The Timber Mesa Fire and Medical District (TMFMD) is committed to the safety and security of our local businesses, their customers, guests, and employees. The Vision of the Fire District is "A Community Prepared for the Challenges of Tomorrow". As part of our commitment to safety, TMFMD conducts periodic inspections of the businesses located within the Fire District as mandated by law and the adopted fire code. Prior to now, these inspections have been formally conducted by Fire District personnel from the Fire Prevention Division. Formal inspections take time, not only for fire inspectors to complete but also time out of the business owner's day and possible interruptions to the business overall.

Occupancies within the Fire District are categorized by the type of business being conducted, the occupancy classification, and hazards present. Certain criteria go into these classifications, and each occupancy is placed on a scheduled rotation as to when it needs to be inspected following the fire code. The risk classifications associated with business occupancies are" low", "medium", and "high".

Your business has been identified as a "Low Risk" occupancy.

 To reduce cost to the Fire District and empower you, the business owner, to complete the inspection process when it is convenient for you, TMFMD has adopted a self-inspection program for qualifying businesses that are typically categorized as "low hazard".

Self-inspections are performed by the business owner or occupant by following a fire safety inspection checklist. Attached, you will find the fire inspection checklist. Once the checklist is completed, the self-inspection form must be returned to the TMFMD Prevention Division. If repairs or maintenance are needed, please note this on the form before sending it to TMFMD.

A business assigned to self-inspection status may opt out and request a regular inspection. If your self-inspection form is not properly and timely completed, you may be removed from the self­inspection program and automatically scheduled for a full in-person inspection. Additionally, falsified self-inspections are subject to penalty, removal from the program, and re-entered into the in-person inspection schedule. All businesses are subject to random compliance visits to ensure accountability and honest reporting.

The self-inspection must be completed before January 1, 2026. Your business will not require self-­inspection for another three years from that date. 

The safety and protection of your business and the lives of all who live within our Fire District is our top priority. For any questions, please contact the Fire Marshal or the Fire Prevention Division at (928) 537-5100.

Thank you for helping us make our community fire-safe.

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Self-Inspection Form

Business Name (required)

Street Address (required)

1. Owner Occupant Conact: (required)

Owner Occupant Phone Number (required)

2. After-Hours Emergency Contact (required)

Emergency Contact Phone Number (required)

3. Email (required)

If you do not feel comfortable performing your own inspection, please place an "X" in the space below to request a standard inspection. Skip the rest of the form and click submit.

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Building Exterior

Are address numbers clearly visible from the street?

Yes

No

N/A

Are all sides of the building free from weeds, trash, debris, or combustible storage?

Yes

No

N/A

Are all dumpsters and containers stored at least five (5) feet away from combustible walls, openings, and roof eaves?

Yes

No

N/A

Are all vents of heat-producing appliances (heaters, water heaters, clothes dryer, etc.) in good repair and functioning properly?

Yes

No

N/A

Is there a minimum of three (3) feet clearance around fire hydrants?

Yes

No

N/A

If your business has a Knox key box, are the keys up to date??

Yes

No

N/A

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Interior

Have breaches, missing ceiling tiles, holes in the walls or ceiling that could allow fire into the hidden spaces been repaired or replaced?

Yes

No

N/A

Have no new walls been added that would interfere with exiting, fire alarms or sprinkler coverage?

Yes

No

N/A

Do all natural-gas appliances have individual gas shut-off valves?

Yes

No

N/A

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Egress/Exiting

Are exit doors free of locking bolts and capable of operation from the inside without use of a key or special knowledge that may interfere with someone getting out?

Yes

No

N/A

Are the exit ways and doors easily recognizable, unobstructed and maintained functional?

Yes

No

N/A

Do all exit door self-closure devices operate and the door latches completely when released?

Yes

No

N/A

Are all exit paths clear of obstructions, displays, and combustible materials? (Note: Exit paths are from any point in the building to the public way)

Yes

No

N/A

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Emergency Lighting/Egress Illumination

If emergency lighting is provided, is it maintained in operable condition?

Yes

No

N/A

Are all egress paths illuminated at all times when the building is occupied?

Yes

No

N/A

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Exit Signs

If exit signs are present, are they illuminated at all times?

Yes

No

N/A

Does the exit sign battery backup work? (Push the test button, exit sign should light)

Yes

No

N/A

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Electrical

Do all electrical outlets, switches and junction boxes have cover plates?

Yes

No

N/A

Is there a minimum of 30-inches clear space in front of electrical panels so that they are easily accessible?

Yes

No

N/A

Are all circuit breakers labeled to show what they control and panel door kept closed?

Yes

No

N/A

Are circuit breakers free of tape or any other obstructions that may prevent them from functioning properly?

Yes

No

N/A

Are extension cords used only for temporary use (less than 30 days) and only with portable appliances?

Yes

No

N/A

Are extension cords replaced with UL® listed power strips and do not pass under rugs, through walls or across traffic paths? All parts of any cord must be visible so that wear or bad spots can be noticed.

Yes

No

N/A

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Fire Alarm Systems

If the building is equipped with a fire alarm system, has the required test/service been performed by a licensed contractor within the last twelve (12) months?

Yes

No

N/A

Have the batteries in all smoke alarms been checked in the last six (6) months?

Yes

No

N/A

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Fire Extinguishers

Is the travel distance to any fire extinguisher less than 75 feet?

Yes

No

N/A

Have all fire extinguishers been serviced and tagged by a licensed fire extinguisher service company within the last twelve (12) months?

Yes

No

N/A

Are all fire extinguishers visible, accessible, and mounted no higher than sixty (60) inches from the floor to the

Yes

No

N/A

Are fire extinguishers at least rated as a 2A-10BC minimum size/type?

Yes

No

N/A

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Fire Suppression Systems

If the building is equipped with a fire suppression (sprinkler) system, has the required test/service been performed by a licensed contractor within the last twelve (12) months?

Yes

No

N/A

Is there a minimum 18-inch clearance below sprinkler deflectors and the top of storage?

Yes

No

N/A

For commercial cooking, has the hood suppression system been serviced within the last six (6) months?

Yes

No

N/A

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Housekeeping and Storage

Is the storage of combustible materials neat, orderly and piled no higher than two (2) feet below the ceiling?

Yes

No

N/A

Are oily rags or similar materials stored in metal, metal-lined or other approved containers equipped with tightfitting covers?

Yes

No

N/A

Are equipment rooms, mechanical rooms, electrical rooms, and areas under open stairways maintained clear of combustible material storage?

Yes

No

N/A

Are flammable liquids stored in approved safety cans?

Yes

No

N/A

Are quantities of flammable or combustible liquids in excess of ten (10) gallons stored in approved storage cabinets?

Yes

No

N/A

Are compressed gas containers (CO₂, helium, etc.) secured to prevent falling?

Yes

No

N/A

Are portable electric heaters an approved type, plugged directly into a wall outlet and kept a minimum of three (3) feet away from combustibles?

Yes

No

N/A

Are all combustibles storage at least three (3) feet away from gas fired appliances (water heaters, furnaces, etc.)?

Yes

No

N/A

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Note: You will be contacted by a Timber Mesa Fire Inspector for all “No” responses addressing violations. All violations must be corrected within 30 days of the inspection date. 1. No Misrepresentations, False Statements, Inaccurate Information. You hereby represent to the Fire Department that you provided information for the completion of your business inspection without intentionally or negligently making false statements or misrepresentations of any kind during the course of the Inspection. Further, you agree to be responsible for any damages or claims made against the Fire Department that arose from or were caused by you providing false or inaccurate information or making misrepresentations during the course of your Inspection. 2. Indemnity. You agree to indemnify and hold the Fire District, its officers, employees and agents, harmless from any third party claim or cause of action, including reasonable attorneys’ fees and costs, arising, directly or indirectly, out of your access to or use of Fire District affiliated web sites, e-mails or inspection results in connection with your Inspection, the information contained therein, and the results thereof, or your violation of any law or the rights of any person.

Print Name of Person Performing the Inspection

Date

Your Signature (required)

Confirm e-Signature

Review Electronic Records and Signatures Policy (required)

Read our Electronic Record and Signature Disclosure

I agree to use electronic records and signatures

Date

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