HOW TO GET YOUR SCHEME APPROVED 1. Complete all sections of the Evacuation Scheme Application Form 2. To the Evacuation Scheme Application Form attach:- (i) A copy of the Draft Evacuation Scheme. The Draft Evacuation Scheme must provide for all the requirements of the Fire Safety and Evacuation of Buildings Regulations 1992. The sample format included will assist you in achieving the requirements. (ii) A copy of all Notices and Wardens Instructions (iii) A sample of the Building Assistance Register for disabled persons. 3. Forward the original documents (retaining a copy for your records) to:- The New Zealand Fire Service Whangarei Fire Station 12 Mansfield Terrace WHANGAREI If further assistance is required phone (09) 438-9539
NEW ZEALAND FIRE SERVICE ADVICE ON COMPLETING DRAFT EVACUATION SCHEME (AS PER ATTACHED FORM FSC 418a) This page offers advice to assist applicants to complete the Draft Scheme (example attached) if appropriate to your needs. However you may wish to produce your own document and the information contained in the Draft Scheme and on this page needs to be taken into account. 1. APPOINTMENT AND TRAINING OF WARDENS Positions of wardens preferred to persons name. Please add as necessary where additional wardens appointed. These details may be provided as an addendum if inadequate room. Areas that Wardens are responsible for preferably should be shown on Wardens Duties notice 2. IDENTIFICATION OF BUILDING WARDEN AND FLOOR WARDENS The Building Wardens must be readily identified to the Fire Service. The Floor Wardens must be readily identified to the occupants. 3. ASSEMBLY POINTS Assembly points should be clear of the Fire Brigade attendance point Crossing a street to an assembly point is not recommended. 4. MEANS OF ESCAPE TO BE MONITORED All doors on escape routes must be capable of being readily opened without the use of keys. Dead Locks: Where dead locks are fitted procedures must be in place to ensure that all doors in the means of escape system are unlocked whenever the building is occupied. This includes for example where cleaners or staff are working after hours. The means and procedures as to how this will be managed must be included in the scheme. 5. DISABLED PERSONS ASSISTANCE It is acceptable in the Assistance Register under Person(s) assigned to assist to write Warden to appoint as required
Evacuation Scheme Application Fire Safety and Evacuation of Buildings Regulations 1992 To: The Fire Region Commander, New Zealand Fire Service I hereby apply for EVACUATION SCHEME approval for the premises described below: 1 Full Name of Applicant Mr Craig McKernan Appointment or Position of Applicant (if not building owner) Principal Postal Address of Applicant 1 Percy Street Whau Valley Whangarei Telephone Number of Applicant [09] 4371039 Fax No. [09] 4377509 2 Name of Building St Francis Xavier Catholic School Street Address (including street number) 1 Percy Street Whau Valley Whangarei 3 Name and Address Bishop Pat Dunn of Building Owner Pompallier Diocesan Centre Private Bag 47904 Auckland 1034 Signature of Building Owner or Authorised Agent Date
4 Name Building s Occupancy Group a List Floors where group is located ( eg. ground floor, second floor etc...) All employees and students are on the ground floor. b Name Occupancy Groups (eg. offices, manufacturer, laundry, tavern) Administration areas, caretakers sheds, office spaces, classrooms. Continue on a separate sheet if necessary c Location and Maximum Number of People in Building When Building Fully Occupied. Count people usually at work and those likely to be at work in building at any one time. Remember to include those self employed, intakes of trainees, etc (If maximum number of persons in the building varies from day to day enter the maximum number likely at any one time). Employees Public/ Occupants i Number Below Ground Floor ii Number On Ground Floor 43 500 iii Number Above Ground Floor
5 Does the building have SLEEPING ACCOMMODATION? Yes No No Complete this section Go directly to section 6 Location and number of bed spaces: Minimum number of people employed at any one time: a i Below Ground Floor level ii At Ground Floor level Nonsleeping iii Above Ground Floor level b Sleeping Day Night Number Number Number Day Night Number Number Number Number c Greatest number of people likely to require Evacuation assistance Day Number Night Number 6 Building Assistance Register Permanent Location of Register Principal s Office (A building assistance register must be provided for all buildings.) Attach a copy of the Register to this application. 7 Give Details of the Building s Floors and Age a Total Number of Floors excluding basement One b Total Number of Basement levels Nil c Approximate Date of building s construction 1951 2004 Several classroom blocks 8 Details of Hazardous Substances Stored or Used in Building. If your building fits the description in Section 21A(2)(b) of the Fire Service Act 1975, please contact your local Fire Safety Department for more information. Name of Substance Maximum Quantity Stored Method of Storage Maximum Quantity Exposed at any one time Petrol 20 litres Caged 20 litres Fertilizer 200 kilograms Spill tray 200 kilograms LPG 9 kilograms Caged 9 kilograms Paint 100 litres 100 litres Sprays 10 litres Locked cabinet 10 litres Continue on a separate sheet if necessary
9 Give Details of Fixed Fire Protection Equipment installed in building Type of System a Automatic Fire Sprinkler Nil b c Automatic Detection (eg smoke or heat) Manual Call Points d Warning Devices - Audible All blocks - Visual Nil e Emergency Lighting Nil Extent of Building Protected by System (If only part of building protected state which part) Frequency of Servicing Testing Smoke detectors Annual Annual f Other (eg. gas flooding) specify Nil (Note Compliance Schedule may assist in determining minimum servicing and testing intervals). 10 Give Details of Manually Operated Fire Fighting Equipment available in building Type of Equipment No. of Units Available Where Installed Serviced Annually? a Hose reels 6 Blocks A,D,G,H,I,J yes b Portable Fire Extinguishers Blocks A,B,E,J,K,L,M yes c Others (eg fire blankets) specify no 11 Give Details of Training Given to Staff in Fire Safety Procedures e.g Subject Induction / Refresher Course to Cover. Frequency of staff training Review of scheme Annual On Induction - new staff Yes Review of Wardens duties Annual Annual N/A Trial Evacuations Each term Every school term Yes Part 1 of Fire Safety & Evacuation Regulations 1992 (Places of Care) Other (specify) School Other (specify:
12 Description of Evacuation Scheme a Date plan prepared? 05 2 09 b Method of initiating evacuation Fire alarm ( eg. operation of Fire Alarm) c Are Exitways Adequately Marked? yes Yes no d Have Wardens Been Appointed? yes Yes no Enter Number of Wardens 6 Description of Wardens Identification Armband 6 Hats Sashes Vests Other e Has a Senior/Building Warden been appointed? yes Yes no f Evacuation Points Inside Building ( Your building must comply with Regulation 16 of the Fire Safety and Evacuations of Buildings Regulations 1992) Name location of proposed points Nil g Name location of final designated On the netball court area outside A Block Assembly Points Outside Building h Name the location of evacuation notice instructions: eg Alongside manual fire alarm points? Near doors on exit routes? In public areas? In staff areas? Other places? (specify) Yes Yes Yes No I e.g Frequency of trial evacuations Six Monthly Every School Term Other (specify) Each term J Describe Method of Accounting for Occupants (after physical check of building.) eg. Tally Board Roll Call Head Count Other (specify) Roll call Please attach copies of The Draft Evacuation Scheme and All Notices and Wardens Instructions
NEW ZEALAND FIRE SERVICE EVACUATION SCHEME FOR: STREET ADDRESS: TOWN / CITY St Francis Xavier Catholic School 1 Percy Street Whangarei CONTACT NAME: Craig McKernan PHONE NUMBER [09]4371039 021 2772333 1. APPOINTMENT AND TRAINING OF WARDENS 1) The Building Warden and Floor Wardens appointed to supervise evacuations are: i) Building Warden: Craig McKernan ii) Deputy Building Warden: Pamela Head iii) Floor Wardens: Tracey Balks / Lynn Douglas Area: Rm 7-14 2) Training: i) All Wardens on appointment. ii) Ongoing Colleen Ferguson Area: Rm 1-6 Glenys Jakicevich Area: Rm 15-19 3) The appointment of Building Warden and Floor Wardens will be reviewed at not less than 6 monthly intervals. 2. IDENTIFICATION OF FLOOR WARDEN [Syndicate leaders] AND BUILDING WARDEN [Principal / Executive Officer] 1) Building Warden is identified by: Vest 2) Floor Wardens are identified by Arm Bands 3. DISPLAY OF NOTICES 1) Notices will be displayed in the building explaining the procedures and routes to be followed in an evacuation. Examples attached to this scheme.
4. TRIAL EVACUATIONS (Delete and initial the non-applicable sentence) 1) To be conducted not more than 6 months after any previous emergency or trial evacuation. 2) To be conducted in educational buildings every term, except any term in which an emergency evacuation has already taken place. 5. ASSEMBLY POINTS 1) The evacuation assembly point is: On the netball courts in front of the junior classrooms. 6. MEANS OF ESCAPE TO BE MONITORED 1) Checks of the means of escape will be undertaken at regular intervals to ensure that: a) They are kept clear of obstacles at all times; and b) Exit Doors are not locked, barred, or blocked so as to prevent occupants from leaving the building when the building is occupied; and c) Smoke control and fire stop doors are not kept open by methods other than hold-open devices that comply with the building code; and d) Stairways and passageways which are designed specifically for means of escape from fire are not used as places of storage or places where refuse is allowed to accumulate. e) Flammable cleaning liquid or material or any other like flammable liquid or material shall not be stored near or within any part of the building used as a means of escape from fire, and shall be in non-combustible containers with close fitting lids. 7 EVACUATION OF DISABLED PERSONS 1) An Assistance Register (sample attached) will be: a) Updated as required. b) Located: Principal s office (so as to be readily accessible to the Building Warden and the Fire Service) 8. TRAINING OF STAFF OF INSTITUTIONS OF CARE (Delete if not applicable to your premises) Those staff who are normally in contact with persons in care will be trained in such Fire Safety provisions of Part I of the Fire Safety and Evacuation of Buildings Regulations 1992 as are relevant and also trained to assist those persons in the event of an evacuation.
WARDENS DUTIES FLOOR WARDENS [Syndicate leaders]: On hearing Warning Signal: 1. Evacuate occupants from your syndicate areas (including toilets and resource rooms) via the nearest safe exit. 2. Note location of persons remaining in premises, including disabled. 3. Appoint person(s) to assist disabled persons as required. 4. Report to Building Warden and advise status of evacuation. BUILDING WARDEN [Principal / Executive Officer] On hearing warning signal: 1. Ensure Fire Service has been called. Dial 9 4389199 2. Report to front entry (fire alarm panel if installed). 3. Receive status reports from syndicate leaders. 4. Advise Fire Brigade on arrival of situation.
BUILDING ASSISTANCE REGISTER FOR PERSONS WITH DISABILITIES Name of Building: St Francis Xavier Catholic School Address: 1 Percy Street Whangarei THE FOLLOWING LOCATIONS HAVE BEEN IDENTIFIED AS AREAS WHERE REGULAR USERS OF THE BUILDING WHO COULD REQUIRE ASSISTANCE TO EVACUATE THE BUILDING IN THE EVENT OF AN EMERGENCY WILL MOST LIKELY BE FOUND: DATE LIKELY LOCATIONS OF PERSONS ASSISTANCE REQUIRED PERSON ASSIGNED REQUIRING ASSISTANCE TO ASSIST 4/ 9/ 06 Classrooms or office spaces Advice and guidance Teacher aides, Teachers. THE FOLLOWING STAFF HAVE BEEN ASSIGNED TO ASSIST EVACUATING ANY PERSON WITH A DISABILITY VISITING THIS BUILDING AT THE TIME OF AN EMERGENCY EVACUATION: DATE APPOINTED PERSON(S) ASSIGNED TO ASSIST 4 /09/06 Teacher aides and teachers who have disabled persons in their care at the time of the evacuation.