Fire Door Inspection Form
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Fire Door's Location
Date
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Inspector's Name
First Name
Last Name
Inspector's Signature
EVALUATIONS
Please choose the most appropriate option and fill in the blanks.
Rows
Fail
Pass
N/A
Notes
1) Is there any special locking arrangement system?
1
2
3
2) Are there any missing or broken parts?(Lockset / Latchset)
4
5
6
3) The door does not swing freely.
7
8
9
4) The door does close properly.
10
11
12
5) The door does latch securely.
13
14
15
6) The flush bolts to fasten properly.
16
17
18
7) Are there any missing or broken parts? (Flush Bolts / Coordinator)
19
20
21
8) Is the door and frame free from holes and brakes on all surfaces?
22
23
24
9) Are all the glazing vision lights frame and glazing beads intact and securely fastened?
25
26
27
10) Are the doors, hinges, frame, hardware, and threshold secure aligned and in working order with no visible signs of damage?
28
29
30
11) Seals damaged, missing, or incorrect type.
31
32
33
12) Non-compliant protection plate & signage.
34
35
36
Findings & Comments
Submit
Should be Empty: