6._GSA_Form_3559.pdf

GSA Form PDF 30 KB Posted

Attached to
Annual Fire Safety Inspections at Child Care Centers in WA, OR and AK
Solicitation number
EQ10PME-16-5005
Issued by

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GSA Form 3559

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Other versions and copies of GSA Form 3559

File Revision Posted Attached to
GSA_Form_3559.docx Revision not stated Fire Safety Surveys for Alaska Federal Buildings
GSA_Form_3559.pdf Revision not stated Fire Safety Surveys throughout GSA NW Arctic Region 10
7-GSA_Form_3559.doc Revision not stated Fire Safety Surveys

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Text version

FACILITY NAME

FACILITY ADDRESS

BUILDING NUMBER

● Scheduled

○ Follow-up

○ Unscheduled

CONDUCTED BY

DATE OF SURVEY

DATE OF REPORT

REPORT CONTROL NUMBER

Findings and Recommendations:

001 Finding:

Recommendation:

Ref:

Estimated Cost:

Hazard Severity: (Assigned by GSA) Mishap Probability: (Assigned by GSA) Risk Assessment Code: (Assigned by GSA) Responsible Official: (Assigned by GSA)

○ S&EM – Safety and Environmental Survey

● F - Firesafety

○ FS&H – Facility Safety and Health

○ OSH – Occupational Safety and Health

○ M - Miscellaneous

R-10 GSA Form 3559 (revised 2014) Page 1 of 1

● F - Firesafety
○ M - Miscellaneous

File details come from the government source that posted it. Updated .