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2. 
3. Fire and Life Safety Inspection Correction Submission Form

   This form is designed to facilitate the swift clearance of corrected violations by allowing business owners to submit photographic evidence of the addressed issues directly to their assigned inspector.

   Please follow the instructions below to ensure your submission meets the necessary requirements for review:

   • Photographs: Submit clear and identifiable photographs of each corrected violation. Each image should clearly show the corrected area with enough context to ensure the location is easily identifiable.
   • Disclaimer: Only photographs that clearly depict the corrected violation and its location will be accepted for clearance purposes. If the photograph or the location of the correction is unclear to the reviewing inspector, an in-person re-inspection will be required. This is to ensure that all corrections meet safety standards.
   • Limited Courtesy: The option to submit photographs for correction verification is a courtesy that may not be extended to all businesses and is dependent on the nature and severity of the original violation.
   • Compliance Documentation: All official paperwork, including inspection reports for fire and life safety systems (e.g., fire sprinklers, fire alarms, fire pumps), must be submitted through the Compliance Engine online by the service contractor. Submissions via this form or over email will not be accepted.

   This portal streamlines the correction process, helping you comply with safety standards efficiently. Please ensure that all submissions are complete and clear to avoid delays in the clearance of violations.

5. Today's Date*
   Today's Date
6. Inspection Number*
7. Occupancy ID*
9. Business Name*
10. Email Address*
12. Business Location Address*

    Physical Business Location - Not Billing/Mailing Address

13. Suite / Unit Number
15. City*
16. State*
17. Zip Code*
19. WFD Inspector
    -- Select One --Morgan SanchezTrista KennedyAsha WhippleDavid KellerEduardo Velazquez-SolorioEvan CooleyGene MayerGreg RussellJeff OliverMarius BretanMatt FlintMatt StokesMax EliaNicholas MartinezNoe LopezRyan MingesSamuel KennedyShawn AllenTara DanielsTravis ZicklerTrevor MoureauxTroy WarrenWalter ScruggsInspector Not Listed
20. Photograph Submission

    Photographs: Submit clear and identifiable photographs of each corrected violation. Each image should clearly show the corrected area with enough context to ensure the location is easily identifiable.

22. Item

    List the item description as listed in the report.

23. Correction Photo
25. Item

    List the item description as listed in the report.

26. Correction Photo
28. Item

    List the item description as listed in the report.

29. Correction Photo
31. Item

    List the item description as listed in the report.

32. Correction Photo
34. Item

    List the item description as listed in the report.

35. Correction Photo
37. Item

    List the item description as listed in the report.

38. Correction Photo
40. Item

    List the item description as listed in the report.

41. Correction Photo
43. Item

    List the item description as listed in the report.

44. Correction Photo
46. Item

    List the item description as listed in the report.

47. Correction Photo
49. Item

    List the item description as listed in the report.

50. Correction Photo
52. Next Steps After Submission:

    After you have submitted your photographs, they will be thoroughly reviewed by the assigned inspector. You will receive an email notification regarding the status of your submission. This email will confirm whether your corrections have been accepted or if further action, such as an in-person re-inspection, is required. Please ensure that your contact information is up-to-date to receive timely updates.

    Thank you for your cooperation and commitment to maintaining fire and life safety standards.

    
    

Leave This Blank:


54. 1. Receive an email copy of this form.
55. Email address

    This field is not part of the form submission.

56. Submit

* indicates a required field