6 Month Fire Hose Inspection

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

FIRE HOSE INSPECTION

• Which hose is being tested?

  Select

• Record asset no. or serial number of hose:

• Does hose freely move and unravel from reel?

  Yes

  No

  N/A

• Is hose free from any obvious signs of damage such as splits?

  Yes

  No

  N/A

• Is nozzle/head free from obvious damage?

  Yes

  No

  N/A

• Does Nozzle work correctly (Test by filling bucket of water)?

  Yes

  No

  N/A

• Has hose been serviced by contractor in previous 12 months?

  Yes

  No

  N/A

COMPLETION AND SIGN OFF:

• Date of inspection:

  Date

• Signed by?

  Sign