Business Self-InspectionBusiness Name (required)Business Address Number (required)Business Street Name (required)Business Zip Code (required)Is mailing address same as business address? (required)YesNoIf not what is the mailing address?Business Contact Email (required)Business Phone (required)After Hours Emergency Contact Name (required)Emergency Contact Phone Number (required)Is the building address number posted with a contrasting background clearly visible from the street? (required)YesNoIs the exterior of the building free from weeds, trash, debris or combustible storage? (required)YesNoAre exit aisles and corridors a minimum of 36" wide and clear of obstructions? (required)YesNoAre all exit doors unlocked, marked with exit signs and can easily be opened from the inside? (required)YesNoAre walls intact without holes or open penetrations? (required)YesNoAre ceiling tiles in place? (required)YesNoN/AIs a 30" wide and 36" deep unobstucted access space maintained in front of electrical panel? (required)YesNoAre circuit breakers properly marked? (required)YesNoAre unused circuit breaker spaces properly covered with blanks? (required)YesNoAre cover plates in place for switches, receptacles and junction boxes? (required)YesNoAre extension cords being used as permanent wiring? (required)YesNoAre mechanical rooms, electrical rooms and areas under stairways clear of combustible storage? (required)YesNoIs there a 24" clearance between storage and ceiling (non-sprinklered) or an 18" clearance between storage and sprinkler head (sprinklered)? (required)YesNoAre combustibles stored at least three feet away from heat sources? (required)YesNoDo fire extinguishers have a minimum rating of 2A/10BC? (required)YesNoAre fire extinguisher locations visible and unobstructed? (required)YesNoHave fire extinguishers been serviced and tagged by a qualified contractor within the past 12-months? (required)YesNoInsert a photo of one fire extinguisher (include pressure gauge and service tag in photo) (required)Service Company Name (required)Service Date on Tag (required)Kitchen suppression system (if present): Attach photo of the service tag found on the manual pull station.Kitchen suppression system (if present): Service Company NameKitchen suppression system (if present): Service date on tagKitchen suppression system (if present): Service company name for hood and duct cleaningKitchen Suppression system (if present): Service date on tag for hood and duct cleaningPrint your Name (required)Initial for Electronic Signature (required)There was a problem saving your submission. Please try again later.Please wait while your submission is being saved...Submitting...SubmitThank you, your submission has been received.