EC Hose Test

• Conducted on

  Date
• Test Location:
  Address

• All Hand and Supply Lines shall be pressurized to 250psi and maintained for 5 minutes.

• If Testing to a greater Pressure or Duration, please specify:

• Officer in Charge:

  Sign

• Apparatus:

  Select 4011 4013 4017 4018 4098 Spare Hose Other

  • 4011
  • 4013
  • 4017
  • 4018
  • 4098
  • Spare Hose
  • Other

• Type of Hose Tested:

  Select 1" Forestry Line 1 3/4" Handline 2 1/2" Handline 5" Supply Line Other

  • 1" Forestry Line
  • 1 3/4" Handline
  • 2 1/2" Handline
  • 5" Supply Line
  • Other

Other Hose Line

• Diameter of Hose:

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional OTHER Hose?

  Yes

  No

• Diameter of Hose:

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional OTHER Hose?

  Yes

  No

• Diameter of Hose:

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional OTHER Hose?

  Yes

  No

• Diameter of Hose:

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional OTHER Hose?

  Yes

  No

• Diameter of Hose:

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional OTHER Hose?

  Yes

  No

• Diameter of Hose:

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional OTHER Hose?

  Yes

  No

• Diameter of Hose:

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional OTHER Hose?

  Yes

  No

• Diameter of Hose:

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional OTHER Hose?

  Yes

  No

• Diameter of Hose:

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Any Hose Failures or Leaks?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

5" Supply Line

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 5" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Any Hose Failures or Leaks?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

2 1/2" Handline

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 2 1/2" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Any Hose Failures or Leaks?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

1 3/4" Handline

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1 3/4" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Any Hose Failures or Leaks?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

1" Forestry Line

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1" Hose Line?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Add Additional 1" Hose?

  Yes

  No

• Hose Length:

  25'

  50'

  100'

  Other

• Hose Color:

  Select Blue Orange Red White Yellow Other

  • Blue
  • Orange
  • Red
  • White
  • Yellow
  • Other

• Hose Number:

• Any Hose Failures or Leaks?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.

• Add Additional Hose Failure?

  Yes

  No

• Hose Number:

• Photo of Failed Hose

  Media

• Was Hose Removed from Service?

  Yes

  No

• Please complete a SERVICE REQUEST audit for the Failed Hose.