Title Page
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Site conducted
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Document No.
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Client / Site
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Conducted on
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Prepared by
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Personnel
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Add location
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EXTINGUISHER (Ref OSHA 1910.157 for details)
EXTINGUISHERS
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What is the Extinguisher Number?
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Photo
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LOCATION
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If on a Vehicle or Equipment ( Equipment Number)
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Mounting Type
- Hanging on Hook 3.5 to 5 feet from the Floor
- Secured in a Vehicle Mount
- Fire Watch: Immediately Available
- On the Ground
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Access to Extinguisher ( Clear on all sides )
- Clear
- Blocked
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Label & Instructions
- Clear, Undamaged, Facing forward
- Damaged, Faded, Turned around
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Safety Seal / Pin Seal
- Seal Unbroken
- Seal Missing
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Extinguisher Gauge
- Gauge is in the Green if Equipped
- Broke Gauge
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Extinguisher Full
- Weight Feels Full
- Discharged/Light
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Physical Condition
- Free from Rust, Dents, Nozzle pluggage, or Hose deterioration
- Damaged
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INSPECTION LEVEL COMPLETED?
- MONTHLY VISUAL
- NEW REPLACEMENT INSPECTION
- Yearly Inspection Expired
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