Title Page
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Site conducted
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Conducted on
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Prepared by
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Location
Fire Extinguisher Information
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Location of Fire Extinguisher
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Serial No. of Fire Extinguisher
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Manufacture Date
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Expiry Date
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Type of Fire Extinguisher
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Size (KG)
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Rating
Fire Extinguisher Inspection
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Has a valid maintenance tag
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Mounted in an easily accessible place, no debris or material stacked in front of it.
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Safety pin is in place and intact. Nothing else should be used in place of the pin.
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Label is clear and extinguisher type and instructions can be read easily.
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Handle is intact and not bent or broken.
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Pressure gauge is in the green and is not damaged or showing “recharge”
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Discharge hoses/nozzle is in good shape and not clogged, cracked, or broken
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Extinguisher was turned upside down at least three times (shaken) to make sure it is full.
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Location of extinguisher is easily identifiable by signs
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Dust and wipe down the extinguisher
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Annual maintenance tag is signed and dated
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Take a photo of the annual maintenance tag
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Overall condition of fire extinguisher
Completion
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Write down observations
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State recommendations about the inspections here
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Name and Signature of Inspector