Fire Extinguisher Inspection

• Document No.

• Audit Type

• Conducted on

  Date

• Prepared by

• Basin

• Location
  Address

Data

• Enter Serial Number

• It is attached to a truck?

  Yes

  No

  N/A

• Enter Vin Number

• Brand

  Amerex

  Ansul

  First Alert

  kidde

• Chemical Agent

  ABC

  Purple K

• Weight

  20 lbs

  10 lbs

  5 lbs

Exterior

• Gauge Condition

  Full

  Discharge

• Handle

  Good

  Bad

• Hose

  Good

  Bad

• Body

  Good

  Bad

• Serial Number Condition

  Good

  Bad

• Inspection Result

  Pass

  Fail

• I hereby certify that all information is accurate and that an actual inspection was conducted

• Auditor's Printed name and signature

  Sign