Fire Extinguisher Monthly Inspection Report

• Equipment Numbers

• Department

• Date of Inspection

  Date

• Inspected by

Inspection of all fire extinguishers should visually determine the following:

• Is fire extinguisher demarcated?

  Yes

  No

  N/A

• Is it conspicuous? (visible)

  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

• Is the hose/nozzle plugged in and not damaged?

  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

• Is there a Fire Siren?

  Yes

  No

  N/A

• Is the box in good condition, is the cover on the box?

  Yes

  No

  N/A

• Is an Evacuation Map present and up to date?

  Yes

  No

  N/A

• Are regular fire drills completed?

  Yes

  No

  N/A

• Are the fire wardens trained?

  Yes

  No

  N/A

• Are the escape routes clearly marked?

  Yes

  No

  N/A

• Comments:

• Inspector's Signature:

  Sign