Laboratory Fire Incident Report Form
Date of Incident
Time of Incident
Location (Lab Name/Room Number)
Name of Reporter
Contact Number
Email Address
Persons Involved
Type of Fire
Class A (Combustibles)
Class B (Flammable Liquids)
Class C (Electrical)
Other
Description of Incident
Cause of Fire (if known)
Actions Taken
Injuries/Damages (if any)
Reported to (Authorities/Departments)
Additional Comments