Fire Watch Request Form - Smith & Associates

Currently, Fire Watch Services are only available in the San Francisco Bay Area. If services are required outside of this area, please contact us directly at (800) 503-3812 to discuss availability and special arrangements.

We appreciate your interest and look forward to assisting you with your fire safety needs.

Is End the

Date of Request *

Requestor Information

Company Name *

Contact Person *

First

Last

Contact Phone Number *

Contact Email Address *

Fire Watch Location

Site Name *

Site Address *

Address Line 1

Address Line 2

City

State

Zip Code

Building/Floor/Area

Service Details

Start Date / Time *

Date

Time

End Date / Time *

Date

Time

Number of Fire Watch Personnel Requested *

Special Instructions

Emergency Contact Name *

First

Last

Emergency Contact Phone Number *

On-Site Management Name *

First

Last

On-Site Management Phone Number *

Is there cell service on the project site? *

If Applicable Directions for Using Landline

Emergency Response Procedures

Fire Watch personnel will immediately notify area workers of fire hazard and contact on-site management in the event of a fire or fire-related emergency.

What are the established evacuation procedures? *

Please Upload Evacuation Procedure Document(s)

Click or drag files to this area to upload. You can upload up to 3 files.

Please describe the communication method to ensure all occupants are alerted of fire related emergencies. *

DISCLAIMER

The undersigned acknowledges that Fire Watch Services provided by Smith & Associates Environmental Health & Safety LLC are for monitoring purposes only and do not replace the functions of fire suppression systems, emergency response, or insurance coverage. Our personnel are trained to identify hazards, report incidents, and follow emergency protocols provided by the requester, but they are not responsible for firefighting or law enforcement actions. By submitting this request, the requester agrees to assume full responsibility for compliance with all applicable fire codes and regulations. Smith & Associates Environmental Health & Safety LLC shall not be held liable for any loss, damage, injury, or claims arising from fire incidents during the watch period.

Requestor Signature *

Clear Signature

Signature of Approval Date *