Report a Fire Incident

A Fire Report form must be completed in respect of ALL fires occurring on University premises. If you have any problems filling out this form, please contact the Safety Office on 01159 513401 (13401 Internal). All fields are required to be completed.

School/Department Address:
Head of School/Department SSO informed (name):
Date:
Time:

Hours

Minutes

Seconds

AM/PM
Safety Office informed date:
Safety Office informed time:

Hours

Minutes

Seconds

AM/PM
Location of fire:
Room:
Floor:
Fire discovered by (name or smoke/heat detector):
How did the fire happen? Please give full details:
Was the fire alarm sounded?
If YES, by whom. If NO, why not?
Was Trent Security alerted (8888)?
If YES, by whom. If NO, why not?
Was an attempt made to extinguish the fire?
If the previous answer is YES, was the attempt successful?
If YES, how (specify number, type and extinguishers used) and by whom. If NO, detail why not.
Was the Fire Brigade in attendance?
Fire Station:
Life Risk - approximate number of persons - Building of Origin:
Life Risk - approximate number of persons - Room of Origin:
Was the building evacuated satisfactorily?
If NO, give details:
Give details of any injuries and any treatment administered. If yes, an accident report form (http://uiwwwliv01.nottingham.ac.uk/ARI/) is also required:
Name and details of witnesses:
Name of person making this report:

First

Last
Position of person making this report:
Email address of person making this report:
Email address of relevant Safety Officer if known:

Health and Safety Department

Pharmacy Building (Building 63)
University Park
University of Nottingham
Nottingham, NG7 2RD

Telephone: Telephone: +44 (0)115 9513401
Email: h&s@nottingham.ac.uk

Report a Fire Incident

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