Gilbert

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Business Operations and Storage Disclosure Form

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In order to perform a complete Fire Code plan review, and to properly assess all hazards associated with a business and/or operation, the following list of information is required. This information shall be reflected on all applicable sheets in the submitted plans in regards to storage and use areas, building layout, equipment locations, hazardous materials use and storage areas and changing stations. All items shall be addressed in a written narrative from the owner of the business. For assistance on this form contact the Fire Plans Examiner at 480-503-6824.

Name of Business *

Address *

Responsible Party *

Phone *

Email *

Provide the fire sprinkler design density for each area of the building *

Define each area of use and its layout (Office, warehouse, storage, lab, etc.) *

What types of materials will be stored in the building? (Pipe, boxes, electronics, etc.) *

Define the materials and their composition. (Plastic, metals, liquids, etc.) *

Provide cut sheets and/or information sheets for the materials, if necessary. How will the stored materials be packaged? (I.E. boxes, bags, open merchandise, etc.) *

How will the stored materials be stored? (I.E. shelves, racks, bin boxes, etc.) *

How will the stored materials be arranged? (I.E. palletized wrapped in plastic, individual packages directly on the shelf, etc.) *

How high will the shelf and/or rack storage be? (Storage over 12’ requires submittal of the High Piled Storage Disclosure form) *

Is a forklift used in moving materials? If yes, how is it powered? (Electric, LPG, fueled) *

If LPG/fuel powered, where and how is the LPG/fuel stored? *

How much LPG/fuel is stored? *

What other types of equipment will be used in the building? *

Provide cut sheets for the equipment listed and define their uses and their mode of operation.

Where will the equipment be located?

Have any cooking appliances been added? Show location and type on the floor plan. *

Have any cooking appliances under existing systems (stoves, fryers, griddles, etc.) been added relocated or removed? *

Provide a copy of the latest testing and inspection report of the cooking suppression extinguishing system. The testing and inspection report must have been conducted within the last 6 months. *

Drag and drop a file here or click to select a file

Have any new liquid carbon dioxide tanks been added? If yes, provide cut sheets and location.

Medical and Dental offices: Will medical gases such as oxygen or nitrous oxide be used during treatment? If yes, provide storage amount and cut sheets on system.

Are hazardous materials* as defined by (2012 IFC Chapter 50) used and/or stored? If yes, complete and submit the Hazardous Materials Inventory Statement (HMIS). * A hazardous material is any solid, liquid or gas that can harm people, or other living organisms, property or the environment. A hazardous material may be radioactive, flammable, explosive, toxic, corrosive, bio-hazardous, an oxidizer, and asphyxiate, an allergen, or may have other characteristics that make it hazardous in specific circumstances.

Where are the hazardous materials being used?

Define how the hazardous materials are being used?

Where are the hazardous materials being stored?

How are the hazardous materials being stored?

How are waste materials being stored and disposed of?

Created by AIPSS

Gilbert

Business Operations and Storage Disclosure Form

Details

Storage, Use, Material Handling and Equipment

Hazardous Materials Storage and Use