Potential Fire Hazard Advice

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Your Details
Which of the following are you?
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Contact Details
Please provide the following details so we can contact you for additional information (if required) and can advise you of the outcome of our assessment
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Contact address
Address finder
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Location of potential fire hazard
Enter the closest address to the location of the potential fire hazard, you'll be able to refine the location on the map below
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Move the marker to the approximate location of the potential fire hazard.

Fire hazard details
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Please provide an image of the hazard in question.This will allow the assessor to better locate the hazard.Please note the accepted file types include PDF, JPG, PNG, DOCX, XLSX.

Drag files here to upload

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    Property contact details
    Is someone living at the property where the potential fire hazard is?
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    Are they the owner of the property?
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    Occupant's contact details
    Please provide the following details of the person living at the property
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    Have you spoken to this person about removing the hazard?
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    Owner's contact details
    Please provide the following details of the owner of the property
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    Address Finder
    Have you spoken to the owner about removing the hazard?
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    Review and submit

    Contact Detail

    Source

    {{ fieldValue('HazardPermitPublicType', 'radio') }}

    Source

    {{ fieldValue('HazardPermitInternalType', 'radio') }}

    Territorial authority

    {{ fieldValue('TerritorialAuthorityID', 'select') }}

    First name

    {{ fieldValue('PersonFirstName', 'text') }}

    Surname

    {{ fieldValue('PersonSurname', 'text') }}

    Email

    {{ fieldValue('PersonEmail', 'text') }}

    Phone

    {{ fieldValue('PersonPhone', 'text') }}

    Mobile

    {{ fieldValue('PersonCellPhone', 'text') }}

    Address

    {{ fieldValue('PersonAddress', 'text') }}

    City

    {{ fieldValue('PersonCity', 'text') }}

    Post code

    {{ fieldValue('PersonPostCode', 'text') }}

    Location of potential fire hazard

    Address

    {{ fieldValue('Address', 'text') }}

    City

    {{ fieldValue('City', 'text') }}

    Post code

    {{ fieldValue('PostCode', 'text') }}

    Fire hazard details

    Location on property

    {{ fieldValue('HazardLocation', 'text') }}

    What road can the hazard be seen from?

    {{ fieldValue('HazardSeenFrom', 'text') }}

    Hazard Type

    {{ fieldValue('HazardTypeID', 'select') }}

    Fire hazard description

    {{ fieldValue('HazardSpecification', 'text') }}

    Additional information

    {{ fieldValue('AdditionalInformation', 'text') }}

    Attachments

    {{ fieldValue('Attachments', 'attachment') }}

    Property contact details

    Property is occupied

    {{ fieldValue('KnowPerson', 'radio') }}

    Occupant is owner

    {{ fieldValue('IsOwner', 'radio') }}

    Occupant's contact details

    First name

    {{ fieldValue('OccupierFirstName', 'text') }}

    Surname

    {{ fieldValue('OccupierSurname', 'text') }}

    Email

    {{ fieldValue('OccupierEmail', 'text') }}

    Phone

    {{ fieldValue('OccupierPhone', 'text') }}

    Hazard discussed

    {{ fieldValue('SpokenToOccupier', 'radio') }}

    Response

    {{ fieldValue('OccupierResponse', 'text') }}

    Owner's contact details

    First name

    {{ fieldValue('OwnerFirstName', 'text') }}

    Surname

    {{ fieldValue('OwnerSurname', 'text') }}

    Email

    {{ fieldValue('OwnerEmail', 'text') }}

    Phone

    {{ fieldValue('OwnerPhone', 'text') }}

    Address

    {{ fieldValue('OwnerAddress', 'text') }}

    City

    {{ fieldValue('OwnerCity', 'text') }}

    Post code

    {{ fieldValue('OwnerPostCode', 'text') }}

    Hazard discussed

    {{ fieldValue('SpokenToOwner', 'radio') }}

    Response

    {{ fieldValue('OwnerResponse', 'text') }}