Life Safety Inspection Form

Chapter:

House Manager/Inspector Name:

Date of Inspection:

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Directions:
- Please complete the form in its entirety making sure to note any deficiencies in the Final Report section.
- Self inspection forms must be completed and submitted each Wednesday by 5PM. Failure to submit this form on time will result in a loss of social event registration privileges for the following weekend and other possible sanctions.
- Gettysburg College will re-inspect each house on a monthly basis unless there is a condition which presents the possibility of imminent harm.
-The Department of Public Safety will follow up on any outstanding safety issues during the Pre-Party Inspection.
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General House Conditions

1. Is there any structural damage that would cause a safety problem?
Yes No

2. Are hallways clear of obstructions and debris?
Yes No

3. Is the area around the house, especially around entry/exit doors, generally clear of debris and obstructions?(Reminder no indoor furniture should be outside)
Yes No

4. Are all grills cleared to within 10 feet of structures when in use?
Yes No

5. Is the laundry area kept clean and the dryer vents clear?
Yes No

6. How often is the trash removed from the building?

Exits, Emergency Signage/Lighting, Egress

7. Are all exit routes clear of obstructions?
Yes No

8. Are all fire escapes and stair towers cleared of objects and in good working order?(including snow and/or ice on walkways and stairs)?
Yes No

9. Are all self closing exit doors closed at all times and in proper working order?
Yes No

10. Are there exit plans posted throughout the house on each floor?
Yes No

11. Are exit signs working with no burned out light bulbs?
Yes No

12. Are emergency lighting throughout the house working?
Yes No

13. Is emergency generator in proper working order (FIJI and Sigma Nu only)?
Yes No

Storage

14. Are storage areas free from any flammable liquids (gasoline, paint, thinner, etc.)?
Yes No

15. Are flammable liquids (paint, thinner ,etc) stored in an approved metal storage container?
Yes No

16. Are areas under stairways free of stored materials?
Yes No

17. Is the boiler room clear of all combustible material?
Yes No

Fire Safety Systems

18. Are the fire extinguishers in place and full?
Yes No

19. Is the fire alarm system operating with no warning sounds or lights indicating problems with the system?
Yes No

20. Do all sprinkler heads have an 18" clearance from other objects mounted on the ceiling?
Yes No

21. Are all extension cords and surge protectors properly used and in good shape (attaching an extension cord to a surge protector is not acceptable)?
Yes No

22. Are wall outlets and light switches operational and unbroken cover faceplate?
Yes No

23. List problems found on the self inspection.

24. List what actions you took to correct the problems identified during the self inspection?

By submitting this information, I am supplying factual information to Gettysburg College, Office of Greek Organizations.

It is a violation of the Gettysburg College Code of Conduct to submit false information to a College Official.