FIRE EXTINGUISHER & FIRST AID KIT INSPECTION REPORT

FIRE EXTINGUISHER & FIRST AID KIT INSPECTION REPORT

• DATE

  Date

• SITE

• AREA INSPECTED

• FIRST AID KIT NUMBER

EXTINGUISHER

• FIRST AID KIT NUMBER

• Add media

  Media

CHECK LIST

• EXPIRY DATE ON SEAL

  Date

• KIT SEALED

  Yes

  No

  N/A

• KIT CLEAN

  Yes

  No

  N/A

• KEY: 1 = GOOD 2 = ATTENTION REQUIRED 3 = IMMEDIATE ATTENTION REQUIRED

• GENERAL CONDITION

  1

  2

  3

• EXTINGUISHER NUMBER

EXTINGUISHER

• EXTINGUISHER Number

• Add media

  Media

CHECK LIST

• INSPECTION DATE ON TAG

  Date

• PRESSURE TEST CONDUCTED

  Date

• SAFETY PIN AND SECURITY TIE IN PLACE

  Yes

  No

  N/A

• INDICATOR NEEDLE (GREEN SECTOR)

  Yes

  No

  N/A

• PLASTIC COVER

  Yes

  No

  N/A

• SECURELY MOUNTED

  Yes

  No

  N/A

• KEY: 1 = GOOD 2 = ATTENTION REQUIRED 3 = IMMEDIATE ATTENTION REQUIRED

• GENERAL CONDITION

  1

  2

  3

MUST BE SIGNED

• INSPECTED BY

  Sign

• DRILLER

  Sign