Title Page
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Site conducted
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SCBA Region
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Region 1 Group
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Station
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SCBA Set Number
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Cylinder Serial Number
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Inspection Date
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Inspector
Cylinder Inspection
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Remove the Cylinder and check the cylinder for damage. Is the Cylinder free of damage?
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Record Cylinder Serial Number
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Remove Cylinder from service and Tag out (Mark inspection complete, replace cylinder and restart new inspection)
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Is current Hydro Test date valid?
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Record Cylinder Serial Number
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Remove Cylinder from service and Tag out (Mark inspection complete, replace cylinder and restart new inspection)
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Does cylinder valve function properly?
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Record Cylinder Serial Number
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Remove Cylinder from service and Tag out (Mark inspection complete, replace cylinder and restart new inspection)
Inspection of backpack and harness.
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Inspect all straps for damage. Are they in acceptable condition?
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Make notes as to what the deficiency/issue is below and record in notes exactly which SCBA if there is more than one with an issue. Capture image if possible as well for each.
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Remove Set from service and Tag out (Mark inspection complete)
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Inspect the back pack for any damage or missing parts. Is the pack in acceptable condition?
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Make notes as to what the deficiency/issue is below and record in notes exactly which SCBA if there is more than one with an issue. Capture image if possible as well for each.
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Remove Set from service and Tag out (Mark inspection complete)
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Inspect all hoses for damage/wear. Are the hoses in good shape?
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Make notes as to what the deficiency/issue is below and record in notes exactly which SCBA if there is more than one with an issue. Capture image if possible as well for each.
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Remove Set from service and Tag out (Mark inspection complete)
Functional checks.
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Functional check of the face mask. Are all the straps working and is the mask in good condition? Is the nose cup seated properly?
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Make notes as to what the deficiency/issue is below and record in notes exactly which SCBA if there is more than one with an issue. Capture image if possible as well for each.
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Remove Set from service and Tag out (Mark inspection complete)
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Functional check of the LDV fitment with the face mask? Do they connect/disconnect easily and Is the LDV in good condition?
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Make notes as to what the deficiency/issue is below and record in notes exactly which SCBA if there is more than one with an issue. Capture image if possible as well for each.
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Remove Set from service and Tag out (Mark inspection complete)
High Pressure Test
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Complete High Pressure Test, turn on cylinder 1.5 turns, allow to stabilise for 30sec, Isolate and Record initial cylinder pressure pressure.
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record start time
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Record the pressure after 1min
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High pressure test pass if pressure drop was no more than 10 bar in 1 min
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If failed, check all connections, remove cylinder and check o ring, refit if OK and retest
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Complete 2nd High Pressure Test, turn on cylinder 1.5 turns, allow to stabilise for 30sec, Isolate and Record initial cylinder pressure pressure.
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Record start time
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Record the pressure after 1min
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High pressure test pass if pressure drop was no more than 10 bar in 1 min
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Remove Set from service and Tag out (Mark inspection complete)
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Make notes as to what the deficiency/issue is below and record in notes exactly which SCBA if there is more than one with an issue. Capture image if possible as well for each.
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Remove Set from service and Tag out (Mark inspection complete)
Low Pressure Test
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Complete Low Pressure Test, keep cylinder off and ensure mask is disconnected from lung demand valve (LDV). Hold hand over lung demand outlet to seal and press the first breath (Black) button in front, monitor pressure gauge and slowly release air from the LDV with your hand, record the pressure when the whistle starts, keep hand sealed on LDV until gauge reaches zero.
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If failed, check all connections and if debris is in the whistle and retest.
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Complete Low Pressure Test, keep cylinder off and ensure mask is disconnected from lung demand valve (LDV). Hold hand over lung demand outlet to seal and press the first breath (Black) button in front, monitor pressure gauge and slowly release air from the LDV with your hand, record the pressure when the whistle starts, keep hand sealed on LDV until gauge reaches zero.
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Remove Set from service and Tag out (Mark inspection complete)
Ancillary equipment
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Is the personal line present
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Remove Set from service and Tag out (Mark inspection complete)
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is the personal line attached to the SCBA set
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Remove Set from service and Tag out (Mark inspection complete)
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Is the cord on the personal line in good condition
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Remove Set from service and Tag out (Mark inspection complete)
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Is the Distress Signal Unit (DSU) present?
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Remove Set from service and Tag out (Mark inspection complete)
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Test DSU, remove tally, did the DSU self arm?
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Remove Set from service and Tag out (Mark inspection complete)
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Test Pre-alarm, don't move DSU for 30 to 40 sec, did the pre-alarm sound?
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Remove Set from service and Tag out (Mark inspection complete)
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Shake DSU, did the pre-alarm stop return to standby?
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Remove Set from service and Tag out (Mark inspection complete)
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Test "full distress alarm", don't move DSU allow it to go into pre-alarm and after another 10sec, did the DSU enter full distress alarm?
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Remove Set from service and Tag out (Mark inspection complete)
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To exit full distress alarm, depress both black buttons on side of DSU together, did the DSU return to standby?
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Remove Set from service and Tag out (Mark inspection complete)
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test manual full distress alarm function, press black button on front of DSU, did the DSU enter full distress alarm?
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Remove Set from service and Tag out (Mark inspection complete)
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replace the Tally and depress both black buttons on side of DSU, did the DSU turn off?
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Remove Set from service and Tag out (Mark inspection complete)
Sign below.
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Inspection completed by:
