Fire Extinguisher Monthly Inspection Report

• Truck Or Equipment Number

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

Inspection of all fire extinguishers should visually determine the following:

• Is fire extinguisher in a designated place?

  Yes

  No

  N/A

• Is it conspicuous?

  Yes

  No

  N/A

• Is it blocked by anything?

  YES

  NO

  N/A

• Has it been activated and is partially or completely emptied?

  YES

  NO

  N/A

• Has it been tampered with?

  YES

  NO

  N/A

• Has it sustained any physical damage?

  YES

  NO

  N/A

• If a pressure gauge is present, does it show to be satisfactory?

  Yes

  No

  N/A

• Have you checked to make sure the hose/nozzle is not plugged up with anything i.e. mud diver's nest, ect?

  Yes

  No

  N/A

• Have you physically removed the extinguisher from its bracket and turned the extinguisher over and shook it to loosen the powder in the extinguisher? Then did you return the extinguisher to it's bracket or storage location?

  Yes

  No

  N/A

• Are monthly and annual inspections being completed?

  Yes

  No

  N/A

• Comments:

• Inspector's Signature:

  Sign