School Board

    Location Name

    Location Address

    Name of Person Responsible

    Email Address

    Copy To

    Phone Number

    Type of Protection

    Valve Number/Equipment Identifier

    Area Protected

    Reason for Impairment

    Number of Turns to Close

    Authorized By

    Fire Protection Equipment Operator

    Emergency organization notifiedContinuous work authorizedPublic fire department notifiedOngoing patrol of areaHazardous operations stoppedHydrant connected to sprinkler riserHot work prohibitedPipe plugs on handSmoking restrictedFire hose laid outOther