information