Title Page

  • Site conducted

  • Site

  • Client

  • Location
  • Conducted on

  • Prepared by

FIRE HYDRANT:

  • FIRE HYDRANT applicable?

  • 1. Is there any symbolic sign displayed?

  • 2. Correct number assigned?

  • 3. Is general paintwork in good condition?

  • 4. In any way damaged?

  • 5. Any corrosion?

  • 6. Any leaks?

  • 7. Background colour-coded?

  • 8. Is floor demarcated?

  • 9. O-ring rubber in good condition?

  • 10. Valve in good condition?

  • 11. Plug fitted to mouth?

  • 12. Coupling connector in good working condition?

  • 13. Fire Hydrant accessible?

FIRE HOSE REEL

  • FIRE HOSE REEL applicable ?

  • 1. Is there any symbolic sign displayed?

  • 2. Correct number assigned?

  • 3. Is general paintwork in good condition?

  • 4. In any way damaged?

  • 5. Any corrosion?

  • 6. Any leaks?

  • 7. Security seal in order?

  • 8. O-ring in good condition?

  • 9. Background colour-coded?

  • 10. Is floor demarcated?

  • 11. Any erosion on hose?

  • 12. Is guide pulley operational?

  • 13. Is valve handle in good condition?

  • 14. Spray nozzle in good working condition?

  • 15. Is there water in the hose?

  • 16. Fire hydrant accessible?

  • 17. Is there a clearly displayed sign stating “NOT TO BE USED ON ELECTRICAL EQUIPMENT”?

FIRE EXTINGUISHER

  • 1. Are all signs clear and in order?

  • 2. Is equipment correctly located?

  • 3. Are hoses in optimal working condition?

  • 4. Is breather clean and unobstructed?

  • 5. Any corrosion?

  • 6. Any leaks?

  • 7. All seals, including security seals, in order?

  • 8. Correct pressure maintained?

  • 9. Is red and white background coding correct?

  • 10. Is demarcation according to standards?

  • 11. Is hose trigger operational?

  • 12. Is equipment in any way obstructed?

  • 13. Is nozzle clean and clear?

  • 14. Is equipment numbered correctly?

  • 15. Serviced annually?

  • 16. Are employees familiarised with use of extinguisher?

  • Additional Information

  • Completed By

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.