Title Page

  • Site conducted

  • Site

  • Client

  • Location
  • Conducted on

  • Prepared by

FIRE HYDRANT:

  • 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

  • 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

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