7.1.4 FIRE EXTINGUISHER INSPECTION

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

MONTH AND YEAR:

• JANUARY

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• FEBRUARY

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• MARCH

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• APRIL

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• MAY

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• JUNE

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• JULY

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• AUGUST

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• SEPTEMBER

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• OCTOBER

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• NOVEMBER

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• DECEMBER

• Gauge

• Charge

• Condition

• Mount

• Pin

• Nozzle

• Nameplate

• Make:

• Model:

• Serial#:

• Type:

• Size:

• Location:

• Inspector's Name & Signature:

  Sign

FILL IN SPACES AND FORWARD TO THE OFFICE ON A MONTHY BASIS.