jorge castro

CHECK LIST EQUIPO DE RESPIRACION AUTONOMA (ERA)

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Title Page

Sitio Realizado
Fecha Inspección
Realizado por
Lugar

Datos Generales

ID del Equipo
Fecha de Calibración
Ubicación del Equipo

MASCARA

ARNES (CINTAS Y HEBILLAS)
VISOR
CUERPO
CONECTOR TIPO P18
LIMPIEZA GENERAL
VALVULA INTERIOR

TUBO O BOTELLA DE AIRE

ESTADO DEL TUBO (RASPADURA, PINTURA)
PRESION
VALVULA
CALIBRACION
CERTIFICACION PH

MALETIN DE TRANSPORTE

ESTADO GENERAL
HEBILLAS DE CIERRE
LIMPIEZA

REFERENCIAS: B (BUENO) R (REGULAR) M (MALO)

OBSERVACIONES:
Firma y Aclaracion

jorge castro

CHECK LIST EQUIPO DE RESPIRACION AUTONOMA (ERA)

Use this Template

Print as PDF

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.