What is the property owner's first name?
What is the property owner's last name?
What is the property owner's email address?
What is the address of the property being evaluated for fire protection?
Fire Department Information
What is the name of the responding fire department?
What is the address of the responding fire department?
What is the full name of the fire department contact?
What is the role of the fire department contact?
What is the phone number for the fire department contact?
What is the email address for the fire department contact?
How is the fire department staffed?
How many paid fire fighters does the department have?
How many volunteer fire fighters does the department have?
How many pumpers does the fire department have?
What is the pumping capacity of the pumpers? (In gallons per minute)
How many tankers does the fire department have?
What is the pumping capacity of the tankers? (In gallons per minute)
Fire Protection Information
What is the protection class of the property?
What is the response time for this property? (Approximate)
Is there a public fire hydrant within 1,000 feet of the home?
What is the nearest water source? (Select all that apply)
Please provide details about the nearest water source.
What is the distance of the water source(s) from the dwelling? (Approximate)
What is the amount of water available? (Approximate)
Is/are water source(s) accessible to the fire department year-round?
Please explain why the water source is not accessible year-round. (Ie. Freezes in the winter)
Are the roads paved and accessible year-round?
Are there any physical barriers to the property? (Ie. Gate, bridge, etc...)
Please describe the physical barriers.
Is the dwelling clearly visible, with no obstructions, to full-time resident neighbors?
Please explain why the dwelling is not clearly visible to resident neighbors.
Please enter any additional comments regarding the fire protection for this property below.
Disclaimer: This online questionnaire is a tool used to gather information. It is not an application for insurance. No insurance coverage will be bound or put into effect by submitting this form.
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